Psychological Response to Injury: Steps to Overcome Fear of Reinjury
Sport related injuries are a common occurrence among both competitive and non-competitive athletes. Studies have shown that approximately three to seven million sport-related injuries occur annually in the United States. Injuries often affect the athlete’s psychological, and emotional health in addition to their physical health.
Post-injury psychological responses often include: fear, anxiety, apprehension, lack of confidence, depression, frustration, self-doubt, and lowered self -esteem. Ideally, as an athlete’s physical trauma heals, there should also be improvements in their emotional and psychological health. When rehab conditions are unfavorable, the psychological impact of a physical injury can adversely affect an athletes recovery, limit function, and prevent successful return to sport or activity.
Overcoming the fear of re-injury is a challenging process that requires a systematic approach to combat the negative thoughts and apprehension associated with rehabilitation.
The following are guidelines we have created to help you navigate the emotional and psychological stressors associated with rehabilitation.
1. Manage expectations: Work with your physical therapist, doctor and coach to educate yourself about your specific injury. Understand the cause of the injury, the estimated rehab timeline, and the “dos and dont’s” for the recovery process. This will help you establish the foundation for reducing anxiety and managing expectations.
2. Trust your rehab team: Spend time finding a quality rehab team that understands your injury, your needs and has experience treating athletes like yourself. A rehab team should include a physical therapist, your coach and/or trainer, and depending on the injury, a medical doctor. Once you have your rehab team, trust them. There’s nothing wrong with getting opinions from qualified professionals that know the full extent of your situation. However, advice from friends/family, healthcare practitioners who have limited information, or “googling” leads to misinformation and confusion.
3. Goal setting: Communicate what your goals are. Goals can be separated into short-term and long-term categories and can vary in difficulty level. Don’t be afraid to make some goals that will be a “reach”, but make sure you have some reasonable goals included too. Setting goals that are meaningful and measurable will keep you motivated throughout rehab.
4. Think Positive: Negative thinking can increase stress hormones and heighten pain levels. Injuries already cause elevated stress levels. Unnecessary added stress will only delay the rehab timeline and increase chances of a negative outcome.
5. Exposure: Graded exposure to stressful situations in controlled environments will positively affect your mindset and attitude. Start off with small repeated exposures that you can handle or break the task up into parts. For example, if you are apprehensive about picking up something from the floor because you’re apprehensive about re-injuring your back, start off by reaching to a chair or stool. Repeat this until there is no longer stress or apprehension and then reach lower. As you continue to improve make the task more complex (reach across your body), more intense (add weight), or more frequent (add reps).
5. Social Support and reflection: Utilize your community to keep you accountable and encourage you during your recovery. Talk about your success and improvement! You can even keep a journal to document every milestone you hit. It is a great way to reflect on the progress you have made.
6. Keep it simple: Trust the process!
Tiara Dunson, PT, DPT
Tiara is a physical therapist at Kauno
References
Hsu CJ, Meierbachtol A, George SZ, Chmielewski TL. Fear of Reinjury in Athletes. Sports Health. 2017;9(2):162‐167. doi:10.1177/1941738116666813
Bijur, Polly E. 1995. "Sports And Recreation Injuries In US Children And Adolescents". Archives Of Pediatrics & Adolescent Medicine 149 (9): 1009. doi:10.1001/archpedi.1995.02170220075010.
Conn, J M. 2003. "Sports And Recreation Related Injury Episodes In The US Population, 1997-99". Injury Prevention 9 (2): 117-123. doi:10.1136/ip.9.2.117.
