Q & A for the Injured Athlete

 

Q: What are some of the psychological hurdles that elite athletes have to overcome in the recovery process?

Some of the psychological hurdles include:

  1. Getting over the disbelief of being injured - many athletes cannot believe that they are injured (or deny the severity of the injury) and have a hard time accepting the issue. 
  2. Loss of sense of self – for so many athletes sport is their life and their self-concept is therefore created through participation. Injury often results in many losing their sense of self. Because the athlete is consumed by their sport (internally and externally), they have a hard time transitioning from sport to other facets of their life. Many times athletes will isolate themselves from their teammates, coaches, friends, and family because they feel like their identity has been stripped.
  3. Replaying the injury over in their minds – many athletes will blame themselves for the injury “I should have been more careful”, and will sometimes act in a hyper-vigilant way to not re-injure themselves. However, the more they think about re-injuring themselves, the more preoccupied they get, leaving fewer cognitive resources available to perform well.
  4. Ignoring the emotional/psychological aspects of the injury – athletes often focus only on the physical elements of the injury and do not reflect on other aspects related to the problem such as anxiety, fear, stress and sadness.  

Q: In what ways does the frame of mind that someone is in during the recovery process affect his or her actual physical recovery? Is thinking positively, for example, an effective technique when recovering from an injury?

A positive frame of mind is often what enables an injured athlete to have a successful outcome during rehabilitation from injury while others may have difficulty returning from an identical injury. Some see the injury as a disaster (negative thinking – e.g. “will I ever get better, I don’t know how to get better”), while others see it as a motivating issue (e.g., Lance Armstrong). Injured athletes with a positive frame of reference are able to take the time away from the sport to work on their mental skills (i.e., goal setting, pre-game preparation, visualization) and will work on some of the technical aspects of their sport that they may not have had time for (e.g., a quarterback being able to study certain plays) before the injury. 



Q: Are there any other specific techniques that athletes can use during the recovery process? 

Some things that can help an injured athlete recover are:

  1. Understanding the injury – what it is, how long does it take to heal, what are the current restrictions of the injury, what type of pain should be felt, what type of pain is felt, who can help me understand the injury better.
  2. Creating a plan in conjunction with the health care team – what will be done each day that will help the athlete return in the proper amount of time. For example, going for physiotherapy/massage on Monday, Wednesday, and Friday, then being at the practice facility on Tuesday, Thursday, and Saturday watching film, learning the sport. Seeing a sport psychology consultant for 1 hour a week, and following up with a sports physician on a regular basis to track progress. 
  3. Goal Setting – setting realistic goals, that are measurable and time oriented (i.e., dated) 
  4.  Having a support system – being able to talk with friends, family, fellow athletes, sport psychology consultant about sport related activities, as well as other activities that make the individual whole (e.g., school, relationships, hobbies etc.). 
  5.  Visualization – see yourself performing the skills mentally in real time while you cannot physically perform. Visualize skills that you were working on before the injury. Once you return to physical action, you have practiced these skills to perfection on many occasions. 
  6.  Stress management techniques – deep breathing, trying to stay relaxed in uncomfortable situations, cognitive restructuring. 
  7.  Celebrate accomplishments – athletes need to give themselves credit for a job well done.   

Q: How do the pressures and obligations that elite athletes face or place on themselves affect the way in which they recover? Do they place more pressure on themselves to recover than recreational athletes do?

Elite athletes have certain obligations/situations that recreational athletes may not have. They often put more time and effort into their sport and many times place more self worth around the sport. The elite athlete may talk about himself or herself as an athlete first, while a recreational athlete may describe himself/herself as a parent, a sibling, or by their occupation. When people have more self worth focused on their sport, the impact of the injury has more relevance. Elite athletes often need to get back as soon as possible because they only know themselves by this perspective.

There are additional pressures on elite athletes because they need to show that they are performing at a certain level or have obtained specific results in order to qualify for specific events (e.g., World Championships, Pan Am Games, Olympics, Championship Games). If they are not able to compete, they may not receive points/reinforcement to get to the desired events.

Elite athletes also have people that they do not want to let down such as their coaches, teammates, sponsors, friends and family.  


Q: In what ways can this impede their recovery?

All of these pressures may impede their recovery because athletes may rush to get back before they are ready. This significantly increases their chances of getting hurt again either with the same injury or an injury to another part of the body because they are compensating. The flip side to this is that the fear of getting hurt again may slow the athlete’s recovery and delay the athlete’s return to sport because of their tentativeness. Athletes are often hesitant in their rehabilitation because they are scared of getting hurt again (e.g., a gymnast might not be able to attempt a certain dismount because he/she hurt herself/himself on that same activity).  


  

If you have any further questions regarding the physical and mental aspects of re-training following injury in athletics, the qualified health professionals at Toronto SEMI would be more than happy to help.

 

 

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Before I needed to seek your care I was a competitive mountain bike racer but was experiencing progressively higher levels of pain in my lower back. When my back finally (and unexpectedly) failed I was unable to walk or stand without great pain your sport medicine doctors diagnosed a herniated disc in my lower back. In hindsight if I knew what to look for I had been missing the early warning signs for almost a year. With your guidance, knowledge and skill I have been able to return to competitive mountain bike racing and am doing so without pain. Your physiotherapy team deserves a lot of credit too. They are a group of skilled and conscientious people that truly enjoy what they do. Such a positive environment only helps the healing process along. Thank you SEMI for allowing me to return to my active life.

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