It's a common mantra in sports to “play through the pain,” as athletes do whatever they can to get the first down, strike a player out or put points on the scoreboard. But the drive to win can lead to sometimes serious injuries. Just such a scene recently played out on national television. During this year's NCAA basketball tournament, Kevin Ware of the Louisville Cardinals suffered a compound fracture to his leg after he jumped up to block a shot and landed awkwardly. Ware had to have surgery but was able to sit with his teammates as they went on to win the championship a week later. Health Matters spoke with Christopher Wahl, MD, chief of sports medicine at the University of California, San Diego department of orthopedic surgery, about what caused Ware’s injury, how student athletes can train properly and why the competitive nature of sports may be leading to more injuries.

What exactly happened to Kevin Ware?

Bones are very good at handling compression but not so great when it comes to handling twisting and bending. I’m sure he’s blocked shots like that a million times and nothing ever happened.

I saw a similar injury when I was the team doctor at the University of Washington, Seattle. The basketball team was playing Texas A&M, and one of their guards, Derrick Roland, went up for a layoff attempt and the same thing happened when he landed.

They both had what can be called an inside out injury. He landed, and the bone either twisted or was bent in a way that caused the bone to break. There’s not much muscle and skin cushioning the tibia (where your shin is), so it doesn’t take much for the sharp edge of the broken bone to lacerate the skin and come out.

Will he be able to play basketball again?

He should be able to. In a weird way, the biggest disservice for Kevin is the way the injury is being overplayed. You hope it doesn’t get into his head and that he can be back playing at the same level with the proper rehab and therapy.

Right after the injury, there was speculation that Ware had underlying stress fractures. Could that have been a cause?

It’s not uncommon for people who train a lot and sometimes over-train to get stress fractures. Stress fractures are the first thing people think about when people break a bone from a “non-event” type situation. But from what I’ve heard, Kevin Ware had a perfectly healthy bone and had no pain whatsoever. Usually people with a stress fracture will have some kind of nagging pain.

How does the competitive nature of sports play a role in injuries?

The biggest thing, which sounds crazy and like common sense, is not playing through the pain. Coaches and parents need to recognize when they see changes in the way an athlete is performing. If they’re slowing down, if they’re changing the way they pitch, it’s likely because something is hurt.

We have to create a culture in sports where it’s okay to accept an injury and not play. We glorify athletes for playing through discomfort and praise them for biting the bullet. The coaches and parents need to be able to tell them to slow down, and take time to recover.

What can student athletes do to reduce their risk?

They need to be doing strength training and agility training. Good warm-ups and stretching is important before a workout, practice, game, anything. And being just as mentally prepared as they are physically prepared is important. With high school and college athletes especially, they’re going to class and studying and then playing sports every day, and they’re exhausted. Being ready mentally is just as important.

What do you think is a big health concern for student athletes that doesn’t get enough attention?

I think kids that are one-sport athletes are at a bigger risk for injury. For example, some of these kids just play baseball for 11 months out of the year, starting when they’re 9-years-old and into their 30s and 40s. We’ve almost ruined an entire generation of baseball pitchers. They pitch so much from when they’re so small, and that’s all they do, so they’re more apt to wear out their arm or shoulder. Cross-training in different sports prevents one part of the body from getting worn out.

Are student athletes as concerned with injuries and staying healthy as they should be?

The whole concept of sports is a real catch-22. What defines great athletes — and what is also their Achilles heel — is that they’re someone who is not going to quit and they’re going to push through the pain to get a starting role on the team or impress a scout. They’re most likely to get an overuse injury, because they’re not going to give up.

Erinn Connor is a staff writer for Health Matters with Dr. Sanjay Gupta