Introdution
Chapter 1 - Been There, Done That
Chapter 2 - Injuries: Tips for Prevention, Treatment, Recovery
Chapter 3 - Case Studies: Meet My Friends
Chapter 4 - Use this Information
Correspondence Course Assignments
Online Course Descriptions
"How to Order."
Volleyball/Chris
Marathon/David
Gymnastics/Stefani
Caving/Debora
Football/Boxing - Dan
Aerobics Instructor/Maria
Water-skiing/Gary
Mountain Biking/Julie
Downhill Skiing/Craig
These are the experiences of different people who have had injuries that affected their exercise or sport participation. Each situation and individual is unique. They each found their own way to deal with their injuries.
"I was active in college volleyball when I was in an auto accident. Hyperextension with dynamic overload of my right wrist caused a broken scaphoid bone. "The original diagnosis with the initial x-rays was a second degree sprain. However six months later, there was still pain with pressure when I extended my wrist. The second diagnosis was a classic hidden break of the carpal bone. This break required surgery. After nine weeks in a cast, I began range of motion exercises. Later I added active-resistive movements with rubber tubing and handweights. The rehabilitation was intense twice a day. To be able to practice volleyball activities, I used a brace and resisting tape and iced the injury. The total recovery time was 8 months. "My reactions to the accident and my wrist injury were frustration and disappointment. I had to miss that volleyball and softball season. After I accepted my situation, I became determined to get back to competition as fast as possible. My main fear was any missed or further damage to my repaired wrist. In this case a second surgery would fuse the wrist and limit my range of motion to zero degrees. "During recovery I used goal setting to complete my rehabilitation. That and the personal drive and determination to resume the activity I love so much helped me recover. If I had known more about it, positive visual imagery could have aided me."
"I suffered a non-displaced fractured ankle while running downhill during training. I completed a 6 month recovery period before I resumed regular training. I started with swimming (using a pull-buoy) and progressed to kicking while wearing an ankle brace. Another activity I used was riding my bike in an easy spin only, using the ankle brace for lateral support. I spent a lot of time stretching to recover my mobility.
"I started running in small increments, 5 minutes twice a week, then 10 minutes, and so on, progressing in my time every week. Before I began running on pavement I did pool running to get my flexibility back and to keep myself conditioned. When I did go back to running on pavement, I only ran on flat roads with my ankle taped. I also used self massage, icepacks and tiger balm to help recovery. I feel that regular massage from a sports massage therapist could have helped me, too.
"When I hurt my ankle, my first reaction was "it will be OK tomorrow, it's only a sprain." I found it mentally hard to adjust from being fit to being unable to get around except on crutches. I felt a lot of frustration and stress from not being able to train and just do normal everyday things. During recovery I took it one day at a time with no definite time frame for my goals. I just knew where I wanted to get to eventually. The hard part was realizing I was not going to be able to race that year.
"I had a big fear of re-injury and of having to start over. When I began re-training I mentally focused on my running form and foot placement. I had to make myself relax as I would tense in anticipation of pain."
"I was a high school gymnast who was looking forward to a college career in the sport. One day during practice, I was doing a handstand on the highbar, then I turned on my hand. I swung down, let go of the bar and landed on the mat below me like I had done a hundred times before. This time my ankle turned and popped and a lot of pain suddenly occurred. I thought I might have broken it because of the pop. I put my foot in a bucket of ice quickly, but it continued to swell and bruise severely.
"There was no official diagnosis but with the pain and how it looked I must have torn a ligament. I took about 3 days off, kept ice on it, and kept it wrapped. When I was able to walk on it I went back to practice.
"I slowly increased my activity over about 2 weeks. I felt it was important to go back to work as quickly as possible because that summer I was planning to go to college and try out for the University of Alabama gymnastic team (the #1 team in the US at that time) I took ibuprofen and taped up my ankle really tight hoping to immobilize it to decrease the incredible pain. Unfortunately, it didn't help and I probably continued to injure it more. As an 18 year old, I was not careful in caring for myself because I had this goal to reach. Total time of recovery until there was no more pain was about 2 months.
"I was devastated because I was working so hard to learn new tricks to impress the coaches of the college team. I tried to overcome the pain by mentally psyching myself up but my determination must not have been strong enough since the pain always won when I was practicing my skills. I felt the coach was tired of me complaining about the pain. I had trouble tumbling, running, or applying any great pressure on my ankle, as when landing a trick. So I did not feel like a good gymnast or a strong enough person to overcome the pain.
"I was fearful of not making the college team especially since I couldn't resume my sport as quickly as I desired. A lot of athletes can put aside pain to get the job done. I tried but it didn't work for me. At 18 my self-confidence and esteem was low so it was difficult to be as strong as I thought I should be. I didn't know how others saw me but that is how I saw myself. No real techniques were used except I knew I couldn't quit otherwise I saw myself as a loser.
"I now believe that if I hadn't been so impatient to get back so quickly, and had allowed myself to recover I would possibly have had the opportunity to fulfill my dreams. I became a coach for children which still kept me involved in gymnastics, the sport that I loved."
"The injury I received was a broken ankle bone when I fell in a cave. I was climbing an unprotected wall in Onyx Cave in the Santa Rita Mountains. The climb cannot be belayed since it requires horizontal movement against a speleothem covered wall where cavers carefully flatten against the wall and deliberately secure hand, finger, and foot holds to transverse a pit. The handhold I was using broke, and I was unable to catch or stop my fall. I slid and fell approximately 12 feet landing on my right foot The impact twisted my ankle and broke the bone.
"At first I ignored the pain and attempted to continue with usual activities like hiking, aerobics, and caving. My ankle swelled and turned an ugly shade of greenish-gray purple, so I had it checked three days after the injury. I was told to ice it and keep off it. I did no physical activity that required bouncing, jumping, etc. I basically had to stay off the foot. I had no bone setting or surgery since the break in the bone was tiny and inaccessible.
"Gradually I started my own exercise program of walking, rotating my ankle, and swimming. I took it easy for a few months. Nothing happened to increase or cause pain, so I increased the intensity slowly.
"I became stressed at not being able to exert myself physically. I had (and still do) relied heavily on working out to alleviate stress, keep in shape, and reach a "plane of balance." I'm sure my temper suffered spurts of crossness. I balked at forced inactivity, fretting about weight gain and loss of conditioning. I anticipated recovery.
"I began caving fairly quickly. Mentally, I struggled with the fact that this accident was unavoidable. Somebody, some time would have tried that handhold and fallen. I was a bit "miffed" that I had taken a fall; I was always careful and had never had an accident.
"I dreaded the return to the place where I'd fallen, and felt stomach flurries when I faced the climb. I forced myself to remain calm and deliberately paused over the pit in the general area where I'd plunged to the slick cave floor below. The next time was easier. Now, I have no problem with that tricky spot.
"During my recovery I would picture myself caving in undiscovered or unvisited caves. I planned upcoming trips and projects. I wrote several short stories. Basically, I charged up my mental exercises while my physical exercise was on hold!"
"I injured my right shoulder/rotator cuff. The initial injury was caused by throwing continuous punches (straight rights) in boxing. Then the injury was aggravated by sustaining numerous hits (tackles) playing football, and continuing to box at the same time.
"My physical recovery included stretching exercises, ultrasound, and lengthy icing of the shoulder joint. Physical therapy concentrated on strengthening the four rotator cuff muscles. The initial injury was suffered in the spring boxing season of 1989. I participated in physical therapy and rehab during that spring, then reinjured my shoulder during football season in the fall of 1989. It was then a nagging, somewhat chronic injury throughout football season and the boxing season of winter/spring 1990. I didn't have the time to let it completely heal, so my physical therapy was concurrent to my continued training.
"Other than the time in the spring and summer of 1989, I never really stopped using my shoulder. I did decrease the amount of shoulder abduction and medial rotation. I hoped and thought my physical therapy strength training of the rotator cuff muscles would prevent re-injury during the next season. As far as boxing was concerned, the injury caused me to improve my left jab and left hook as I was a little tentative to overuse my right, in fear of re-injuring the shoulder. During football, I played split-end (wide receiver). It was extremely painful to lift my arms. Shoulder flexion, external rotation, and shoulder abduction could not be performed without pain.
"Initially, I denied my injury. I figured that with a little ice and a little rest, it would be okay, and I could continue to perform training. I had a mental method of distinguishing between being hurt (feeling pain) and being injured (unable to perform). The mentality of "I can tough this out" prevailed. As for boxing, I knew I could compensate for the pain I'd feel in my right, by using my left more ... I could still throw my right, albeit with pain, but I didn't feel I needed to stop. In football, as long as a pass wasn't thrown over my head, I could catch without pain, and for balls thrown over my head, the pain was quick. Again ice and heat was enough to keep me going. After all, it was my senior season. I wasn't going to allow injury or pain to prevent me from competing.
"At times, I felt sharper pains in my shoulder than at others. I did fear, that at any given time, one of the sharp pains was going to be "it"; that I would be unable to continue. But my doctor did explain the injury to me, and pretty much assured me that the injury was inflammation of the muscles surrounding the glenohumeral joint, and that there was not a muscle or ligament tear involved. He told me that the only way for it to get better was to rest, and to strengthen the rotator cuff muscles, but there wasn't any real danger of making the injury worse.
"I used mental visualization and some meditation to relax the muscles in my shoulder. I would visualize throwing shorter, quicker punches with my right to minimize the rotation of the joint."
"I had a serious knee injury a few years ago. I injured my knee teaching aerobics, at least I think that's where it happened. I never experienced one major trauma to it, it just began hurting after I would teach. The only activity I had been doing around the time of the injury was aerobics.
"Most people were sympathetic to my injury especially since it was work related. At the time I was an aerobics coordinator with over 50 classes per week to cover and I was sometimes teaching 3x per day because I was short staffed. My company did little to help me cover the classes. It was like they expected me to be super woman.
"I had a detached meniscus, a hairline fracture on my tibia and a tendon tear. The surgery and rehab were tough! I was very depressed after the surgery because I was so used to being so active. The rehab was very painful and at times discouraging. I dreaded the range of motion exercises. I did cry sometimes since it hurt so bad. The physical therapist and athletic trainer I worked with really helped me. I could not have done it without their support and help.
"Four months after surgery I was back to doing aerobics and teaching just a little. Now three years later I am back to normal! It feels great, no pain!"
"I injured the middle hamstring muscle of my left leg. It separated midway between the attachment points at the upper and lower ends of the thigh bone. Where before there were three muscles constituting the full hamstring group, there are now only two.
"The cause of the injury, indirectly, was a failure to warm up and to stretch out prior to entering the water for skiing. The direct cause was a 54 year old man letting two thirtysomething women talk him into a stupid situation, specifically, a one ski, deep water take off, with no warm up. The loud "ping" that I heard underwater, was the muscle letting go. The injury was exacerbated by slipping in the shower a month after the initial injury, and ripping the hamstring again. That really totaled it out.
"My initial therapy was sitting on a gallon container of ice for 4 hours while driving back from Lake Roosevelt. That was followed by alternating ice and heat on the leg for two days. I remained off of it for a total of four days, except for eating and going into the bathroom. 800 mg of Motrin was prescribed three times a day for 30 days to reduce the inflammation and bruising. A bruise, displaying all the colors of a Van Gogh paint palette ran from the top of my leg to my ankle. It remained for about 6 months in some form or other.
"Rehabilitation started the second week, and consisted of me trying to walk again. Slow stretching was also tried, but was it not acceptable, pain wise. Icing continued to reduce the bruising for about two months. I saw four separate doctors in the period of a year, and they all said that the injury had to heal itself, and for me not to stress it. Recovery time was predicted to be anywhere from a year to three years. At the time of this writing, it has been a year and a half, and I now am able to run around the block. That, from a pre-injury daily regimen of three 7-minute miles.
"My continuing rehab consists of hamstring curls, various quadricep exercises, leg presses, rowing machine work at maximum levels, Nordic track work, also at near maximum difficulty, and the recently added running. I also run sideways on the treadmill to develop lateral flexibility and sideways leg strength for snow skiing. The treadmill is set at it's maximum elevation and I run at 2.5 mph.
"I also had a series of deep muscle massages on the hamstring to break up the scar tissue and to enhance blood flow through the bruised areas. Although not a pain-free experience, it appeared to help the injury. Based on the recommendation of the massage therapist, I converted my mountain bike to clip-on peddles, which allows me to pull my legs through the bottom and top of the pedal stroke and also to lift up on the pedals. This gives exercise to not only the quads, but the hamstrings on each pedal stroke.
"However, it should be noted, that to date, my left hamstring is able to lift only 10% of what my right leg is capable of. I can lift 250 lbs with my quads, but only 5 lbs with my left hamstring.
"I have made no effort to resume water-skiing, as the doctors have all said that any further injury to the left hamstring will result in a surgical moving of ligaments and muscles to that leg from elsewhere in my body. That prognosis has killed all desire to resume water-skiing. If I ever do start again, I will either do a single ski shore start, or a two ski, deep water start.
"I was told not to run for a year. As I now run, I have to talk to my leg and basically tell it what to do. In essence, I am teaching my left leg to run all over again.
"My winter job is full time snow ski instructing. I had six months to recover prior to the 95-96 season. Because alpine skiing is mainly an exercise in quadriceps usage, the weak hamstring was not too much of a liability. However, I was not able to teach bump skiing until the end of the season, due to the possibility of catching the tips of my skis and hyperextending my left leg.
"I spend approximately an hour and a half in the gym each weekday, working on upper body and leg strength. In all exercises, the thought of re-injury is in my mind.
"Mentally, the injury has been traumatic. This is the worst injury I have ever had, and has made me aware that I am not immortal. On the other hand, I see people who cannot walk, and I realize that my injury is, in the whole scheme of things, minor. But not to me. Because of the protracted recovery time, I am always aware of the possibility of re-injury and have, as a result, slowed down in most activities. I am nervous when in a situation where my footing is unsure as I DO NOT want to hyperextend my leg again.
"On the positive side of the issue, I think I am now less prone to any other different types of injury that I might have incurred had I continued in the attitude of "it can't happen to me."
"The fears that I had to overcome in sports activities have included a sense of vulnerability, a realization of growing older, and an acceptance of slower performance. In the summer I conduct sailing charters, and I am always aware of slick decks, scrambling around ladders and lines, and the potential for injury when jumping from boat to dock. I now gauge my capabilities rather accurately, instead of over-optimistically.
"As I said before, I am not sure that I will ever water ski again, as the potential for injury in my leading leg is much higher than my thrill in water skiing. In short, t'ain't worth it!
"Mental techniques I used in recovery were essentially those of realistic appraisals of the skills required to do my activities, and acceptance of the loss of those that are now beyond my abilities. Again, as mentioned before, I am constantly talking to myself as I run, and also whenever I am doing something that approaches my limits of ability. I find that I must also overcome the fear in my head whenever I get into a potential injury situation. For example, when I stand at the top of a difficult bump run on my skis, I have to mentally work through the body mechanics required to accomplish the run. I have used the technique of repeating a personal "mantra" designed to get me through whatever difficulty I am currently facing. When running, I will repeat "flow", or "relax" and when skiing, I often use "attack", "edge", "flex", or "extend" as required.
"Tai Chi had been suggested as a help, but I never used it formally. I have learned to slowly stretch and loosen my muscles, something I did not do before. I think the greatest help from a mental technique would have been before the injury. And that is simply to recognize what is common sense, and to apply what you know about your own realistic capabilities."
"In March, 1995, while I was a graduate student at Arizona State University, I was struck by a pickup truck while riding my mountain bike, and my right femur was broken. I had surgery the same day. A metal rod was drilled into my leg from my hip to my knee to keep the bone together. I spent a week in the hospital.
"What surprised me most about the ordeal was my doctor's attitude - "get back on your feet as soon as possible" and "do as much as you can as long as it doesn't hurt" In fact, 48 hours after surgery, physical therapists had me out of bed and using a walker to get around. There was never a cast on my leg. The doctor sent me home with a list of simple stretching and lifting exercises to do immediately, as soon as I could stand it.
"Four weeks after the accident, when the swelling began to subside, I started seeing a physical therapist. I went two or three days a week for two months. Initially, I was shocked by how quickly the muscles in my right leg had atrophied. The physical therapist told me that it was fortunate that my bicycling routine had gotten my quadriceps in pretty good shape before the accident, or recovery would have been even more difficult.
"My physical therapy routine consisted of about 10 minutes of light exercise biking (my leg didn't bend too well), leg lifts using ankle weights for both legs, including quadriceps, hamstrings, and side to side motions, sonograms, "shock" treatments that made my muscles twitch, and always a 15-minute ice pack and rest at the end. I came to enjoy the physical therapy sessions. Each time I felt less fragile and more like my old self.
"I was on crutches for about 4 months total, so my arms were in great shape. However, just because I was off crutches didn't mean my recovery was over. I still had a long way to go to regain my strength. Lingering pain and inflammation in my right hip often kept me awake at night and limited the number of activities I could do. I often walked with a limp and sometimes my hip felt so stiff I could barely move.
"From July on, I gradually increased the variety of activities I tried: pool exercises and swimming, floor exercises, riding a stationary bike, and eventually walking and weight lifting. I was strong enough do dance at my own wedding in October and go snorkeling on my honeymoon. In January, 10 months after my accident, I even went skiing (but I stuck to the bunny slope instead of my usual route).
"During the whole ordeal, my biggest obstacle was the mental scars which coincide with a traumatic injury like this. At the time of my accident, I was not wearing a helmet. For months, I punished myself by reliving the accident thinking how much worse my injuries could have been. I also had to deal with anger, frustration, and fear associated with my physical limitations - not being able to tie my shoes, shop for groceries, drive a car, etc. I really began to empathize with elderly people and their fear of falling; stairways and slick bath tubs were now my enemy, too.
"My vanity also took a hit. The surgery left me with a 10 inch scar on the outside of my right thigh and a 4-inch scar on my right hip. But, with the unwavering support of my husband and family, I eventually learned to be proud of my "battle scars".
"What helped me most was being able to talk about the accident to my husband, my family, my friends, my coworkers, and just about anyone who would listen. I think in my focus on working hard, getting better, and moving on, I often neglected to realize what a scary, difficult ordeal I'd been through.
"March 7, 1996, marked the one year anniversary of my accident. I was still somewhat bothered by recurring flashbacks and nightmares about the roaring engine of the truck just before it struck me. I was also depressed about the weight that I had put on, partly because of the fancy meals and desserts I prepared to impress my new husband, and partly because of the sedentary lifestyle I felt I was being forced to endure.
"That spring I decided to quit feeling sorry for myself and do something. I wanted to try to run again. My first attempt at jogging after the accident was very awkward and a little painful. My right leg felt like jello, as if there was no coordination between my thigh and calf muscles. With my husband's company, I started by running a few yards at a time and walking. Eventually, I began to jog several blocks at a time.
"In June 1996 I underwent a second surgery to remove the metal rod from my leg. After a week or two of soreness, the change was incredible. My leg was finally healed. I had a full range of motion and I felt like a new woman. I could run, hike, climb stairs, cross my legs, sit on the floor; all without pain.
"On a positive note, since my accident, I have developed a healthier attitude towards exercise. Before, it felt like competition, either competing in sports or competing with my sorority sisters to burn calories, lose weight and be a perfect size six. Now, exercise has nothing to do with anyone else; not pleasing my husband or competing with anyone else. Exercise is about me feeling healthy, stronger, more capable and whole again. Since my accident, I have learned to be kinder to my body. I do any sort of movement that feels good, whether it's a strenuous five-mile run, a cool swim, or a few minutes of stretching and calisthenics. I no longer make myself exercise, I want to do it. It's a joy just to be able to move my body without pain, and without the nervousness and guilt I used to associate with exercising.
"Now, 19 months after my accident, I've gotten back into shape, and I'm as active as I ever was. My mountain bike was totaled in the accident, and I still don't know if I really want another one. I've ridden my husband's bike a couple of times. Both times I was very nervous and constantly looking over my shoulder. I realize I still have a way to go until I feel confident enough to ride on the street again, but as with other hurdles, I know with a little patience, I can conquer this one, too."
Craig is a triathlete who has a business as a massage therapist. His athletic background has been both meaningful and exciting, and interrupted by injuries. Having postgraduate courses in Exercise Physiology he is in a good position to both discuss his past injuries and give some insight into coping and healing from injury.
The major injuries Craig incurred was not as a triathlete but as a skier. Skiing, especially downhill racing, is a dynamic, powerful sport that requires strength, anticipation of what will happen next, and a degree of abandon with speeds of 30 mph or more. While on a run in 1982, Craig misjudged a turn. The surface texture of the downslope was hard, and the upslope appeared identical, however it wasn't. Instead of the anticipated hard surface his skis hit soft snow. Skis do not turn as readily in soft snow at high speeds. Craig was deflected off course and hit a large pole that was anchored in the ground. He saw something dark and reflexively put his elbow up in front of his face, saving his life but shattering his elbow into 17 pieces. His shoulder was also broken and dislocated.
This accident proved the contrast of being human and the vulnerability we are subject to. While we are very resilient on one hand and can begin thinking that nothing injurious could happen to us (the individual) on the other hand we are fragile and can get hurt without warning. This was both sobering and humbling.
He was told that he would recover only ten degrees of movement in his elbow. This was a prospect he refused to deal with so Craig decided to approach rehabilitation with the same vigor he approached sport training. He forced flexion and extension until near full range of motion was achieved. It sounds easy on print but doing those solitary levered joint movements left him sweating from pain. The strength of his will to return his arm to working condition is not possessed by everyone.
A few years later and back to skiing, Craig's right knee was also severely injured. His quadriceps were extraordinarily strong for the muscle balance with the hamstrings and the anterior cruciate ligament in the knee. Racing downhill he put some tail pressure on his skiis and slightly sat back. He tried to pull himself up and snapped the anterior cruciate ligament. To repair it the surgeon took tendons from the semitendinosis (one of the hamstring muscles) and transplanted them to augment the anterior cruciate ligament. As a result he doesn't have the capacity to use his hamstrings as in preinjury. Craig understands the importance of muscle balance in rehabilitation and sports training, but in reality it is impossible for muscles to totally compensate for one that is fully or partly missing. Bicycling proved to be a good exercise during rehabilitation.
While Craig has regained use of his body in a very active way, he does not consider himself 100% recovered. He will always be in rehab. A shoulder injury is still present. He was given the options of either more surgery in which a piece of bone from his hip would be used to repair the shoulder, or he could swim regularly to use the shoulder and keep it mobile. He decided to swim.
As a result of his injuries and the exercises he chose for rehabilitation, the opportunity to compete in triathalons seemed a logical step. He had been a runner since he was 18, using it as conditioning for skiing. He was using a cycle and swimming for injury recovery. Put the three exercises together and it adds up to triathalons. Craig has competed in triathalons for eleven years now and places consistently high. His victories include ten times All American. He was fifth in the world in Olympic or International distance (1.5k swim, 40k cycling, 10k run) In 1996, Craig was the reigning National Champion in sprint triathalon distance in his age group.
There have been several other injuries to his knee. An initial serious injury to the knee makes it very unstable. Because of the lax joint it is easy to have chips of the meniscus, which is fibrocartilage which cushions the knee joint. One day while Craig was running he was distracted and lost focus on his foot placement. The resulting injury required more surgery, bringing the total knee surgeries to four. He is now very careful while running, as he want to continue as long as possible.
When Craig became injured initially one of the most effective therapies he used was massage. He was so convinced about the benefits massage offers that he became a massage therapist. Some of the ways massage promotes healing is by increasing the blood flow, removing toxins from the muscles, and lengthening the muscles. Massage is one of the few ways to lengthen muscle units without necessitating range of motion movement. There is also a mind/body connection when massage is performed. Sometimes a person is not fully aware of how his or her muscles work or what they feel like. The touching or massaging of a muscle takes your mind to that muscle, allowing you to focus on it and visualize how it works. When a person works with a massage therapist who has an extensive knowledge about body mechanics and how the muscles work, this neuromuscular connection is likely to happen and the mind will assist the body more fully in the healing process.
Craig feels that the mind/body connection is one of the most important aspects of healing from an injury. The body knows how to heal itself but humans tend to try to push the process in the impatience for it to heal quickly. Using therapies such as massage is a process that shows the best results over a period of time. Many injuries take months to heal. Many modes of rehabilitation include varying levels of discomfort. In general, therapy for injuries can be uncomfortable and not all persons are willing to tolerate the discomfort. For the active person who is determined to achieve full recovery, the power of the mind can go a long way. Using techniques such as visualization will help that person see the end results of healing. By visualizing imagery of positive results, the mind is drawn away from the discomfort, enabling it to be a positive thing because of the outcome that will be realized. Visualizing the healing process is a complement to any therapy that is being used.
Looking forward to many active years, Craig plans to continue competing in triathalons and helping others recover from their injuries.
Introdution
Chapter 1 - Been There, Done That
Chapter 2 - Injuries: Tips for Prevention, Treatment, Recovery
Chapter 3 - Case Studies: Meet My Friends
Chapter 4 - Use this Information
Correspondence Course Assignments
Online Course Descriptions
"How to Order."