- The Washington Times - Tuesday, August 12, 2008

The Washington Nationals will be at home to play the New York Mets on Tuesday night, and as usual, first baseman Nick Johnson will be elsewhere.

He is back in Sacramento, Calif., where he grew up and lives with his wife and daughter. But his primary residence is the disabled list, where by now he owns an estate.

Once known as a smart, patient hitter with a knack for getting on base, Johnson is still that - when he plays. But he is known more for not playing because of his knack for getting hurt. Every conversation or piece of news about Johnson usually includes the words “injury prone.”

Recovering from surgery on the ligament in his right wrist that he tore in May, Johnson said he refuses to dwell on his misfortunes. Quiet and even-keeled, he is disinclined toward self-analysis or introspection.

“I’ve been hurt. There’s no other way to put it,” he said. “Maybe I didn’t drink enough milk when I was little.”

The injury-prone label is freely applied in sports. Asked whether this is merely a convenient, simplistic device for fans and the media or a genuine medical issue, Nationals team doctor Ben Shaffer said, “There are guys who, for whatever reason, seem to struggle and be more a part of a medical team than an athletic team.

“I think people can develop a clear pattern of having a cloud over their heads. Nick would be an example of one. … Some guys have the Midas touch. He’s the polar opposite.”

The cloud was never darker than it was two years ago, when Johnson broke his right leg in a collision with outfielder Austin Kearns. The injury led to hip complications and forced Johnson to miss all of last season.

It also was totally avoidable; neither player called the other off a pop fly. Still, it wasn’t baseball’s first outfield collision, and sometimes players get hurt. But no one misses the entire next season. No one but Johnson, that is.

“Without saying this in a pejorative way, Nick Johnson is sort of my orthopedic Pigpen,” Shaffer said.

Johnson’s latest injury occurred when he simply swung the bat during a game. It was supposed to take four to six weeks to heal, but now another season is ruined.

“The guy has delayed healing,” Shaffer said.

“You can’t explain it,” Nationals general manager Jim Bowden said at the time, a comment that also might apply to the team’s rash of injuries this year.

Johnson’s injuries, beside numerous, have been varied. In 2004, a ground ball took a bad hop and hit him in the face. Fractured cheekbone. Starting with his first team, the New York Yankees, then with the Montreal Expos and now the Nationals, he also has injured his shoulder (1998), right hand (2000, 2003), left thumb (2001), right knee and left wrist (2002), lower back (2004) and left heel (2005), in addition to the broken leg and torn thumb ligament.

The 2000 hand injury happened when he merely checked his swing during an exhibition game. On the cusp of promotion to the Yankees, he ended up missing the season with what doctors called a strained muscle. No one misses an entire season because of a strained hand muscle — except Johnson.

When it was suggested that the injuries were random, Johnson replied, “That’s pretty right on.

“I can’t do anything about it,” he said. “I try to get my muscles loose and run around, but you can’t do anything for a ligament. I broke a leg and took one off the cheek. Certain things happen, and you’ve got to pull through.”

But although many injuries are unavoidable, doctors and trainers agree that some injury-prone athletes help bring their woes upon themselves. Some try to come back too soon. Pitchers like Mark Prior and Mike Hampton are susceptible to injury because of faulty mechanics and the normal wear and tear on their arms.

Advancing age and poor conditioning are common factors. Baseball players who run into walls and dive into seats and running backs who try to break every tackle take risks.

But Johnson is not yet 30. And while he is known for playing hard, Shaffer said he is not reckless. Johnson isn’t exactly a great physical specimen but Shaffer said he works out diligently and that his injuries “have nothing to do with conditioning.”

One reason for Johnson’s three-year, $16.5 million contract extension in 2006 was that his injuries appear to be unrelated.

“I think it’s largely a case of bad luck,” said Johnson’s agent, Rex Gary. “I’m not a doctor, but so many of these things that have happened to him are not related. … It’s not one chronic thing.”

Johnson’s broken leg, actually a fractured femur, healed slowly. He developed bursitis in his hip, and the injury ultimately required several operations.

“I would never have predicted that,” Shaffer said. “Normally a guy is healed in four months. I didn’t see anything physiological that would predispose him to having that experience.”

That leaves Shaffer with a diagnosis of misfortune.

“If you saw a litany of medical things, you’d say there was something wrong with the guy, he’s a medical risk,” Shaffer said. “And you’d be right. But I would look at Nick and say ‘medical misfortune.’”

Perhaps. But research is shedding new light on whether psychological, emotional and subtle physical factors make some athletes naturally predisposed to injury.

“One of the leading causes of injury, we think, is stress and anxiety,” said Delaware associate professor of health sciences Charles “Buz” Swanik, who has studied the causes of noncontact knee and shoulder injuries. “As soon as a person becomes anxious or stressful, it changes their muscle tone. They can’t think as well. And they’re in an environment that is very dynamic, very fast moving.”

Swanik tested several college athletes on their “processing speed” and reaction time and found that those who graded out slower suffered more knee injuries. Most of those injuries “occurred from a failure of coordination.”

“No one ran into them,” he said. “They weren’t hit by anything. They were running, and they wanted to land or jump or cut, and they injured their knee.”

According to Swanik, a lot of it is in athletes’ heads - what Swanik calls “situational awareness,” which basically is knowing the surrounding environment and what to do when things go wrong.

“If we say someone is injury prone, it’s probably a neuro-cognitive issue,” he said. “Meaning, it’s mental. Or a lot of it is mental. … I think it’s a mental breakdown that would characterize them as injury prone.

“Very quickly, you can become saturated with information,” Swanik said. “Very quickly, athletes can lose their concentration and injure themselves almost instantly if they don’t have a good plan or if they’re anxious.”

David Ahern, a psychologist at Brigham and Women’s Hospital in Boston and a member of the Harvard faculty, supports some of the same ideas. He said some repeated injuries might stem from “psychosocial” causes like depression and stress, which can put the entire body at risk. He does not consider bad luck to be a cause.

“I believe events are determined,” he said. “These are human beings. They have the same potential for stress, depression, anxiety, marital problems, substance abuse as anyone else. … If someone is depressed or is undergoing psychological stress, it impairs their function and put them at greater risk.”

Such theories might help determine which athletes might be more injury prone than others.

“It begs the question,” Ahern said. “Just like we know the risk factors for cardiovascular disease, can we determine the risk factors for athletes? … There’s a reason a lot of these teams have sports psychologists.”

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