After my first post on recovering from injury and getting back to playing, I got quite a few questions about strategies for dealing with an initial injury and getting through the recovery process itself. That’s what this post is all about. If I had to sum it up in one sentence it would be:
Recovery is a dynamic process – be aware of changing conditions, adapt, be patient, and persist.
Here are my tips for getting through the process of recovering from an injury. As always, ask questions and share any other strategies that have worked for you!
Maintain Realistic Expectations: Plan for the roller coaster
What I’m about to say in this section isn’t meant to be harsh or get you down. It’s meant to prepare you if you’re just starting the recovery process. It’s meant to normalize your experience if you’re already deep into the process. It’s meant to help you say: I can get through this.
Experiencing and recovering from injury is a challenge. It can test your body, mind, spirit, and relationships.
It can be a mental and emotional roller coaster: You’ll likely have days where you’re upbeat and feel good followed by days of the exact opposite. Grief, anger, sadness, detachment, no motivation, irritability, lost confidence…these are all normal.
A provider (Dr., PT, ATC, etc.) may say, “You’ll be able to return to play in X months.” Then X months may come and go and you’re nowhere near being able to play. A friend may say, “I had that same thing happen and it took me forever to heal” or “I had that same thing happen and I was back a week later.”
Knowing that these ups and downs are coming can help us to manage them when they arrive and can help us understand they will come and go.
Keep a journal of progress & setbacks
I highly recommend keeping a detailed journal of your progress. Often athletes make small improvements that go unnoticed. And a common response to not feeling like we are making any progress is to push too hard.
The journal also helps you more objectively see the 'two steps forward, one step back' type of progress. Instinctively, we more easily notice and remember the 'one step back.' Reviewing journal entries can help you see how far you’ve come.
If you have a provider (ATC, PT, Dr., etc.) you’re working with, ask for their thoughts and feedback to add to your journal as well. They are experts and may be seeing progress that is hard to feel and offer a different perspective.
Track your progress & the strategies that helped. Track your setbacks & the lessons you learned.
Re-frame your thoughts
Are your thoughts about your injury and recovery helping or harming you?
If you find that your thoughts are not effective for your recovery, you’ll likely need to do some work to re-frame them. This takes practice and some effort initially, but as you begin to retrain your brain it will become more second-nature.
One strategy is to identify and recognize the reality of the situation (don’t ignore it, that’s actually not helpful) and then also identify where you have control and what you can do to help your body heal.
In the early stages of an injury, your thoughts may sound like: “I hate not being active, I can’t stand to sit around” or “If I don’t play I’m going to lose my spot on the starting lines.”
Re-framing these thoughts might sound like: “Not being active is hard for me, but I trust that rest is what my body needs to heal fastest” or “The only way for me to maintain my starting spot is to heal as efficiently as I can.”
Stay tuned-in to your thoughts throughout the recovery process. The thoughts that get in your way immediately after an injury may be different than the thoughts that get in your way a week, a month, or many months into the process.
Keeping track of your initial/unhelpful thoughts and the re-framed thoughts is another great way to see progress. It can also help you transition between stages. For example, early on you may need to be more protective and then transition into a stage where you need to push a bit more – different thoughts can be helpful in these different stages.
How you think matters to your recovery – choose to be your own ally instead of your own enemy.
Culture of respecting the recovery process.
Finally, but certainly not last: Coaches, leadership, and teammates have to be on-board with creating a culture where the recovery process is valued. More importantly, this should be explicitly stated as something that is valued. Otherwise, athletes inevitably 'mind read' pressure from their coaches/leadership/teammates to return to play sooner than they are ready.
Most athletes put enough pressure on themselves that they actually need the encouragement of others to hold-back. Sometimes this is easier said than done. Be aware of how your beliefs or preconceived notions may be influencing your perception of an injured athlete. Some people may push a top-tier athlete to return to play because they are needed, and some people may protect a top-tier athlete more than others. Some people may judge a lower-tier player’s injury to not be as serious and unintentionally pressure them to return to play. Tune-in to your thoughts and reactions to your athletes/teammates injuries and how you may be influencing their recovery.
The more people we have on our side through this process the better.
TODAY'S JOURNAL WORK: REFLECT & ADAPT
Where are your expectations set? Are they helping your recovery or making it harder?
Are you aware of your progress no matter how small? Would tracking your progress in a journal help you see your progress more objectively?
Is your thinking helping or harming your recovery? Could you be thinking more effectively?
Are you supporting your athletes and teammates in their recovery as well as you could be?
Another post in the Q&A series...
The first thing I want to say is that I hope people read this post whether or not they've ever been in this exact position with an injury:
Question: "What are some of the strategies you use in overcoming an injury? Specifically, is there a mental pep-talk you give yourself after recovering from an injury when you have a scary moment where you overreact mentally? I find myself apologizing and explaining that I had a recent injury, but need to pull myself together quickly to keep playing after a "close call." I've seen others struggle as well. Advice?"
Certainly, if you've been injured and felt like you've 'overreacted' in 'close call' situations during your recovery (or even well after you've recovered), it's important for you to know what's (likely) going on in your brain and body.
If you're a coach/captain/teammate/friend of someone who's ever had a serious injury or struggled to come back from injury, or has 'overreacted' in 'close call' situations, it's important for you to understand what might be going on for them.
Additionally, the information I'm going to present in this post is valuable for everyone to know because it has broad connections to any type of injury or trauma someone may have experienced in their life.
Let's start by defining the term "overreact." We use this term to describe the moment when our actions/reactions turned out to be more than the situation warranted. It is usually retrospective and it is usually judgmental in tone. I can't think of a time I've ever planned to "overreact" in advance. It usually just happens and it often happens before we really know that it's happening.
This post is written to help you understand why and how our brain and body react seemingly without your direction, much less your permission.
Here's how one athlete describes this experience:
"Everything is fine until all the sudden it's like my brain senses or feels someone running up behind me. I freeze – I go from a full sprint to a dead stop - my body just stops, tenses-up and I scream. All this to find out seconds later that the player behind me wasn't even close to me. The reaction – stopping in my tracks, tensing up, screaming – is instantaneous …it all happens before I even knew it happened. When the time warp ends, I stand there untouched, unscathed. Embarrassed, I apologize...but I feel shaken."
While there is a lot of technical neuroscience stuff that can explain these reactions down to the neuron, I want to keep it more basic here so we can all have a usable big picture understanding.
This is a textbook experience of what it's like when our primitive and emotional brains hijacks our thinking brain.
The primitive brain is responsible for our survival functions like breathing and threat detection. When a threat is detected, our sympathetic nervous system kicks in and we experience symptoms commonly referred to as "fight or flight" such as increased heart rate, muscle tension, and surges of adrenaline. These physiological changes are designed to help us survive the threat by priming us to run or fight for our lives.
Another somewhat lesser known response is the "freeze" response. The physiological changes in the freeze response include a similar activation of the sympathetic nervous system, but a disabling of body movement. The primitive and emotional brains basically says, "this threat is so severe that our best chance of surviving is to play dead."
What's most likely happening for athletes who experience a freeze response while playing is that the primitive brain detects a threat because the conditions - 'someone running up behind me' - are similar to the conditions under which the athlete experienced a severe injury.
Other athletes may experience similar physiological or emotional symptoms to a lesser extent. Maybe they don't freeze, but they hesitate. Maybe it's not in the moment of play, but upon returning to the field where they tore their ACL or facing the opponent they were playing when they got a concussion.
It might seem hard to believe that the brain would create such a strong response to one data point when it has thousands of other data points that are strikingly similar and nothing bad happened. This happens because our brains are wired to encode emotionally charged memories (the one data point) significantly deeper than average, non-emotional memories. Why? To keep us safe. Unfortunately, sometimes they overshoot the mark - especially when it comes to strong emotional memories like an injury.
So what do we do about it? How do we reign-in our primitive and emotional brains and allow our thinking brain to execute some control?
TODAY'S JOURNAL WORK: THE PLAN
#1: Manage your expectations.
This is my number one rule for anything injury related and is especially true here. Retraining your brain to respond differently is going to take time and effort - trust that it's worth it.
#2: Remove the judgment.
Unfortunately, when we judge ourselves or others judge us for our 'overreactions,' it can actually reinforce the intensity of the emotional connection to the response, which can reinforce the response itself.
Try starting by acknowledging the judgemental thought: "I'm feeling embarrassed." Then, acknowledge that your response was in fact nothing to be ashamed of, but simply a survival instinct gone too far, "my brain felt threatened and took over, I wasn't in charge."
#3: Release your physiology.
When we have a survival response like fight, flight, or freeze, our bodies fill with neurochemicals and hormones that create physiological activation such as increased heart rate, blood pressure, respiration, and muscle tension. If there is no threat, we want to release these things from our body as soon as we can so they don't continue to influence us unnecessarily.
Try starting by noticing which of these symptoms you're experiencing: "My heart rate is through the roof, I'm short of breath, and my shoulders are hunched up to my ears." Then, take deliberate action to release these sensation such as a few deliberate breaths, shaking out your arms, or a quick sprint. Be sure to pay attention to what it feels like as your symptoms release.
#4: Start rewiring your brain.
Once the judgment is contained and our body is returning to baseline, we now want to get our thinking brain truly back online. The thing is, you want to be as deliberate about this process as you can as this is a great time to start rewiring your brain for the long haul. I highly encourage you to pre-plan these thoughts in a moment of calm instead of relying on them to come to you in the moment. The stronger the emotional resonance, the more effective they will be.
Try starting with a word, phrase, mantra, or image that fills you with a positive emotion such as hope or gratitude. It could be something as simple as "I'm OK." It could be more complex like a reminder of 'your why': why you play the sport, why you love the sport, why you're pushing to play past this experience. Perhaps something like, "I'm a living example of perseverance for my kids/friends/teammates." If possible, connect this new thought to your calmer physiological state or the positive emotion it elicits. This will help you more deeply encode this response.
Numbers 2-4 are a plan for in-the-moment. The first few times you try to engage these strategies, it might be a bit slow, clunky, or bumpy. That's to be expected. The idea is that this new plan will become easier and more natural each time. You'll start to recognize indicators sooner and be able to more quickly recover. Numbers 5-X are strategies to rewire your brain in calmer moments.
Our brain has a hard time distinguishing between what is real and what is imagined. It's why we feel physical excitement just from thinking about something exciting; or feel stress from thinking about something stressful. Use this to your advantage by training your brain to respond how you want it to in your mind first.
Try starting by imagining yourself playing, using all of your senses. When you get comfortable, imagine yourself in the conditions that usually elicit your intense response - like feeling someone running up behind you. It is likely that you will start to feel some emotional and physiological activation at this point. Ideally, instead of letting that primitive brain response take-over, you imagine yourself staying calm and playing through that moment.
It may take many repetitions at this to 'get it right' and actually see yourself playing through it without having an extreme reaction. Your brain is a powerful thing, harnessing it will take time (see rule #1). If you do still see yourself responding with a fight/flight/freeze response, see yourself implementing your new recovery plan (#2-4) and returning to baseline faster.
#6: Enlist help.
Struggling is hard. Struggling alone is harder. Know that other people have gone through what you're going through. Those people may not be on your team, but that doesn't mean your team can't still be helpful.
Try starting by taking time to think about what you need/seek from people in those moments. Do you need to make eye contact with someone? Would you benefit from someone saying something specific to you? Then, think about who you want to ask for that support. Maybe start with a best friend, maybe start with a coach - whoever you feel will be most helpful for you.
#7: Embrace a new normal.
It is important to understand that injuries, even when fully physically healed, still impact us. Pay attention to what mark that injury is leaving on you and know that you can work to frame that mark in a way that it is helpful instead of harmful.
Try starting by recognizing what impact you might be noticing: "I'm not planting and cutting as much off my surgery leg." Then, think about how you could frame that in a way that is helpful: "That is forcing me to tune-in to my cutting patterns in a way I never have before." The idea here is to recognize and embrace that big things impact us, and with some deliberate work they can have a positive impact on us.
Many people who experience major life events (like athletic injuries) recognize that while they'd never wish it on anyone else, they appreciate how it has helped them grow. We might be smarter, stronger, or straight-up tougher than we were before. Let's recognize and leverage it.
I really hope you found this post helpful in understanding what might be happening for people with injuries. If you want more information on any of the topics discussed or have questions about your own experience, please reach out and let me know!
Finally, I want to acknowledge and thank a few people for their contribution to this post: E Kruise (a fellow sport psych consultant for some mind-bending 'nerd out' conversations), Jenn Housholder (a trainer with the Trauma Resource Institute for her insight on injury and the brain), and the athletes whose first-person accounts inspired and informed this post.
A few additional resources for those interested in the details of the brain and the different responses, check-out the videos below...
Emotions and the brain:
Areas of the brain:
Hi! I'm PK. I am an Ultimate player, spouse, parent, and human performance coach. My passion and my profession is to help individuals and teams perform at their best through research-based mental skills, resilience, leadership and team dynamics training.
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