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While season-ending ACL tears are unfortunately commonplace in many sports, there is good news: Research has shown that mental skills training can improve an athlete’s performance in both sports and rehabilitation contexts. So, if you’re an ACL healing athlete, what can you do to set and achieve your rehab goals?

This simple mental skills guide for ACL-injured athletes includes information on goal-setting, imagery, relaxation, and confidence building. This will guide will lead to a BETTER RECOVERY. In part 1 we will cover the first month of healing. This will be a critical period as it will set the stage for the rest of rehab. By utilizing these mental skills, you can maximize your chances of success in both rehabilitation and your return to sport.

Focus on ACL Healing

In the first month, your focus is solely on your body recovering from surgery. Your body has gone through the trauma of the injury and then the trauma of the surgery. This is the hardest part of the recovery in my mind. Your body is at its weakest physically, and your mind struggles to cope with the injury.

But, for you to have a BETTER RECOVERY your body needs you to be at your best. Your rehab is going to be fairly simple physically but mentally it might be the hardest. In this stage mental skills will be centered on managing pain, staying positive, and setting attainable goals. Ensure you have a strong support system to help you through the recovery process.

Goal-setting:

Start with attainable daily goals based on walking, range-of-motion exercises, or daily life basics. You are going to get a list of things to do from your doctor, physical therapist, or athletic trainer. However, it will be easy to say “I don’t feel like it today”. But, today turns into tomorrow and then we keep pushing healing back.

Daily I want you to think about: If I do X then tomorrow I can do Y:

If today I do my CPM machine for the time the doctor said; then tomorrow I can reach my flexion goal that my PT and I set up.

If today I do my quad sets then tomorrow I can walk without crutches with my AT.

Setting daily goals demands your brain to think about today and tomorrow instead of thinking about what you cannot do.

Imagery:

General Rules for Imagery

• Find a quiet, comfortable place to sit or lie down.
• Close your eyes and take several deep breaths.
• Visualize a specific image or scenario that is relevant to your injury.
• Engage all of your senses in the visualization. Imagine the sights, sounds, smells, and physical sensations of the image or scenario.
• Repeat the visualization for several minutes, taking time to focus on each aspect of the image or scenario.

Start with the basics:

The first thing that you have to be able to do is imagine simple things. So, I like to start with imaging the 5 senses. The 5 senses you know and understand without having to think about it. See A Top 5 Guide To Imagery For A Better Recovery for more information.

Then healing:

By visualizing the injured area healing and regaining its strength, athletes can activate the body’s own healing mechanisms and speed up recovery.

Once you get the basics of imagery down you can start to imagine the body healing:

Relaxation:

Relaxation techniques at this stage are mainly breathing exercises to gain control over anxiety and avoid building tension in the muscles.

Injured athletes can benefit greatly from learning to breathe correctly, as it can increase blood flow, promote relaxation, and help the body work more efficiently to promote healing. However, not knowing how to breathe correctly can lead to using muscles improperly, putting too much tension on an injured area, and focusing on the pain instead of the healing process.

3 breathing techniques that I like and teach my athletes are:

1. Wall bug breathing
2. 360-degree breathing
3. Alligator/crocodile breathing

Visit my list of top breathing techniques including video examples and guides to help you with this process. Any one of these breathing techniques will help to distract your brain. By taking the brain’s focus away from the “bad” of the injury you can allow the brain to focus on healing the injury. Relaxation takes practice and that is why we are focusing on only breathing at this point. In the coming months, you’ll learn other relaxation skills to push healing and calm racing thoughts.

Confidence Building:

Focus on the progress you have made so far and on the positive emotions of completing each daily goal. This is going to be a long process and you’re at the very beginning. But, this is also probably the time your confidence will be at its lowest. There are a lot of limits put on your body and that will be a struggle for athletes that are so active daily.

Building confidence this early requires that you look for wins within your rehab. It would help if you were journalling these wins regularly. An easy way to do this would be to write struggles before and then wins after rehab sessions and make this a habit.

What could you not do before rehab that now you can do?

• Did your range of motion increase?
• Were you able to walk without a brace?
• Could complete your straight leg raise?
• Did you get your quad muscle to fire?

Look for your wins. Everything feels like a loss right now; but, it is not. There are wins available and those will help you gain momentum toward confidence building.

FINAL THOUGHTS: ACL HEALING

ACL-injured athletes can improve their mental skills by following this guide as we move along the ACL rehab journey. Part 1 provides tips on how to stay positive, focus on the future, and develop a strong mental base for this journey. The following parts (Building Strength and Flexibility, Building Endurance, Preparing for Return to Sport) will go into more depth about each mental skill. With these guidelines, athletes can learn to cope better with their injury and have a BETTER RECOVERY.