Monday, November 24, 2008

Book 4 of 52: Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports

I've been meaning to read Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sportsby Michael Sokolove for a long time. When I first saw that the book was excerpted in The New York Times Magazine my heart plummeted, which you'll understand in a minute.

The book takes a look at the horribly high incidence of ACL injuries in female athletes -- they experience this injury eight times more than men. He asks the tough question of why do women get hurt more than men? It's not an easy issue to tackle. Sokolove makes it clear that he believes in the benefits of Title IX but that women need to be looked at as different athletes, not just smaller, lighter men.

His theory that overspecialization too early makes sense. Instead of playing a different sport a season, girls are playing the same sport all the time. They aren't cross training, and their bodies start to break down. He takes a peek into the world that is highly competitive youth female sports, but it's just a peek.

That's why this is not the book I wanted it to be, which, as a criticism, isn't exactly fair to Sokolove. It's not as if he sat down and said "I want to write a book for Jen Miller." His purpose -- his thesis, if you will -- is that ACL injuries is an epidemic among young female athletes, not about the overall bigger picture that make it almost certain that girls are hurt so much.

This is good and bad. It's bad because it was a book that did not reach my expectation (again, partly my fault). But it's good because that book about intense teenage girls sports? I want to be the one to write it. And here's why.

I was always an above average athlete. I liked playing, and my dad promoted sports. My older brother did not show much of an interest, so the focus fell on me.

I know my dad only wanted for me to do well, and to do well I had to be tough and play like a boy. One soccer season, I actually did play with the boys. I think I was 11, and it did not go well. I couldn't keep up, and my coach hated having a girl on the team, especially when there was a girls team I could have played on. He made fun of me endlessly, and even made up one practice exercise to show that I couldn't even do a cartwheel -- "something any real girl can do" he said.

Soccer, though, was not my best sport, even though I liked it the most. I never either had the training or the innate ability to excel (though I did start on my high school team senior year). My best sport was softball.

Out of the gate, I was good. My dad had trained me, first in t-ball, which was co-ed, and then more so before softball tryouts. I hit off tees. I went to the batting cages. We did endless fielding and catching drills. When I tried out my first year at the age of seven, I was one of the first girls "drafted" out of the pool of choices.

And I liked playing, at least at that level. I liked being in a good team with a friendly coach, and I liked being chosen for the All Star team, which played in a tournament in Pine Hill, N.J every summer.

Of course there was pressure, sometimes more than I thought necessary. Keep in mind, too, that I was a somewhat volatile child. I had an intense temper. I didn't know how to control it, and sometimes I acted out (I once kicked a girl in a high school game). Being put into an increasingly tighter pressure cooker didn't help.

I played all over the field. I liked first base, but hated grounders so went to the outfield in high school. My dad had wanted me to be a pitcher. I even went to pitching camp in the off season -- I still remember my dad driving me down to Pine Hill in his blue Oldsmobile, usually in the dark since camp was held in the winter. I went on Sundays because it didn't interfere with basketball, which I played until high school.

But my temper got in the way of pitching. I didn't have the mental control to do the same thing over and over again, to work on the mechanics, and to deal with games that didn't go well. I'd cry. After one CCD class (a Catholic education class for those of us who went to public school), a girl on another team wrote "crybaby" over all the pages in my notebook while I was in the bathroom.

But as a fielder and hitter, I was good. I was also left handed, a bit advantage in softball when the distance from home to first base is much shorter than in baseball.

I was so good that, as a teenager (I think 14), I was recruited to play for the Sharks, now the Outlaws. The Sharks were considered an elite team. They crushed our town team All Star team in any competition. And they were mean -- one season, they all shaved the lower half of the back of their heads. Why? Apparently, they thought they intimidated other teams.

They also used that All Star series to pick new players -- the ones whose parents didn't know that those leagues existed -- and I was one of two Bellmawr girls asked to play for them that year. From what I remember, my father was ecstatic. Finally! All the hard work was paying off. Of course I said yes. Why wouldn't I? It showed that I was doing a good job. It was a chance to play at another level, and the road that would lead to maybe college softball and a scholarship.

But I wasn't fully committed. Softball, even in my early teens, took up a lot of time. My family had a place down the shore, and that All Star game ate into shore season. I was always relieved when the season was over and I could go to the beach and rest up before soccer started in the fall.

If I joined the Sharks, that wouldn't happen. They played all summer, and their training wrapped around the entire calendar. Could I still play soccer? Could I still do musicals in the winter? What about my summer? Would I ever make it down to Avalon? As much as I liked softball, I liked all those other things, too.

I still remember when I changed my mind. I was being fitted for a uniform. It was going to cost $100 -- out of pocket, of course. I started tallying up how much this was going to cost my family, and I knew the uniform was just the beginning.

Everything was out of pocket -- uniform, equipment, and travel to tournaments, which included driving, lodging and food. Softball would become my life, so I said no.

As Sokolove shows (though more for soccer), not many people would say no because joining an elite team is the natural progression for a lot of athletes. But I just knew I didn't want to do it (I've always been bullheaded).

I don't remember all of the fallout. If I work on this topic more, I'm sure it'll come to me -- and if I ask my parents, too. I think my dad was disappointed. He wanted me to become an elite player -- even bought me the glove that would last me through "high school and college," he said. But I pushed back, which is where I defer from the athletes Sokolove writes about.

That didn't stop softball for me, though. I played on another traveling team and, of course, high school. The traveling team gave me a taste of what that other life was like -- some tournaments, we'd play two or three games a day. Sometimes the same pitcher would pitch all three games. I played some varsity as a freshman but spent most of the season in JV. My father was so upset when I didn't make the varsity squad my sophomore year, and so I was. At Haddonfield Memorial High School, which puts a lot of emphasis on sports, it was OK if you didn't make varsity your freshman year, but if you don't make it by a sophomore? Forget it. You were out of that sports club. You weren't one of the students whose parents talked to college scouts. It wasn't going to be an option if you missed that first high school step.

In other sports, this had been going on long before high school. I knew there was some sort of caste system with club soccer teams. If you didn't get on the right one, you would never excel to the top level. It wasn't as big a priority for me because I didn't exactly care. Even though I focused on softball, I was a more traditional athlete in that I did a different sport per season. Even when I stopped playing basketball, I danced in musicals -- still a great physical activity.

But back to sports. How humiliating not to make varsity my sophomore year! Softball was supposed to be my game. It wasn't that popular at Haddonfield, and most of the better athletes ran track. I felt like I wasn't living up to the promise I showed so early. And, yes, those are the thoughts of a 14 year old. Softball was that big a part of my life.

So I kept working at it, kept playing, kept perfecting my throw from center field to home without a cut off and, my junior year, I made the varsity squad. We were horrible, but I was still at the top of my team. Senior year, I was captain.

And that's where it all started to fall apart.

I had felt pain in my throwing shoulder before. I saw a doctor (a doctor who I think should have been put out to pasture long ago), and he said it was nothing and sent me on my way. The shoulder hurt through warm ups, and then was fine.

Senior year, though, that ache never seemed to go away, especially on those cold early season practices and games. It didn't help that our coaches made us play in that cold, even practice in driving, freezing rain. I could never get it going. I was having more and more trouble throwing in from the outfield. I still did it, but in pain.

I saw a trainer, who wanted me to go to the doctor to see if I tore anything, but I walked out of his office. If I had made it to my senior year, I wanted to see that season through. After that, I knew softball was over. I had had enough -- enough of the practices and games and stress about wining and being the best. My coaches senior year had come to take over the program after working at a private school with a top softball team. "We could have made you all state," one of them said. And you know what? By that point, I was in so much pain and so numb to a sport where our coach demanded we miss spring break and prom to practice, that I didn't care. I just wanted the season to be over. I wanted to go to college where I'd never have to play again.

But the pain didn't go away, of course. It intensified. I wasn't playing anymore -- and wasn't doing much physical activity at all -- but the physical act of writing, especially writing by hand at length, requires motion from your hand, arm and shoulder. I wrote a lot more by hand then, and it hurt. Sometimes I couldn't sleep because of that persistent ache.

I wasn't diagnosed until I was 23, but I started writing about all of this when I was 20. I took a journaling class in college, and one assignment asked us to write to a letter to a body part. I wrote my letter to my shoulder and cried the whole time. The tone, from what I can remember, moved back and forth between outrage at the shoulder itself for failing and the people who kept pressing me to play. Then there was regret for not being more vocal about my problems, and for pushing through when something was so obviously wrong.

After turning in that assignment, my professor, who was also my advisor, pulled me aside and asked me if I would go see a doctor. He saw then that this problem was not just a mental issue for me but a physical one, especially because he saw me becoming a writer (which I thought was crazy at the time) and knew that such pain could have an impact. I insisted I was fine, switched to typing as my entryway into writing, and downed more Advil.

The funny thing about a chronic pain is that it becomes such a part of you that you forget what it was like to be normal, and you forget that other people don't deal with the same sorts of issue every day. My shoulder pain was just another part of my life, just like studying. It was always always there, and I got used to it.

It all came to a head in the spring of 2004. For my graduate thesis, I wrote just about a book-length manuscript about that softball life. I took a good, hard look at the environment I lived for so long, and wrote about it. I put everything -- EVERYTHING -- into it, from my JV coach who smoked with her players, to the intense fear that my ability to be a girlie girl and woman was ruined by being so involved in sports for so long. My graduate advisor loved it as a piece of memoir, and I started shopping it around as a possible book (I got a few nibbles, but no big bites. I don't blame the literary community. I'm a much stronger writer now, and it would need a complete overhaul).

I lived in Manayunk, Pa., then, and while driving home from one night, I almost hit a dead deer on the road. I swerved, wrenching my shoulder in the process. It hurt -- oh God it hurt -- but I figured I just tweaked it. I was working at the University of Pennsylvania Health System at the time as an assistant press officer, and one of the areas I covered was Sports Medicine. So I asked the chair if he would take me on as a patient. We were still at the diagnosis stage when this all started. He thought he knew what it was, but he had to do more tests to be sure.

I was also, at the time (yes, I was busy), preparing for a job interview. The position was editor of SJ Magazine -- a regional magazine about Southern New Jersey that I wrote for as a freelance writer. In preparation for the interview, I was to go through back issues, critique one, and say what I would do differently. The Rutgers University-Camden library had the back issues. One afternoon, I took all the magazines off the shelf and carried them to a study room in the basement. My shoulder hurt, but I figured it was normal. Then I tried to write notes and realized I couldn't control the pen. Then I couldn't feel my hand.

The next day, I tried to work, but my shoulder throbbed. I still didn't have full function of my hand, so I told my boss I had to do something. They sent me to the ER. Thinking that the pain was from sitting at a desk all day, the ER sent me to yet another office that handled workplace injuries. They looked at me, my condition, then sent me back to the ER.

At that point, I'd had it and paged my doctor -- a no no but the doctor said he didn't mind, knowing that I was already looking into the problem. I called my mom, too.

By the time he had a spot open to examine me, I was sitting in a room in front of an audience of six -- doctor, doctor's wife (also a nurse), my mother, and three interns. I was, apparently, a unique case, and having dating a medical student, knew the value of unique cases for teaching, so OKed the interns to be there. But there was little the doctor could do. Anytime he touched my shoulder, I screamed.

What happened? Apparently, in high school, I tore the labrium in my shoulder, which is a ligament that helps keep the bones in their proper places. The injury happens one of two ways: trauma or overuse. My injury was caused by those throws from center field to home plate without a cut off. "No one your weight and size should have been doing that. Your body could never have supported your shoulder" he said. When I sought help, I was misdiagnosed, and kept playing, but it is a problem that can be repaired through surgery -- both my father and younger brother have had it. My doctor suspected that was the problem. However, between swerving out of the way of the deer and carrying the magazines, I most likely damaged the nerves, which made surgery too risky. We never did the tests because they are painful, but I showed all the signs -- intense pain, loss of feeling and control in my hand. And it doesn't go away. I used to experience numbness three or four times a year. It's happened one so far in 2008.

There was nothing I could do then but wait and not use the shoulder and take a nerve suppressant. I kept my arm in a sling, and I still remember taking it out of the sling for my job interview because I didn't want to show weakness.

Good news was that I got the job, and went into physical therapy where I learned that, by tightened the muscles around the shoulder, I could force my body to hold everything in place. I went through the last round of PT in 2005.

So where does that leave me now? Am I still in pain? Sure I am. My shoulder throbs just writing this. But I don't think it throbs so much because of the strain of typing -- more a flashback pain to how my life used to be.

The difference? Running, and temperence.

I've written about running before on the blog, so I won't go so much into it here. But I never expected to become a runner. I hated it -- the physical activity of it, the boredome of it. It was also a different kind of sport. While we had cross country and track teams, running was still an individual thing to do. Your performance wasn't all that much affected by an opponent's move, skill or ability. You competed against yourself.

And that's exactly why I think it's the sport I consider mine now. I never thought I'd be an athlete again, and even writing that here is bizarre. An athlete without a team? But I work out four times a week -- even now when I'm not in training, my schedule involves lifting on Monday, cross training and lifting on both Wednesday and Friday and a longer run on Sunday. When I'm in training, I am either on the treadmill or on the road five days a week. I've placed in two races. Why wouldn't I consider myself an athlete?

Because it's not a team sport. There's no combat. There's no intimidating your opponents and using sheer force of will to overpower someone. Those are the things that Sokolove writes about, and one of the changes in women's sports that can lead to injury. He makes a much better case for it than I do, so I'll leave that to him. But in comparison to the soccer and softball that I played, running is more pure. You only do as well as you train and only rarely will someone else's intensity affect your performance.

The team pressure is also taken out of it. If I don't do well, it's not like everyone else on the softball field are affected -- just me. I've never not run a race well, so I don't know what that's like. But even when I missed my goal time in my last 5k, so what? It's just a race. My running coaches have tried to get me to train more intensely because, apparently, I'm fast. But I pushed back every time. I don't want this sport to become a job because then I know I'll hate it. I need it to be something I enjoy doing for the sport of it, not as a means to push myself as far as I can go.

That's the perspective I didn't have in high school, and I'm sure most student athletes don't have now: at the end of the day, it's just a race, or a game, or a meet. Lives are not at stake. Yes, maybe a scholarship or two, but I made more in scholarships as editor of my student newspaper than the average athlete gets in scholarship money. Sokolove cites a sobering statistic: about five percent of high school athletes play in college, and only about one percent get full scholarships. One percent. What about the thousands of dollars parents spend on club teams, equiptment, travel and coaching? How does that "it's all for her to get a scholarship" rationale sound now? The ends do not always justify the means, especially when our future vitality is at stake.

My shoulder is still an issue. I've had to stop training at times because of it, but it's not nearly so bad anymore, in part because of a change in sport, and also in part because I now lift weights and am stronger than I ever was in high school. My muscles support the shoulder where they didn't before. If I had built up support while flinging a ball from center field to home plate without a cut off? I probably wouldn't have torn the labrium.

I don't regret playing sports. I think the skills I learned and even aggressiveness I used while playing has helped me as a professional. I have a job that comes with high levels of stress. You have to keep pushing yourself to perform because no one else will. I think part of those abilities come from sports. But even though I pushed back early against going full force into softball, I wish I had spoken up soon. I wish I had saved my shoulder. I wish I could still throw a ball.

In an almost perverse twist, I don't know if I'd have become a writer. I went to college for marine biology, but I was bored. I was so used to going to practice after school that I needed to do something, so I joined the student newspaper, which gave me the base training for what I do today. I never could have edited the newspaper while playing softball. I never would have had the time to explore other options, and I might not be sitting here in my home office typing away if I still played. So good thing have come out of what happened.

I know that was probably long and rambling, and not really a critique of Sokolove's book, but as I've always said about this blog, I let the books lead me to other places, and this is a place I'm very much in right now. I ran into my graduate advisor the other day, and he asked me about "the book." I had breakfast with my college advisor while in Tampa last month, and he asked me about "the book." Neither one were asking about the book I published but the manuscript that's in a box in my spare room.

I don't know what will come of this. Immediately, I'm writing an article for a magazine about an athlete who tore her ACL, so that is where I will start. From there? We'll just have to see...

Most immediately, though, I do have a 5k coming up on Saturday. It's in racing where I feel that competitive surge sometimes, especially at the end of a race. I don't just jog to the end. I run to the point of almost vomitting because I tell myself that I must leave everything on the road. I've done quite well, too. In two of my races, I beaten some of those girls who were elite athletes in high school. It gave me, I admit, a small charge that I did that (and if you're reading this right now, I know, it's stupid, but it is what it is).

It's so petty, but I thought about that today as I tried to figure out what I'll wear to my 10 year reunion, which is on Wednesday. It'll be interesting to see where everyone ended up, especially those elite athletes. I wonder what their lives are like right now and if they have the perspective I do now that 10 years have passed and we're on with our "grown up" lives. I think it'll be a lot of posturing and bragging. I've had a great run since graduating, but I know I'll feel like I'm a behind because I'm not married, which is a stupid thing to feel. Part of me will feel like that tomboy, which is probably why I'm so worried about what to wear. I want to show that I've grown up, that I got out of my sweatshirt and jeans phase, that I really could be girlie -- that I could be more than just that so/so softball player.

Life really does always go back to high school, doesn't it?

Anyway, I think I've gone on long enough for now. If you've got kids who play sports, especially girls, read the book. Just because ACL injuries happen a lot doesn't mean they're harmless. Some of these athletes could need total knee replacements in their 30s. Or at least check out the Santa Monica Orthopaedic and Sports Medicine Group, which runs an ACL prevention program. As much pain as I've suffered because of softball, I'm thankful that I did not hurt a weight bearing joint. Cross training probably saved me there.

One more note, then I promise I'll let you go -- I've actually crossed paths with Sokolove. The first time was back when I worked at Penn and I arranged for him to interview one of the doctors (though I never met him -- I was home sick with the flu that day). The second was this summer. He was on NPR talking about the book, and I called in. I surprised myself by quickly coming to the brink of tears when talking about my shoulder and how it has limited my life.

What's next? Not sure. I don't think I've tipped my hand in saying that I want to write about this. I've talked to a lot of people about it, including an agent who has talked to publishing folks. I would need to put together a proposal and finally open that box in my spare room that holds my old manuscript. It is so painful at times to go back there, but if I can help another athlete from doing what I did? I think it'll be worth it.

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1 comment:

cgrock24 said...

Jen, I've just read "Warrior Girls" and think it's one of the most important books that I've ever read. It led me to your blog and I was touched by your story. I'm the parent of a 14 year old daughter and a 10 year old son. I've coached over 300 girls in youth sports. I plan on highlighting your article and others in an e-mail that I'm preparing about the book. Simply, parents and teenagers need to be aware of the issues Sokkolove brings up in his book. It's interesting you gave it 3 stars. I would give it 5 without hesitation. Do you know why, because it raises awareness. It got you to tell your story to the world via the internet. It boggles my mind that your shoulder injury was not diagnosed as soon as you did it. I wish you the best. You've dealt with your situation remarkably well. Some people say God has a plan for us. I recently read a story that featured this quote from a young man who had just been accepted to West Point. "Victory is won by struggling against opposition. Victory is something you have to get up and take charge of." http://cli.gs/zehR3t Wishing you the best in your writing career and with your health.