SPORTING CHANCES AS MORE STUDENTS PLAY, INJURIES TAKE A GREATER TOLL.

During Thanksgiving break her freshman year, Cleveland High School point guard Megan Okui went up for a shot. When she came down, her season was over.

``My left leg landed funny. It just felt dead, like a huge weight was being put on the inside of my knee,'' Megan, 17 and now a junior, said of the accident that happened two years ago. ``It felt like it had been stretched way beyond what it should be.

``Around January, I tried playing again, but I could feel that something was wrong with my knee. Every time I would try to cut or do something other than running straight, it would just give out.''

Megan had torn her anterior cruciate ligament, the ligament in the center of the joints that connects the thigh and shin bones. The injury would require surgery with standard rehabilitation and recovery time placed at six months.

The injury is not unique. The American Academy of Orthopedic Surgeons estimates that 100,000 ACLs are ruptured and repaired each year with the majority sustained by athletes between the ages of 15 and 25.

'Is my ACL torn?'

``The injuries are so common, that most of these kids already know what an ACL is. A teammate or some kid down the street had it,'' says Dr. Peter Laimins, chief of orthopedics at Kaiser Permanente in Panorama City and the surgeon who repaired Megan's knee. ``I have 12- and 13-year-olds saying, 'I'm worried about my ACL. Is my ACL torn?' and their main concern is not injury and surgery, but the sadness of missing a season.''

The loss of playing privileges can mean a student no longer has comfortable access to his or her peer group. If I'm not a basketball player, who am I?

``Girls tend to be more of a group, hanging out together,'' says Laimins. ``When they have an injury, they're more removed from this group. Guys are more competitive. They're thinking about college. This is their time to shine.''

Knees and shoulders are the most frequently injured body parts, although as any jock will tell you, when competition heats up, if you use it, you can sprain, strain, tweak, pull, break, fracture or otherwise ``ouch!'' it.

The AAOS reports that more than 1.4 million children under age 15 are treated in doctors' offices each year for injuries related to football, baseball, soccer and basketball. Sports injuries send more than 775,000 children under 14 to emergency rooms, according to data collected by Lucile Packard Children's Hospital at Stanford University Medical Center. Athletes between ages 5 and 24 account for 20 percent of all ER visits, 2.6 million total.

It's not necessarily that kids are getting injured more frequently, say sports medicine doctors, but between the evolution of sports and substantial increases in participation, there are more young athletes to get injured. The 1990s have seen significant increases in activities such as in-line skating, roller hockey, snowboarding and off-road mountain biking - all sports with a fairly high injury potential.

Soccer, the only team sport to see an increase in total participation in the 1990s, has seen a substantial increase in the numbers of female players, according to Dr. Lyle Micheli, author of ``The Sports Medicine Bible for Young Athletes.'' In 1999 alone, the number of female soccer players increased from 5.7 million to 7.3 million. And female soccer players are more likely to sustain certain injuries - including ACL tears - than boys.

But while a certain amount of injury risk is built into sports - especially contact sports like football, hockey and basketball - researchers are tracking injury trends and, whenever possible, focusing on prevention. The AAOS is currently conducting a survey on sports injuries, as is UCLA's School of Public Health. At the AAOS' annual meeting earlier this year, the director of the Institute of Preventive Medicine in Ann Arbor, Mich., declared that the vast majority of children's sports injuries were preventable.

Sports injury doctors say prevention means education - of children, their parents and their coaches. Careful stretching and wearing properly fitting equipment need to be part of the regimen, but athletic trainers also emphasize that attitudes need fine-tuning as well. Young athletes need to realize that their bodies are not indestructible, while their coaches and family members must understand that life goes on when the game stops.

``With these 'elite kids,' I think we're going to have to reassess our volume of training,'' says Micheli, the director of sports medicine at Boston's Children's Hospital. ``Coaches have the simplistic approach that more is better, and there's no evidence to support that.''

By way of an example, Micheli cites a figure skater he treated who starts her day at 4 a.m. to train, goes from school directly to the rink and doesn't start her homework until after midnight, barely getting enough sleep.

Or there's the parent, pushing his kid to elite athlete status, who informs the doctor examining the injured child ``my daughter is going to be an Olympic swimmer.''

The agony of defeat

Like overworked adults, young athletes can burn out physically and psychologically. Physical fatigue can easily lead to injury, say doctors.

``I had a very promising figure skater who got to the point where it was just too much,'' says Micheli. ``There were all these recurrent little injuries, painful knees, back and hips. She opted to go out for women's ice hockey to train for 10 hours a week rather than 28.''

Young athletes who believe that sports may be a ticket to a college scholarship or an eventual professional paycheck are the ones who sometimes need counseling as well as rehabilitation. It can be comforting to know that the majority of sports injuries can be successfully rehabilitated, allowing the player to get back to the game.

But try telling that to the player at the time of his or her diagnosis. Serious athletes, doctors say, only hear the bad news: ``You're out of action.''

``It was horrible, one of the worst feelings anyone could ever get, I think,'' said Tim Gregory, a senior at Hart High School in Newhall who tore both his ACL and the meniscus (cartilage) during the second football game of his junior year.

And he's not referring to the pain.

``I was ready for a big season and they told me I couldn't play, that I'd be lucky to play next year,'' he added. ``It was just devastating. I was in shock for a while. I didn't know what to think''

A talented running back with scholarship prospects, Tim attacked his rehabilitation knowing that college scouts would be looking to see how well he rebounded from his injury. Following a second surgery that kept him out for four weeks, Tim reports that he is back and anxious to start the season. He wears a metal brace that restricts his movement and guards against the knee buckling should he get hit.

``It's kind of a pain wearing it,'' he said. ``I have to adjust it after every play and wear a sleeve over it. But whatever. At least I'm out there playing.''

Trainers needed

On a scorching Monday afternoon about a week before the beginning of classes, the varsity football team at Chatsworth High School goes through drills, refueling for water breaks whenever necessary.

Sitting in the bleachers taking in the proceedings is Mike Nash, a certified athletic trainer to all of the school's approximately 150 student athletes (including cheerleaders) thanks to an outreach program co-sponsored by California State University, Northridge, and West Hills Hospital.

Nash - and his counterparts at Taft, Oak Park and Calabasas - are in charge of injury prevention, management and rehabilitation. He's there to tape and wrap before games, supervise weight room exercises, work directly with athletes who may have a history of, say, ankle or knee trouble, and evaluate any injury that takes place during a game.

The sooner an injury is examined by a qualified trainer or doctor, the faster healing and rehabilitation can begin, says Joe Muhe, a certified athletic trainer who coordinates the West Hills program. ``When an athlete does come back, they're going to be stronger than they were before the injury,'' said Muhe. ``Typically, it's not the first injury that really destroys an athlete. It's usually the second, for instance the kid who sprains an ankle, mildly, and never gets any attention.''

West Hills puts up a $12,000 stipend per high school and the trainers are concurrently working on graduate degrees that will eventually place them in the classroom as well as on the field. Nash, a CSUN student, is interested in biomechanics or possibly exercise physiology.

Having a certified athletic trainer full time, for all sports, is a luxury not enough high schools enjoy, said Muhe. During the second year of Muhe's employment at West Hills, a study was conducted to determine how often high schools used certified athletic trainers.

``We found out that at public high schools within the Los Angeles area, there were none,'' said Muhe. ``Some of our physicians were providing sports medicine at Calabasas High School. They came to the hospital administration and said 'We're covering games on Fridays, but these kids practice and play every day, and more than 60 percent of injuries happen during practice.''

``We'd like to see schools step up and say, just like now we have a teacher who is a football coach, now we have a teacher who is also an ATC on campus to provide sports medicine coverage. We feel it's important.''

Common sports injuries

Contact sports come with the greatest risk of injury. We asked certified athletic trainers Joe Muhe and Mike Nash about some of the most common injuries in individual sports. Muhe coordinates West Hills Hospital's outreach program that provides athletic trainers for injury prevention and management at four Valley high schools. Nash is the certified athletic trainer (ACT) at Chatsworth High School.

Football: Ankle and knee sprains, mild head injuries, dislocated shoulders, wrist sprains, hand and thumb fractures. ``You can pretty much hurt anything in football,'' said Muhe.

Basketball and volleyball: Ankle and knee sprains, overused-shoulder injuries.

Tennis and swimming: Overused-shoulder injuries.

Soccer: Lower-extremity strains and sprains including ankles and knees, concussions. ``Or, if you're playing at the World Cup level, the occasional skull fracture,'' said Muhe.

Baseball: Shoulder and elbow injuries.

CAPTION(S):

4 photos, box

Photo:

(1 -- cover -- color) Tim Gregory, a senior at Hart High School in Newhall who severely injured his knee and has had two surgeries to repair it, puts on a knee brace as he prepares for football practice.

(2) Trainer Mike Nash, right, tapes up Chatsworth High School football player Alonzo Contreras. Nash assists the school's 150 student athletes through a program co-sponsored by California State University, Northridge, and West Hills Hospital.

(3) Football and soccer players often suffer ankle injuries.

(4) Mike Nash, right, adjusts a knee brace on Neal Spearman of Chatsworth High School; damage to knees and shoulders are the most frequently reported sports injuries.

Tom Mendoza/Staff Photographer

Box: Common sports injuries (see text)