The pain of not playing

Michael Waddell knows lonely. The Tennessee Titans cornerback and former North Carolina Tar Heel has done his time in the NFL's most ostracized position -- the injured guy in street clothes on the sideline. "It's really bad," Waddell said about missing the 2006 NFL season with a ruptured patella tendon in his right knee.

"The coaches ignore you. Nobody speaks to you."

The not-so-subtle message: Can't play? You're no good to us.

The recent storm over former New England Patriots star Ted Johnson's accusation that three-time Super Bowl-winning coach Bill Belichick pressured him to play with a concussion shows how volatile an issue it can be.

Athletes admit they often play with pain or injury, though concussions are a more dangerous situation. Still Waddell's experience shows how a cocktail of fear -- "I can't lose my job" -- and competitiveness -- "I must play for us to win" -- can create powerful motivation to play hurt.

Competitiveness spurred former UNC linebacker Larry Edwards, now a rookie with the Buffalo Bills, to play against South Florida last season after hurting his collarbone during pregame warm-ups.

Not knowing the bone was fractured, Edwards said at the time, "You would have had to shoot me to keep me from playing."

Coaches, parents, and agents, push, too, said orthopedic surgeon Lyman Smith.

"All together too often," said Smith, who works with the N.C. State men's basketball team and the Carolina Ballet. "All I can do is give the best possible advice and do my job as best as I can."

To play or not to play

Elite athletes take pride in playing hurt. Edwards was supposed to miss the rest of the 2006 season. He missed just three games.

"Those weeks on the sidelines were the worst in my career," said Edwards, who played the final three games of his senior year. "It was not an option for me not to [play]."

Women's basketball player Carrem Gay felt the same way when her Duke team was trying to get back to the Final Four this spring.

Gay played the final month with a brace protecting her separated right shoulder. She doesn't regret it. "I think I saved my best play for the end," she said.

Competitiveness motivated Edwards and Gay. ACC offensive linemen Kalani Heppe, a fifth-year senior at N.C. State, and Drew Hunter, who played at UNC in 2002-03, were motivated by other factors.

"The way I look at it is the more time you're not on the field, the more time you give someone else to take your spot," said Heppe, who has played with shoulder, foot, and toe injuries at State. "It's a self-confidence thing. It's not a thing teammates or coaches do to you. ... It's on you to stay positive."

Hunter initially kept quiet about the "stinger" he suffered against Arizona State in 2003. The pain from the stretching of neck tendons lingered until Hunter began having migraines. Then he couldn't fully turn his head. Next, he felt pain at the base of his skull and in his spine each time he hit someone.

"It wasn't like walking around with a cast on your knee," Hunter said. "That's easy to see. I was walking around and standing on the sidelines in street clothes on Saturdays. Looking at myself in the mirror was the hardest thing."

Hunter said his coaches and teammates never pressured him to play hurt. He praised UNC's sports medicine staff -- 10 people worked on him for nearly a year. He was healthy enough to play in 2004 but chose to stop.

"It came down to, if you want to play with your kids in 10 years, you have to hang it up," said Hunter, now a medical student interested in orthopedics at the University of South Carolina.