What are the psychological effects of an injury in sports?

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What are the psychological effects of an injury in sports? image

What are the psychological effects of an injury in sports? And how does an elite athlete come back from a serious injury?

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Answer by Lee NessBritish Athletics Event Group Coach. Wiltshire Athletics Track and Field Manager. City of Salisbury A and RC Head Coach

Injury recovery tends to follow the Kubler Ross cycle. I've written about this in my upcoming book The Sports Motivation Masterplan and on my blog Athlete Performance Training,  but here are the highlights Kubler Ross originally wrote about a person’s response to being diagnosed as terminally ill. However, later research then showed that this process applied to many different traumatic events and an injury to a sportsman, especially one that is striving to become elite, is traumatic. While clearly this is not the same level of trauma that the model was written for, sports people will understand how this model works for them and, if you have been injured, you will recognise some of your responses to the injury.

Kubler Ross’s cycle is not prescriptive in that not everyone goes through every stage and the stages do not necessarily have a specific order. Generally though the reactions and responses to an injury will resonate in roughly the order described here.

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Shock

This is usually the first response; an initial shock that something serious has happened. Your body will start to process this quickly and the reaction will often be over very quickly. 

Denial

Often this will be the second response and it is very important to understand that it  is a natural response that everyone will initially go through but one that you need to be overcome quickly. “It’s not that bad”, “I can keep going” and “I can play on”.

Fear

Fear of the future is asking yourself (or others), will you ever be the same again? Is this a career threatening injury? If I miss training I will fall behind all my competitors? If I miss this opportunity will I get another one, or is this is my only chance? Fear is always about what might (or might not) happen. It is the unknown. Usually, this involves being scared of what could happen and assuming the worst. It is okay to voice your fears. Once you have laid them bare, you then need to process how likely each scenario is. Focus on getting facts.

Anger

You may be angry with yourself, for getting in a situation that caused the injury. You may be angry with your coach, your parents, or the opponent who injured you. You might even be angry with the people who are telling you the prognosis, especially if you are still in denial. There are many people to be angry with and you cannot cope with it merely by trying to suppress it. 

Guilt

You may feel that you have let your team down because they were relying on you. You have let your coach down who has put so much effort into getting you where you are. You have let your parents down who have supported you for so long. You have even let yourself down. You didn’t prepare properly, you made a stupid mistake. You should not have gone into that tackle.

Grief

Often the most overwhelming emotion in an injury is the sense of loss; lost opportunity, loss of ability etc. It is a sadness that may only be an underlying feeling but it will be a pervading one while you are injured and sometimes afterwards. This is usually the lowest point for the athlete in the cycle. 

Recovery

Now that you are in the process and you can understand your reactions to the injury, you can start to mentally recover. Recovery comes from dealing with the injury and the time that you are injured.
Kubler Ross described the next stages as Understanding, Acceptance and Integration.

Understanding is exactly what has been described in the first stages. If you understand that they exist, that they are natural and what they are then you are in a better position to achieve acceptance and move forward to integration. This means that you integrate the injury into your development program. It has happened, now you must make the best of it. Additionally, there are all the other things that an athlete does not get time to do when they are training that they can work on while they are injured. One example is to watch your sport. Sometimes, competitors do not get to watch much of their own sport. If you are a footballer watch some matches. Watch teams that are better than yours, or older. Watch your own team, watch your competition. 

Lastly you can refine your plan going forward for once you are injury free. Your schedule is now likely be different to what your coach is working on and if you are part of a team or a training group, your schedule is now different to theirs as you come back to full capability. Work with your coach to plan what you will be doing, in training and your competition schedule. Get into some detail. 

With injuries you have to be patient to recover and not  come back too quickly. In order to be patient, you must be working on things that will maintain your development, albeit in a more general, less specific way. You cannot afford to take it easy with this work because you will not fool yourself. You must commit yourself in the same way as you would normally train. It does matter and it is important so approach it in the same way that you would approach any level of training and development.

I wrote an article for Stack on this very subject as well 3 Steps to Coming Back Better From Injury.

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