Caleb Christie

Sport Psychology

Psychological Response to Injury

Dealing with a sport injury is one of the hardest things for an athlete to do.  The athlete often feels lost and scared.  However, everyone reacts in different ways and it is important  to understand what an injured athlete is going through to help them get through that hard time in their life.  Some athletes might react well to being injured they will have a plan and continue accordingly. While others react poorly obsessing about when they can come back or might have lots of anger and confusion about their injury. When an athlete is injured they will go through a wide range of emotions such as anger, depression,scared, and stressed from the loss of their self identity and the team atmosphere. This can be very hard to deal with.   What ever the injury maybe there are many different stages and emotions that an athlete goes through during time of injury and the process through recovery.

Part of dealing with a sports injury is going through a grief period.  Everyone grieves in different ways but when involved in a sport injury it is typical for a person to go through five stages.  Those stages are denial, anger, bargaining, depression, and acceptance and reorganization (Hardy, Grace 1990).   Keep in mind that each athlete is different and will continue through the five stages in a different order and pace.  A person my skip one stage and then revert back to another.  “...People do not move neatly through set stages in a predetermined order, rather, many have more than one of these emotions and thoughts simultaneously or revert back to stages that they have experienced previously (Udry et al., 1997).”   Depending on the type and severity of the injury each persons reactions are going to vary.   I don't believe that every injured athlete will go through all five stages of grief.  Everyone has a different state of mind going into an injury which often times has an affect on the grieving period after the injury and through the recovery process.  Many athletes know and understand the risk of having an injury occur during participation.  I feel that this type of person may skip a few of the stages and get right to the acceptance and reorganization stage.  However, if you think you are invincible or never even consider getting hurt while playing a sport I can see how you could become very angry.    

Anger is a feeling that many people will go through when being injured. “Not being able to play, train, practice or compete can come as a huge blow to an athlete, often producing anger at the unfairness of being sidelined with injury, especially if they believe they weren’t to blame (Thompson 2010).”  When an athlete puts so much time and effort into their sport and it is taken away from them in an instant its easy to see how anger can take over.  "Whenever something is taken from you and you don't really have control over that process -- most humans don't respond well to this (McKeag 2010)."  I believe this makes a lot of sense. Think about another aspect of life, not sports. Lets say your only mode of transportation breaks down unexpectedly and you had no time to prepare for this it would be very upsetting and probably cause you a lot of anger.  It’s the same in sports.  When an injury happens you don’t necessarily expect it at that moment, it’s reasonable to show and have feelings of anger. Having your sport taken away from you does not only make you angry but it can also take away your self-concept and self-image.

Being injured effects more than just their athletic life.  An injury can be very debilitating; preventing the athlete from working and living a normal life for the period of time that they are injured.  “For athletes and physical impairment that prohibits active involvement in their sport, whether temporary or permanent, can be cognitively, emotionally, and behaviorally challenging (Pedersen, 1986).”  You can lose a big part of your life with an injury not being able to do things that you were once able to do.  If you were a highly active person that is limited physically with an injury your life will be dramatically changed and very hard to cope with.  Athletes often identify themselves by who they are as an athlete.  Often time an injury will put a lot of stress on ones self-concept. No longer being able to participate in a sport due to injury can be very hard and upsetting, it can feel like a loss of identity.  “ Identity loss, some athletes who can no longer participate because of an injury experience a loss of personal identity.  That is, an important part of themselves is lost, seriously affecting self-concept (Weinberg and Gould 2007).”  I agree with this quote, people often times identify themselves with the sport they play.    Take Bret Favre for example, he has retired a few times and came back.  I know this is not an injury but I do think it shows how ones identity can tie in directly with the sport they play.  I think Bret left the sport and missed it so much he didn’t know what else to do other than play football.   Favre is lucky that he has that choice to come back, many injured athletes just have the sport ripped from their lives. 

Anger and the loss of self-concept are only a few of the emotions when dealing with a sport injury.  When athletes are injured and unable to engage in physical activity they may have difficulty dealing with other daily stresses.  “The development of neuroses in fitness fanatics deprived of exercise was at least partially because their life stress prior to injury or illness had been managed by physical activity rather than by articulating emotional concerns (Smith 1990).”  Furthermore, the injury can produce additional stress that may induce emotional disturbance.  It’s easy to relate to this quote. Sometimes the best way to release stress is to participate in physical activity.  If you unable to release the toxins that produce stress by means of physical activity then often times you will find yourself in a worst spot emotionally then where you started. Furthermore what may cause this stress is fear of failure, social evaluation, and the loss of control over ones environment.

Not being able to participate with your team can have a huge emotional toll on injured athletes.  Being apart of a team can feel like being apart of a family; there is constant support and stability.  Being injured for a long time rips this away from you and consequently can put you in an uncomfortable emotional state.    “A disturbance to the fulfillment of that need causes anxiety and may be traumatic in the extreme (Deutsch, 1985).”  Not all injuries cause the same amount of emotional stress.

Many times athletes emotional reaction to a sports injury is do to its severity.  According to the study Self-esteem and Coping Responses of Athletes With Acute versus Chronic injuries  (Wasley 1998),  the type of injury may determine differences in self-esteem and coping behavior. Several studies have demonstrated that chronic injuries have a greater effect than acute injuries.  In other words, athletes that suffer from a severe injury are going to express more depression, tension, fatigue and confusion than a less injured athlete.  Another factor to a person’s reaction to an injury is the time invested in that particular sport.  People who are more involved in sport and exercise before injury registered higher levels of confusion and perceived their recovery to be less at the end of rehabilitation.  “A stronger connection between athletics and self-identity is created as the athlete invests more time in sport. For this reason the emotional disturbance may be greater among those who invest more time in sport ( Johnston and Carroll 2000).”  It’s easy to see that an injured athlete who has put in many hours and even years into their sport may become emotionally hurt when their sport is taken away from them.  Not only does invested time in the sport play a role into an athletes emotional state when injured but it can also have an affect on the way an athlete reacts to an injury. 

  Another factor that should be considered when taking about emotional response to injury is age.  Young adults, older adults, children and teens all differ in their self-perceptions, emotional responses, social influences, motivations and self regulation skills relative to physical activity and sport involvement (Weiss 2003).  Younger age groups like adolescents tend to cope with sports injuries better than older groups they are able to become less depressed over time and also tend to have more social support (Manuel 2002).  Athletes at the college level tend to have common responses like disbelief, fear, depression, tension, insomnia, loss of appetite and fatigue.  Again, college athletes have invested much more time than adolescents, so there emotional state is often more severe.

Although injuries can be frustrating to an athlete, there are ways to help and rehabilitate them psychologically; social support being one of them.  Research suggests that social support can be an important coping resource for athletes recovering from a sports injury.  “Ten elite downhill skiers who had recovered from serious sport injuries were interviewed about the sources of stress associated with injury and the role of social support in recovery from sport injury. Content analyses of the social support data revealed that the skiers needed various types of emotional, informational, and tangible support from the occurrence of injury through the return to full activity. Members of the treatment team, the ski team, and the skiers' home support net works provided social support throughout these phases. In general, the skiers were satisfied with the support received, indicating that it reduced distress and kept them motivated throughout recovery. The findings from this research have implications for the design of sport injury interventions (Bianco).”  I agree that social support from friends, family, and doctors would help with an injured athlete.  When so much stress is involved with an injury it would really be helpful for your support system to stay positive and help relieve stress.

There is another study “Social support patterns of collegiate athletes before and after injury” that examines the pre-injury and post-injury social support patterns among male and female collegiate athletes.  It seems to me that females would have more social support than male athletes. However that is not the case.  According to the study females have less support but have greater satisfaction with the support received.  Also reveled in this study “Injured athletes reported relying more on coaches, athletic trainers, and physicians  for social support after they became injured. Athletes also reported greater post injury satisfaction with social support received from friends, coaches, athletic trainers, and physicians (Yang 2010).”  From this study its easy to see that having a good support system of friends, trainers, coaches and doctors is important for a positive and satisfactory recovery.  If you can place yourself in a strong support system your recovery from an injury is going to be less stressful.  I feel this study is very useful and can be a good source of information for a coach, parent or friend of an athlete who has been injured.

It’s just as important to attack an injury from the psychological perspective as it is to physical side of the injury itself. “Many athletes spend hours and much energy each day physically preparing for competition, more often than not they are unprepared psychologically to handle the stress associated with an unforeseen or unexpected injury. (Crossman 1997.)”  My experience throughout my sports career, which does include three years of collegiate level, you have all the tools needed to rehabilitate physically but have no resources to recover psychologically.  Still to this day there are limited resources to the psychological side of an injury.  Its important for athletes to have some sort of outlet to deal with the stress of a debilitating injury.  I recall breaking a bone in my hand and having to sit out a year.  At that time I received no support from the team, I felt that since I was no longer helping the team they didn't want anything to do with me.   It’s crucial for coaches and players to help injured athletes by being supportive.

Suffering from an injury can put a lot of stress on an individual.  Many athletes will go through a grief period that could include anger,  depression, loss of self, and confusion.  You never know how a person will react but there is going to be some sort of stress involved with every injury. There are many tools and resources for an injured athlete to recover physically but not necessarily emotionally.  Emotional pain from an injury can be just as destructive as the physical injury itself.   A good support system that includes family, friends, coaches and even doctors can help the injured athlete recover emotionally and return to the state prior to that injury.

Sources

Bianco, T. (2001) Social Support and Recovery From Sport Injury: Elite Skiers Share Their Experiences. Retrieved from PubMed database.

Crossman, J. (1997, May). Psychological rehabilitation from sports injuries. Sports Medicine,

23(5), 333-339.

Deutsch, R.E. (1985). The psychological implications of sports related injuries. The

International Journal of Sports Psychology, 16, 232-237.

Hardy, L. (1992, July). Psychological stress, performance, and injury in sport. Abstract

retrieved  2006 from PubMed database.

Johnston, L.H., & Carroll, D. (2000). The psychological impact of injury: effects of prior sport

and exercise involvement. British Journal of Sports Medicine, 34, 436- 439.

Manuel,  (2002,). Coping with sports injuries: An examination of the adolescent athlete. Journal of Adolescent Health, 31(5), 391-393.

McKeag, D. (2010). Athletes Recovering From Injuries Can Experience Depression, Anger, Denial. Retrieved 2010 from newsinfo.iu.edu/web/page/normal/9614.html

Smith, A.M., Scott, S. G., & Wiese, D.M. (1990). The psychological effects of sports injuries coping. Sports Medicine, 9(6), 352-369.

Urdy, I. (1997) Coping with Sport Injury: Response loss and the Role of Social Support. Retrieved from web. ebscohost.com.

Wasley, D., Lox, C.L. (1993, June). Self-esteem and coping responses of athletes with acute versus chronic injuries. Abstract retrieved  2006 from PubMed database.

Weinberg, R. Gould, D. Foundations of Sport Exercise Psychology. pg 453

Weiss, M.R. (2003, June). Psychological aspects of sport-injury rehabilitation: A developmental perspective. Journal of Athletic Training, 38(2), 172-175.

Yang J, Peek-Asa C, Lowe JB, Heiden E, Foster DT. (2010) Social Support Patterns of Collegiate Athletes Before and After Injury.  Retrieved from 2010 PubMed database.