Jacob Phillips

An injury doesn’t just affect an athlete physically but can also affect their mental health while they are in recovery. Sitting at home waiting to be cleared to play can take a toll on their mental health as they watch their team struggle or in some cases succeed without them.

One of the most infamous cases of this was with Olympic skier Picabo Street in 1998. One month after winning the gold medal at the 1998 Winter Olympics, Street would snap her left femur and tear a ligament in her right knee when she careened off course while racing at the final downhill of the 1998 Alpine Ski World Cup. Her rehabilitation took her 20 months to fully recover.

In an interview with the New York Times, Street explained what she was going through mentally: “I went through a huge depression. I went all the way to rock bottom. I never thought that I ever would experience anything like that in my life. I think it was a combination of the atrophying of my legs, the new scars, and feeling like a caged animal. I went from being a very physical person, a very powerful athlete, to barely having any strength to get from my room to the kitchen. You’re stuck and you can’t do what you normally do and it makes you crazy.”

One of the most important parts of the recovery process is to keep strong mentally.

Judy Goss, a professional sports psychol- ogist and a member of the Canadian Sport Psychology Association, told Scribe about her experience working with and helping athletes who go through mental health struggles when recovering from injuries.

“An important factor in how the injury affects the athlete mentally is how much does this take them out of their environment.

“If they have, let’s say, a shoulder injury and they can still go through physical conditioning with the rest of the team and be with the team during practices and have the team support them during recovery, the athlete won’t feel that feeling of isolation,” Goss said.

“Another factor is how much do they identify with the sport or their athletic identity. If they have a big athletic identity then they won’t think of themselves as anything other than an athlete,” Goss continued. “If they do suffer an injury and they can’t play, it will make the recovery process harder for them to complete [recovery] because they will have that emptiness because they can’t do what they want to do that makes them what they are.”

It happens all the time in sports, including in the NBA last season. All-Star Gordon Hayward of the Boston Celtics suffered a season-ending injury at the worst possible moment.

Hayward’s injury came just five minutes into the season when he broke his ankle playing against the Cleveland Cavaliers.

Hayward would miss the entire 2017-2018 NBA season as he watched the Celtics take the second seed in the eastern conference and go all the way to the eastern conference finals where the Celtics faced the Cavaliers in a close seven game series that the Celtics lost.

In an interview with NBC Sports when talking about his injury rehab Hayward said, “It’s been painful, but it’s nothing like sitting around watching the team you were supposed to be playing with this year. I signed to play for the Boston Celtics this year now to only sit and watch the Boston Celtics this year. That part has been difficult and much more difficult to deal with than the pain.”

One of the factors that can affect an injured athlete mentally is not wanting to be replaced, limited, or side-lined on the team. An athlete might not want to reveal the full extent of their injury to their coach so they can still play.

In a blog post called “The impact of injuries on mental health” Dr. Carla Edwards, a sports psychiatrist from the University of Guelph, gave examples in professional sports of athletes withholding injury information from their coaches. “It would be a challenge to find an athlete who has not withheld information about an injury to their coach (or treating staff). I admit that I did it on more than one occasion.”

Humber Hawks men’s volleyball player Jake Gomes, who suffered a stress fracture in his shin describes what he went through and how he is able to keep his mental health and morale up.

“I already had a feeling that something was wrong but I felt like I could play through it to provincials and nationals. It didn’t take long for our head coach to take charge when he noticed I was limping a lot.”

Humber Men’s volleyball head coach Wayne Wilkins shared examples of cases he

had to deal with when his players withheld that they were injured.

“It’s in an athlete’s nature to compete and they beat tons of other people to get a spot on the team and when they have an injury that could cause them to lose their role, that competitive nature kicks in and they don’t want to lose that spot to someone else.”

From the perspective of a head coach Wilkins has “seen players play through injuries because they tell me they are afraid of losing their spot on the team and I have to pull them aside and tell them that they need to sit because they’re hurting themselves trying to push themselves.”

“I try to reassure them that they will be able to keep their spot on the team.”

The most common reason for withholding this information is that the athlete does not want to risk being limited or sidelined. “In some sports, being sidelined for injury can lead to loss of their role on the team,” Dr. Edwards wrote. (For instance, when Dak Prescott replaced Tony Romo with the Dallas Cowboys 2016 season, or when Matt Murray replaced Marc-Andre Fleury for the Pittsburgh Penguins’ playoff run in 2016-17). “Some injuries can be concealed and the players try to play through them; while others necessitate an imposed break for treatment and rehabilitation,” she said.

Even then, every athlete’s response to the injury is different with no predictable first response or reaction to the injury and how long they will be out. The response to the injury, all matters on after the injury happens and the athlete’s immediate reaction, the post- injury surgery, rehab, and then how long they will be out until they can return to physical activity come into play. Common emotional responses to long term injuries are sadness, isolation, irritation, lack of motivation, anger, frustration, changes in appetite, sleep disturbance, and disengagement.

One of the not talked about points with athletes struggling with mental health as they go through injury is how a physiotherapist can not only help an athlete physically, but can also possibly help an athlete mentally.

Physiotherapists can be an injured athlete’s best friend and someone to talk to when an athlete is struggling mentally.

Darryn Mandel, a physiotherapist in North York, Ontario, said that physiotherapy is so much more than just guided stretches. Physiotherapists will use targeted exercises, massage therapy and other disciplines to help you not only return to your pre-injury level of performance but also help you improve your fitness overall.

“When an athlete is injured, usually their initial reaction is one of anger due to them not being able to play and being ignorant on how long it’s going to take to recover. And when they get told that this injury isn’t short- term like a week to a month, when they are told it could take six months or a year to fully recover their morale, emotions just drop and can cause them to be depressed Mandel said.

Players can also start to get anxious because they wonder if they can fully recover and play like they used to.

Mandel said an athlete’s mental state changes over the course of the rehab. “When they start to see improvements on how they’re recovering, they start to get more hopeful again, but because of this they sometimes try to rush their rehab.”

Mandel says athletes in recovery might expect to move the process along faster than the average person. “They can challenge their physiotherapist by saying ‘I want to move on already to the next step’, even though they are not physically and mentally ready for it,” he says. Rushing rehab can put athletes in a hole.

When asked on how to help athletes during this phase Mandel talked about how physiotherapists handle it. “You have to talk and counsel them on their injury. It’s more than just physical therapy, you also have to deal with their emotional and mental struggles so they don’t push themselves too hard and hurt themselves”.

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