REHAB AFTER INJURY: HOW SPORT PSYCHOLOGY CAN PUT YOU ON THE FAST TRACK

CARL, A 23 YEAR OLD PROFESSIONAL BASKETBALL PLAYER, contacted me one month after surgery to repair a meniscus tear. He was frustrated and discouraged, in large part because he had joined a new club where he expected to have more playing time, and generally looked to this to be a breakout season for him.

Having been away from playing for a month, he felt disheartened as he watched his teammates making progress and feeling like he would never catch up.

I shared with Carl the fact that nearly every player experiencing injury feels a sense of loss because he is no longer an active part of the team and feels like “what should have been” was taken away from him (in a small way not unlike what we experience after the loss of a loved one). Beyond this, it is typical for a player to feel a loss of identity because of the temporary inability to experience the on-court achievements that typically contribute to an athlete’s sense of identity and even his sense of self-worth. 

THE FIRST THING I WANTED TO HELP CARL WITH WAS TO CHANGE HIS ATTITUDE AND FEELINGS from discouraged to hopeful. He had many weeks of rehab ahead of him before he was likely to return to the basketball court and if he couldn’t see the “light at the end of the tunnel” he would have a pretty tough time.  So we talked about the progress he had made since he began his rehab work a few weeks ago. He told me things had gone rather well… in fact he was already running and going harder and further each day.

I suggested he write down once each week the progress he had made that week so that he could not only reflect on feelings of accomplishment, but also after three or four weeks he would be able to see an accumulation of successes which would really help him feel encouraged.  Beyond that, a series of successes would be a great source of motivation to keep working – even though he had many more weeks to go. (As the saying goes, “nothing succeeds like success.”)

I ALSO EXPLAINED TO CARL THAT BY SETTING WEEKLY GOALS   it would make things more manageable for him than the larger goal of returning to playing condition. Smaller goals that we can reach in shorter periods of time offer a greater sense of control than a single large goal whose accomplishment is a long way off, and when we feel in control we are more able to take action.

THE SECOND THING WE TALKED ABOUT WAS USING VISUALIZATION and three ways it could help him: 

(1)  To picture performing the rehab exercises properly and effectively. This can help an athlete get the maximum benefit from when he does the exercises by managing complete focus rather than just going through the motions.  Sometimes it can help an athlete to envision achieving greater range of motion in his mind than he is actually able to execute which can in turn speed up the rate of his progress in that respect.

(2)  To use visualization to picture some of his best moves and games from before he was injured, which can help him remain positive and confident about his game during this period when he cannot actually play.

(3)  To use visualization as a way of envisioning the moves and skills he needs to work on in a way that is available to him during his time of injury. When the American football player Michael Vick was in prison he spent time visualizing the plays as a way of staying ready to play. As he told the Wall Street Journal, “I was locked down for 23 hours of the day with only one hour to go out and walk around the yard. I used the time visualizing myself coming back and doing great things.” Other athletes also report successfully using visualization to simulate the kind of training they are unable to physically engage in, paving the way to a much quicker comeback once they are cleared to train and compete once more.

THE THIRD THING WE DISCUSSED WAS HOW TO BEST KEEP CONNECTED WITH THE TEAM PRACTICES EVEN THOUGH HE COULDN’T BE OUT ON THE COURT.  Carl told me that this also was very frustrating for him, as he watched his teammates working and improving while he sat on the sidelines. Of course it is much easier to learn and practice moves when you can actually do them, but it was important for Carl not to throw up his hands in frustration because he couldn’t do that.  Most of us would find it hard to keep a high degree of focus at practice in those conditions, but I asked Carl if he thought he could maintain total focus for five minutes, and he told me he could. I asked if he could maintain high focus for 10 minutes and he said he could do that too. Also, he agreed that he could keep his focus for 15 minutes. 

The point here is that trying to stay focused for a full two-hour practice when watching from the sidelines might be a daunting challenge, but doing this for 15 minutes is very “do-able.” I told Carl that if he could do this for three or four days in a row before long he would find himself able to stay focused for 20 minutes and soon for 30 minutes, and so on.

AND ONE LAST POINT I discussed with Carl to keep in mind during this period that can be highly frustrating. In such circumstance, friends and family want to help and often offer suggestions that may or may not be welcome … things like “Have you tried… ?” or “You should …” or “Why don’t you …?”  Such suggestions and advice may originate more in the needs of the giver to feel helpful than in what the injured athlete is ready to find actually helpful. For many of us, this only adds to the frustration (these “suggestions” sometimes make us feel like the other person thinks it’s so easy, and all you have to do is __________.) Of course, if you find such suggestions helpful that is great, but sometimes we find benefit in handling things in our own time and fashion. While we should be wary of indulging in self-pity, we all get to the point where we just want someone to know how frustrated we are without feeling that they have to either help us solve our problems or make us feel better.  I told Carl if he could find one person who would allow him to just “vent” – to just listen when he needed to share his frustrations without feeling the need to respond, he might find it helpful. While keeping in mind the critical importance of doing the work that will help you heal as quickly as possible and return to playing condition, a certain measure of “grieving” is not inappropriate. And just as mourners may find such comments as “God needed your wife/mother/sister, etc more than you do” to be unwelcome even if well-intentioned, the same thing might apply to similarly well-meaning comments (e.g., “Look on the bright side… ) made by friends and family.  As in all things, a measure of proportion is always suitable.