The Hidden Crux of Sports Injuries: Emotional Impact and Recovery
By Anna Enright, DNP, PCNS-BC
Being sidelined by a sports injury can be devastating for the athlete. Recovery can be a physically and emotionally rigorous experience. Physically, injuries are diagnosed and treated by a medical team. Although complicated for some, this aspect of treating an injury is clear. The problem is diagnosed, and a treatment plan is mapped out. For a full recovery to occur however, the athlete, coach, and parent must consider the emotional impact. Most athletes get plenty of help with understanding the physical roadmap to recovery but are left ill-equipped when it comes to the emotional and psychological recovery process.
The psychological impact of a sport injury:
There is a psychological impact which occurs with sports injuries. This secondary trauma, if unattended, may end up interfering with the athlete’s performance as they return to their sport. More concerning, it can lead to a mental health impact compromising the athlete’s wellbeing on and off the field.
If we are going to be helpful to an athlete’s psychological process of recovery, we need to understand how an injury can play out in this realm. Athletes spend hours training every week, making sport central to their experience. When an injury occurs, it triggers a loss on multiple levels:
• Loss of social connections (being away from friends)
• Loss of a sense of identity (If I’m not an athlete, who am I?)
• Loss of a healthy coping mechanism
• Loss of confidence (Being away from training and loss of skill)
• Loss of structure and routine (not being able to participate in practices and competitions)
Increasing awareness of the psychological impact of injury and reviewing the possible ways this can show up, will normalize the experience. This helps athletes not feel alone in the recovery process and empowers the athlete to map out a supportive plan to work through the emotional aspects of recovery.
If you are recovering from an injury, consider the following:
• It’s normal to feel sad, angry, frustrated, worried, disconnected, afraid or a host of other feelings. Acknowledging feelings and seeing them for what they are, will put you in the driver seat in forging a plan to take care of yourself emotionally. Practice self-compassion! This means treating yourself as you would a friend who was in the same situation. Switch to kinder self talk. Remember you are not alone and many athletes have returned to their sport after an injury.
• Stay focused in the present moment. Our brain is wired for survival and will generate worried thoughts like, “What if I don’t improve? What if I lose all my skills? The season is over! I worked hard for nothing!” Be aware of the “what ifs”. When you catch yourself in the “what if” mode, shift your focus on what you know for sure…”my doctor said it will take 4-6 weeks or 4-6months to a full recovery…I will fully recover and can again work on building up strength….today my plan is to take care of myself, eat right, stay optimistic about my recovery as best I can….”
• Stay connected with your teammates and coaches. There are often training exercises you can do! Ask your coach if they can provide you with a modified training plan. Join your team for practices if you are able.
• Use your support system. Make a list of who in your circle is there for you. Include medical team, family members, friends, teammates, and coaches. The more extensive and detailed, the better. Reach out and stay connected.
• Remember to trust in the process of recovery, be patient with yourself and use strategies to keep a positive mindset!!
• The recovery period may also be a good time to reflect on your relationship with climbing and think about big picture goals. Reminding yourself that your goals extend far beyond the current season will make it easier to sit with the reality that you may need to take time off to fully recover.
• Treat your recovery as your current training objective. Invest as much energy and enthusiasm in your recovery as you do in regular training. Get lots of sleep, prioritize nutrition, hydrate and follow your recovery plan diligently.
• Gratitude Letter
Recent research recommends gratitude can be helpful to recovery (Salim and Wadey, 2019). Expressing gratitude to someone who has been especially kind during the recovery period has been shown to enhance the interpersonal connection and subjective well-being for the athlete
Salim and Wadey, 2019, developed the Gratitude Intervention for Athletes after Injury Rehabilitation. This work on gratitude was initially pioneered by Dr. Martin Seligman, the father of positive psychology (Seligman et. al, 2005). In the process of returning to sport after injury, an athlete is given one week to write a gratitude letter. Here are the steps recommended:
1. Reflect on the injury experience.
2. Write a letter properly thanking someone who was especially kind during the recovery process.
3. Deliver the letter in person, read it out loud, and spend some time talking about the content of the letter with the person.
Coaches’ Role
Coaches guide, inspire, and play an important role in the emotional life of the athlete. Athletes report feeling disconnected and isolated when an injury keeps them out for a significant amount of time. When a coach understands this, they can do some simple things to address this emotional aspect of recovery.
• Help them stay connected. Let your athlete know you understand this is hard and will help them through it.
• Include them in practices when appropriate and find a role they can play on the team. They can help with coaching younger teammates, help with practice logistics or simply cheer for their teammates.
• Visualization and imagery drills may be another way to keep injured athletes actively practicing skills like route reading, specific body movements etc.
• Formally check in with your injured athlete from time to time.
Parental Role
Parents play a big role in supporting a young athlete who is injured. Showing up with empathy is key. Let your athlete know you love them, that it’s going to be OK, and you are on this journey together. Stay optimistic and encourage your athlete to stick to the treatment plan.
You are in a key position to recognize signs which may indicate your injured athlete is starting to struggle emotionally. Keep in mind that moodiness, frustration, and anger are normal when these states come and go, and your athlete works through these moments.
A psychiatric consultation from a professional who understands athletes, may be warranted when the athlete exhibits the following signs, after an initial period (1- 2 weeks) of adapting to the injury:
• Persistent feelings of intense anger or sadness which last more than 2 weeks.
• Denial that there is a serious injury.
• Withdrawal and disengagement from activities and teammates.
• A sudden shift in mood or to being non-compliant with the treatment plan.
• Maladaptive coping (e.g., substance abuse, isolation, not attending to sleep needs, engaging in activities which impede recovery etc.).
Conclusion
An injury which keeps an athlete out of the sport they love for a significant amount of time can be devastating to the athlete’s mental wellbeing. We are good at checking in with injured athletes regarding their physical recovery but often neglect the mental aspects. Helping athletes, coaches and parents understand the psychological impact of an injury, gives the athlete additional tools to support recovery, maintain connection, and return to sport mentally strong.
References
Salim, J., & Wadey, R. (2019). Using gratitude to promote sport injury-related growth. Journal of Applied Sport Psychology. doi:10.1080/10413200.2019.1626515
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60, 410-421. doi:10.1037/00003-066X.60.5.410
