Sporting Psyche Series 1: Back from Injury

Injuries to athletes are commonplace but that doesn’t necessarily mean that individuals always manage both the experience of being injured, and therefore missing out on their daily diet of doing their ‘job’, and the period following rehabilitation when they are expected to resume their performance level irrespective of how long it may have been since they were injured.

Physical injuries are the norm for most contact sports and with continued advancements in surgical and rehabilitative technology, recoveries form serious fractures and breaks, that decades ago would very well might have been career-ending, are now not so. Yet physical injuries are not only physical and we are now much more aware of how the mind is affected by injuries and that any return to form for an athlete will depend as much on the mental strength as on the physical restoration.

Above all, recovery will come with being patient, realistic and positive. The British Journal of Sports Medicine published an article by Clare Ardern and colleagues which examined the psychological factors associated with return to sport. Ardern et al. (2012) completed a systematic review of the literature on the topic and included 11 studies involving nearly 1000 athletes. They concluded that positive psychological responses are associated with a higher rate of return to sport after injury and should be taken into account by clinicians during rehab. Ardern et al. identified three main areas – autonomy, competence and relatedness which fit within the context of self-determination theory.  In essence, ‘autonomy’ is the self-driven and independent way in which an athlete takes control over his or her recovery.  ‘Competence’ refers to our capacity to practice what we need to do in a systematic way, whilst ‘relatedness’ alludes to the importance of being in communication and contact with others, whether it is those in our athletic field or others in our personal network.

Injuries and time away from our arena may mean that we lose our identity as an athlete and in the case of team sports, being a team member. There will be a vacuum in our sense of self broken legthat needs to be filled up. Other losses include one’s physical health which will take a battering and in many cases, a sense of invincibility given how our success and self-belief will have been interrupted when there may never have been any genuine preparation for this eventuality. Our self esteem is also affected by the lifestyle shift and disappointment, whilst there will often be a sense of isolation and alienation from having to withdraw from our activity which in most cases is both the ‘job’ and the ‘passion’.

There are obvious things that athletes who have been struck down with this misfortune to ease themselves back into their sport.

Keeping Perspective
Of course, we have to wade through the pain and frustration of the injury and its implications in that we may well have to have time away from doing the normal things that are part of our fabric. We may be contending with pain, immobility, but it may be the emotions of frustration, anger and even depression that disable us as much. In essence, we are experiencing a loss and there may well be an unpredictable path that we have to contend with. Yet, as with any disappointment, we can reflect about its significance in relation to other things in our life and prevent ourselves from catastrophising. Firstly, we have every chance of putting this behind us and coming back stronger and this will be a small jolt on our path and pursuit of success and happiness. Second, we may well benefit from thinking about the other areas of our life besides our sport.

Belief that this experience will better you
Though this will be a frustrating interruption, the belief has to remain that you will grow as an individual and athlete from the break, and the rehabilitation and distance will even make you into a better athlete and a more resilient and stronger person.

Given that you won’t be able to do what you normally do, and this is often the greatest source of self esteem, validation, meaning and satisfaction in your life, the challenge will be find other activities that will temporarily fill that void and allow you to remain positive and in good spirits.

Use Mental Imagery
Mental imagery has been shown to be very potent and beneficial and is already used by many well known athletes. Using images repeatedly in one’s head helps connect your mind and body and can even help activate our body in the same way that we would if we were performing the sport itself. We can trick our body into thinking we are performing.

Master Your Goals
Goal setting can improve both productivity and performance. It is important to document clear and precise information about your goals in a positive manner and this can be empowering. This is not a solitary task and can and should be done alongside doctors, therapists, coaches, and family/friends.

Confidence and Comfort
Rehabilitation from injury will be facilitated by finding one’s comfort zone so that you believe in the whole rehabilitation process, the thoughts of you trainer and any other professionals around you, and your own capacity to get through the process.

Overcome Anxiety
As the rehabilitation process continues, you will start to draw attention to resuming your activity again and this is where anxiety may need to be managed. We’ll possibly be confronted with questions such as whether we’ll still be as good as we were, or whether we need to be careful about the possibility of another injury,. There may well be a heightened focus on you as a player who has been injured with such scrutiny as to whether you would be able to flourish again. This may come from fellow/opposition players, coaches, the public and the media. For all of the above, guided imagery will be important to believe and envisage that we can thrive in this phase.

Of course, you have been involved no doubt in sport longer than the time out from the injury. You have to remember that you have the strength, endurance and technique to manage this. Your focus always has been on practice and peformance so this will be no different. If re[eat injuries come along, then of course it will be more challenging but then it is expected you will be more able to ride the disappointment.