Injury is so much more than it seems. Most think of it as physical trauma as the definition states, unless you are the one who is injured.

A local therapist who works with kids on injury and chronic pain reached out to me and we met today for coffee. It reminded me that I need to talk more about the psychology of injuries. I often give presentations on injury to athletes and coaches but the parents are not typically there and play a big role when their young athlete gets injured. Why?

The psychological stages of injury

Why? There’s a lot of psychology that comes with an injury – a lot going through their minds. I work with kids who have been injured in the past, but there is so much that could have been addressed when these kids were recovering from their injury. That is the time when a lot of mind chatter is happening and they may or may not deal with it properly.

Stage 1: The apprehension when a child gets an injury

One of the hardest parts of an injury is getting hurt. One minute your child is fine and the next minute they are injured. The unexpectedness can leave a child feeling many emotions but at the top of the list is scared. Whether this is their first or third injury, getting injured is scary. It pulls a child away from their sport, the coach, and the team. Not only can they not play but generally there is pain associated with an injury, lack of physical activity, physical therapy, sometimes surgery, and then the recovery. Your child can be pulled away from their sport for several weeks to several months and during that time; they will experience many changes in life and in their emotions.

Stage 2: The psychology of being injured and the recovery

Here you will see just part of the psychology behind an injury. Injury is a loss that kids will go through. They will most likely experience most, if not all, of the five phases of grief – denial, anger, bargaining, depression and acceptance.

1. Denial: Life makes no sense – kids are numb and in a state of shock.
2. Anger: Feelings of displeasure overtake their thoughts.
3. Bargaining: They will do anything not to feel the pain of this loss. They remain in the past, trying to negotiate our way out of the hurt.
4. Depression: Empty feelings present themselves, and grief enters our lives on a deeper level. This depressive stage feels as though it will last forever. It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss. We withdraw from life, left in a fog of intense sadness.
5. Acceptance: Accepting the reality of what has happened and recognizing that this new reality is the permanent reality is critical. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it.

These phases don’t last for weeks or months. They are responses to feelings that can last for minutes or hours as we go in and out of one and then the next. This does not happen in a linear fashion. Kids may feel one, then another and back again to the first one. If kids aren’t allowed to go through these stages and don’t get help dealing with them, the outcome usually isn’t positive. Some kids get stuck in anger or depression.

Stage 3: The young athlete returns to their sport after being injured

The first two stages regarding getting injured and moving through an injury are just the beginning of the psychology of injury. Coming back from an injury is the third and sometimes even more difficult stage in this process.

Why?

1. Kids feel pressure to come back too soon. They feel guilt for letting their parents, coaches and team down.
2. Some kids worry that they’ll get injured again. An injury tends to stick with kids (and adults). Kids fear having to deal with the injury and everything that comes along with it again.
3. Kids subconsciously think they will come back at the same level they were prior to the injury. They don’t always realize that while they are injured the entire system changes. The injured kid loses fitness, strength and sports specific skills while everyone else continues to get stronger.

Parents can help

I know parents often feel helpless in these situations and kids rarely want to take your advice. Here are some recommendations for helping your child through this situation:

• Ask your child what they need. They may say nothing, but keep asking.
• Let your child know you are there for support. They’ll need a nonjudgmental person to talk to.
• Discuss with your child the psychological and physical process of their injury. The more they know, the better they will feel.
• Help them come up with questions to ask the doctor.
• Make sure they like and have a good relationship with their doctor. Trust is important.
• Help your child figure out how they can continue to be a part of the team even though they are not playing. Staying connected can be helpful.
• Brainstorm ideas to maintain fitness. Have complementary activities to their physical therapy. This helps them feel like they are doingomething for their return to the sport although sometimes you must monitor this because kids don’t know where the boundaries are.
• Brainstorm ways for your child to spend their time. Isolation is so easy during an injury. They don’t want friends to see them as an injured person.

They don’t want to hear about what they are missing, and they don’t want to feel judged.

Coaching and consultation on all spectrums ensures the best long-term results

In cases where you are not sure whether to seek help, please call or email me about your concerns. I am available to walk you and your child through this process. Awareness is key and making the right decisions can be tough.

The following signs or symptoms indicate the need for a consultation:

1. You might see or hear emotional or behavioral indicators that would suggest that your child is under stress.
2. You might notice a change in thought or behavior that displays rage, anger, anxiety, apathy, hopelessness, loss of interest or pleasure in activities, mood swings, or sadness.
3. Your child may be getting injured more frequently.
4. Your child is not following the physical therapy protocol.

Injury is an obstacle and can be overcome. The physical injury and recovery may seem like it takes forever to go away, but mental injury can last a lot longer and have a bigger impact.

Seeking help does not mean there is anything wrong with your child. It simply means they need help dealing with this situation. We seek a doctor for the physical injury, and with that, we need to also seek help for the psychological injury.