Grafton Bruce went up for a rebound Dec. 10.
It was one of many he'd grabbed for in his 29-year basketball career; he'd reached for rebounds back at South Carroll High, and at Anne Arundel Community College, and several nights a week in the Carroll County Men's Leagues, where the 36-year-old had been playing since 1976.
But this time, he stepped on another player's foot, and Bruce heard a pop -- a characteristic pop. Then he felt "excruciating pain."
"When my foot came down, my knee just popped to the inside," says Bruce, who left the game in an ambulance.
Dr. Samuel Matz, medical director of the Carroll County Sports Medicine and Rehabilitation Center, diagnosed the injury as a torn anterior cruciate ligament, the same injury that sidelined Bullets forward Bernard King when he was starring for the New York Knicks.
Bruce, who ran three miles a day in addition to playing basketball, considered himself to be in good shape. But he ran into one complication that affects an older athlete'srecovery: a time crunch.
Because the injury occurred just before Christmas, Bruce, who is a service representative for Pitney Bowes, was unable to schedule the surgery to repair the knee until January. During those five weeks, he lost a lot of muscle tone.
It's a common problem with athletes who also have jobs and families, says Paul Welliver, a certified athletic trainer with the Carroll County Sports Medicine and Rehabilitation Center.
"They don't get it fixed because they don't have the time."
Bruce was able to take a short-term disability leave and undergo the 3 1/2-hour operation. During surgery,Matz replaced the torn ligament with tendon from the kneecap and anchored it with screws into the tibia and the femur. Therapy was slow.
"They don't want you to injure what they just fixed," says Bruce. "At my age, it's not much fun."
Bruce, who's "walking almost like a normal person," says that, like Bernard King, he will play basketball again, albeit with a brace on his knee.
He's one of the lucky ones.
Welliver notes that knee injuries are tough to rehabilitate.
"Many times these people have to give up the sport and change their lifestyle," he says. "It's tough to tell someone who's 35."
Matz, who specializes in sports injuries in athletes who range in skill from Olympians to weekend athletes, says he sees two common types of injuries. The first are overuse injuries such as tendonitis and bursitis. The second are traumatic injuries, which tend to be related to the specific sport.
Welliver notes that runners are prone to the overuse syndrome, with injuries such as Achilles tendonitis. Golfers contend with sore backs, elbows and shoulders from the stroke. Basketball and football players are all too familiar with knee injuries, as are skiers and tennis and softball players. It's the deceleration and the sudden cutting movements that cause those injuries, explains Welliver.
"They're running and they want to stop; there doesn't even have to be anyone else around, and you feel a pop inside."
When thathappens, the anterior cruciate ligament tears, affecting the entire stability of the knee.
Aggressive attitudes also cause problems.
"It's the guy who, rather than getting thrown out, decides he's going to slide," says Matz.
Or, adds Welliver, "trying to do a BrooksRobinson move and not exactly being Brooks."
Overuse injuries canbe treated by backing off and using ice and ibuprofen.
"Non-surgical treatment will allow most of those conditions to repair themselves," Matz says.
Torn knee cartilage can be repaired with arthroscopic surgery as can certain ligament problems. But major ligament tearsusually mean traditional surgery.
Matz says the rotator cuff is the most commonly torn tendon, and the chances of tearing increase with each decade of life. While arthroscopic surgery can correct partialtears, full tears mean lengthy surgery.
The problem begins long before the older athlete takes to the field, and again the problem is time.
"You simply can't remain strong by doing the activity," saysWelliver, adding that a conditioning program is a must to prevent injuries. "But they don't have the time."
He recommends trying to shave hours from the beginning and end of the day with activities such as stationary biking, walking or running.
Matz agrees: "If you're an aging weekend athlete who's going to play on the company softball team, start in January with light conditioning."
And, notes Welliver, older people are more injury prone.
"Nolan Ryan is the exception to the rule," he says.
But with common sense, Welliver and Matznote, older players can continue to play and enjoy athletics.
Matz says that players must be honest with themselves when they assess what kind of shape they're in. Welliver points to Nolan Ryan as an example of proper conditioning.
"What did he do after throwing a no-hitter?" he asks. "He went and rode the stationary bike.
"Older athletes should be in a conditioning program and a strengthening programbefore they start playing softball. It will prevent injury at the least, and at the most it will make you better."
His advice is tailor-made for Carroll countians.
"In particular, I find that Carroll County has a very active, fitness-oriented type population," says Matz. "People are remaining active in sports longer and longer. It's much better to prevent injuries than to treat them."