Getting back in the game: Using mental skills for sports injury rehabilitation
It’s no secret that after you get injured, you are going to have to engage in some sort of injury rehabilitation. Almost all rehab programs focus on improving physical attributes like strength, range of motion, balance, and functional training to get you back to playing your sport.
But, a lot of rehab programs are missing something.
Did you know… research has shown that one of the biggest predictors of returning to play after an injury is psychological readiness (1).
In the research world, psychological readiness is defined as follows:
Psychological readiness to return to sport after injury reflects an individual’s state of mental preparedness to resume sport-specific activities and is likely comprised of three dimensions, including cognitive appraisals (confidence, expectations, motivations, risk appraisals, internal or external pressures), affective (anxiety or fears about re-injury or movement, moods) and behavioral components (approach-avoidance behaviors to demonstrate physical function/neuromuscular control, and engage in sport-specific tasks). (2)
This is just a fancy way of saying that an athlete needs to feel mentally ready to go back to sport, and this includes factors like confidence, motivation, and positive mood.
So, how do we ensure that athletes are psychologically ready to return? Mental training.
Incorporating mental training into the sports injury rehab process is critical to ensure that athletes have the ability to cope during early stages of rehabilitation, and feel ready to return to sport at late stages of recovery. This may include a focus on the psychological components of rehabilitation, such as coping strategies, self-talk, visualization, goal-setting, and building confidence.
This blog post will explore the psychological impact that sports injuries have on athletes, various mental skills that athletes can use during the sports injury rehab process, and how to integrate mental training into physical training to help facilitate recovery.
Understanding the Psychological Impact of Sports Injuries
Athletes may deal with one or more of the following psychological consequences after sustaining an injury. It is important to understand and address these concerns, because they have a significant impact on athlete perceptions, functional outcomes, compliance to rehab protocols, and readiness to return to play. (1)(3)
1. Loss of confidence
Athletes commonly experience a reduction in confidence after an injury. Uncertainty around recovery timelines and outcomes, doubt, and questioning capabilities can all contribute. For many, performing well in competition is a source of confidence, and this is also taken away.
2. Fear of reinjury
Injuries are a huge source of fear and anxiety. Especially concerning the fear of re-injury, the fear of not being able to return to previous levels of performance, or the fear of missing out on future opportunities.
3. Loss of athlete identity
For many athletes, sport is central to their identity. When an injury sidelines you from competition, it can lead to a disconnect with the athlete identity and a struggle to define who you are outside of sport.
4. Mood disturbances and emotional distress
Injuries can trigger a range of negative emotions, such as sadness, anger, disappointment, frustration, and even guilt. You may experience a sense of loss and grief for the disruption to training, competition, and athlete identity.
5. Decreased self-esteem
A reduced sense of self-worth and personal value occurs with athletic injuries. This is coupled with a loss of identity and confidence as well as negative thoughts.
6. Reduced internal locus of control
Often, injured athletes feel a reduced sense of control over their situation. A low internal locus of control (and therefore high external or chance locus of control) has been associated with poorer outcomes after rehabilitation.
7. Social Isolation
Injured athletes commonly have feelings of being isolated from teammates and coaches and the broader sports community. Because they can’t participate in the same way, they may feel like a burden, or disconnected from their support networks.
8. Loss of motivation
Prolonged recovery, setbacks, and uncertainty can lead to a loss of drive and enthusiasm to adhere to long-term rehab.
So… how can an athlete address these things to ensure the best possible outcome for their recovery? Mental skills training!
Benefits of Mental Skills Training during Sports Injury Rehabilitation
Using mental skills training can help to specifically address the psychological impacts of sports injury.
Mental skills can help develop coping strategies to deal with negative emotions, stress and anxiety, and other challenges associated with injury.
Mental skills can help athletes stay motivated, resilient, and compliant with their rehab programs.
Mental skills can contribute to a faster recovery and more successful outcomes by addressing and overcoming psychological barriers, and promoting overall well-being.
The SIX Mental Skills for Sports Injury Rehabilitation
1. Goal-Setting
What is goal-setting?
The process of devising a plan to achieve the result you want.
There are two steps: identify WHAT your goal is and then determine HOW you will reach it
There are different types of goals: outcome, performance, process
Why is goal-setting important for sports injury rehabilitation?
Identifies clear objectives to enable a return to full fitness
Acts as a motivator, leading to productivity and results
Has positive effects on adherence to the rehab process (such as attending appointments, completing exercises, etc.)
Increases levels of self-efficacy and self-confidence by enabling a sense of achievement when goals are met.
2. Mindset
What is mindset?
An individual’s established beliefs, attitudes, and cognitive framework that shape their approach to challenges, setbacks, and performance.
Encompasses patterns of thinking and mental habits that influence how athletes perceive and respond to various situations
Why is mindset important for sports injury rehabilitation?
Influences confidence, resilience, and overall psychological well-being
Fosters a belief system that supports ongoing learning, embraces challenges, and encourages a proactive approach to overcoming obstacles
3. Self-Talk
What is self-talk?
Thoughts or statements addressed to the self.
It serves a function (i.e. it is instructional, motivational, etc.)
It is multidimensional (i.e. it can be negative or positive)
Why is self-talk important for sports injury rehabilitation?
Reinforces helpful thoughts, which leads to emotions and behaviours that contribute to a successful rehab outcome.
Boosts motivation
Improves coping mechanisms
Challenges and reduces negative thoughts, contributing to better mental health and reducing unwanted emotions.
Improves focus and concentration leading to more effective and efficient rehab sessions
4. Social Support
What is social support?
A form of interpersonal connectedness which encourages expression of feelings, reassurance, and improved communication and understanding. (4)
A multifaceted process in which an athlete is aided by the existence of a caring and supportive network, and by their perception of others’ availability to provide help in times of need. (5).
Why is social support important for sports injury rehabilitation?
Gives the athlete a sense of belonging and assurance that they are not isolated in their experience
Provides assistance during a challenging rehab process
Acts as a coping resource that can be drawn from when dealing with stressors.
5. Visualization & Imagery
What is visualization and imagery?
VISUALIZATION IS… Practicing a physical skill using mental images associating different senses
IMAGERY IS… cognitively reproducing an object, scene, or sensation as though it were occurring in physical reality.
Why are visualization and imagery important for sports injury rehabilitation?
Facilitates better coping with injuries
Helps manage emotions, anxiety, worry,and stressors
Helps to manage pain
Increases motivation to comply and adhere to rehabilitation
Prepares athletes for a successful return to pre-injury level of performance both physically and mentally
Aids in eliminating unhelpful thoughts
6. Relaxation Techniques
What are relaxation techniques?
Techniques that give you the ability to reduce energy level (relax) when needed.
Relaxation: “a temporary deliberate withdrawal from everyday activity that aim to moderate the functions of the sympathetic (fight or flight) nervous system which is usually activated under stress” (Hill, 2001).
Why are relaxation techniques important for sports injury rehabilitation?
Improves ability to cope with pain
Reduces symptoms of stress and anxiety
Reduces tension in muscles
Alters the body’s physiological responses (such as decreasing heart rate and blood pressure)
Acts as a pre-cursor to other mental skills, such as visualization
Want some specific exercises on how to use these techniques and skills in your training? Click below to get our FREE mental skills toolkit for injured athletes.
Practical Application of Mental Skills in Sports Injury Rehab
Develop a mental skills toolkit. Create a personalized plan of skills to develop and use throughout your rehab. If you don’t have one - we got you ;) (Click here to get ours for FREE).
Talk to your physical therapist / rehab practitioner. Ask them to help you integrate the skills into your rehab routines and treatment sessions. For example, you can practice visualizing a muscle getting stronger or tissues healing as you perform a squat (or whatever exercise your practitioner has given you).
Hire a mental performance coach. A mental performance coach can help you determine what mental skills are right for you, based on your individual needs and concerns. They can work collaboratively with your physical therapist to ensure that the physical and mental sides are working together.
Need a mental performance coach? I am accepting new clients. Click here to book a discovery call with me.
Closing Thoughts
Almost every athlete is affected psychologically after getting an injury. You’re not alone!!!
It’s super important to prioritize your mental well-being and recovery alongside physical rehabilitation. Including mental skills training in your rehabilitation will give you that edge to come back stronger and more resilient than ever when you’re ready to return to your sport.
Looking to add a mental performance coach to your rehab team?
You can book a discovery call with me here.
Or you can check out the “Find a Consultant” directories for the Canadian Sport Psychology Association (CSPA) or the Association for Applied Sport Psychology (AASP).
References
(1) Ardern, C. L., Taylor, N. F., Feller, J. A., Whitehead, T. S., & Webster, K. E. (2013). Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. The American journal of sports medicine, 41(7), 1549-1558.
(2) Podlog, L., Wadey, R., Caron, J., Fraser, J. J., Ivarsson, A., Heil, J., ... & Casucci, T. (2022). Psychological readiness to return to sport following injury: a state-of-the-art review. International Review of Sport and Exercise Psychology, 1-20.
(3) Christino, M. A., Fantry, A. J., & Vopat, B. G. (2015). Psychological aspects of recovery following anterior cruciate ligament reconstruction. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 23(8), 501-509.
(4) Heil, J. (1993). A framework for psychological assessment. Psychology of sport injury, 73-88.
(5) Rees, T. (2007). Influence of social support on athletes.
