Why me? The mental side of injury

Following on from the last blog post I thought it would be a good idea to talk about the mental side of injury – hopefully you agree.

With any injury it is not just physical, it is important to recognize the psychological challenges too. It’s the thing that people fail to see and acknowledge and it can be just as hard, if not harder to deal with than the physical part of injury. The physical aspects are quite apparent but the emotional and psychological ones are less obvious and it can be devastating.

There are many feelings associated with injury as well as ways to cope. I’m certainly no expert so please bear with me, all I can do is speak from experience and let you know that you are not alone.

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Denial – ‘it’ll be fine’

One of the first feelings associated with injury is denial. At some point in sport someone will have heard the common phrase ‘aw it’ll be fine, I’ll be back soon enough’ unfortunately this isn’t always the case.

So many people go through denial and end up pushing it, causing further damage – please don’t do this. It is important to respect and listen to your body, you’re in pain for a reason.

Loss

Once the seriousness of an injury has been realised, it starts to get a little rough with the sense of loss overwhelming. If it’s not bad enough losing your sport, you lose your sense of invincibility and independence too – damn injuries!

‘Why me? It’s not fair’ this seems to continue on a loop for some time causing frustration, anger and mood swings. Anyone in the near vicinity this is your warning, please be careful – they may bite!

While stuck in this negative whirlwind, why not throw a loss of opportunity in the mix too just for good measure. A feeling of failure, missing important games and a chance to show people what you can do only add to the frustration.

Loneliness

Now comes the loneliness – time to get the tissues. Depending on the severity of your injury you may be hampered by immobilisation and a lack of transport, leading to isolation. Even though a little quiet time is can be a good thing, too much can drive you crazy.

It’s not deliberate but injury can also lead to social disconnect as you feel unable to interact both physically and mentally. Sometimes you just can’t bear to be around teammates as you feel you don’t belong.

Don’t get me wrong teammates can be awesome and supportive, however this may not be the case for everyone. Again it’s not intentional but teammates at times don’t know how to react around injured people which can create feelings of a lack of support and understanding. Combined with the feelings of sensitivity and depression this compounds the loneliness.

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Self-esteem – ‘Who am I without my sport?’

Along with loneliness, injury can make you feel a little empty, especially if sport is a big part of your life. You lose a sense of your identity and don’t really know what to do. This drop in self-esteem can make you feel weak and worthless – which is never good when there is rehab to be done.

Guilt

Another common feeling which is felt during injury is guilt. When an athlete is under pressure to perform taking a break due to injury can sometimes create a sense of relief. This unexpected feeling then causes you to feel guilty as it shouldn’t be this way right?! Wrong, it is very normal and common to experience this when injured – don’t be ashamed.

Envy

The green eye monster also regularly makes an appearance when going through an injury. Trying to be involved with your team and watching other people succeed around you is emotionally painful. Jealousy is not a nice feeling and being embarrassed to talk about it makes it harder to deal with.

Coping – control or be controlled

Phew! Now we’ve got the emotions out of the way let’s talk about coping. There are many suggested ways of coping, however it is important to note they may not all work for everyone. Just try some and see what happens.

Goal setting

Is it just me or are emotions starting to come back again?! Quick, let’s set a goal before it’s too late.

Remember as I said earlier it is normal to have a range of different feelings – just expect them. The way you respond to them and your injury will affect your rehab and recovery.

A great book by Sports psychologist Jim Afremow mentions ‘the goal is for the athlete to be the master of injury rather than letting the injury master the athlete.’ The book has a pretty useful section about injuries- if anyone is interested it’s called ‘The Champions Mind’.

When setting goals they should be realistic such as being able to rest your foot on the floor, putting socks on, moving your toes. Try not to set a strict time limit– nobody likes a ticking clock. You are ready when your body and mind says so, don’t be distracted by dwelling on deadlines. Goals should also be flexible and be adapted depending on your stage of recovery.

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Attitude

When it comes to dealing with injury, attitude is crucial. It is essential to accept your injury and allow yourself to be sad – but not for too long! Once you have come to terms with your injury it is time to focus on recovery, a negative attitude will only hamper it.

Be patient and don’t get overwhelmed with the bigger picture, concentrate on the little victories.

Have the mind-set that you broke doing something you love and see the setback as an opportunity for a comeback.

Focus

During injury, focus is key. Don’t focus on what could have been or should have been – it will torture you.  Focus on what you can do and not what you can’t.

Direct your energy into other challenges that you can work on such as nutrition and tactical knowledge. Reflect and appreciate the finer things.

Stay connected

Build on your attitude and focus and try and stay connected with the people around you – don’t be afraid to talk.

It’s hard at first, but if your emotions allow, try and think of what other things you can do in the team such as coach or officiate – it will make a big difference.

It can also be good to watch training and keep up with tactics. It will make return from injury that little bit easier as you will have one less thing to worry about.

Keep busy

Take advantage of all this time you have and concentrate on other hobbies to keep your mind engaged – you never know, you may have some other hidden talents.

Make rehab your new sport, see it as your new challenge and don’t slack off. If you can do this it will dramatically affect your recovery.

Returning – the fear

So you have gone through the emotions, coping strategies and rehab, you now have an important decision to make – do I return to sport or not. It is very tough to decide, there are many aspects to consider such as family life, work, teammates and of course the physical and mental side too. Coming back or not, have pride in the fact you have come this far and don’t feel ashamed to walk away or take a break.

If you do decide to return to your sport you now have a new challenge to face – the fear. I’m not going to lie returning to sport after injury is terrifying, but please know that this is normal. It’s likely that you will replay your injury in your mind over and over again. Alongside this your brain will be in panic mode and make excuses not to do things – tell it to shut up!

I know it’s tough and will take time, just remember to maintain your positive attitude and ease yourself back in gently.

In 2013 a review by Ardern et al concluded that fear is a prominent emotional response when transitioning back into sport and positive psychological responses appeared to promote a greater likelihood of athletes returning to their preinjury level and return to sport more quickly.

Don’t concentrate on what you’re afraid of happening, but concentrate on what you want to happen such as perform a certain skill or complete a particular drill. Imagery and visualisation are great tools to help with this. Remember as I said earlier – little victories.

It’s also good to look at some of the great athletes who came back from injury for a little inspiration such as Dan Carter, Felipe Massa, Niki Lauda, Monica Seles, Tom Brady, Pele, Petr Cech. It may also be a family member, friend or teammate that provides that inspiration.

Reflection

Sorry for the emotional nature of this post, I just want people who are going through this to know that you are not alone.

It is also important to inform family, friends, coaches and teammates about the side of injury they may not see and how they can have an impact on someone’s recovery.

There are many factors which affect an athlete’s experience such as severity of injury and support, but no matter what some of these feelings will be involved.

I hope that one day you may be able to reflect and take some of the positives about what injury has taught you – sometimes pain can be useful.

If you have any experiences or advice you would like to share please feel free to comment below.

Amy 🙂

Physio Blog - by Amy Brown

As well as skating for Newcastle Roller Girls, Amy is also a sports therapist and has a keen interest in most sports. She has worked in various settings including professional football, women’s premiership rugby, 2012 Olympics and superleague netball. Having undertaken a range of postgraduate training, Amy is also a Kinesio taping practitioner and member of the Society of Sports Therapists.

Alongside providing injury prevention, treatment and rehabilitation within sport she also works in private clinics treating both athletes and the general public.

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