1、Chapter 12: Helping the Injured Athlete Psychologically,An athletes mind is also affected when the body is injured Negative psychological response to injury often results in longer and more difficult period of rehabilitation Appropriate psychological care provided by the sports medicine team may fac
2、ilitate the athletes return to competition Must work together to get the mind and body ready to return to competition,Coaches and fitness professionals working with injured athletes must have an understanding of how athletes react to injury and the rehabilitation processThe manner in which coaches a
3、nd professionals support the injured athlete can have a dramatic impact on the rehabilitation process,Athletes Psychological Response to Injury,Athletes deal with injury differently Viewed as disastrous, an opportunity to show courage, use as an excuse for poor performance, or exhibit courage Severi
4、ty of injury and length of rehab Short term (4 weeks) Chronic (recurring) Terminating (career ending),No matter the length of time, three reactive phases to the injury process occur Reaction to injury Reaction to rehabilitation Reaction to return to play or termination of career Other matters that m
5、ust be considered are past history, coping skills, social support and personal traits Injury may impact a number of factors socially and personally Be aware of possible self-esteem issues,Predictors of Injury,Some psychological traits may predispose athlete to injury No one personality type Risk tak
6、ers, reserved, detached or tender-minded players, apprehensive, over-protective or easily distracted Lack ability to cope with stress associated risks Other potential contributors include attempting to reduce anxiety by being more aggressive or continuing to be injured because of fear of failure or
7、guilt associated with unattainable goals,Injury prevention is physiological and psychological Athlete under stress emotionally is prone to injury compared to one that is adjusted emotionally Example Angered athlete may attempt to take out frustrations on other players, lose perspective on desired an
8、d approved conduct Skill and coordination could be sacrificed resulting in injury that may have been avoided,Stress and Risk of Injury,Stress is defined as positive and negative forces that can disrupt the bodys equilibrium Tells body how to react A number of studies have indicated negative impact o
9、f stress on injury particularly in high intensity sports Results in decreased attentional focus, create muscle tension (reduces flexibility, coordination, & movement efficiency),Sports can serve as stress to athlete. Athlete will walk a fine line between reaching and maintaining performance Must be
10、able to handle peripheral stressors imposed Expectations Stress from school, family, and work can also lead to emotional stress.,Overtraining,Result of imbalances between physical load being placed on athlete and his/her coping capacity Physiological and psychological factors underlie overtraining C
11、an lead to staleness and eventually burnout,Recognition and early intervention is key Implement short interruption in training Should lower work load but maintain training intensity until athlete shows signs of recovery Follow with gradual return to same workload Should be removed from competition d
12、uring this time period,Staleness Numerous reasons including, training to long and hard w/out rest Attributed to emotional problems stemming from daily worries and fears Anxiety (nondescript fear, sense of apprehension, and restlessness) Athlete may feel inadequate but unable to say why May cause hea
13、rt palpitations, shortness of breath, sweaty palms, constriction of throat, and headaches Minimal positive reinforcement may make athlete prone to staleness,Symptoms of Staleness Deterioration in usual standard of performance, chronic fatigue, apathy, loss of appetite, indigestion, weight loss, and
14、inability to sleep or rest Stale athletes become irritable and restless Increased risk for acute and overuse injuries and infections,Burnout Syndrome related to physical and emotional exhaustion leading to negative concept of self, job and sports attitudes, and loss of concern for feeling of others
15、Burnout stems from overwork and can effect athlete and coach Can impact health Headaches, GI disturbances, sleeplessness, chronic fatigue Feel depersonalization, increased emotional exhaustion, reduced sense of accomplishment, cynicism and depressed mood,Goal Setting as a Motivator to Compliance,Eff
16、ective motivator for compliance in rehab and for reaching goals Athletic performance based on working towards and achieving goals With athletic rehabilitation, athletes are aware of the goal and what must be done to accomplish Goals must be personal and internally satisfying and jointly agreed upon,
17、To enhance goal attainment the following must be involved Positive reinforcement, time management for incorporating goals into lifestyle, feeling of social support, feelings of self-efficacy, Goals can be daily, weekly, monthly, and/or yearly,Providing Social Support to the Injured Athlete,Coach is
18、often one of the first people to interact with the athlete following injury Must show athlete he/she cares not just a member of a team, a person as well Athletes perception of coach will also impact rehabilitation Must respect coach before trusting him/her in the rehabilitative setting,Be a Good Lis
19、tener Active listening is a critical skill Listen to athlete beyond complaining Pay attention to fear, anger, depression, or anxietyBe Aware of Body Language Must be concerned and should look athlete in the eye with genuine interest when meeting with them Will be meaningful and help develop trust an
20、d respect,Project a Caring Image Consider the athlete an individual not just an injury Relationship should be person to person Treat athlete as an equal will help athlete take ownership and accept responsibility for rehabilitation Establish rapport and a sense of genuine concern,Neglecting the athle
21、te will give them the perception that they are “outcasts” May contribute to injury or re-injury Some will limit contact of other athletes until injured athlete is ready to return While effective with some players and minor injuries causes major adjustment difficulties for athletes suffering serious
22、injury Some coaches will refuse to talk to athlete or tell others athlete isnt tough enough or doesnt want to play Creates more frustration and separation between coach and athlete Athletic staff will either support athlete and gain loyalty and dedication or undermine athletes trust setting the athl
23、ete up for a let down (may result in athlete underperforming out of spite),Find out what the problem is Allow the athlete the ability to discuss their injury be a good listener Take everything into consideration and discuss the situation with the athlete Explain the injury to the athlete Be certain
24、the athletic trainer or physician clearly explains the injury and its circumstances Provide a clear and simple explanation Manage the stress of the injury Stress associated with playing and meaningfulness of sport to the athlete may dictate the rehabilitation process,Rehabilitation is often more suc
25、cessful if the athlete is engaged fully in the process Stress may be a deterring factor May be able to use various techniques (imagery, relaxation cognitive restructuring, thought stopping) to assist athlete in managing stress Modifying athletes perception with regard to the injury may have a positi
26、ve impact on rehabilitation process,Keep athlete involved with the team Must work to keep the athlete involved particularly when long term rehabilitation is necessary Athlete may begin to struggle socially may also feel that support from coaches and teammates is absent Teammates may pull away injure
27、d athlete is a reminder of what could occur Work to maintain sense of camaraderie and belonging with the team,To assist in maintaining identity incorporate sports specific drills, perform rehab during and at practice Assist athlete in re-entering team culture Rehabilitation is often more tolerable i
28、f carryover with sport exists,Help the athlete return to play Athletes perception Ready to return and not be allowed or being forced to return too soon Coach should assist athlete and provide facts may make situation less cloudy Sports and identity often become intertwined Athlete may have difficult
29、y in “different culture” Difficult to determine place in that culture New set of rules,Return to Competition Decisions,Difficult decision When is the athlete truly ready is it safe? Athletic trainer and physician need to be part of the process Psychologically the athlete needs to be ready to return
30、Determine if fear of re-injury is present and aid athlete in overcoming fears Be cautious of the phrase “you have to play with pain” Could be a dangerous decision,Athlete vs. Non-athlete and the role that pain plays in decision making Athlete is often willing to play through pain while the non-athle
31、te would prefer to treat the pain prior to returning The athlete that continues could do damage lasting a lifetime Athletes often look at the present and the rewards of competition may pose problems if career ending injury occurs,Return to play decisions Coach = Status and game situation ATC = Statu
32、s of athletes injury Returning to play too soon may result in a longer absence due to re-injury and may reinforce a coaches decision to play someone else Poor performance in competition may illustrate to all involved parties that an athlete is not ready to return Utilizing benchmarks/baseline perfor
33、mance data may aid in the decision making process Use pre-injury and post-injury scores to assess readiness,Rehabilitation of athletic injuries is more than just physical, emotional or psychological Also involves environment, support of the athletic community and the culture involved with participat
34、ion in sports,Referring the Athlete for Psychological Help,Coach is often first to notice athlete that is emotionally stressed Changes in personality and performance may be indicator of need for change in training program Conference may reveal need for additional support staff to become involved,Ath
35、letic trainers and coach must be aware of counseling role they play Deal with emotions, conflicts, and personal problems Must have skills to deal with frustrations, fears, and crises of athletes and be aware of professionals to refer to Team physician may also play a role in athletes that are overstressed Many psychological responses, thought to be emotionally related, are caused by physical dysfunction Physician/psychologist referral should be routine,
