Can you recall a time when you got injured and could no longer participate in your sport for a period of time? How did you feel? What was your reaction when you were told the news that you would have to miss the rest of the season? How did you feel seeing your teammate’s training and winning games without you? Did you feel sad, frustrated or angry for not being able to play or exercise?
If you haven’t experienced an injury yet, how do you think you would react? I certainty felt frustrated and angry when I got injured and was told I would have to stop participating in sports for at least six months. I honestly hated everything about being injured (despite the smile on my face in the picture). Looking back, I realise that I learned a lot from my injury, although it certainly did not feel like a positive experience at the time.
I often questioned myself whether I was overreacting, being too grumpy or frustrated during my recovery. Knowing what I know now, I don’t blame myself for having had these types of feelings and reactions, it was completely normal given the mental implications sustaining an injury entails. However, I do wish I had had some strategies which could have helped me better manage and cope with my injury at the time.
What’s a sports injury?
Sports injury refers to damage to bones, ligaments, tendons and nerves caused by sports participation (musculoskeletal damage). Unfortunately, injuries are inevitable and tend to occur quite frequently in sports, no matter a person’s experience or level
How do athletes psychologically respond to their injuries?
Injured athletes face problems not only from the actual painful and unpleasant physical repercussions of sustaining an injury, but also other hurdles such as enduring tedious, repetitious and sometimes painful rehabilitation exercises.
While the physical repercussions are usually easily apparent, those of a psychological nature are less obvious. Injured individuals tend to experience many different negative psychological responses.
- Emotional – How you feel about the injury
- Behavioural – How did you act and react to the injury situation
- Cognitive – How you viewed the situation of being injured
It’s not surprising that when an athlete’s primary source of enjoyment is no longer accessible to them due to injury, their mood is affected. This type of reaction is particularly evident when an athlete truly identifies with their sport and it plays a big part in their life (for example, their career/full-time job or a way to escape from daily stressors).
Fear and anxiety
Injured athletes can feel fearful and/or anxious for different reasons; because they don’t know how fast they will recover from their injury, or because they wonder if they will re-injure themselves during their rehabilitation or upon their return to sport.
Seeking social Support
Injured athletes tend to seek social support from their social support circle (family, friends, teammates, coaches, physiotherapists, etc.). Social support provides athletes with crucial reassurance, comfort and encouragement for them to successfully manage their emotions, thoughts and feelings during their recovery. They may initially resist help but will certainly be grateful for it when they seek it.
Non-adherence to a rehab programme
Rehabilitation programmes can be long, monotonous and repetitive, with only a little or slow progress evident and it can therefore be hard for injured athletes to adhere to it. The temptation to return and compete in their sport prematurely can be overwhelming, despite the risk of re-injury or causing new injuries.
Alienation and social isolation
Sustaining an injury isn’t always bad
A common misconception that athletes frequently have when sustaining an injury is that it is only negative. However, once recovered, athletes, (including myself), may be able to perceive the experience in a totally different manner. I certainty experienced negative feelings, but going through my injury experience was definitely insightful and I grew as a person. This way of responding is also known as post-traumatic growth.
After experiencing adversity such as an injury, the positive outcomes can include:
- Enhanced relationships. Post-injury, athletes may value friends and family highly and feel more compassion towards others, demonstrating their appreciation for all the support they received from their support circles.
- Changed self-perception. Recovered athletes can develop wisdom, personal strength and gratitude and may have a greater acceptance of their vulnerabilities and limitations. Any athlete, no matter the level or their current form can easily get injured. No one is invincible.
- Changed life philosophy. Spending time away from sport enables athletes to reflect upon their life in general and current circumstances, to put things (such as minor life issues) into perspective and to appreciate things they didn’t before. I know this may sound a bit cliché, but you would be surprised how much this is actually the case, especially when you are deprived of something you thoroughly enjoy.
- Other responses. Being injured can also lead to the development of new skills such as time-management and goal setting, which can be applied outside of sport. Additionally, overcoming such a difficult experience undoubtedly strengthens an individuals’ character, self-confidence, and resilience.
If I didn’t perceive my injury experience as being a positive and insightful experience, I probably wouldn’t have written this blog. Don’t’ forget, there’s always light at the end of the tunnel.
So why do athletes respond in these ways?
Well, the best way I can explain this to you is by sharing with you a model which was developed by sport injury researchers.
It has a long name (The Integrated Model of Psychological Response to the Sport Injury and Rehabilitation Process) but the important thing to understand is how different factors interact with each other to determine how an athlete can potentially react to their injury.
The model suggests that both personal and situational factors influence the way an athlete perceives their injury (i.e., cognitively respond). This influences the way they will emotionally respond which will, in turn, affect the way they will behaviourally respond.
These factors combined with the different responses will determine if an athlete will have a positive or negative injury experience and recovery.
If Cristiano Ronaldo sustained an ACL injury, which is a severe injury, and given the fact that he has a competitive, ambitious and determined personality (personal factors) combined with the fact he is at the highest level, he trains every day, plays competitive matches every week (situational factors) he is highly likely to have negative thoughts concerning the injury. As a consequence, his cognitive responses (such as social isolation and low self-esteem), will influence his emotional responses (such as fear, anxiety, and depression) and his behavioural responses (for example, seek social support and difficulty to adhere to his rehabilitation programme). These factors combined (either being positive or negative) will determined his recovery outcomes.
The key takeaway from this model is that the way an athlete responds to his injury is entirely individualistic, as there can be many contributing factors. There isn’t a ‘right way’ to feel, think or behave when it comes to enduring and coping with injury. It is normal and OK to feel the way you are feeling; no one should decide for you.
How can I better cope with my injury?
Now, this is the part you are probably most curious about.
There are various psychosocial strategies you can learn, practice and apply to yourself to better manage and cope with your injury. Don’t be put off by the word ‘psychosocial’, it’s just the name of the type of intervention sport psychologists use.
These specific ones are designed to promote positive factors such as self-efficacy, confidence and athletic identity and reduce negative factors such as anxiety and depression which majorly influence the recovery process and an athletes’ successful return to sport.
As an athlete, you may tend to reflect upon your training or game performances and establish clear short-term or long-term goals. When faced with your injury, the route to achieve these goals is put on hold, providing a great opportunity for you to set new ones. You can use the SMART acronym to help you set your injury recovery goals. For example, a recreational runner may use this strategy in the following way:
- S = Specific. Get 5K running time as I did pre-injury (e.g., under 20 minutes)
- M = Measurable. I can track my time using Strava, Apple Watch, etc.
- A = Attainable. I know I’ve achieved this time before so I can do it again.
- R = Relevant. I love running and I want to continue to do so.
- T = Time-bound. In the meantime, I’m going to take time to heal from my injury and undertake the necessary rehab exercises, go for shorter runs to then be ready for the 5K race I signed up for in two months.
This process will allow you to shift your negative thoughts concerning your injury into more positive ones. Saying positive affirmations verbally out loud or internally to yourself can help provide you with direction and motivation throughout your recovery period. Cues such as ‘I can overcome this’, ‘I can do anything’, ‘I have to work to get my leg as strong as my left one,’ are all useful positive self-talk techniques you could employ. Of course, you can come up with your own ones.
Mental imagery allows you to connect your mind and body while imagining performing a movement. Using imagery actually slightly activates the muscles you would usually use to undertake the actual movement. For example, you can use imagery to visualise you successfully completing your rehabilitation exercises that you didn’t think you would be able to achieve or that you’re currently struggling with, boosting your confidence. Lastly imagining plays, drills, movements and techniques allows you to not only sharpen your skills by reminding you of what needs to be done once fully recovered but also to overcome fears of re-injury(16). One successful example of the use of this strategy is Vincent Kompany: ‘When I was injured and when I was watching the games, I visualised how I would have tackled this or that attacker, what pass to make. I realised that I could progress without even being able to train.’
Emotional written disclosure
Write down your emotional feelings related to your injury in a journal, as doing so with commitment and consistency can be an extremely helpful way to cope and manage with your emotions. It can also be a useful future resource you can refer back to if you experience another setback (e.g., getting re-injured).
I can appreciate it may be a bit daunting reading about these different techniques and no one expects you to be an expert right away. The idea of this blog is to raise your awareness and let you know that these are some of the ways that you can help yourself.
If you would like to learn more about these techniques, there are various resources online to help you learn and practise them. Alternatively, if you would like to apply these techniques, working with a qualified sport psychologist to support you with this process will be beneficial.
Just know you don’t have to be a professional athlete to learn, practise, and apply these strategies, anyone can do it.
- Injury affects everyone taking part in sport, regardless of your level of experience.
- It is OK to not feel 100% when you’re injured, it’s not an easy experience, be kind to yourself.
- Sustaining an injury isn’t only negative and great things can come out of it.
- There are various strategies available you can use to help you cope better with your injury.
- Don’t be afraid to ask for help from family, friends, coaches, physiotherapists, sport psychologists; that’s what we’re all here for.
I hope you found this blog interesting or helpful whether or not you’re currently injured. I hope that I have shed light on some of the implications sustaining an injury can induce, allowing us to be more aware, kind and empathic to ourselves and others.
An earlier version of this article was first published by Jonathan Brain.
Jonathan Brain is studying MSc Sport and Exercise at Loughborough University.
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