“Mind over matter?” – Psychological factors in athletic injuries

ImagePhysical activity and sports are essential for keeping fit and being healthy, everyone knows that. However, exercising and participating in organized sports also carries a risk of getting injured. In the United States it is estimated that 3 to 5 million people are injured in sport and exercise settings annually. In Europe, about 9.1 million people are treated in hospitals for sport-related injuries every year, with most injuries occurring in team ball sports, predominantly in football, handball and basketball.

Apart from simply being accidents, injuries can result from physical factors such as muscle imbalances, improper conditioning, physical fatigue, overtraining and high-speed collisions. Poor training practices, improper gear or faulty equipment can also lead to injuries. However, many people are surprised to hear that psychological factors contribute to the occurrence of injuries in the sport setting as well.

The psychological factor stress, for example, has been identified as a contributor to injury incidence. But what does stress have to do with getting injured, you might ask? High stress is known to reduce an athlete’s peripheral attention, potentially causing him/her to trip over an obstacle on the training pitch or to overlook a charging defender during a game. Additionally, stress is accompanied by muscle tension that can interfere with the balance and coordination of the athlete, again increasing the chance of injury. Athletes who are likely to appraise situations as stressful, who have little social support and who possess few or dysfunctional coping resources are especially susceptible to sport injuries.

How to reduce the risk of injury

What can you do – as a coach, team member, physiotherapist or sport psychologist –to lower the injury risk in your sports team? Monitoring stressors in your athletes’ lives may give you a good estimate of the injury risk of your athletes. For example, if one of your athletes loses a loved one, struggles in school or at work, moves to a different town or experiences a change in economic status, ask about these stressors, carefully observe your athlete and potentially adjust training regimens accordingly. It is important to communicate that you (as well as the rest of the team and staff) are available for support and that you could refer your athlete to professionals if required.

Furthermore, one should be careful with statements such as “act tough” and “more is always better” in the sport context, as these attitudes might cause athletes – especially young ones – to feel pressured. When athletes are already overstrained, they should not be pushed to take undue risks, as this increases their chance of injuring themselves. In this context it is important that athletes learn to distinguish the normal discomfort accompanying high training loads from the pain signaling the onset of an injury.  Moreover, the notion “if you’re injured, you’re worthless” should not be conveyed to your athletes. If athletes think that winning is more important than their well-being, they might play while hurt and sustain even worse injuries. Therefore, it needs to be emphasized that your athletes’ health is of highest priority and that success and medals come second.

How to cope with injury

If an injury has already occurred, it is crucial that coaches as well as team and staff members build rapport with the injured athlete and show interest and concern by visiting and phoning frequently. Injured athletes often feel forgotten after the “novelty” of the injury and the accompanying interest of others have worn off, subsequently experiencing frustration, anger and vulnerability. Therefore, showing empathy and offering social support go a long way in the strenuous and sometimes enduring rehabilitation process. The injured athlete also benefits greatly from knowing what to expect during recovery and that setbacks might occur. That is why it is important that the coach and medical personal provide the athlete with accurate and detailed information about the injury and recovery process. Overall, it is crucial that the injured athlete still feels included and remains an integral part of the team, potentially in an organizing or managing function during training or as an assistant to the trainer during competitions. The athlete can speed up the recovery process him/herself by implementing psychological skills exercises: relaxation techniques, imagery routines as well as acceptance-commitment-therapy training have all been identified as facilitators in the rehabilitation process.

As difficult as it sounds: the athlete and his/her respective team should try to accept the state of injury and positively deal with the situation by actively working on the physical and mental recovery and making use of all available support. In the words of the award-winning writer Haruki Murakami: “Pain is inevitable. Suffering is optional.”

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3 Responses to “Mind over matter?” – Psychological factors in athletic injuries

  1. joggingproud says:

    I can really relate to your article. I have had injuries in the past where I used the “Suck it up” attitude and kept pushing, inevitably hurting myself more. I think it is very important to know your body well and can tell the difference between good pain (No pain, no gain) and bad pain (I think my knee bent the wrong direction). Other than injury, I think the brain gets in the way of progress as well. I can’t tell you how many times I have been in a 5K race and by the last quarter mile, I think I have nothing left and want to walk. But as soon as I see the finish line ahead, I realize that I had energy that I wasn’t using and I sprint to the finish, upset with myself for not going faster earlier. I am going to try to do better at my next race. The only thing holding me back is myself.

    Simon A.

  2. Johanna Belz says:

    Thank you for your reply, Simon. I am glad that you can relate to the article. Good luck with your running career!

  3. Pingback: Injury Blues: Fighting Depression and Anxiety During Rehabilitation | Lockeroom Sports

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