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Chris Armas 鈥�94 stood just three games away from representing the United States in the biggest sporting event in the world. Armas, a former star in Major League Soccer and a member of the 麻豆直播 Athletics Hall of Fame, had been selected as a member of the U.S. National Team that would compete in the 2002 World Cup in South Korea and Japan. But in the first of Team USA鈥檚 three exhibition games before the World Cup, a match against Uruguay at Robert F. Kennedy Memorial Stadium in Washington, D.C., it happened.

鈥淚 made a movement to try to steal the ball鈥攁 movement I had made a million times鈥攁nd my right knee buckled,鈥� Armas said. 鈥淚 played another 15 minutes or so. But I knew something wasn鈥檛 right. I went to the bench and had the team physician check my knee out. He did a test on it and told me I had a torn ACL [anterior cruciate ligament]. I went to the hospital and an MRI confirmed it.鈥�

The news devastated Armas. On one seemingly innocuous play, he went from an athlete preparing to perform in his sport鈥檚 marquee event to a forgotten man.

Many performers, be they athletes or dancers, have experienced a similar fate: An injury deprives them of their unique gift and source of pride and passion.

Could the injury have been prevented? If so, how? What types of injuries are more likely to threaten a performer鈥檚 career? When injured, to whom should a performer turn for help? And will the performer ever be the same again?

Such questions play on a performer鈥檚 mind during the lonely days and nights of rehabilitation. Armas experienced it as a world-class athlete. For three years, he experienced it as the coach of Adelphi鈥檚 women鈥檚 soccer team, which posted a 14- 3-4 record in 2014 and made the Northeast-10 Conference playoffs.

Armas recently accepted a coaching position with the New York Red Bulls of Major League Soccer, but when he spoke to AU VU he was still coaching at Adelphi and spoke in detail about his efforts to help the women on his team avoid injury.

Women athletes are eight times more likely than men to tear an ACL, according to a study by the National Institutes of Health (NIH).

鈥淲omen are more prone to these injuries because of their body type,鈥� said Mike Gavagan, M.A. 鈥�03, Adelphi鈥檚 assistant athletic director for sports medicine. 鈥淭he angle of women鈥檚 hips is different from men鈥檚. Also, women have more estrogen, which makes the ligaments a bit looser.鈥�

Other reasons cited by the NIH include: Women tend to run and cut sharply in a more erect posture than men and, after a jump, women tend to bend their knees less.

In a preventative measure, Coach Armas had his players do exercise drills, including squats and dynamic one-legged movements, to get their muscles warm and loose and stretch out the ligaments. Still, one player suffered an ACL tear in 2014, as did three in 2013.

鈥淎side from the physical pain of an ACL tear, there鈥檚 a psychological and mental pain as well,鈥� said Armas, who suffered a staph infection in his injured knee in 2002 and did not play again for a year. 鈥淵ou鈥檙e very alone in those moments.鈥�

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The Psychology of Performing

Someone who works toward making performers feel less alone and more empowered on their road to recovery is Linda Hamilton, Ph.D. 鈥�89, a former dancer with the New York City Ballet (NYCB) and a specialist in the field of performance psychology.

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鈥淭here is definitely a loss of identity for the athlete or dancer who is sidelined,鈥� said Dr. Hamilton, whose clients include young dancers in the Alvin Ailey American Dance Theater and athletes. 鈥淭he loss of identity makes you wonder, `If I鈥檓 not a dancer or part of a team, then who am I?鈥� Another issue is if you have a particularly bad injury, you don鈥檛 trust your body any longer. You鈥檙e hesitant to make the same move that caused the injury. Sometimes, after an injury, dancers throw themselves back into it and reinjure themselves. And sometimes they hold back, which adversely affects their performance.鈥�

The field of performance psychology did not exist when Dr. Hamilton dropped out of high school at age 16 to join the NYCB. Yet it became a logical second career for her since, as a ballet dancer, she routinely offered support to colleagues who struggled with injuries, anxiety or eating disorders. As Dr. Hamilton, she is a wellness consultant for the NYCB and, with the support of artistic director Peter Martins, she implemented a wellness program which reduced the number of weeks of disability in the NYCB by 46 percent.

鈥淒ancers are similar to athletes鈥攖here鈥檚 a lot of pressure and there can be problems coping with that pressure,鈥� Dr. Hamilton said. 鈥淥ftentimes we create our own problems. A lot of self-sabotage exists among dancers. I try to help them avoid living a lifestyle that doesn鈥檛 support their goals鈥攏ot getting enough rest, not eating right, not giving your body time to recover from an injury, or putting your personal needs aside.鈥�

Those who work in performance psychology say it鈥檚 easier to help performers if their coaches believe in the process. Sharon Chirban Donohoe, Ph.D. 鈥�93, whose Boston-based company, Amplifying Performance Consulting, works with athletes and dancers, had a decidedly negative experience with a coach who did not buy in to her guidance.

鈥淚 worked with a synchronized swim coach who humiliated swimmers by weighing them in front of everybody and criticizing the ones who gained weight, and when I tried to give the coach some advice on how she should talk to them, she didn鈥檛 want to hear it鈥攂asically, I was fired,鈥� said Dr. Chirban Donohoe, whose clients include Northeastern University, Harvard University, Boston Ballet and the Boston Marathon. 鈥淲hen I work with an athlete, I tell them, 鈥業鈥檓 not here to make you change your coach, I鈥檓 here to work with you.鈥欌��

USA Soccer encouraged Armas to work with a sports psychologist before and after his knee injury. (He tore his other ACL in 2006 while trying to land a spot as an alternate on the World Cup team.) Armas found the sessions 鈥渧ery helpful.鈥�

鈥淚 was able to deal with the ups and downs of games and the pressures of soccer better than ever,鈥� said Armas, the USA Soccer Athlete of the Year in 2000 and a Major League Soccer midfielder from 1996鈥�2007.

鈥淢any athletes spend so much time on preparation in areas such as strength and conditioning, skill work, video, nutrition and supplements鈥攂ut they fail to address one major area: the mind and the power of it,鈥� he said. 鈥淗aving the ability to cope with mistakes, failure, success, injuries and all that comes with competing can be a major asset.鈥�

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Overcoming Anxiety

Although there are distinct differences between athletes and dancers, both groups deal with performance anxiety and the challenge of trying to return to peak form after an injury. Both groups deal with broken bones, stress fractures, and ligament and muscle tears; in addition, athletes face the possibility of concussions while some dancers struggle with eating disorders.

鈥淎 Division I basketball player and a ballerina are very similar in how they deal with injuries and rehabilitation,鈥� Dr. Chirban Donohoe said. 鈥淭here鈥檚 anxiety about wanting to get back to what they love to do. Some athletes make terrible patients because when they鈥檙e told an injury will take nine months to heal, they think they鈥檒l be like [New England Patriots quarterback] Tom Brady and come back in five or six months. When that doesn鈥檛 happen, they get frustrated. The hardest thing is to get an athlete to take it easy.鈥�

Dr. Chirban Donohoe and Dr. Hamilton both earned their Ph.D. in the . Dr. Hamilton has authored three books on performance psychology and writes a monthly column for Dance magazine. Dr. Chirban Donohoe became interested in the field because her three children (a figure skater, a hockey player and a dancer-cheerleader) were involved in youth sports.

鈥淲hen I work with a client who has suffered an injury, first I normalize the injury,鈥� Dr. Chirban Donohoe said. 鈥淚f a performer is worried about getting hurt by making the same move again, I let them know that鈥檚 normal. If they鈥檙e worried about not being able to do everything they once did, I let them know that鈥檚 normal. I take them back to class, back to training and the repetition of it and back to the performance. Once they鈥檙e back to thinking about the enjoyment of performing, their anxiety level subsides.鈥�

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Making Athletes More Efficient

Keeping the bodies of pro basketball players fine-tuned is the work of Ben Kenyon 鈥�06, now in his second season as a sports performance specialist for the NBA鈥檚 Portland Trail Blazers. 鈥淭he speed, quickness and athletic ability of an NBA player are God-given,鈥� said Kenyon, a former star on the Panthers basketball team. 鈥淎nd our goals are to allow them to be as efficient as possible.鈥�

Kenyon devises health and fitness regimens and individual workouts for each of Portland鈥檚 15 players. The workouts focus on improving a player鈥檚 speed, strength, explosiveness and quick-jumping ability. 鈥淲e go through certain movements that mimic what a player would do in a game. We make sure their neuromuscular system is ready. The intensity of the work we do on a game day is much higher than it is on a practice day.鈥�

Whenever Portland plays a home game, Kenyon raises his own athletic intensity by running three miles before reporting to work to better identify with the pushit-to-the-max attitude of a seasoned NBA player. He plans to debut this summer in a half-marathon and a triathlon (swimming, cycling, and running).

Kenyon works with athletes who often are expected to perform at or near peak efficiency despite nagging injuries. 鈥淎 player needs to be put through exercises that turn on the muscles he needs to compete at his best,鈥� he said. 鈥淢uscles that have been underutilized need to be trained. If I鈥檓 working with a guy who hasn鈥檛 been playing, we may do a hard 20 minutes a day in the weight room. If you don鈥檛 prepare as a player, then you鈥檙e doing yourself a disservice.鈥�

Before joining the Trail Blazers, Kenyon worked as an assistant athletic director for strength and conditioning at George Washington University. He enjoys the work despite a demanding schedule that sometimes has him in four different cities in five days. But it鈥檚 worth it, he said, to help players get quicker, faster and stronger or simply remain ready to contribute to one of the NBA鈥檚 best teams. Another payoff is the credibility the 6-foot-2 Kenyon has earned in a league of large men. 鈥淭he ability to walk into a room and have a physical presence with these guys definitely helps,鈥� he said. 鈥淭o be able to tell these guys what they need to do with their bodies, you need to look the part.鈥�

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Protecting the Brain

Despite the best efforts of performance specialists like Kenyon, athletic trainers like Gavagan and coaches like Armas, athletes are still susceptible to concussions鈥攂rain injuries that, in some cases, heal in a few days, but in others, linger long enough to imperil careers.

鈥淥ne thing I鈥檓 conscious of is how much air they put in the ball鈥攊t鈥檚 easy to overinflate a soccer ball,鈥� Armas said. 鈥淚f the ball鈥檚 overinflated, some of the little head traumas that happen during a match will become bigger problems.鈥�

Fortunately for athletes, concussion protocol has changed for the better. Youth coaches are required to have concussion certification from the National Federation of State High School Associations. And sports leagues are making more of an effort to protect the athlete, too.

Student-athletes at Adelphi are given memory tests before the season to obtain a baseline score. If a player sustains a head injury in season, the same tests are done and the scores compared to assess the extent of the injury. If a player who sustains a concussion is symptom-free for seven days, then he or she can begin light jogging or ride an exercise bike. Only after a battery of tests is a concussed athlete medically cleared to return, usually after 10 days.

That鈥檚 not how it used to be. 鈥淵ears ago, when an athlete suffered a concussion, the trainer came out with smelling salts,鈥� said Dan Bedard, M.A., a clinical assistant professor in sport management at Adelphi and a former pro hockey goalie in France and Sweden. 鈥淭oday, we understand that to use smelling salt to wake up an athlete is a clear sign that he should not be playing because he had been knocked out. If you鈥檙e in a car accident and you鈥檝e been knocked out, nobody鈥檚 going to say, 鈥楬ey, get back in that car and drive home.鈥欌��

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What Parents Can Do

A child suffering a concussion or some other serious injury is every parent鈥檚 nightmare. Nevertheless, parents should avoid becoming overanxious, which could spoil the child鈥檚 joy of performing, Dr. Chirban Donohoe said.

Parents should not assume the worst. The benefits for a child in taking part in sports or dance far outweigh the risks.

鈥淚鈥檓 a low-anxiety athlete鈥檚 mom,鈥� Dr. Chirban Donohoe said. 鈥淢y 20-year-old daughter competes in regional figureskating competitions. Whether she鈥檚 doing a double lutz or a triple axel, I never know what [kind of jump] I鈥檓 looking at. What鈥檚 important is that she鈥檚 enjoying it.鈥�

One more nugget for parents from Dr. Chirban Donohoe: Back off.

鈥淚 joke sometimes that kids need to be saved from their parents. There鈥檚 a term in sport psychology鈥攁chievement by proxy. The parent鈥檚 sense of self becomes defined by the child鈥檚 achievement. Have you ever met a hockey dad who claims his 4-year-old is bound for the National Hockey League?鈥�

Armas, a six-time Major League Soccer All-Star, has sons, Christopher, 13, and Alexei, 10, in youth soccer. Still, he said it鈥檚 important for parents not to steer a child toward their favorite activity.

鈥淪ometimes a parent will tell an 8-year-old, 鈥極K, do this sport.鈥� But how does he know what an 8-year-old wants to do?鈥� Armas said. 鈥淚鈥檓 Mr. Soccer Guy, and my boys play soccer. But they also play roller hockey, basketball, baseball and flag football. My wife and I don鈥檛 push them toward soccer. We tell them you don鈥檛