Navigating the Injury Recovery Mindset

Navigating the Injury Recovery Mindset

From an outsider’s perspective, recovering from an injury seems like a straightforward process, but for athletes, it can be mentally and emotionally taxing.

Injuries can come with a cluster of feelings and emotions – from pain and anger to malaise and grief. Not only as coaches do we need to set the athlete up for physical success, but also emotional as they experience and overcome injury. There is an entire realm of physiological and psychosocial factors we can address with the athlete to maintain emotional health and wellness throughout the injury process. 

Grief

The first, and arguably most important, part of an injury is acceptance. With an injury, comes loss. Loss of being able to participate in a sport they love, loss of competition, loss of purpose, loss of routine. Allow your athlete to mourn the loss of what they love. Mourning a loss, whether it is the passing of a loved one or sport, comes in all different forms. Some athletes may experience depression, anger, or sorrow. Reminding the athlete it’s okay to mourn the loss of what they love is the first step in injury acceptance. This would be a great time to seek out professional help for your athlete in the field of sports physiology. 

Intrinsic Motivation

It’s a known fact that exercise is addictive. The constant release of endorphins and dopamine, green boxes on our TrainingPeak’s account, and positive feedback all create this positive-feedback loop our athletes seek. Don’t forget to continue to support your athletes as they go through the injury process. In fact, this may be when they need their coach more than ever. Establishing short-term goals and motivational factors creates a structure for success. 

If your athlete is currently under the care of a health professional, such as a physical therapist, reach out to the provider with the athlete’s consent. The physical therapist can educate you on their injury diagnosis, prognosis and treatment goals. It’s during this time, the coach needs to put their exercise prescription aside and assume the role of a supportive listener. 

This is also a great time to establish a more interpersonal relationship with the athlete. Learn their intrinsic motives. An understanding of why they started the sport in the first place is key to learning factors that motivate them. Prescribe the athlete small, frequent, attainable goals that reflect their motivational influences.

Try New Things

How often have you tried to balance the fine line between physical and emotional stress for your athletes? This is a constant ebb and flow every coach must address. As stated before, with injury comes changes in mood and motivation – oftentimes marked with feelings of anxiety, depression and anger. Though not exactly what we signed up for as a coach, we need to be prepared when the scales tip towards the side of an athlete’s emotional stress.

There is true physiological merit to meditation and relaxation techniques that are now easily accessible via apps and smartphone technology. Breathing is vital in all physiological responses of our body which include our physical and emotional states. Breathing is composed of three dimensions: biochemical, biomechanical, and psychophysiological. If our breathing is dysfunctional, it will cause our nervous system to be in a hyperarousal state. This hyperarousal state keeps our body in the “fight” response of our sympathetic nervous system. Have your athlete fill the gaps in their physical training with meditation or other relaxation techniques that may include – reading, listening to audiobooks, going for a walk if able, knitting, or other low-key activities the athlete hasn’t gotten to do recently. 

Maintaining Cardiovascular Fitness

There are plenty of opportunities for creativity when returning from an injury; even if it’s just under the category of general fitness and maintenance. This is when simple tools, with an open mindset, can be important. First and foremost, it’s important to remind the athlete to focus on where they are, rather than where they were. The lack of cardiovascular training will cause the athlete to feel deconditioned and likely frustrated. 

With the reduced aerobic training to allow the body appropriate healing capacities, encourage the athlete to use their Rate of Perceived Exertion when returning to fitness. These are simple, either 1-10 or 1-20, scales of effort levels. Instead of having the athlete jump directly back into paces, heart rates, or power outputs; a safer approach is to utilize these effort level scales to keep activity within the appropriate intensities. This is when the subjective report of how the athlete feels trumps objective data. 

Once you feel comfortable, allow the athlete to return to heart rate training. Heart rate is an excellent tool in boosting effectiveness by providing an objective measure of how the body is responding to stress. This tool can be used to determine the appropriate exercise prescription for your athlete. This will allow you to be more objective in coaching tactics – oftentimes reminding the athlete to not exceed a certain point. At this point in your athlete’s progress, this tool can allow us to know when we need to push harder or pull back during a session. You may need to set parameters with the athlete to be sure they don’t work too hard initially. 

Cardio Options

Good merit also exists for incline walking, hill running, and variable efforts in running to reduce impact while still achieving moderate-high energy costs. For example, uphill running will increase muscle activity, power generation, and energy costs all while reducing impact. This is a win-win activity for returning to sport post-injury. Do remember, this may come in the later phases of returning to sport.

Another option for the athletes is to allow them to “play!” In fact, when the American College of Sports Medicine released its Fitness Trends for 2020 on that list was outdoor activities. As endurance athletes, we move in a very linear fashion. It’s so important to gain stability and dynamic control in all planes whether it’s vertical, side-to-side, and linear. I always recommend athletes to go, “play.” It could be a game of Frisbee in the park, rollerblading, hiking, etc. These atypical movements to our sport can act as a great supplemental, fun way to work on stability and control.

In conclusion, there are a lot of positive reinforcement techniques to use with the injured athlete to accommodate the training void in their life. Allow your athlete to mourn their injury and the current loss of their sport, learn what motivates them intrinsically, encourage new activities, and promote health and a safe return to activity above all.

Caitlin Glenn Sapp

Dr. Caitlin Glenn Sapp is the founder of Crew Racing and Rehab, a performance coaching and physical therapy company. She holds her Doctorate of Physical Therapy as well as a Bachelor of Science in Exercise Science. She also holds certifications as a USA Triathlon Level I Certified Coach and American College of Sports Medicine Personal Trainer. Dr. Sapp is a seven-time Ironman finisher, which includes the Ironman World Championships, and is a multiple-time USA Triathlon All-American. She takes great interest in educating the industry, from athletes to coaches, on how to stay injury-free while performing at a high level. For more, visit Crewracing.org or email Caitlin at caitlin@crewracing.org.