Dealing With Sport Injury: A Psychological Battle

By Jacqueline Lo

Photography by: Hyning Gan

 

When it comes to recovering from a sports injury, most people only acknowledge physical rehabilitation and don’t consider the emotional ramifications and psychological responses that play a role in the road to recovery. Traditionally, sports medicine professionals and physicians have focused the majority of their attention on the physical aspects of injuries, spurring continuous improvements in physiotherapy through developments in training, equipment, and a range of other treatment types. Although these therapy methods are highly beneficial, they only address the physical aspect of the human body. 

 

For many individuals, injury that prohibits continued athletic participation can cause emotional impacts and a significant impact on their vulnerability and resilience post-injury. These emotional reactions to injury, such as ineffective coping mechanisms and high pressures, can affect how well one may adhere to rehabilitation regimens and their chance of a successful recovery. Despite this, patients are not given enough guidance on when and how to address the psychological consequences of an injury throughout rehabilitation. As a result, athletes often find themselves in positions where they are unable to cope with the physiological stresses following an injury.

 

As a dancer who has dealt with more than 3 consecutive injuries within the span of one year, I can say from experience that dealing with the mental trauma that comes with an injury was a huge obstacle was not prepared to face, and had to learn to overcome alone throughout the process of recovering. In my experience, I made many mistakes and faced huge setbacks because of false conceptions and a lack of knowledge about how to properly deal with an injury. Here are some key lessons I learnt during my road to recovery – they may seem simple and obvious, but they are things I wish I had been aware of prior to recovery. It all started off with a minor discomfort in my foot.The throbbing and aching pain that started to bother me during training wasn’t enough to worry me. My mindset was: “no pain, no gain.” In order to improve, I had to work hard and train everyday for large amounts of time. In my head, if the pain wasn’t affecting my daily activities, I was fine. Eventually, the pain became unbearable; I finally visited the doctor and was diagnosed with tendonitis of the posterior tibial tendon which was what was causing the pain surrounding my navicular bone. I was told to take 6 weeks off. 

 

Lesson 1: Listen to your body 

 

I used to think that injuries only result from direct and immediate impact caused by a specific event, such as breaking a bone or tearing a muscle. However, injuries can also be caused by overuse: repetitive stress and repeated microtrauma. When many athletes don’t have history of a direct injury and feel any sort of aching pain, tenderness, or swelling, they ignore these symptoms as insignificant issues that will “resolve” on their own. But these signs and symptoms should be taken seriously. Moreover, in many cases, injured athletes often have a fear of appearing weak, hence develop an unwillingness to seek medical treatment.

 

“No pain, no gain” is a phrase used by sports coaches and athletes to prompt improvements in athletic performance. However, misinterpretations of this phrase and a lack of self awareness, can be detrimental. Many athletes think that having a “no pain no gain” mentality is an important mindset to have when striving to achieve success in their activity of sport. Although achieving a high level of physical fitness requires pain, endurance, perseverance, and self discipline, this mentality, especially with younger individuals, can increase the risk of injury or cause one to avoid addressing an injury. Over-exercising and the inability to recognize the difference between discomfort (e.g. muscle soreness) and pain (pain that causes instability, extreme muscle weakness, and limits mobility), which can potentially lead to a serious injury. 

 

A key lesson I learnt is that any sort of pain is a warning signal from our bodies that something is damaged. As athletes, we want our bodies to be healthy, but if we don’t listen to the instrument that gives us the ability to perform our sport, the instrument will become damaged. And if something is damaged, it won’t get better if we leave it alone: we must take time to tune it or get it repaired. As such, it is important to listen to those signals, be conscious and aware of our own bodies, acknowledge our limitations, and get something checked up before it becomes a long term issue.

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A couple months later, I started to feel a sharp pain in my hip when I was dancing. My physiotherapist assured me that my hip pain was a minor issue resulting from misalignments and muscle tightness and so I continued training. However two months later, the pain just got worse. After getting an MRI, we discovered that I had torn my labrum in my hip, partially tore my gluteus minibus, and strained my iliopsoas. An orthopaedic surgeon informed me that at my age, labrum repair surgery was not an option. Instead, he recommended me to take 8 weeks off, and so I did. Another two months went by. I had not only lost a significant level of athleticism, but felt no sign of improvement. I was confused, frustrated, and angry at myself and at my doctor; why did my hip feel exactly the same even after taking such a long break? I struggled to find a solution. Months later, I finally found a physiotherapist who experienced a very similar injury that I had; she informed me that staying active (moderately) and consistent conditioning was key to relieve my hip pain. I realised that taking so much time off, had done more harm than good. 

 

Lesson 2: Self Responsibility 

 

At the beginning of my recovery, I put significant trust into any doctor I visited and would listen to any instructions given to me. However, this mislead me to make inappropriate choices that slowed down my recovery. 

 

However, I eventually realised that a medical professional’s diagnosis is purely a recommendation based upon the knowledge they know. Although doctors are are educated professionals, it does not mean that they won’t have limited knowledge and perceptions to a certain type of injury. Hence they can make diagnostic errors. Due to these reasons, it is important for one to consider a second opinion as well as approach various types of rehabilitation regimens in order to make the most informed decision on what’s the next best steps in their treatment.

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While dealing with my hip injury, I was landing from a jump during rehearsal and my foot slipped from under me. Within seconds, I was on the ground. Although I didn’t feel pain, I had a jolt of fear. I had twisted my ankle many times in the past, but this time it felt different – I had partially tore my lisfranc ligament and was instructed to take another 12 weeks off. 

Facing another huge set back while feeling like I was just starting to make progress with my prior injuries, was devastating; I felt uncertain that I would ever be able to return back to my sport.

 

Lesson 3: Acceptance

 

Many athletes may find themselves despondent after sitting out for a prolonged time as their involvement in sport is strongly attached to their identity. In other words, they identify themselves with their athletic role. Hence when they are faced with an injury and is consequently restricted or stopped, they don’t know what to do – even temporarily – without their activity. This threatens their sense of self worth as an athlete, which can lead to a state of confusion, fear, depression, and frustration.

 

In my experience, I found that when I constantly felt sorry for myself; my perception of my injury was frequently clouded with a sense of negativity. This lead me to have long term feelings of hopelessness. Although it was extremely frustrating to be immobilized for such a long period of time, I learnt, however, that it is very important to accept an injury or else recovery will be slow and incomplete. 

 

It was only until I accepted my injury that I was able to forget about it’s negative implications, alleviate overall stress, and fight unhealthy thoughts. This is because adapting to a mindset where an individual is able to recognize the process that must follow an injury, without attempting to change or bargain with it, will allow them to develop a sense of peace that encourages healing. Additionally, excess muscle tension caused by anxiety and negative thoughts can suppress the immune function and further delay the time it takes for an athlete to recovery. 

 

My thoughts looking back… 

Although recovery was a painful and stressful process, I have come back to my sport with a stronger and healthier mentality. As athletes, it is easy for us to take our bodies for granted and forget why we take part in a sport when it becomes part of our daily routine. However, being away from my sport for such a significant amount of time not only lead me to develop a newfound respect for my body, but has made me realise the importance of approaching every practice with gratitude, presence, and purpose in order to minimize the risk of injury and optimize long term success. 

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