Costly Injuries from Sports Posted on August 10, 2017

Note : This is a continuation of my earlier post ‘ How to run on different terrain’.

By Rameshon

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I have written on the ranking of terrain for walking and running in my earlier post and many who have read it say that they find it interesting to read and also suggested to me to write  more on the subject on terrain appropriate for jogging and running. I thank them for their feedback.

Today, an athlete told me that she did not know that treadmill running could lead one to avoid injuries. I told her that I myself was ignorant on treadmill running, in the past. An understanding of the impact that is placed on the bones made me to minimise future injuries, which can be less expensive and some can be very expensive, especially, during the aging process. 

The key message of the post is to inform that there is cost involved, irregardless whether one wants to exercise or not. Those who keep exercising, they will expend some of their income resulting from sports injuries. However, over time, they would be able to save a lot in the long run, while they also look 4 to 20 years of younger than their present age. Some can be as much as 20 years younger than their original age.

Moreover, at age 52, I have not spend any money from my CPF medisave account so far and am hoping that it comes in handy when I need it in much later and not now. Exercise makes one to age gracefully. Hence, while we exercise, we should ensure that we keep the cost of injuries down. In running, the cost of injuries can be great if you do not know the understanding of the terrain well enough.

Those who do not want to exercise, tend save money now and lose a lot of money later on due to diabetes, osteoporosis, hip fracture, easily getting sick, high blood pressure, even cancer (as research shows that some cancers can be prevented by doing exercise). Studies have shown that if a sedentary person, those who do not exercise, usually gets injured at the knee area by the time they reach 40 years of age, and those who exercise, usually will get injured by the time they reach 45 years of age. The studies show that between exercising and not exercising, the price we have to pay for not exercising can be very great, later on in life.

Having said that, for this post, I would like to focus on what a person could do to avoid paying too much money for injury so that one can stay healthy, be fit or to perform well in running. As we know, that acute injuries cannot be avoided as it is the same as getting into an accident, suddenly, without one’s knowledge. It is, however, still in one’s control  to prevent injuries coming from repetitive stress to the joints and bones, as impact of our walking or running do  affects us.

My Experience as a Coach

In the past, there was once I had a school camp with Hwa Chong Institution (High School Section). Usually, in school, I have told the runners to run on grass and when they are at MacRitchie Reservoir, they will run on the dirt ground there. Moreover, I make them avoid hard ground, totally, in my training. During the camp, for the morning runs, the athletes, instead of going for their runs on grass in school, they decided to go for run outside school, on pavement. They told me that they have been running a number of times on grass and they wanted a break from it and they wanted to run on pavement instead. Within few days, nearly all those who run on pavement got themselves injured, except for those who ran on grass. Once injured, it was a very difficult thing to make them come out of injuries.

In my life, I found that many runners who run on grass terrain rarely complain on injuries. They only get themselves injured if they do not stretch before and after an activity. Throughout my running career, I was able to do high mileage of above 120km -150km as I ran more on grass. Looking back, running on hard ground and grass, I did not see the benefits of running on grass until I was enlightened by by my own long term experience of not getting injured through grass. The most I had was getting heel pain on my foot, especially early in the morning. The mileage was also high as my body, bone and joints were able to cope well. That was my experience when I was in my 20s, usually winning the men open races for 5000m races and above, at that time.

Running when I was 35 years  and above

When I got older, in my early 40s, there was a time when I did a time trial given by my Army Unit, when I was doing my reservist, before I could do a 1hr 10min, I did 1hr 17min for half – marathon in a time trial somewhere in May, four months before Army Half Marathon. I ran on pavement mostly in the trial and got my injured for a year, having plantar fasciitis. It was very painful. Not just my medical cost increased for no reason, but also the time needed to come out of it was rather long. Worst still, I could not run at all, except for walking only. From then on, with conviction, I kept running on grass and dirt ground and avoided pavement, concrete or ground made up of cement.

One should know that when they reach 40  plus of their age, the knee may give problems as there will be wear and tear. Studies show that an active person, throughout his or her life gets knee problem at 45 years old and above. A person who do not keep oneself active, gets injured by the time they reach 40 onwards. It is important to understand and be aware of this by everyone, especially the public, as there will be aging going on and there will be cost which will be costly if the injury is neglected.

Over time, the meniscus and ligaments at the knee area will wear off. The more one keep walking or running on pavement, the higher the chance of injury, later on in life. One should take note of this. That is why some parks in overseas are made of trails, not pavement, and it is up to the authorities to assist the public in this. I have already seen two Physical Education teachers having knee reconstruction and it can be as high as $40000. When we are young, we do not get injured easily. However, when we grow old, we easily get injured. So, it is wise to be aware of the terrain.

Walking or running on grass or dirt ground will spare the meniscus of our knee more and it will not wear off easily. One Former Head Of Department for English in Hwa Chong Institution (college section), told me that Meniscus should act as a stabiliser which is found knee joint, in between the humorous bone (thigh) and tibia bone (shin) area. However, a great many of us, instead, use meniscus for cushioning of the impact we get from the ground and it does a great job for that, but the meniscus will start wearing  off at a much faster rate, till there is not much stabiliser left for the knee. Sharp pain will take place, after the wearing off of meniscus. I have seen a women who was limping throughout her life, as she told me that her meniscus has worn off. I felt compassionate for her.

This reminds me of a time when I was injured at the knee area and I was out of action for 3 solid years. After  winning Stanchart Marathon 2008, again, I was injured for very long time from year 2009-2011. By doing agility training and Sri Sri Yoga (physical stretching which involves deep breathing) as well,  I came out of injury. Good running Posture and technique were important and it got my, joints, aligned to my body. It should be we getting injury at a much later years like age 70 and above, and not now. Prevention should be utmost in our mind!

That is why, nowadays I treasure the days when the authorities were kind enough to give access to public to run on the grass. By running on grass, one can feel the cushioning capacity of the terrain. No wonder, I was able to run 10km in the morning and 10km in the after noon all the time. I could feel the muscles, bones and joints not affected.

As such, it is understood that Healthcare is becoming a very hot topic, where Singapore is going to lose about 10 to 15 billion dollars, in a decade, from the country’s reserves. The government is hoping that people will exercise and follow active aging. This is also the key message of 2017 National Day, which was on Healthcare as well.

Everyday, people are told to exercise by taking 10000 steps. However, to do on which terrain has not being mentioned. People will have a better quality of life by being independent to keep exercising to slow down the atrophy, the act of muscles becoming smaller due to not exercising weakening the muscle strength in the process, in the long run.

From my research, in year 2008, on Sports Participation, I realised that more needs to be done by the authorities to increase participation for the public. It is not a wise thing to see many going for joints problem which is related to terrain. More resources, the venues, should be made up of trails and grass.

In the past, when I was in my teens, in former St  Andrews Junior College, at Alexandra Road, I was allowed to run on grass and in many stadiums many could run on grass. Right now, we have do not have the privilege, as we have to give in to sports, for example, S-League etc. Moreover, even running on track, there are other problems coming. Some running on the track are faced by coaches who use many lanes and block others from running. These coaches could actually use earlier times like early in the morning, 6am/7am to do it when the crowd is not around. Else, the people may feel deterred to exercise as they find no resource to exercise, as this goes opposite to what the government wants to do for the citizens. 

As coaches, it is a wise thing to put training in the early hours, as mentioned or early afternoon 3 30pm to 5 30pm to do coaching on the running track. But I see that in some stadiums there is no problem for the public to exercise on lanes of the track, If one lane is taken, by the authorities, the group should not come to other lanes and disrupt the public.

it is wise for authorities to open the field that is not booked, to the public. I have seen a field in the past, where has been reserved. but I did not see any activity for several months on that particular field, and this is not encouraging. I also rarely see anyone running on grass nowadays and it is a sad thing. In the past, when the field was booked, a number of clubs and groups do allow runners to continue running on the side, so long there is no match going on. There must be give and take in this.

I have asked a person on why she is not running and the answer came, ” I was running until I got myself injured.” I asked,” Where did you run, grass, road or pavement.” The answer came as ,” Pavement, as it is safe to run” I told why the person did not run on grass or dirt ground. To this the person retorted,” What is the difference? ” Therefore, I find that although we have a vast majority of people running, many out there are not informed of the knowledge on pros and cons of running on different terrain.

Also, I hope that if there are not enough resources, the field could be shared with the public so that the individual can save the Medisave money in the long run or use it when one ages. When one age, the premium for insurance gets higher and it is very important for oneself to prevent injury and at the same time lead an active life. Our countries’ Healthcare funds can be saved thus.

When I was in England doing my degree, 1992-1994, I realised that the university campus was easily accessible by anyone from outside who wants to run. The whole route could be about 5km and it is mostly filled with grass route, which is a levelled ground as well. There are some High School field  that we can run, although they have bigger field. Singapore, which has lack of space may have to keep options open for the public to use grass field of a stadium so that one’s exercise can continue, instead of one running on roads which can be dangerous.

For us, whether one exercises or not, there will be injuries, and it is wise to minimise it and having a knowledge of the terrain is important. Animals in forest are spared of injuries as they walk or run on grass or dirt ground in the forest. It is wise for the authorities to engage the public to give ideas on how the limited resources can be use to the fullest  advantage of the public rather than using the terrain for just training and performance of  a game alone. A field could be used for multi purpose, just like a multi-purpose hall, can be used for other purpose when not in use. If field is being treated like the Golf Club area, then the vast majority of the public will not be able to benefit from walking or running on grass as the space is very limited for exercise. If this happens, then, more Singaporeans will benefit and the individuals and government’s massive Healthcare funds can be save to a great extent. Many of the citizens will not clamour for Healthcare as a very important issue.