Despite medical advances, injuries remain a constant hazard for college athletes

The pain is unmistakable.

Balancing on one leg, Ashley Armour looks straight ahead into a mirror as she raises her right leg up and backward. Her eyes are focused, but the former gymnast cannot help but grimace as her left leg trembles uncontrollably. That’s just the start.

What was once a promising gymnastics career was cut drastically short. In her entire four-year career at UK, Armour competed in just four meets. That was all during her sophomore year — the only season she did not start in a leg brace.

In a time when athletes are bigger, stronger and faster, and when sports medicine is more efficient than ever, it would seem unlikely that athletes like Armour, a marketing senior, would continue to sustain serious injuries.

But hundreds of athletes do every year, even with advances in rehabilitation and sports medicine. And many injuries are high-profile stories, bringing more attention to athletes’ susceptibility to injury.

While there seems to be a rise in athletic injuries, in reality there is no rhyme or reason to high or low injury counts each year, said Jim Madaleno, director of sports medicine for UK Athletics.

“The data supports the fact that injuries are cyclical,” Madaleno said. “You have good years and bad years — that’s the truth.”

Not for Armour, though. Every year has been a bad one.

She wakes up every day with pain in both of her knees. Every Tuesday and Friday morning, she makes her way to the Kentucky Clinic to rehab her latest knee injury — her sixth in all.

Three torn anterior cruciate ligaments — one left, two right — and three meniscus tears add up to what Armour estimates as four years in rehab. And the pain has never gone away, especially if the forecast outside is anything but sunny.

“The pain depends on the day,” Armour said. “Some days it’s worse. Rainy days mostly.”

With no meniscus in her right knee and fresh off a January surgery to put the muscle graph back into the same knee, there is no doubt that Armour is done as a gymnast. But at this point, competition is not the priority — being like everyone else is.

“That’s kind of the goal,” Armour said. “To be normal after six surgeries. But I don’t know what normal is.”

Armour cannot run on a treadmill or over long distances. She walks into a rehab room twice a week just trying to get back to normal. The most recent rehab sessions are to benefit her at an older age, hopefully ensuring that she will be able to walk well at age 60.

“I want to be able to walk around everyday,” she said. “And get some athletic ability.”

Armour is not a high-profile athlete. Most people, if any, have never heard of her. But people have heard of the injuries on the high-profile UK football and basketball teams, which is why Dr. Timothy Uhl, an athletic trainer in UK’s College of Health Sciences, believes injuries have gotten so much publicity of late.

The issue surrounding injuries is not about how many occur, Uhl said, but to whom.

“I don’t see that there’s a big change in the frequency in injuries,” Uhl said. “There’s an increased emphasis depending on who gets hurt, when they get hurt. So when (former football wider receiver) Keenan Burton gets hurt, it’s a bigger deal to a lot of people than when a second-string guy on the basketball team or football team gets hurt.”

Gail Friedhoff, the physical therapist who works with Armour, said fatigue has a lot to do with the frequency of injuries. Not just physical fatigue, but mental fatigue as well. And in a manner similar to the rich getting richer, Friedhoff said that she does not see many injuries from championship teams.

“Winning teams have almost no injuries,” Friedhoff said. “Losing teams have a lot of injuries. It’s the mental fatigue.”

The biggest question surrounding major injuries has always remained the same: Is this the injury that spells the end? Armour called her decision to retire “heartbreaking.” But it took her six injuries, six surgeries and four years of rehab to finally pull the plug on her career. She considered quitting much sooner, however.

“You feel down and out,” Armour said. “At the same time, you think ‘Why did I just think that?’ It’s the stresses of being away from home. You can’t run down the hall and cry to mommy and daddy.”

After finishing her rehab simulation on the balance beam at one of her morning workouts, Armour slides an elastic band around her waist. The band is secured inside a door, and five colored markers are set on the ground in a semi-circle. It is a brand new exercise, but like most rehab patients, Armour hates it.

“I’m so out of shape,” she said to Friedhoff. “Do we really have to do five?”

She does it anyway. Just because Armour can no longer compete does not mean she is without the desire to win. She wants to get the rehab over with and get back to being “normal.”

But it is that same “win now” mentality that gets athletes into trouble. They often want to get back into competition too quickly, which usually results in worsening an injury. Finding a balance between the desire to get back on the field and the need for rehabilitation is difficult to manage, Uhl said.

“I think it’s accepted that it’s the norm, that we push them to the envelope,” Uhl said. “It’s not a good or a bad thing — it just is. I mean that’s the whole reason we’re here. If we didn’t care how long it took them to get back, you don’t need us. Then you can go put a cast on everything and let it all heal up.”

Part of an athletic trainer’s job is to protect his or her athletes, Uhl said. But at the same time, the “win now” mentality does not just affect coaches and players. It affects the athletic trainers too.

“Even at smaller colleges, there’s that emphasis to win now and athletic trainers are the guys that are protecting the athletes,” Uhl said. “That’s our job, to protect the athletes. But I’ve been on an 0-10 UK football team. It’s no fun, losing all the time … but our primary responsibility is to protect the athletes.”

Armour’s problems started in high school, when she competed for a club gymnastics team. After suffering her first ACL tear at 15, Armour continued to compete. Many times, Armour said she would hide the extent of an injury from her club coach so she could continue to compete. Competitiveness is rampant in gymnastics, Armour said, which leads to hiding damage the sport inflicts on the body.

Armour can no longer hide her injuries. Two-inch scars run down each knee showing the years of pain and hard work she has endured. Small craters sprinkle what was once a well-defined kneecap.

After completing her latest exercise, Armour sighs. Four years of rehabilitation wears on her mentally as much as it does physically. After so many days, weeks and months of routine, Armour has not become numb to the experience.

“You get to where you don’t want to go,” Armour said. “Even though I know I’m doing it for a good reason, I’m like, ‘Why am I doing this again?’ ”

It could be because so many athletes come back from injuries far ahead of schedule, stronger and faster than they were before. Uhl uses the example of UK sophomore guard Derrick Jasper, who had microfracture surgery on his knee prior to the 2007-08 basketball season.

“In the past, in the ’80s when I started as an athletic trainer and therapist, there was no operation to fix him. He was done,” Uhl said. “Now, it took him a while, but he’s back, he’s playing and contributing.”

And then there is Cierra Baker, a kinesiology sophomore who has gone through the pain and surgeries Armour has.

The former Hopkinsville High School cheerleader tumbled on gym floors across Kentucky for 12 years. But that wear and tear forced Baker to the sidelines by the time she arrived at UK.

“When I came to UK I had problems walking around campus,” Baker said.

Baker is doing a special rehab session, helping with research on knee injuries for the College of Health Sciences. So far, it has helped take away some of the pain.

But not all injuries can fully heal. And some injuries just keep reoccurring. That is the fate that has befallen Armour. Now that she is done with athletics, she must restart life.

Armour is required to work in the marketing department for UK Athletics to keep her scholarship. Schoolwork and friendships have also taken a priority in her new life outside gymnastics.

“I’ve found ways to keep myself busy,” Armour said. “It’s not that I didn’t do these things before, it’s just now I have a lot more time to do them.”

Armour estimates her scholarship to be worth around $100,000 in total by the time she graduates in December. It is money that UK is spending on an athlete that no longer competes.

“They’re a commodity,” Friedhoff said. “There’s a lot of money invested in these athletes. If they aren’t competing, it’s like a waste of money.”

Armour does not regret a single minute of her career. In her four-plus years of compiling injuries, she never once gave up. She admits she is too competitive for that. And her advice to others in a similar situation is simple: Do not quit.

“I would tell them to keep their head up,” Armour said. “Because you never know. Always try to come back.”