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Sports Injuries and the Negative Effects of Specialization and Toxic Masculinity

Golf may not be known as the most physically imposing sport, but on a summer day in 2008, Tiger Woods displayed how disastrous even contact-free competition can be. That year, Woods would go on to win his 14th Major during the U.S. Open at Torrey Pines in Southern California, but at a heavy cost. Most people remember his putt to force a playoff and his tremendous comeback after a slow start. What is impossible to forget, though, are the injuries the golfer fought through to compete and ultimately win. After undergoing knee surgery earlier that year pre-tournament, Woods further injured the same left leg, sustaining two stress fractures in his tibia. Playing in the tournament also reaggravated the injury to his anterior cruciate ligament (ACL) and created even more pain for him. Many told the superstar, who at the time was the highest-paid athlete in the world, that he should not finish the tournament. His doctors even told him beforehand he should not compete. The injuries that Woods endured and aggravated that day were preventable and while many other factors were at play that led to his downfall (before his eventual revival), his performance should stand as a case study for how not to deal with injuries and the dangers that come with sports. Specialization and irregular motions inherent specifically to sports put the body in unmatched stress which results in severe injuries. Those, compiled with toxic masculinity, can lead to a dangerous cycle of athletes reinjuring themselves in hopes of becoming the best in their sport.

Injuries can be chalked up to bad luck, whether it be in the world of sports or in everyday life, but many injuries are preventable according to Spectrum Health Newsroom (2016). In sports, athletes, trainers and the very nature of the games lead to most preventable injuries. Take the Tiger Woods example. He exemplifies the three aforementioned possible root causes of sports injuries. Woods is notorious for his strict upbringing by his father, Earl Woods, who attempted to create the greatest golfer in the history of the sport, as depicted in the 2021 Tiger documentary, directed by Matthew Heineman and Matthew Mamachek. At the age of two, he was already in the spotlight appearing on the Mike Douglas Show alongside Bob Hope and Jimmy Stewart. He was everything but made in a lab to be the ultimate golfer. He went his whole youth barely sniffing another sport, spending all available time perfecting golf. This is specialization on its highest level, a level that no amateur and even many professionals will never reach. Combining his relentlessly focused training with mechanics, albeit perfect mechanics, that are not natural movements for the human body, there is a recipe for disaster from putting the body in a compromising position over and over again. The societal pressure to be hypermasculine and push through pain was just the spark that lit the keg that left Woods’s career in a fiery mess.

Professional athletes at the top of their game almost always fall victim to specialization. Jayanthi, Pinkham, Dugas, Patrick and LaBella define sports specialization as “intense, year-round training in a single sport with the exclusion of other sports” (2013). This is a common practice in modern athletics, especially when it comes to youth training. Parents typically force their children into more specialized training at a young age to help make them more competitive at their sport. The promise of scholarships and acclaim, along with professional aspirations, fosters competition at every level. Specialization is not restricted to the world of sports nor youth alone. Specialization exists in other professions, but in sports, it can lead to more severe consequences like career-ending injuries. Yet given the rarity of professional success, athletes choose to put their bodies at risk in hopes of succeeding. But for many, they harm their body for nothing. It is a near-impossible climb to professional sports as noted in a study by Adam Virgile on early sports specialization. He found in the 2016-2017 school year that only “0.04% athletes who played sport in high school were drafted into the pros” (2019). While this does not account for undrafted players, it also includes drafted players who never even saw the field. For every person who makes it to a league, 2,499 do not. Specializing is typically the way to make it to the professional level, though even then it is not likely, making the negative impacts of specialization seem worse.

The repetitive nature of sports can also increase the risk of injury, especially when combined with specialization causing an athlete to focus on the irregular motions of one sport and not varying his movement through multiple sports. The more athletes engage in sport, the more likely it is that they will encounter overuse and acute injuries according to Dalton (1992). Specializing athletes fall into this category because there is never an off-season to rest and rehabilitate the body and hence, presenting more opportunities for injuries. The repetitive motions that athletes do nearly every day for the majority of their life have consequences, mostly in the form of overuse injuries. For example, pitchers in all levels of baseball are known to have elbow injuries that require surgery because of the repeated stress of a single unnatural motion. This repeated stress leads to the tearing of the ulnar collateral ligament (UCL) and requires “Tommy John'' surgery, named for the first pitcher to undergo the procedure. According to Johns Hopkins Medicine, Dr. Frank Jobe conducted the procedure for the first time on the pitcher in 1974 by replacing the ligament in his elbow with a collected from another part of his body and grafted to the torn UCL. Before 1974, as orthopedic surgeon Dr. Ben Zellner describes it, “a torn UCL was once considered a career-ending injury for baseball players. It was called ‘dead arm’” (2018). Only thanks to advancements in surgical procedures can athletes with overuse injuries caused by irregular motions continue their careers. Pitchers will always have a rough time with arm injuries because the body is not meant to throw a ball over 90 mph or endure the stress of a throw anywhere close to it. The same is true for golfers and tennis players with their elbows, though they deal more with pain from overexertion of a muscle and tendon than full tears according to the Mayo Clinic. Tiger Woods swinging a club hundreds, if not thousands, of times a day in the same motion will inevitably build up strong muscles for that motion. However, at a certain point, the strength becomes a strain.

While overuse injuries are a direct result of specialization and repetitive irregular motions, acute injuries could be an indirect consequence of the two due to these weakened and overused muscles and ligaments. Acute injuries occur from one particular event of trauma, like slipping on a patch of ice and banging and bruising your knee. In sports, acute injuries are unpredictable incident to incident, yet not completely random. They are not fully arbitrary because sports are destined to lead to injuries due to non-standard movements. Nothing in the evolution of humanity helped our bodies become better at landing on the ground after completing a 360º dunk over someone or better at sustaining a helmet-to-knee collision at 63g’s. The very nature of most (if not all) sports leaves open the possibility for injury. Doctors still argue whether acute injuries are linked to specialization. And while it is hard to say that Joe Theismann or Alex Smith had their legs break due to anything but an unfortunate collision, acute ligament damage could be the result of repeated stress already weakening the ligament before the event of trauma.

Cutting on a dime in any sport puts your muscles and ligaments through intense pressure and stress. Acute injuries are when the body fails to support that stress in a single event of trauma. In a study of ACL injuries in youth athletes, Schub and Aluan state that ligament damage can be attributed to specialization:

Injuries to the pediatric and adolescent athlete are becoming more common as increasing numbers of this patient population are participating in year-round sporting activities. As these figures continue to rise, there have [sic] been an escalating number of patients with both traumatic and nontraumatic, sports-related knee injuries presenting to orthopedic surgeons for evaluation. (2011).

When enough stress is built up, and no break is taken from using the same muscles year-round, injuries are almost inevitable. Sometimes a small misstep that usually results in a minor injury could become the tipping point for a more dire one. Players like then-Vikings quarterback Teddy Bridgewater and then-Clippers point guard Shaun Livingston possibly are victims of this. Bridgewater had a non-contact injury in practice that nearly resulted in him losing his left leg after he tore his ACL and dislocated his knee. Livingston had a mostly uncontested layup on a breakaway and landed poorly as one does hundreds of times throughout their career. This time, it resulted in his left leg getting mangled. He dislocated his left knee, tore his ACL, meniscus, posterior cruciate ligament (PCL) and broke his leg. Major injuries like these are not common in non-athletes, especially from something as simple as a slip. The immense repeated stress on the ligaments from athletes builds up until one wrong step or landing overloads the ligaments from years of stress, like a balloon popping when it gets too full.

Possibly the worst “injury” to come out of specialization and nonstandard movements/collisions is chronic traumatic encephalopathy (CTE). Popularized by Dr. Bennet Omalu after his discovery of the disease impacting the brains of former NFL players in 2005 – as depicted by Will Smith in 2015’s Concussion, directed by Peter Landesman – CTE, according to the Concussion Legacy Foundation, is a degenerative brain disease caused by repetitive trauma inflicted to the brain. It is not caused by a few concussions, but rather “hundreds or thousands'' of subconcussive blows to the head. This is the case for many football players. The game of football is aggressive by nature. Though there have been many efforts to remove head-to-head contact from the game, it is impossible to eliminate it entirely in the current state of the game. The repetitive blows that are known to lead to CTE only increase the longer an athlete participates in football. CTE can be described as an overuse injury, since it is wear and tear on the brain, and not linked to a single event of trauma. According to Dr. Jillian Urban who specializes in biomechanics and public health, football practice is one of the main culprits, as players go through drills that require the contact that causes the disease. Urban interacts with the Wake Forest University football team and focuses on brain injuries from football. In her work, she found that many of these football players “receiv[e] a greater percentage of their head impact exposure during practices compared to games.” She also added that these collisions are controllable and changeable if coaches were to reduce the drills involving a heavier volume of contacts. Other contact sports have been linked to CTE as well, such as rugby and hockey, though the disease has been or is predicted to be found in almost any event with repeated head trauma, sports, or otherwise (i.e. the military).

Toxic masculinity may also play a role in promoting injuries, though there has not been enough research on the link between the two to make any concrete declarations. According to Maya Salam, an author at the New York Times, “toxic masculinity is what can come of teaching boys that they can’t express emotion openly; that they have to be ‘tough all the time’; that anything other than that makes them ‘feminine’ or weak.” While the latent effects of toxic masculinity permeate outside of sports and harm society as a whole, the same mindsets are not viewed as negative in sports. Sports can be a stage where toxic masculinity is on full display. If you are not strong enough or get injured, your masculinity is questioned in front of everyone, pushing you to get better or give up. Not wanting to show your inability or, as Salam explains, “maintaining an appearance of hardness,” is one of the factors that drive athletes to get back in the game after debilitating injuries. An injured athlete who stays tough may lead to an incredible comeback that is celebrated, whereas an athlete who chooses to retire after an injury can face criticism.

One such revered comeback story that plays into toxic masculinity narratives is that of Adrian Peterson. In December of 2011, Peterson tore his ACL and medial collateral ligament (MCL), an injury that 50 years ago would typically end a career. Peterson rewrote the book on what it means to come back from injury, especially ligament tears in the knee. These injuries typically require eight months to over a year to restart full participation in sports. An NFL player usually misses an entire season. Peterson did it in eight months and did not miss a single game. While returning from an ACL, players rarely return to form, at least right away. The former-Vikings running back not only got back to where he was before the injury, but he also ended the season falling just nine yards short of the NFL record for rushing yards in a season. No one is supposed to be able to come back that quick, let alone win the league’s Most Valuable Player award. World-famous orthopedic surgeon Dr. James Andrews has performed surgery on numerous other athletic superstars like Michael Jordan, Tom Brady and Jack Nicklaus (all considered the “Greatest of All Time” in their respective sports). Yet, Andrews acknowledges that Peterson was different than the rest and that his recovery was far from the norm. His first year was more of an irregularity, bordering on miraculous. According to Andrews, running backs “may come back and play a little bit,” but “they don't do what [Peterson] did” (2013). Andrews looked at the statistics of players returning to the NFL after an injury and concluded “running backs are the hardest to get back, period.” There was no reason for Peterson to rush back into action as he did. It was a self-imposed drive to prove to everyone that he should not be defined by an injury that pushed him back into action so fast. But much like his comeback, he is more of an outlier in his recovery that can fuel toxic masculinity in other players.

Coming back from injury in record time typically does not end as Peterson’s story did. Kevin Durant is the shining example of that. During game five of the Western Conference Semifinals of the 2019 NBA playoffs against the Houston Rockets, the Warriors’ superstar forward strained his calf. The injury was worse than initially diagnosed and kept Durant out until nearly the end of the NBA Finals. At the end of his month-plus stint of inaction, Durant suited up again in game 5 of the NBA Finals, only being able to play 12 minutes before suffering another injury, this time to his Achilles tendon. A torn Achilles is known as one of the most difficult injuries to return from, with many basketball players never returning to form. In an interview with The Mercury News, Dr. Nirav Pandya, an orthopedic surgeon and associate professor for UC San Francisco, mentioned how calf injuries lead to Achilles injuries. Because of the lack of strength in the calf, Pandya says returning too soon and beginning intense movement again puts more stress on the Achilles and “it is not surprising there is going to be an injury on that side” (2019). In all fairness to Durant’s case, it is important to note he was medically cleared to return to action by the staff of doctors on the Warriors. There were no teammates, coaches, general manager, or owner that told him to step back on the court. The doctors allowed it and Durant made the final decision. Durant returned to action in game five of the NBA Finals – an elimination game. Had this been the middle of the regular season when the Warriors were doing well enough and could afford to lose a few games, Durant may have not been cleared so fast nor would he have decided to return while not feeling 100%. But it was the greatest stage in the sport, and possibly the last chance of the season to contribute. Durant undoubtedly pushed himself when he should not have. A ring was at risk, but so was the rest of his playing career.

While the drawbacks of specialization, irregular motions, and toxic masculinity can derail entire careers after exhausting the body, the allure of pushing the body to the max and becoming the best pushes athletes to look past the negative consequences. Specialization has pushed many modern athletes to new heights that challenge the preconceived notions of what we collectively believe humanity can physically achieve. Usain Bolt, known as the fast man on earth, recorded a blisteringly fast 9.58-second 100-meter dash in 2009, still a world record over a decade later. Bolt also holds the Olympic record in the same event with a speed just 0.05 seconds slower. In the 1896 Athens Olympics, the first of the modern games, Thomas Burke clocked in at 12.0 seconds, nearly two full seconds slower than the 8th place finisher from the most recent Olympics in 2016, Trayvon Bromell. Jim Hines was the first to break the 10-second barrier, doing so in 1968, over 70 years after the first modern Olympic games. Breaking the mark was no easy feat and required extreme training and advancements in technology in training and equipment. Another reason sprinters were able to knock valuable decimals of seconds off their time was because of specialization. Athletes did not use to stick to one sport. Look at Daniel Norling of Sweden who won two gold medals in gymnastics and another gold medal in equestrian jumping throughout three Olympics in the early 1900s. Jim Thorpe won gold in the pentathlon and decathlon in 1912 and also played professional football and baseball and the highest level of basketball. He is renowned for his versatility as an athlete, but what if, like Bolt, he focussed on a singular sport? What could he achieve then? Similarly, how dominant could Bolt be if he trained or even participated in any other sports besides short distance running/sprinting? Ricky Simms, Bolt’s agent, said in an email to the New Yorker, “Usain has never run a mile.” While it is likely hyperbole, the essence of the message exemplifies the achievable possibilities from specialization. Running a mile is very different from a 10-second sprint. There are different muscles required, different strategies, different equipment. If a sprinter, like Bolt, wants to be the best at sprinting, they need to focus on generating power and force. As a result, they will repeat only the stress-inducing motions that help achieve that goal and society will reward them for their perceived dominance and triumph over the body’s natural weaknesses. They do not need to worry about their endurance like a long-distance runner if it does not lead to the dominance they are seeking. Time spent outside of the specialized field is wasted as it does not help to achieve the ultimate goal of obtaining elite status.

Regardless of the negatives that lie with specialization and toxic masculinity, there are not many clear-cut solutions to fix injury incidences in sports entirely due to the irregular nature of heavy activity in the first place. Reducing contact practices and focusing more on rest and rehabilitation is a good start but not enough. Coaching is an area, especially when it comes to youth sports, that needs to be addressed because in many cases the coaches have no formal medical training and cannot determine the severity of injuries. Add in a young athlete’s self-destructive drive to keep play as to not show weakness and injuries are bound to pile up. Just as we cannot remove all injuries from the game nor can we outright eliminate specialization and toxic masculinity altogether. They are both concepts that exist outside the world of sports and permeate everyday life in one way or another. However, by expanding the scope of sports and activities that youth and professional athletes compete in, we can still reduce the number of overuse injuries caused by specialization, and even curtail the number of acute injuries by lowering exposure to sports altogether. Physical activity is healthy and recommended by every doctor, but all athletes can help themselves by taking their foot off the gas occasionally and taking a break. This is even more important when it comes to rehabbing injuries. Toxic masculinity should not push athletes to show off to anyone and the dialogue needs to shift from “proving them wrong” to “putting my health first.” Athletics are not everything and with the odds of becoming a professional athlete so slim, the negative ramifications of injuries far outweigh the possibilities.


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