Injuries. (the psychological effect)

Injuries. The psychological trait of, and effect to an athlete, from inception to rehabilitation.

By Andy Matson

“Over the years, I have learned when to back off.” (Allen, n.d. Cited in Friel & Byrn, 2003,PP.141)
If only more athletes would adopt Mark Allen’s approach, playing fields, gyms and running tracks would be a safer, happier place. Unfortunately it’s all to common now to see so many athletes of all walks of life, from elite to your local club runner with injuries.
Why is this? Is it something to do with their physiological makeup, overtraining or could it be a psychological problem. Well the truth is it is probably a number of occurrences that cause the onset of an injury.
This article will take you through the psychological effects to the injured athlete. It will look at why certain athletes are prone to injuries more than others. From the time of inception to rehabilitation. Finally by using the power of the mind to enhance recovery.


The injury
Sports injuries can be defined as an injury that’s a result from trauma, e.g. a direct blow, or overuse, usually repetitive movements.
Nearly every injury exhibits some form of warning sign, e.g. pain, tight muscles, swelling and inflammation.
Warning signs that are ignored are often when full- blown injuries occur. Many athletes who have an injury cannot remember how the injury happened, again ignoring the warning signs. They do however remember the amount of training time they have missed as a result of their injury.

Studies into Injuries
A study in the United States estimated that 3-17 million people are injured every year in sport, exercise and recreational environment. (Bijur, et al.,1995 cited in Weinberg & Gould,2006,pp.448).
In another study, up to 18% of time loss as a result of an injury was explained by psychological factors (Smith, et al., 2000 cited in Weinberg & Gould, 2006, pp.449)
Scenario of an injured athlete
It is the start of the triathlon season and Kate (A name I have randomly picked) has big aspirations for the season. Kate trains hard; she also has a stressful work and home life. Mid way through the season she becomes injured, again.
This has happened for the last two seasons. Most of the time they are minor injuries and she only needs a week or two to recover. This time her injury is going to put her out for the rest of the season.
Does this sound familiar? How many Kate’s are out there?
The Kate scenario happens far too often. There is a psychological pattern why some athletes get injured more than others so let’s take a look.


Stress and the Athlete
Athletes with high levels of stress tend to have more sport related injuries than athletes with less stress in their daily lives. It is also true that physical reasons are the main cause of the injury, but psychological factors play their part as well. Psychological factors also play an important part in the rehabilitation process; we will look at this later.
Sport psychologists showed the relationship between a stressful athletic situation (e.g. Competition, important practice, poor performance) and injuries. It was shown, depending on the athlete and how threatening they perceived the competition or practice, will determine their stress levels. Some athletes will cope with the situation better than others. If the athlete finds the environment they are in as threatening, it will cause a number of changes in their focusing skills and attention. What will probably happen next is a tightening up of their muscles, resulting in an injury. (Williams & Anderson 1988 cited in Weinberg & Gould, 2006, pp.448)
Stress is not the only psychological reason to cause an injury, but is an important one that needs to be addressed at source and sometimes overlooked by the sporting field. Other psychological factors such as self esteem also play their part.

Everyone needs to understand how stress can affect the athlete in their sporting abilities. Coaches, managers, family and friends and of course the athlete themselves must learn ways to help the athlete cope with stress. It is important to build a rapport with the athlete especially once the reality of the injury has sunk in. Trying to understand how the athlete feels and working together will show the athlete they are not forgotten.


Coping with stress (stress management)
Many athletes would benefit from stress management techniques as a way of coping with stress, whether it was in their sporting field or home life. Research has demonstrated that effective reduction in the stress response is associated with a reduction in the number and severity of injuries sustained by athletes. (Davis, 1991 cited in Cox, 2002, pp.411)

Psychological responses from inception
Some of the psychological responses to look out for from the onset of the injury are;
Anger, frustration, depression, confusion, and denial.
Researchers have also studied self confidence and self efficacy in injured athletes. Self confidence and self efficacy decline as a result of a sports injury. (Connelly, 1991 cited in Cox, 2002, pp.415)
Some athletes may start to feel that they are worthless once they have an injury. Also taken part at all cost will result in multiplying the severity of the injury; this would be denial in the worse case.
Some athletes experience additional psychological reactions to their injuries. They are: identity loss, fear and anxiety and performance loss. (Petitpas & Danish, 1995 cited in Weinberg& Gould 2007, pp.453)
Knowing when to back off is the key and sometimes this takes confidence!


Knowing when to back off. Unfortunately this tends to be hard for some athletes for reasons just mentioned (confidence, denial). Overtraining tends to happen if the athlete is not giving their body enough time to recover. Some athletes feel that more is better, or they try to follow training plans set for more experienced athletes .Some of the psychological signs to look out for are: disturbed sleep patterns, loss of appetite and irritability. Athletic performance will also suffer. One way to limit the chance of overtraining thus resulting in an injury is to plan your season. This is called an annual training plan or periodized training.

The power of the mind to aid recovery
So far we have looked at how psychological factors play their part in injuries; it has also looked at the psychological responses to the injury and overtraining. Now it will look at some psychological coping strategies.
It has been shown in a past study that using psychological strategies such as stress control (already talked about), self talk, imagery and goal setting can enhance the recovery phase of injury. (Levleva & Orlick, 1991 cited in Weinberg & Gould, 2007, pp 455)
Athletes who are self motivated and positive will more likely to follow a treatment plan for their injury, and avoid re-injury.
Social support is also an important coping strategy, this could come from friends, family and other athletes around.

Self talk
What is it? Well it’s basically talking to yourself. It can be used to change habits from bad to good, focus your attention on a situation or even boost your confidence. An example of self-talk for an injured athlete could be, “healing takes time, and I will recover.” In competition you could use key words to control their physical arousal (e.g. “Easy,” “Quiet,” “Relax,”) uplifting words (e.g.” Go,” “get up,” “faster”) It would be prudent to always choose words and affirmations that suite the situation and the athlete.

Imagery has been defined as “Using all the senses to re-create or create an experience in the mind.” (Vealey & Greenleaf, 2001 cited in Cox,2002,pp.261)
Most athletes if not all have used some form of imagery (sometimes called visualization). Athletes usually take either an Internal or External perspective for viewing their imagery. (Mahoney & Avener, 1977 cited in Weinberg & Gould, 2007,pp.301)
Internal, is viewing from your own vantage point, e.g. a camera on your head. If you where a runner you would see all the other runners around you and imagine yourself picking them off one by one.
External imagery is you viewing yourself from the outside, just like you were watching a movie of yourself. Athletes would benefit using imagery for coping with pain and injury. It can help speed up the recovery process and keep up skills from deteriorating. ( Levleva & Orlick, 1991 cited in Weinberg & Gould, 2007, pp.308)
The athlete recovering from an injury could imagine themselves returning back to fitness stronger than ever.

Goal setting
Goal setting is the theory of motivation that effectively energizes athletes to become more productive and effective. (Locke & Latham, 1990 cited in Cox, 2002,pp.90)
Goal setting is a useful tool for the athlete when recovering from an injury. Setting short term goals first is a good start. Long term goals could be set once the athletes is well on the road to recovery. Caution! Weinberg & Gould (2007) state that highly motivated athletes tend to want to do more than is required during the recovery phase, and they can reinjure themselves.

Another reaction that affects the athlete is the fear of re-injury. Athletes who are concerned about re-injury or feel that that they are not fully recovered may re-injure themselves. Example- athlete returns back to competition; they will experience negative thoughts about their injury. This will cause the athlete to become distracted and lose control and then become injured. On the other hand athletes who take a positive view about their injury will learn from their injury and find new ways to combat re-injury. While every athlete fears injuries and re-injury there are benefits, rest is a key element in recovery, also some athletes will experience personal growth.

This article has looked at the psychological effects an athlete encounters through their injury. It has also seen why some athletes tend to get injuries more than others. Athletes who are positive about their injury will recover quicker and are less likely to re-injure themselves. This has given an interesting insight into the psychological aspect of athletes with injuries.
Athletes need to recognise the importance to train the mind as well as their body and take a holistic approach to their sporting activities. Stress plays a major part in injuries and needs to be addressed. Use some of the techniques mentioned above, and use all the resources around you to help(social support).
Coaches also need to be also aware of the psychological responses and personality traits of their athletes and adapt training accordingly. It’s no use the coach pushing the athlete to extreme limits if they are not aware of the consequences.
So let this leave you, the reader with one last thought. Remember! “Your legs will go wherever your mind takes it.”

Allen, M., n.d. Going Long. Boulder: Velo Press.
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Connelly, S.L., 1991. Sport Psychology concepts and applications. 5th ed. New York: McGraw- Hill.
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Petipas, A., & Danish, S., 1995. Foundations of Sport and Exercise Psychology. 4th ed. Leeds: Human Kinetics.
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Vealey, R.S., & Greenleaf, C.A., 2001. Sport Psycholgy concepts and applications. 5th ed. New York: McGraw-Hill.
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Williams, J.M., & Anderson,M.B., 1998. Foundations of Sport and Exercise Pychology.4th ed. Leeds: Human Kinetics.