Anyone who has dabbled in athletics knows what it’s like to go a little too hard or perform with less-than-perfect posture only to end up with a muscle pull here or an ankle sprain there. But for full-on athletes – you know, the people whose trips to the gym likely have more to do with staying shape for the football or basketball season than they do burning off enough calories to justify this morning’s bagel – sports injuries can be more than just minor setbacks from time to time: they can be pretty big threats to bigger careers in athletics.
For athletes, even the smallest of injuries can progress into something bigger, and sometimes all it takes is one bad fall or one wrong move for the body to hit a point that it can never really fully come back from. When that’s the case, physical therapy becomes the key to regaining the physical strength and range of motion – even if not entirely all of it – that gets lost after a serious sports injury. But looking beyond the physical repercussions of an injury, there’s another pretty big piece of the puzzle that’s often less addressed: the emotional blow.
For the most part, people think about sports rehabilitation in the context of physical therapy. But mental rehab can be just as crucial – in some cases, maybe even more so – than the physical because of the sheer magnitude of a sports injury’s implications. Think about it: if you’re a serious athlete whose career or whose future relies pretty solely on your ability to play a sport, an injury that more or less threatens to stop you from playing said sport could certainly be enough to send your mind into a bit of a spiral.
One of the biggest emotional issues that may arise after an injury is a lack of acceptance. Injured athletes may have a sense of denial regarding the intensity of the injury, which studies show can actually lead to serious depression and a major roadblock in the post-injury recovery process.
“Acceptance is something that needs to be achieved early on,” says Lyndsay Hirst, a physiotherapist who works with high-level athletes post-injury to develop workouts for maximum recovery. According to Hirst, coming to terms with an injury early on allows players to develop realistic recovery goals that set them up for success in the future. “If a player is likely to be out all season, then the focus needs to be on getting as fit and strong as possible for next season.”
Beyond acceptance, there’s also a self-esteem component, where injured athletes can almost feel like they lose their identity with the injury. Studies have found, for example, that while the degree to which self-esteem and mood are affected by an injury depends heavily on the intensity of the injury, there are still significant hits to confidence (and pretty serious cases of anger) after an injury.
The effects of an injury on self-esteem carries into a third major issue with sports injuries, which is fear. Basically, after an injury, and even after considerable physical therapy, athletes tend to struggle with trusting their bodies again. To that end, making a comeback becomes a pretty serious emotional hurdle, even if the physical challenge is ready to be met.
For Justin Hussong, a former athlete who has dealt with his fair share of injuries – a broken femur from a chop block in football, three herniated discs from deadlifting, and numerous broken ankles from basketball – found that this fear was almost crippling, even after a significant amount of rehab.
“Rest and rehab were difficult, but it was encouraging to see progress and feel a bit better each day, clearing hurdles one by one,” he says. “But the toughest emotional part of coming back from the injury, to me, was always the last step. Clearing that final mental block and trusting your body once again is extremely rough, and with every cut or jump, in the back of my mind I was worried my knee or back would give out.”
To Lindsey Pearson, a former college basketball player turned yoga and meditation coach, the fear that came from her injuries – in the past four years, Pearson’s racked up a meniscus tear, a SLAP tear in her shoulder, and a bone spur in her wrist, but her problems first started in high school when her back gave out during a playoff basketball game – was kind of like being in PTSD mode.
“It wasn’t until someone told me to breath when I was experiencing pain that I realized, in those moments, it’s like I’m back in high school and I’m afraid that I’m going to lose feeling in my legs again,” she says. “Our natural reaction as humans in pain is to stop breathing, and that’s what I was doing. I was kind of getting triggered and just going into fight or flight mode.”
So, how does one cope with the emotional stress that comes with a sports injury? For starters, practicing mindfulness to separate the actual pain you’re feeling from the perceived intensity you’re creating out of fear is crucial.
“The medical research about mindfulness and chronic pain is that there is what’s present – the acute injury – and then there’s our actual experience,” says Pearson. “We have the direct experience – a tingly, numb sensation or something like that – and those come and go. But then there’s that narrative experience, which is how we’re building it up in our heads.”
Of course, that’s not to say that you should put your mind over matter and totally ignore your body. (That’s how you work your way up to serious injuries in the first place.) Instead, it’s just about learning to be in tune to your body so that you can distinguish the kind of fear that signals you to take it down a notch from more of a discomfort that’s coming from anxiety.
Another important step towards bouncing back? Being realistic about your goals so that you can celebrate the small wins along the way.
“Setting targets both short term and long term are also key to success, having something to focus on really helps athletes mental recovery,” says Hirst. “One thing I always do with patients is involve them with exercise very early on in their recovery to give them some focus and drive. I often suggest they do clinical Pilates as a way of building back and maintaining core strength, as well as making sure their injury doesn’t start to cause compensations. An athlete who starts to develop compensations will take much longer to recover and will be more at risk of further injury.” Hirst also recommends sport-specific exercises where possible, as that can be super encouraging given that it puts injured athletes back in the environment they would normally participate in.