Athletic Injuries and Psychology PDF

5/11/2017 Lecture Outline Athlet...

5/11/2017 Lecture Outline Athletic Injuries and How Injuries Happen Psychological Antecedents Psychology Stress–Athletic Injury Model Explaining the Stress–Injury Relationship Psychological Reactions to Exercise and Athletic Injuries Centre for Exercise Science and Sports Medicine, Other Injury Reactions FIFA Medical Centre of Excellence Signs of Poor Adjustment to Athletic Injuries School of Therapeutic sciences, Faculty of Health Sciences, Roles of Sport Psychology in Injury Rehabilitation University of the Witwatersrand Johannesburg Recommendations for Coping With Injuries for Other Injured Athletes Recommendations for Facilitating Rehabilitation for Coaches Miss Natalia Neophytou Recommendations for Facilitating Rehabilitation for Sports Medicine Personnel Questions Psychological Factors Objectives in Athletic Injuries Be able to draw and discuss the Stress–Athletic Injury Model Some 3 to 17 million people are injured each year Be able to Explain the Stress–Injury Relationship in sport and exercise. Be able to list Signs of Poor Adjustment to Athletic Injuries Physical factors are the primary causes of injury, Be able to discuss the Roles of Sport Psychology in Injury but psychological factors can also contribute. Rehabilitation Be able to state the Recommendations for: Coping With Injuries for Other Injured Athletes Facilitating Rehabilitation for Coaches Facilitating Rehabilitation for Sports Medicine Personnel Questions How Injuries Happen Psychological Antecedents Stress–Athletic Injury Model Personality factors To date, personality factors associated with athletes’ injuries have not been successfully identified. Stress levels People with high levels of life stress have more sport- and exercise-related injuries. Adapted, by permission, from J. Williams and M. Anderson, 1988, "A model of stress and athletic injury: Prediction and prevention," Journal of Sport and Exercise Psychology 10(3): 297. 1  5/11/2017 How Injuries Happen How Injuries Happen Psychological Antecedents Psychological Antecedents The stress–injury relationship is complex. The stress–injury relationship is complex. Smith and colleagues (1990) found that life The greatest stress sources for injured stress related to injuries only in “at-risk” athletes were not the physical aspects but athletes (those with few coping skills and low the psychological ones (e.g., fear of re- social support). injury, shattered hopes or dreams). Individuals who have low self-esteem, are pessimistic and low in hardiness, or have higher levels of trait anxiety experience more injuries or loss of time due to injuries. Teaching stress management can reduce risk of injury and illness. (continued) Explaining the Stress–Injury Explaining the Stress–Injury Relationship Relationship Attentional disruption Other stress–injury relationship explanations: Stress disrupts an athlete’s attention by Overemphasis on acting tough and a “giving reducing peripheral attention and causing 110%” attitude distraction and task-irrelevant thoughts. Failure to distinguish between normal Increased muscle tension discomfort and injury pain High stress can cause muscle tension and “You’re injured, you’re worthless” attitude coordination interference. Physiologic Components of Psychological Reactions to Exercise Athletic Injury Stress and Athletic Injuries Psychological stress increases catecholamines and Three general categories of emotional glucocorticoids, which impair the movement of healing reactions to being injured: immune cells to the site of the injury and interfere with the removal of damaged tissue. 1. Injury-relevant information processing Prolonged stress may also decrease the actions of insulin- 2. Emotional upheaval and reactive behaviors like growth hormones that are critical during the rebuilding process. 3. Positive outlook, coping Stress also causes sleep disturbance, another factor identified in interfering with physiologic recovery. 2  5/11/2017 Psychological Reactions to Exercise and Athletic Injuries Other Injury Reactions Identity loss Keys When athletes can Most people experience a typical response to no longer participate injury, but the speed and ease with which they because of an injury, progress through stages can vary widely. they may experience a loss of personal The period immediately following injury is identity. That is, an characterized by the greatest negative important part of emotional reactions. themselves is lost, seriously affecting self-concept. Other Injury Reactions Other Injury Reactions Fear and anxiety Lack of confidence When injured, athletes can experience high levels Given the inability to practice and compete and of fear and anxiety. their deteriorated physical status, athletes can They worry whether they will recover, if re-injury lose confidence after an injury. Lowered will occur, and whether someone will replace confidence can result in decreased motivation, them permanently in the lineup. inferior performance, or additional injury because the athletes overcompensate. Because the athletes cannot practice and compete, there’s plenty of time for worry. Signs of Poor Adjustment Other Injury Reactions to Athletic Injuries Performance decrements Feelings of anger and confusion Obsession with the question of when one can return Because of the lowered confidence and missed to play practice time, athletes may experience post-injury Denial (e.g., “The injury is no big deal”) performance declines. Many athletes who have Repeatedly coming back too soon and experiencing difficulty lowering expectations after an injury re-injury expect to immediately return to a pre-injury level Exaggerated bragging about accomplishments of performance. (continued) 3  5/11/2017 Signs of Poor Adjustment Poor Adjustment to Injury: to Athletic Injuries Getting Professional Help Dwelling on minor physical complaints When abnormal emotional reactions to injuries are Guilt about letting the team down identified, a referral to a sport psychologist or Withdrawal from significant others another qualified mental health provider should be made just as should be the case if an uninjured Rapid mood swings athlete exhibits general life problems (e.g., Statements indicating that no matter what is done, depression, severe generalized anxiety) of a clinical recovery will not occur nature. Roles of Sport Psychology Roles of Sport Psychology in Injury Rehabilitation in Injury Rehabilitation Keys Keys A holistic approach is needed, emphasizing the healing of both the mind and body. Using relaxation and imagery during rehabilitation reduces anxiety and was associated with greater Psychological factors play an important role in injury recovery (Ievleva & Orlick, 1991). knee strength in athletes after knee surgery. Injury treatment should include psychological Psychological factors (e.g., self-talk, goal setting, techniques to enhance the healing and recovery self-motivation) also positively affect adherence process. to injury treatment protocols. Athletes will not automatically transfer psychological skills used in athletics (e.g., imagery) to the injury rehabilitation situation. (continued) Roles of Sport Psychology Roles of Sport Psychology in Injury Rehabilitation in Injury Rehabilitation Understand the three-phase process of Each phase dictates different approaches to rehabilitation and recovery: the psychology of recovery. 1. Injury or illness phase Injury or illness phase—focus on helping the 2. Rehabilitation and recovery phase athlete understand the injury. 3. Return to full activity phase Rehabilitation or recovery phase—focus attention on helping sustain motivation and adherence to rehabilitation protocols through goal setting and maintaining a positive attitude. (continued) 4  5/11/2017 Roles of Sport Psychology Roles of Sport Psychology in Injury Rehabilitation in Injury Rehabilitation Each phase dictates different approaches to Build rapport with the injured party: Take the the psychology of recovery. athlete’s perspective, provide emotional support, and be realistic but positive and optimistic. Return to full activity phase—although an athlete is physically cleared for participation, complete recovery does not happen until Educate the injured person about the injury and normal competitive functioning occurs. recovery process. (continued) Roles of Sport Psychology Roles of Sport Psychology in Injury Rehabilitation in Injury Rehabilitation Guidelines for providing social support Teach specific coping skills: Discuss goal setting, positive self-talk, imagery, visualization, and Provide social support to athletes (sources of relaxation training: support include coaches, significant others, and Teach how to cope with setbacks. medical personnel). Foster social support. Athletes generally turn to coaches and medical professionals for informational support and to Learn from injured athletes. family and friends for social support. Social support needs to vary across rehabilitation phases. (continued) Roles of Sport Psychology Recommendations for Coping With in Injury Rehabilitation Injuries for Other Injured Athletes The need for social support is greatest when Accept and positively deal with the situation. setbacks occur or when other life demands place additional stress on athletes. Focus on quality training. Set goals. While generally helpful, social support can have negative side effects (e.g., when the support provider does not have a good relationship or have credibility with the athlete or when support is forced). 5  5/11/2017 Recommendations for Facilitating Recommendations for Facilitating Rehabilitation for Coaches Rehabilitation for Sports Medicine Personnel Foster coach–athlete contact and involvement. Educate and inform athletes about injury and Demonstrate positive empathy and support. rehabilitation. Don’t repeatedly mention injury in training. Foster positive interaction and customize training. Demonstrate competence and confidence. Questions Thank you ! References 1. The entirety of this lecture is based on Prof Leon Lateran's lecture notes: Athletic Injuries and Psychology(2008). Correspondence : [email protected] 6