An Injury is More Than Physical
It is estimated that 3 to 17 million adults and children are injured each year in the United States in sport, exercise, and recreational settings. This means that you might be an injured athlete at some point in your career.
Although physical factors are the primary cause of injury, psychological factors also contribute. Recent evidence shows that managing the psychological factors associated with injury and dealing successfully with stress that might contribute to injury, are equally important to rehabilitation and injury prevention. Because of this, it is important to understand the psychological responses to injury and how mental techniques can help facilitate the recovery process.
How injuries happen
As you might already surmise, physical factors such as muscle imbalances, high speed collisions, overtraining and physical fatigue are the primary causes of athletic injury; however, psychological factors also play a role. Two major psychological factors associated with injury are personality traits and stress.
Personality traits are #1 among the psychological factors associated with injury. And although it’s been difficult to successfully identify and measure the specific personality characteristics associated with injury, recent evidence has shown that factors such as lack of optimism, low self-esteem, hardiness and trait anxiety do play a role in injury.
Stress levels have definitely been proven to correlate with injuries. Athletes with higher levels of life stress experience more injuries that those with less stress. It’s important for coaches, family and friends to have good communication with an athlete in order keep up on any major life changes or stressors that athlete might be grappling with. When such changes occur it’s important for athletes to make appropriate changes and carefully monitor what is going on for them and get support from coaches, family and friends.
The recovery cycle
There are three phases of injury and injury recovery that are of importance to understand. The first phase is the injury phase. In this phase the athlete is dealing with the emotional upheaval that accompanies the onset of injury. Phase two, the rehabilitation-recovery phase; a good time to work on sustaining motivation and adhering to rehabilitation. Lastly, phase three, return to full activity phase, is important to understand that although you might be cleared to return to full activity, recovery is not complete until that participant can return to normal functioning which might take time and patience. And although the you might be recovering physically the mental side might take much more time to deal with.
Psychological reactions to injury
To give you a better understanding of how athletes react to and deal with injury and to understand the emotional response to injury, the stages have been compared to the work of Dr. Elizabeth Kubler-Ross on terminal illness. Kubler-Ross suggests that terminally ill patients go through five stages in struggling to cope with their illness: denial, anger, bargaining, depression, and acceptance.
In addition, another study has extended the research on injury to include the cognitions that affect the emotional response to injury. These cognitions were categorized into 4 main themes including internal thoughts, injury and rehabilitation concerns, concern for and comparison to others and looking ahead to the future.
- Internal thoughts included worry, concern, time lost from training, and effects to future plans causing injured participants to feel depressed, down, low self-esteem and increased anxiety.
- Injury and rehabilitation concerns. There was a struggle to remain positive while dealing with the emotional impact of the now physical limitations. For many, there was a period of time spent reflecting on the cause of the injury, the “what ifs” and self doubts.
- Concern for and comparison to others. It’s not uncommon for participants to compare their fitness level and lack of training with others. These thoughts were reported to cause anxiety and tension.
- Looking ahead to the future. Although fear of reinjury was not a predominant theme in this study, the reality of participating again brought with it apprehension and hesitation. As a return to participation drew nearer, some participants experience an emotional roller coaster of emotions.
The psychology of recovery
Recent studies have shown that psychological interventions positively influence an injured participant’s recovery, mood during recovery, confidence, and adherence to treatment protocols. Sustaining and recovering from an injury can be emotionally difficult for an athlete and that’s why it’s important to have a basic understanding of the psychological reactions of injury and rehabilitation and to understand that those reactions derive from the cognitive and emotional responses to injury and also important to have an idea of psychological techniques to assist in facilitating the rehabilitation process. Those techniques include: the injured athlete having good rapport with health care professionals, physical therapists and coaches, the athletes needs education about the injury and recovery process, it’s important for the athlete to learn specific psychological coping skills (goal setting, relaxation techniques, anxiety management and imagery) particularly upon reentering the sport, preparing the athlete to cope with setbacks, fostering social support, and learning as well as encouraging the participant to learn from other injured athletes. Effective emotional management of injury is essential to efficient recovery.
Happy Wednesday!
Dr. Michelle
Photo credit: womenssportsfoundation.org
