1. Sports Injury Psychology David Smith MS ATC Sports Medicine 1

2. Injury • When the body is injured the mind is also affected • Research shows that athletes who experience negative response to injury have a longer and more difficult recovery • The nature of interaction with the coach, teammates, friends and ATC affect recovery either +/- • We must pay attention to the athletes MIND as well as their body to help them return to play

3. How to Treat an Injured Athlete • Psychologically the athlete will be devastated after major injury • Keep athlete as involved as possible during rehab • Must be positive in your approach at all times • Set Goals (Daily, Weekly, Monthly..)

4. How to Treat an Injured Athlete • Never Lie to the athlete • Let them know they are making progress • Never let them feel sorry for themselves • Know who you are dealing with

5. Psychological Reaction to Loss or Injury • Denial • Anger • Bargaining • Depression • Acceptance

6. Emotional First Aid • Normal Reaction • Be calm and reassuring • Over Reaction • Allow athlete to vent • Under Reaction • Be empathetic • Encourage them to talk and express feelings

7. Psychological Response based on Length of Rehab • Short (<4 weeks) • Reaction to Injury is Shock and Relief • Reaction to Rehab is Impatience and Optimism • Reaction to Return is Eagerness and Anticipation

8. Long (> 4 Weeks) • Reaction to Injury is Fear and Anger • Reaction to Rehab is Loss of Interest, Irrational Thoughts and Alienation • Reaction to Return is acknowledgement

9. Chronic (Recurring) • Reaction to Injury is Anger and Frustration • Reaction to Rehab is either a Dependence or Independence • Reaction to Return is Confident or Skeptical

10. Termination (Career Ending) • Reaction to Injury is Isolation and a Grief Process • Reaction to Rehab is Loss of Athletic Identity • Reaction to Not Returning is Closure and Renewal Example of Mark at UNM with ACL Injury

11. Considerations for the Coach • A coaches perception of the athlete makes a difference in that athletes recovery time and effort to come back • The coach needs to listen to the athlete beyond the complaining • Should listen for anger, depression or anxiety in their voice and actions

12. Considerations for the Coach • Neglected athletes or treating them like “outcasts” can contribute to an injury or re-injury. • Coaches who treat their players like they have no self worth when injured are not received well • Some coaches refuse to talk to the athlete or tell his teammates that he is “soft” or that he/she doesn’t want to play or isn’t tough enough

13. Return to Play • Coaches need to help the athlete when returning to play after injury not hinder them • It is the toughest part of the rehab process and the athlete will need encouragement

14. Return to Play • “you have to play with pain”? • “Give it up for the sport or my team”? • “I’m Invincible”? • Lack of this attitude may make them viewed as not being a team player or they are weak

15. Things a Coach can do to help the Athletes • Establish a rapport with the athlete • Earn the athletes trust • Establish good communication • Have an interest in the athlete prior to injuries • Be a good listener

16. Things a Coach can do to help the Athletes • Look the athletes in the eye to show listening • Don’t neglect or ignore the athletes • Facilitate social support of the team • Include the athlete in their feelings of return to play

17. Predictors Of Injury 1) Injury Prone Athlete • Those who take risks • Traits tend to be reserved • Detached or tender minded • Apprehensive • Over Protective • Easily distracted players

18. Predictors of Injury cont. 2) Stress • May be Positive or Negative • Positive are making all state team • Negative tend to lead to risk of injury • Negative examples are failing drug tests, not starting, costing the team the game

19. Predictors of Injury cont. • These lead to lack of focus and increased muscle tension therefore leading to injury • Lack of Focus may lead to miscues • Increased Tension leads to pulls, tears or major injuries

20. Observing Stress in Athletes • The coach is often the 1st to realize the athlete is becoming burned out, MUST back off!! • ATC must realize if the athlete enters the game or practice angry, frustrated or discouraged, can make them more prone to injury

21. What Causes Stress? • Training too hard w/o rest (Overtraining) • Coach who is like a drill sergeant • Lack of positive reinforcement and encouragement • Negative statements • Unreasonable expectations by self, coach, parents, teammates

22. Interventions for Stress Reduction • Unfortunately many coaches don’t have an interest in or ability to work with athletes who need help • Coaches of smaller teams may notice if one of the athletes is having problems.

23. Interventions cont. • If they notice something wrong refer them to someone that can get them help. • Need to do this quietly so it is not made a team issue that may embarrass the athlete

24. Using Buffers • Buffers are techniques that alleviate symptoms but do not address the problems. • Many athletes feel that the sport they play is the ONLY POSITIVE thing in their life!!

25. Buffers cont. • This activity gets them through the tough times of extreme stress • Some buffers that may help are Relaxation techniques, imagery, exercise, reduction of caffeine, treatment for sleep disorders and time management programs.

26. Relaxation Techniques • These allow athletes to control stress with a series of deep breathing, voluntary muscle contractions and relaxation exercises • Athletes that are coping well on own should not be forced into these exercises • We will do these relaxation techniques as a class

27. Imagery • Imagery is the use of all senses to create or recreate an experience in the mind. • Visual rehearsal, emotive imagery rehearsal and body rehearsal • Athletes visualize their success in competition beginning with basic skills to game situations • Body rehearsal helps the athlete in their healing process • Not all athletes respond to this technique

28. Create your own Imagery • We will now have you create your own imagery • I will give you some examples • Now write your own imagery and hand in • Write your name and period on it