Luis Ramos

Ramos 1
Dr. Loren Higbee

3/23/2022
To Be or Not to Be… Returned to Competition
Introduction:
In the greater sense of things, it is easy to assume that more often than not when it comes

to one’s health, a person might want to do what is best to not only make sure that they continue

living with not only the least amount of difficulty or pain necessary, however also with the most

comfortability they can. While this might seem as though it would be an “obvious choice” to not

only act in a way that would potentially accomplish both tasks but prolong their lifespan, some

people might see it in other ways to not initially make the choice as it could affect them in one

way or another. One specific instance of this taking place that has been raising a lot of eyebrows

and ruffling a few feathers recently can be seen in the community of sports and more specifically

with that, sports medicine. It has been a long going debate that has a lot of medical professionals

and sports organizations up at arms as to which side of the argument they should be on in the

case of an athlete’s injury during any form of contest. While for the most part there are obvious

cases on where an athlete should continue to compete or not, there are also a lot of grey areas as

to where an athlete might not be able to. This is where the argument comes in, as with these grey

areas there are multiple different ways in which an athlete or coach might think that they can

return to play, however the medical professional designated to that team might not be so sure.

The argument of whether to let an injured athlete continue to compete or act against the athlete’s

wishes and force them out of a contest to start the recovery process is one with an argument for

each side and has made for a quite volatile and dangerous conversation over the years.

Pro-Athlete Argument:
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Dr. Loren Higbee

3/23/2022
To see one’s problems as their own is either a sense of empathy that is heightened to new

levels, or to work in a field such as that of medicine. With this field being as stressful as it is, it’s

important to consider not only what an individual has learned in not only their education but their

actual labor. While working with athletes, especially ones that have become injured to some

degree it is important to see not only from their point of view physically, but how it could affect

them mentally. There is a multitude of reasons as to why an athlete might want to continue

competing after an injury regardless of severity the first of which that comes to mind would be

pride. A sense of pride is instilled into every athlete at various levels, and it is important to

consider and acknowledge how something coming in the way of an athlete completing their

goals can affect them. Alain Decrop and Christian Derbaix seem to support this idea by making

sure the reader is given a few examples of things that might tend to ring in the minds of an

athlete such as “Make us proud” which is one of the most common phrases an athlete might hear.

(586). The thought or overhanging idea that an athlete might let someone down if they do fail to

complete and succeed to the best of their ability might be something that drives an athlete to not

want to give up just yet as there is a form of pride that they must not let down those who believe

in them. The potential toll that it could take on the athlete’s mental health could be greater and

longer sustained than that of risking further injury in some cases. Having the potential of

prohibiting further competition could also be built off while looking at a book written by author

Nancy Diekelmann where the entire first chapter titled “Harming patients in the name of quality

of life” looks over just that. while the book is not strictly focused on that of an injured athlete it

covers how more or less there are certain times where further injury or worsening of a condition

might be worth the risk in the long run because ultimately the life at risk is not that of the
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Dr. Loren Higbee

3/23/2022
professional but the patient. Overall, at least hearing out an athlete on why they feel they can

continue can be crucial to decision making and in certain cases is the deciding factor.

Pro-Medical Professional Argument:

While an athlete might have their reasons for wanting to persist in the face of injury, it is

critical to understand that there are multiple reasons as to why a team’s designated medical

professional might deny re-entry to a contest. The two main reasons that this might occur would

be that a premature return could either make the injury worse, or it could cause various chronic

injuries or diseases to come to the athlete in time that could greatly affect them and how they

function as a human. For the first option looking into re-injury caused by a premature return to

play, an article written by Lisa K. O’Brien and others can be looked at, this article makes sure to

provide their audience with a lot of information not only on the injury and subject of the article

known as “Femoroacetabular Impingement Syndrome” , but the reader is also given statistics on

the likelihood of return to play for athletes at different levels after dealing with this injury. At the

professional level around 88-95% of the players were able to make a return, at the high school

level around 90% would come back and at the recreational level only 73% would make a return

to their sport. (160) With this being taken into consideration it would make sense as to with even

just 5-12% not returning at all at the highest level of competition with this injury why a team’s

medical professional would not want to send an athlete back out when dealing with an injury as

even though the rate is still small it could be made much larger if making the situation any worse

than it could currently be. In the case of creating a chronic injury or disease that is avoidable in

some way there are many examples that could be taken from. Looking at another article titled

“Sleep Following Sport-Related Concussions.” by Nadia Gosselin and others, a study was
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Dr. Loren Higbee

3/23/2022
conducted on athletes who had dealt with concussions and those who haven’t and the results

showed that “Concussed athletes reported more symptoms and worse sleep quality than control

athletes”(35), throwing an athlete back into competition too soon might end up costing them not

only worse sleeping conditions but other mental health risks associated with it. Comparing this to

another study done by James D. Carson and quite a few others, results showed in students

dealing with concussions that “In 43.5% of concussion cases, the patient returned to sport too

soon and in 44.7% of concussion cases, the patient returned to school too soon.”(310.) and with

their returns to both school and play too soon they ended up suffering in both aspects showing

that even if an athlete might seem fine to return, it is better to be safe than sorry as a person’s

brain is a very sensitive object and if even slightly rushed in recovery, the patient could suffer.

For one last example of a chronic injury/disease developing, an article written by Cornelis P van

Wilgen and others, they had an athlete’s pain mechanisms inspected and conclusions made from

this article showed that as a result of chronic injuries from sports, many athlete’s neuropathic

pain mechanisms have been altered due to the constant stress their bodies have been under

through the processes of getting injured and then getting reinjured.

Conclusion:

Going through both sides of the argument provided, it is plain to see why this

conversation is so highly debated upon in the greater scheme of things. Regardless of where one

falls in their opinion on this topic it is more acceptable to acknowledge the fact that to some

extent both sides have some form of validity to their own argument. With no end in sight as of

right now to this harrowing debate, all that can be done in current times is take injuries on a case-
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3/23/2022
by-case basis and from there it should be decided between the athlete, the coaching staff, and the

medical professional on what actions should take place next.

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Dr. Loren Higbee

3/23/2022
Citations

Diekelmann, Nancy L. First, Do No Harm: Power, Oppression, and Violence in Healthcare.

University of Wisconsin Press, 2002.

Gosselin, Nadia, et al. “Sleep Following Sport-Related Concussions.” Sleep Medicine, vol. 10,

no. 1, 2009, pp. 35–46., doi:10.1016/j.sleep.2007.11.023.

Van Wilgen, Cornelis P, and Doeke Keizer. “Neuropathic Pain Mechanisms in Patients with

Chronic Sports Injuries: A Diagnostic Model Useful in Sports Medicine?” Pain Medicine, vol.

12, no. 1, 2011, pp. 110–117., doi:10.1111/j.1526-4637.2010.01023.x.

Decrop, Alain, and Christian Derbaix. “Pride in Contemporary Sport Consumption: A Marketing

Perspective.” Journal of the Academy of Marketing Science, vol. 38, no. 5, 2010, pp. 586–603.,

doi:10.1007/s11747-009-0167-8.

Carson, James D, et al. “Premature Return to Play and Return to Learn After a Sport-Related

Concussion.” Canadian Family Physician, vol. 60, no. 6, 2014, p. 310-315.

O'Brien, Lisa K, et al. “Return to Sport Following Femoroacetabular Impingement

Syndrome.” Operative Techniques in Sports Medicine, vol. 27, no. 3, 2019, pp. 159–167.,

doi:10.1053/j.otsm.2019.04.009.
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Dr. Loren Higbee

3/23/2022
Reflection Essay

I would like to begin this reflection essay by stating some of the things that I had learned

during the drafting and writing processes of essay one was able to carry over and help me in the

writing of essay 2. The lesson that rang through my mind constantly was to find a way to

implement the information found in my sources in an easily digestible manner. With so many

sources to work with, it was a juggling act to sort of hold all the information together, with that

being said I will now continue with the rest of the reflecting process.

The writing process of this essay was one that of which I was not sure how it was going

to go exactly until I had finished writing it. I had started out with a topic that I had thought would

have been the perfect one for me which in hindsight while I feel as though it was a very good

choice, I probably should have at least done a little more searching before I settled on this topic

just to make sure I couldn't have done any better. However, regardless of the topic choice made

for the essay, it was completed to the best of my ability. While for the most part, I had a decently

smooth time creating and writing out the essay, I feel as though the hardest two things that

occurred to me during the drafting/writing process was staying in the word limit provided and

getting all the sources needed to sufficiently meet the requirements of not only the essay but the

annotated bibliography.

Staying in the word limit was somewhat difficult to me this time around which was a

rather new experience for me as I typically just meet it and say everything that I planned on. This

time around having to use at least six peer reviewed sources in my essay I found that a good way
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Dr. Loren Higbee

3/23/2022
to save space was to paraphrase or summarize instead of quoting (depending on the situation)

and doing this really did keep me from droning on for too long on certain things.

When it comes the sources for the annotated bibliography, it was more so than anything

else just very time-consuming as I had to read through around 37 Peer-Reviewed Essays, articles,

and even some books to get the resources that I felt would help me to create this essay. Although

the process of making it was very tedious and tiring to do, I ended up being glad that the

annotated bibliography was required and that I had done it because once that document was

created, not only did I not have to worry about finding my research (or in more general terms

really doing it because I had already done it previously) or figuring out how to implement it into

place. Having the annotated Bibliography really did just help the essay form and again that is one

thing that while time-consuming I am really glad I had spent the time to create it.

While looking over comments that I had gotten from my peers while writing this essay

whether it be from people that I had asked on my own time during the drafting process or people

I had ended up conversing with from class, the most common comment that I had ended up

receiving was that I needed to find a way to smoothly transition from my essay to introducing a

few of the sources. With so many sources that I had needed to use for this essay it was a little

difficult to find a way to implement into my writings it did become a little more difficult than I

had expected to incorporate some of the things that I had wanted to. But with those comments in

the back of my mind I ended up knowing that I had to make the transitions into my quotations,

paraphrases, and summaries as cohesive with the essay as I could, and for the most part, I really

do feel like I succeeded.

Luis Ramos
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Dr. Loren Higbee

3/23/2022
Overall, this essay had taught me a decent amount that I wasn’t expecting mostly about

how to do research with peer-reviewed sources and make them manageable/palatable to go

through when I have a lot to read, but also how to implement them into my work as smoothly

and seamlessly as possible. While during the writing of this essay I was given spring break to

sort of break up and have a mental reset on my work for this essay, I have still spent just a bit

more time than I would have liked to on it, and I would (Just as most of my other essays)

respectfully like to not look at this essay again for a while.