The Psychology of Returning From Injury

The Psychology of Returning From Injury

“Reject your sense of injury and the injury itself disappears.”

Marcus Aurelius

Returning from injury isn’t just a physical battle. The mental battle is almost as important. Unfortunately, while doctors are (usually) great at treating the injury itself the emotional side of recovering from injury is often ignored.

Research has shown that there are three distinct phases of athlete injury. The first is the injury-illness phase. This is followed by the rehabilitation-recovery phase and then the return to full activity phase. Different stresses affect athletes at different phases of the injury. This guide to the stresses felt at each stage will help you to take the best psychological approach. Injured athletes tend not to have an optimistic view when it comes to estimating their ability to return to previous levels of performance. They also worry about the risk of re-injury. We know that when the medical team considers the psychology of the athlete compliance with rehabilitation improves. So it is paramount to take the right mental approach so you can get back to your best.

The Early Phase of Injury

Master Your Emotional Response 

During the initial phases off injury it can be useful to think about your emotional response to the injury. Consider and seek answers to the following questions:

  • What are your sporting goals and have they changed since the injury?
  • Who supports you in your sport? Is it a coach or family member or friend? Is this support positive or does it add to the pressure?
  • What kind of emotions do you have about your injury?
  • Do you have any fears about returning to sport?
  • Do you have much support in you rehabilitation?

Sometimes an injury can make an athlete want to return to an even higher level of competition. In other cases the athlete may want to continue their sport at a recreational level for the sheer love of it. Thinking about these questions in depth allows you to focus your rehabilitation on the outcome that you want. This is not the outcome that other people such as coaches and family might have in mind.

Master Your Goals

Early in the rehabilitation process goal setting can improve both productivity and performance. Clear and precise documentation of your goals in a positive manner can be empowering. It is also a great opportunity to plan, share decision-making and review progress with doctors, therapists and coaches.

Master Your Tasks

One approach to early rehab is the ego-orientated approach where outcomes are measured against the achievements of others. This approach is associated with lack of persistence, a feeling of the outcome being by chance and higher anxiety levels. A task mastery approach instead is associated with persistence and optimal performance outcomes. This approach promotes maximal effort from the outset; the focus is on executing each task in your rehab programme as well as you possibly can.

The Rehabilitation Phase of Injury

Process Over Outcome

Setting personal goals and believing in your ability to achieve your goals leads to better sports performance. When recovering from injury focus your goals on the process rather than the outcome. Goal setting and concentration on task mastery mean you are more likely to stick with your rehab. Athletes with a task mastery emphasis rely on variables that are within their control. This leads to increased self-confidence.

Find Your Comfort Zone

Confidence is crucial in injury rehabilitation. To this end, it is important that you feel that your trainer is capable. You should also fee comfortable in your surroundings, it may be useful to continue to use your usual training environment. A structured and progressive rehabilitation programme will allow your coach or therapist to provide performance-based feedback and allow you to grow in confidence.

Returning to Full Activity and Peak Performance

Overcome Anxiety

As you return to full training and competition after injury anxieties about your skill levels are likely to be paramount. Make sure you are not under any external pressure to return to sport. Maintain your autonomy and set a realistic target for return to competition. If you are anxious about re-injury relaxation and guided imagery sessions can help. A couple of great apps for this are Headspace and Calm.

Break it Down to Build Belief

As you approach a return to sport go through some simple tests of balance, strength and endurance. Work through any weaknesses you discover. Breaking down your sport into these elements can help build confidence. Gradual improvements will give you the belief that you will be able to perform to your previous standards.

The Haters Gonna Hate

When athletes have been out of action for a while with injury it is natural to worry about what teammates and coaches think about them. Having not had an opportunity to show your ability for a while it is common to worry about appearing unfit, de-skilled or not up to the same standard. Shift your thinking away from worrying about what others might think. Instead think about the excitement of returning to what you love doing. As Taylor would say “Shake it off.” Appreciate the effort you have made in your rehabilitation. Know that you do not have any control over other peoples thoughts so don’t worry about them. Focus on specific goals that are under your control, such as mastering a specific skill or gaining a particular time in a performance test. It is important to feel that you are technically ready and not under any undue pressure to return to sport.

Connect to rehabilitate

Maintain contact with your teammates even during rehabilitation from injury. This is beneficial in feeling connected to the athletic environment. It has also been shown, most notably in adolescents, to improve adherence to rehabilitation.

Treat Yourself

Having rewards for achieving smaller goals can help you achieve the long-term goal of getting back to your best athletic self.

Putting it all together

Various stressors pervade at differing stages of injury and rehabilitation. So it is important to tailor your mental approach for each different stage. Consider your emotional response to the injury and set goals early. Focus on mastering skills and hitting performance targets that are within your control. This will help increase confidence and decrease anxiety about re-injury. Don’t worry about what others might be thinking about your skills or fitness levels. This is not within your control. Close liaison with doctors, coaches, friends and family improves adherence to rehabilitation. It can also give you the confidence you need to return to your sporting best.

Dr Hugh Coyne