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Bouncing Back

Wide receiver Brent Casteel received world-class care at the U after suffering a season-ending knee injury last fall.

Bouncing Back
How the U mends its injured athletes.

by John Youngren

Knee X-ray

Nothing is more cringe-inducing in sports—whether at the college, professional, or amateur level—than when a player goes down … and stays down. In a split second, a knee can pop, a bone can break, and a season can come to an end.

Take Brent Casteel. One of Utah’s current football stars, the junior wide receiver was a second team all-Mountain West Conference (MWC) player during the 2006 season, and big things were expected from him in 2007. Versatile and experienced, Casteel was the Utes’ all-purpose guide in 2006; his 10 touchdown receptions led the team.

But in September 2007, during the second quarter of what turned out to be a 20-12 Utah loss to Air Force, Casteel was tackled hard around the knees. He went down and didn’t get back up. Diagnosis? A torn anterior cruciate ligament (ACL) in his left knee, which ended his season.

It was Utah’s second game of 2007. Casteel would be one of nine starters to miss at least a portion of seasonal play, and one of four to suffer season-ending injuries.

“When they first told me my ACL was torn, I broke down and cried for probably 20 or 30 minutes,” Casteel says, months later. “It puts a lot of pressure on you. You wonder if you’re ever going to get back to where you were [before the injury]. “You wonder if you’re ever going to be the same.” (He finally started doing very light workouts with his teammates again in practices shortly prior to their 35-32 win over Navy in the late-December 2007 San Diego County Credit Union Poinsettia Bowl, but he was still not yet healthy enough to play in the game and watched it from the bench.)

At the U, putting an athlete like Casteel back on his feet after an injury of any scope falls mainly to the team of experts in the U of U Sports Medicine Department. That crack team is composed of five athletic trainers (each of whom focuses on one or two particular sports and assists on others), the first line of doctors, specialists, sports psychologists, strength and conditioning experts, and varied other medical professionals from across campus who are called on to mend the University’s athletes.

“Between our staff and [each] team’s doctors, as well as the Utah Orthopaedic Center staff, we really have a well-established team here,” says Bill Bean BS’79 MS’86, the U’s director of Sports Medicine, who’s been treating Utah athletes for more than three decades. “We have so many people to go to for help.”

Indeed, the whole of University Health Care’s world-class facilities is available to Utah’s athletes. This depth of resource and ongoing attention is something that sets an athlete’s care above and beyond the level of doctoring the rest of us typically receive.

“It used to be, if we had an athlete who needed an MRI, we’d be lucky if we could get it done in a week,” Bean says. But the U’s many resources and advances in technology and specialties have evolved. “Now we can get an MRI done in two to three hours most of the time and get the crucial information to the coaches a lot more quickly.”

In Casteel’s case, the MRI confirmed the initial diagnosis within the first 24 hours, and he underwent surgery within a week. Doctors told him it would be at least six to nine months for his injury to heal properly; he felt he was ahead of pace at year’s end.

“I feel pretty good about where I am,” Casteel says now. “I never doubted myself.”

Marshall Mccormick
Bill Bean, U of U director of Sports Medicine, examines Brent Casteel.

The expansion of the U’s conditioning and sports medicine facilities in recent years is another reason the program is able to care for its injured athletes on a more comprehensive basis. Utah athletes can get treatment at the Dee Glenn Smith Athletic Center, the HPER Athletic Training Room, and the Dumke Gymnastics Center. The training staff renders ongoing treatment and rehabilitation, counseling the student-athletes, their families, coaches, and others concerned about an injury’s treatment and prognosis.

Still, all the technology and fancy new treatment centers in the world can’t overcome some basics. “If you break a bone, there’s a biological clock involved. The bone has to have the time it needs to heal,” Bean says.

And surgical advances in the past couple of decades might make it so that certain surgeries are less invasive than they once were, “but the body still needs to heal,” Bean stresses.

Getting the athlete back in the game as quickly as possible is obviously a priority, but overall, the Utes have typically “always erred on the side of conservative,” notes Bean. “There are a lot of dynamics involved with [any single student’s] case, but typically we ask, ‘What would you do for your own child?’”

Besides the physical, there are psychological aspects to consider. Depending upon the seriousness of an injury, student-athletes can easily become afraid that they may not be able to return to a sport and play at the same level, or, worse, that they may not be able to return at all. And unlike older, more seasoned athletes, students in their late teens or early 20s may not have undergone the trauma of being seriously injured earlier in life.

“I think the thing that can be forgotten is the mental and emotional trauma an athlete goes through when seriously hurt,” Bean says. “Part of their life feels like it’s been taken away from them if they can’t play their sport.”

That’s why the Utah athletic program provides for the mental and emotional aspects of physical injury, offering psychological counseling to its student-athletes.

“For every injury, there is an emotional and mental side in addition to the physical side,” says Keith Henschen, of the U’s Department of Exercise and Sports Science. Henschen, who, like Bean, counts more than three decades of working with Utah student-athletes, has served as sports psychologist to generations of injured players over the years.

“An athlete may be ready to go back from a physical point of view, but that doesn’t always mean they’re ready to go back from a [mental] point of view,” Henschen says. “We really have to work with them to accept that they have to heal emotionally as well as physically.”

While every individual case is different, Henschen says student-athletes facing serious injuries will typically go through a healing process that begins with denial, followed by bargaining (“What do I have to do to get back quickly?”), and probably some depression. Eventually, most come to a point where they’re able to cope by addressing the situation more objectively and following the appropriate steps to regain their health.

Casteel admits that his first days after his injury were particularly dark, and he indeed suffered some depression. But the U’s staff, and a number of both past and present teammates (particularly quarterback Brian Johnson, who suffered a similar injury in 2005), rallied around him. “They gave me some words of wisdom—that I had to fight through it and come back,” Casteel says.

Younger collegiate athletes are different from, and sometimes more difficult to work with, than their older counterparts because they can be prone to youthful indiscretion, Henschen notes. “They heal quicker [physically] because they’re young. But often, that means that they try to come back [and participate] too early. We try to work with them to realize that they’re only going to complicate the situation if they don’t follow the rules.”

Like Bean, Henschen has had a longstanding attitude of putting the student-athlete and his or her needs first. The needs of the team, the coach, and any short-term gain are set aside in an honest one-to-one counseling relationship.

“Sometimes, they just need someone to talk to who doesn’t have another agenda,” Henschen says. “That’s what we provide. It’s good to work with somebody on the mental side of things as well as the physical side.”

Perhaps not surprisingly, female student-athletes are more likely to seek psychological counseling, and, in general, get more out of it. Male athletes “maybe have their ego in the wrong place at times,” Henschen notes, and are more likely to simply play along with the process, rather than fully buying into it.

But, he says, the fears every athlete faces when seriously injured are pretty much the same. “They’re the fears everyone experiences: ‘Will I be able to play again?’”

In every case, a student-athlete’s medical unit—from the individual physician assigned to each team, to Bean and Henschen and their staffs, to the strength and conditioning professionals, and/or any other experts consulted—works with a student-athlete from the moment of injury through rehabilitation and, ultimately, recovery.

“Some injuries, like a sprain, you can be a little more aggressive with [because they] don’t require as much care,” he explains. “Some are obviously more serious—and we’ll end up with a doctor’s orders on what they want us to do as we take an athlete through rehabilitation. Every case is different.”

And every injury can be traumatic—especially if it’s the first time an athlete has been hurt. Again, consider the case of Brent Casteel—who optimistically intends to be able to play a full and healthy senior season in 2008 and has NFL aspirations beyond that.

”It was hard for me to sit out the season, but I knew I’d get back—I’m a fighter,” he says. “And it’s given me a whole new outlook about football itself. A lot of people might take [playing] for granted. My mindset now is, you’ve got to give it your all.”

óJohn Youngren works in advertising for Love Communications in Salt Lake City and has written many previous articles for Continuum.

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