Beyond the Physical Impacts of Sport Injury

Athletic identity is the extent to which a person aligns with an athletic role in their life1. Physical injuries causing a decline in athletic ability may have greater psychological impacts on individuals who have stronger ties in their athletic identity1. Common emotional reactions to injury can include anxiety, sadness, isolation, frustration, changes in appetite and sleep disturbance2. While these reactions are fairly normal and can certainly almost be expected, as fellow athletes, coaches or trainers, it is important to recognize more serious, and potentially problematic responses to injuries. Such reactions can include disordered eating, alienation, verbal and nonverbal behaviours, emotional outbursts, and substance abuse2

Sport and physical activity are often a primary coping method for athletes’ psychological stress3. High levels of stress can slow recovery time4, and when coupled with a removal of their coping method, athletes can experience substantially higher levels of stress surrounding their recovery. Additionally, experiencing pain is often normalized in sport, leading to athletes downplaying injuries instead of taking time to recover3. Injury stigma plays a large role in the social influences surrounding athletic injury, which can lead to athletes suppressing their injuries and even experiencing feelings of shame. Athletes feel like they can’t speak up due to fear of loss of play time, respect, legitimacy, performance and fitness3.

Physical injury can accumulate and trigger many psychological impacts that extend well beyond the physical healing period. Studies show an athletes confidence in return to play and previous athletic ability is tied to a perception that their injury has healed5. In one study, it was found that athletes who tore their ACL noted a significant decrease of pain over a time period, but during that same time period their fear of movement and re injury did not decrease6. There are strong links between an athlete’s psychological response to injury and rehabilitation outcomes, tied to fear of re injury, mood state, and sense of identity5. Athletes who are physically ready to return to sport but not mentally ready can experience significant barriers in their to return to play. Issues like decreased confidence, worry of sustained injury, higher risk perception and less confidence in ability to avoid an injury all play a role5. Regardless if they’re physically ready, athletes who are not psychologically ready to return to sport are in fact more at risk of re injury, poorer sport performance, and overall lower quality sport experience7.

Investment in athletics or team sports comes with increased social connections and coping methods which can reinforce and positively impact personal identity with regards to self-esteem and confidence. When athletes experience physical injuries, it can often be extremely devastating on their mental health due to a loss of the aforementioned factors. So with that in mind, it is important to consider the effects that physical injuries have on athletes beyond what can be seen with the naked eye. Physical recovery is widely accepted and often emphasized for athletes, but there needs to be more emphasis on psychological recovery as well. According to the National Collegiate Athletic Association (NCAA) there are a couple things that can be done. A good step in the right direction can be creating a good support network for an injured athlete including teammates, coaches, athletic trainers and physicians2. As a coach or athletic trainer, it is important to understand and recognize common signs for mental health issues2. Both teammates and coaches can support injured athletes by helping them remain involved with the team2. Even something as simple as “giving an athlete permission” to seek treatment can be significant for athletes who may try and push through their injury or are experiencing feelings of guilt2. If stigma surrounding physical injuries can be mitigated and further psychological support offered for injured athletes, athletes’ recovery time would ideally be minimized for more effective and efficient return to play. After all, the ultimate goal is to get athletes back on the field at 100% while mitigating both the negative physical and psychological impacts of injury. 

Sources
  1. Why Athletic Identity Is an Issue – https://www.academia.edu/17980593/Athletic_identity_and_its_relationship_to_sport_participation_levels[][]
  2. Mind, Body and Sport: how being injured affects mental health – http://www.ncaa.org/sport-science-institute/mind-body-and-sport-how-being-injured-affects-mental-health[][][][][][]
  3. Athletic Identity, Psychological Flexibility and Motivation for Return to Sport in Injured NCAA Athletes – https://search.proquest.com/openview/175a5934c7a36e0fb6ef767f1580ba6c/1?pq-origsite=gscholar&cbl=51922&diss=y[][][]
  4. The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3052954/[]
  5. Factors Associated with Psychological Readiness to Return to Sport After Anterior Cruciate Ligament Reconstruction Surgery – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598700/[][][]
  6. Physical Activity in Former Competitive Athletes: The Physical and Psychological Impact of Musculoskeletal Injury – https://www.researchgate.net/profile/Hayley_Russell/publication/321691197_Physical_Activity_in_Former_Competitive_Athletes_The_Physical_and_Psychological_Impact_of_Musculoskeletal_Injury/links/5afca5370f7e9b98e03e8a21/Physical-Activity-in-Former-Competitive-Athletes-The-Physical-and-Psychological-Impact-of-Musculoskeletal-Injury.pdf[]
  7. Effectiveness of psychological intervention following sport injury – https://www.sciencedirect.com/science/article/pii/S2095254612000415[]

5 Comments

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I relate to the study regarding the tearing of an ACL. I found it very difficult to return to downhill skiing after that same injury. Although I am not a professional athlete, I do hope that both amateur and professional athletes will begin to benefit from the increased awareness of psychological affects from injury as our society studies and understands more and more the effects of that aspect of injury.

I completely agree with your point Colette. I hope that by sharing experiences and spreading awareness regarding this topic, we can provide further support to those individuals who are experiencing injury.

Thank you for taking the time to write out this article, I am not active in competitive sports anymore but I think back to all my time playing these sports where I played through pain. Not only because it was the norm, but I missed playing so much and I felt taking time would let my team mates down.

Hi Fred, thank you for taking the time to read my article and for sharing your experience. I myself have experienced similar feelings when I am injured. Although you are not playing competitive sports anymore I hope that you have found other passions, whether that be in sports or anything else!

Your article is very poignant in today’s society, especially when we are reading about studies and concerns over the numerous incidents of concussions in sport. For years this injury has been downplayed and ignored and I’m sure athletes have persevered with unfortunate outcomes later in life. Stigma around the psychological recovery and the ignoring of what an athlete goes through that is internal or unseen is starting to change with articles like yours that begin to shine a light on how things can and should change.

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