Categorized | Health

Injuries: Coping With Not Being in the Game

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InjuryCoping with a sports injury, irrespective of which sporting discipline you participate in, requires both physical and psychological rehab. Sports injury recovery typically focuses on physical rehab, but it’s important to include sports psychology skills and techniques to help an athlete recover faster and learn to use physical setbacks to become a more confident and resilient athlete.

Athletes react to injuries with a wide range of emotions that may include denial, anger, sadness and even depression. An injury often seems unfair to anyone who has been physically active and otherwise healthy. Although these feelings are real, it’s important to move beyond the negative and find more positive strategies to cope with this setback. In many cases, dealing positively with an injury helps an athlete become a more focused, flexible and resilient athlete.

Learn About Your Injury
Learn as much as possible about the cause, treatment and prevention of your injury. Not fully understanding an injury can cause fear or anxiety. Ask the following questions of your doctor, trainer, coach or therapist until you know exactly what you can do to heal quickly and completely.

  • What is my diagnosis?
  • What type of injury do I have?
  • How long will recovery take?
  • What is the purpose of the treatments I am receiving?
  • What should I expect during rehab?
  • What alternative workouts can I safely do?
  • What are the warning signs that I am getting worse?

By understanding the injury and knowing what to expect during the rehabilitation process, you will feel less anxiety and have a greater sense of control. This greater sense of control can also increase your determination and allow you to set goals for recovery. First, however you must accept personal responsibility for the injury. What this means is that you accept that you have an injury and you are the only one that can fully determine your outcome. By taking responsibility for your recovery process, you will, once again, find a greater sense of control and will quickly progress in recovery, rather than dwelling on the past or blaming the injury on an outside factor.

To heal quickly, you must be committed to overcoming your injury by showing up for your treatments, working hard, and listening to and doing what your doctor and/or athletic trainer recommends. You also need to monitor what you are thinking and saying to yourself regarding the injury and the rehab process. Your self-talk is important. Are your thoughts negative and self-defeating? To get the most out of your daily rehab, you need to work hard and maintain a positive attitude. Remain focused on what you need to do.

Growing research shows that it may be possible to speed up the healing process by using a positive mental attitude and specific mental skills and techniques such as imagery and self-hypnosis.

Imagery techniques use all of the senses to create mental images, feelings and sensations related to a desired outcome as though it is happening now or has already happened.

A common response after an injury is to become isolated from teammates, coaches and friends. It is important to maintain contact with others as you recover from your injury because they can listen when you need to vent some anger or can offer advice or encouragement during the rehab process.

Just because you are injured doesn’t mean you should stop planning or setting goals. Rather than viewing the injury as a crisis, make it another training challenge. Your goals will now focus on recovery rather than performance. This will help keep you motivated. By monitoring your goals, you will also notice small improvements in the rehab of your injury. You will feel more confident that you are getting better and improving. Remember to work closely with your therapist or doctor. They can help you set realistic goals that are in line with each stage of your rehab. Most athletes have a tendency to try to speed up the recovery by doing too much too soon. It is important to accept that you are injured and know your limits.

Depending upon the type of injury you have, you may be able to modify your training or add alternate forms of training to maintain cardiovascular conditioning or strength. Work with your trainer, therapist or physician to establish a good alternative workout program, implementing different methods of exercise. For example, if you can’t run, perhaps you can cycle or swim. Create a modified, strength-training program. Do a limited amount of exercise to maintain cardiovascular fitness or focus on better nutritional health.

Exercise-induced injuries frequently prevent optimal training and competitive success for an athlete and can limit or discourage others from enjoying the health benefits of exercise. Enhancing recovery from sports injuries is therefore crucial to athletes and recreational trainers. Injured exercisers often use methods such as rest, ice, and/or stretching in an attempt to enhance recovery from injury, but frequently overlook nutrition.

These injuries generally have two main phases, both of which may be influenced by nutrition. Immobilization atrophy is the first phase. Depending on the type and severity of the injury, immobilisation can last from a few days to several months. During this time, metabolic changes in the tissues resulting from inactivity lead to loss of strength and function.

Rehabilitation and increased activity of the injured limb is the second phase. This phase follows the return of mobility, leading to muscle hypertrophy and the return of functionality. Unfortunately, the complete recovery of strength and function following injury-induced immobilization takes much longer than the time it takes to lose them. Whereas, the ideal, nutritional regimes may be similar for these two phases. Some differences that may be important to consider are the degree of inflammation, muscle loss, energy expenditure and rehabilitation.

Immediately following a severe injury, an inflammatory response is initiated, which is generally considered necessary for proper healing. The inflammatory stage may last from several hours to several days ,depending on the injury. But, as with many situations, too much of a good thing may be bad. Recommendations are often made to reduce the inflammation by using anti-inflammatory medication; however, given that inflammation may be critical for proper healing, artificially dampening it may not be wise.

During immobility, the most obvious change is a loss of muscle mass leading to reduced muscle function. Inactivity results in rapid muscle loss, and the primary metabolic factor leading to muscle loss is decreased muscle protein. Muscle protein balance is the metabolic mechanism responsible for changes in muscle mass. So nutritional interventions should focus on alleviating, as much as possible, the decrease in muscle protein synthesis so that any period of negative muscle protein balance is minimized. Increased protein intake is often the first nutritional countermeasure considered for muscle loss. However, protein intake may not have the same impact during inactivity.

Another important consideration during injury-induced immobilization is the total energy intake, such as calories consumed. By necessity, the total energy expenditure is likely to decrease during immobility. Depending on which limb is immobilized, a substantial decrease in total energy expenditure is likely because exercise is more difficult or less convenient. Furthermore, a more subtle reduction in energy expenditure may stem from reduced protein turnover. This fact contributes to the necessity for many injured athletes to dramatically reduce energy intake and avoid weight gain. However, there are factors to consider here. First, it is clear that during the healing process, energy expenditure is increased by as much as 20%, particularly early on and if the injury is severe. The total energy intake may still need to be reduced, but the reduction in calorie intake may not need to be severe.

Another factor related to calorie intake is the energy cost of moving around. If an injury results in the need for crutches, to get about, the energy cost can be dramatically increased. This increase results from the fact that, per unit of distance covered, walking with crutches increases energy expenditures 2 to 3 times over that of regular walking. Depending on how much ‘crutching’ is done, the energy intake may not need to go down by much at all. Although muscle loss is the obvious concern during inactivity, tendons and ligaments are also affected by immobilization. This results in changes in the way that tendons move, which is associated with decreased tendon collagen synthesis.

The functional situation and metabolic requirements during the rehabilitation stage may be very different from those during enforced inactivity of the limb. It’s likely that the overall energy expenditure will increase to a greater or lesser degree. Muscles that have atrophied will begin to hypertrophy with increased activity. Moreover, muscle protein synthesis requires a lot of energy, which will further increased energy requirements.

With the right knowledge, support and patience, an injury can be overcome without turning your whole world upside down. By taking things slowly, setting realistic goals and maintaining a positive, focused approach, most athletes can overcome minor injuries quickly and major injuries in time.

About Hari McCormack

I studied sports coaching and sports injuries at the University of Wales Institute Cardiff, my main areas of interest include injuries within performance and the interpretation of women in particular within male orientated sport. In terms of sporting performance I am an International Women’s rugby player and have also played international hockey, however I am currently a teacher with the aim of passing on my pride and passion in sport on to future generations.

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