The Mind Game

Recently, I have been focusing on return to sport, or high level sports performance, following an injury. The psychological factors associated with sports injuries are almost as, if not more, important to address and treat as the physical damage done during the injury. The mindset an athlete has at the time of the injury and throughout the recovery process is crucial to their success as they return to their sport. (If you think you are hurt and will never get better…. you will never get better.)

Some factors to be aware of immediately post injury and during the recover phase are positive/negative attitude, lack of motivation, response to rehab, performance pressure, and severity of injury.

The athlete’s attitude immediately following an injury needs to be observed by family and friends to catch signs of depression, fear, anxiety, etc. MANY factors go into play at the time of injury; individual versus team sport, time left in a season, love of the game prior to injury, age, severity of injury and time out of sport. All of these things are going to play with the athlete’s mind as they lay cringing on the field. The worst thing they can hear is ‘you are out for six months.’ Especially for younger athletes, this can be crushing. Positive psychological responses from family, friends, coaches, and teammates will promote a greater likelihood of a positive attitude from the athlete and a stronger return to the game after being cleared from the doctor. A negative outlook throughout the rehab process is a strong predictor of that individual never returning to sport at all.

This leads to motivation. The person with a positive attitude and strong desire to return to sport stronger than they were when they got injured is going to excel throughout rehab, do what they are suppose to do to protect and heal the injury, and gain the strength and stamina needed BEFORE they step back in the game. If the athlete struggles to complete the basic exercises needed to rebuild muscles and protect their joints from future re-injury and jumps back in too early, the risk of re-injury is significantly higher. On the opposite side of that, an athlete can be overzealous and push them self too hard during rehab and cause injury by not following the proper protocol in order for tissues to heal. Balance. Recovery is about balance, patience, and knit picking technique until it is absolutely perfect. One of the most common errors I see from athlete to athlete is compensation for the injured area. If they hurt a knee their squat, walk, stance, and running suffer. If they compensate and repeat bad movement patterns they will never regain the proper strength and stability through the previously injured joint, leaving room for potential re-injury or injury to other areas due to the compensation. Same with a shoulder or elbow. Constant error in movement patterns creates repetitive strain to all other areas above and below that joint.

Another thing you have to be aware of is the pressure put on the athlete by peers, family, coaches, their position on a team, financial responsibilities, etc. These factors may also lead to a premature return to sport before an athlete is physically OR psychologically ready to return to the game. If you rehab correctly and do what is needed to correct movement errors and weaknesses that make one susceptible to injury, your position on the team, athletic ability, strength, power, speed, etc. should be BETTER than it was previously.

Lastly, injury severity may create severe negative psychological responses. There comes a point when our bodies take priority over a Friday night game. If an injury occurs that is life threatening, long term debilitating, or career ending, the psychological impact is going to be drastically worse than the physical effects caused. Seeking help for the emotional toll is just as important as the physical rehabilitation.

Fear is a prominent emotion when athletes are actually returning to sport. It is imperative that therapists monitor for the psychological signs throughout the rehabilitation process and to make sure that the athlete is 100% ready to step back on to the field.

Unless it was a traumatic injury (collision, fall, crash, etc), most injuries are due to poor movement patterns. My goal is to correct these movement patterns BEFORE any major injuries occur, or in the event that I see someone post accident, re-train correct patterns to prevent any future, preventable injuries.