Welcome to the House of Terror.
A visitor to the Sports & Rehabilitation Center in Asheboro might hear that salutation, but it's said as much out of admiration for the professionals who work there as consternation for the pain suffered by people recovering from a sports injury.Previously, when athletes were injured, they looked forward to visiting the trainer to have their aching joints massaged in a whirlpool or have their tired muscles kneaded with analgesic balms.
These days, however, the leading theory behind sports medicine is muscle conditioning. Instead of soothing aches and pains, trainers help athletes strengthen their muscles to stabilize their joints. In a word, the process can be tormenting after a severe injury or surgery.
``We don't use any of the modalities - ice, heat, ultrasound,' said Dr. Thomas Osteen, an orthopedic surgeon with the center. ``In general, the literature has never been able to support it. We change things very frequently. If we can't show that it's effective, we can't use it.'
What professionals at the center use most often are devices to build strength, such as stationary bicycles, stair-stepping machines and various weight machines.
Felicia Rouse, a point guard on the Asheboro High School girls' basketball team, is recovering from arthroscopic knee surgery and does her rehabilitation at the center.
``When I got in therapy, I started lifting weights, and it hurt really, really bad,' she said. ``It was depressing after my surgery, but sometimes I'll tell myself, if I do 100 more steps, I'll be closer to getting better. Now I put all my energy into rehab.'
Rouse, a senior, has had knee problems since she was in the eighth grade. She said her knee cap has slipped out of place four times, causing the bone to chip. During a late December basketball practice, she ``went one way and my knee went the other'.
Because the tendons on the outside of her knee were too tight, the knee wasn't tracking correctly. Osteen performed outpatient surgery on Rouse to separate some of the tendons from the tissue around the joint.
She was injured on a Tuesday, had surgery that Friday and was walking the next Wednesday.
Her therapy, which she does three times a week, involves riding a stationary bicycle four miles in just over 13 minutes, exercising on a machine that gives negative and positive resistance, straight leg raises and stair stepping on a machine that resists the leg needing strengthening.
For years, experts have emphasized stretching as one of the most important ways to prevent sports injuries. Osteen believes that facet may have been over-emphasized. Strengthening the muscles has proved most effective, yet it hasn't gained the popularity that stretching has.
``What we stress over here is conditioning,' he said. ``Some of these injuries can be prevented with adequate muscle conditioning. In football, some injuries cannot be prevented. Where injuries can't be prevented, rules and restrictions have helped.'
For instance, tactics such as spearing and clipping cost football teams 15 yards in penalties, so the frequency of those offenses and the injuries resulting from them has declined.
Injuries are associated with almost all sports, but the negative consequences of not being physically active probably are greater, Osteen said. Furthermore, there is no evidence that a normal joint will be affected by weight-bearing exercise.
``A normal joint doesn't wear out,' he said. ``It likes motion. It likes activity.
``Studies have shown the incidence of arthritis over a 20-year period among runners is the same or less in matched populations, assuming the joint is a normal joint to start with.'
He emphasized, however, that an abnormal joint can be adversely affected by too much exercise.
A sidelight to the knowledge gained over the years in sports medicine has been its value to industrial medicine. Experts are finding the same types of injuries in sports - those involving trauma or those linked to repetitive motion - in industry as well.
For that reason, the rehabilitation center treats a number of injuries caused in the work place. Dave Fletcher hurt his back about a month ago when the scissor lift he was operating tipped over.
His therapy has been rigorous.
To treat back disease, experts at the center focus on three risk areas: cardiovascular fitness, muscle strengthening and flexibility.
Fletcher works out on a treadmill and does a series of flexibility and strengthening exercises. Despite the pain, it seems to be paying off.
``At first it's hard, but it gets easier as you progress,' he said. ``I had trouble getting in and out of the car before I started coming here.'