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Welcome to ELEVATED Sport Injury. This is a place I want members of a healthcare team to come for tools to bring your injured athletes’ rehab to the next level. As an athletic trainer, I know the decisions and the rigor that healthcare teams go through with every athlete that comes through the doors. We have a tough job. I want this to be a space to go for tips, suggestions, and general support. Everyone reading this knows an injured athlete and is working to get an injured athlete back to playing.
So, we start by stating that INJURIES SUCK! They are miserable no matter if you have to tell an athlete they are missing 1 day, a week, a month, a season, or more. Sit on that for a moment. You have the hard job of breaking this to an athlete. But, as part of a healthcare team, you have the joy of watching that athlete work crazy hard to get back to what they love. My “why” for choosing athletic training is doing what I love to help others do what they love. Undoubtedly, I’d say you have a similar reason for doing what you do. So, back to the original statement…
Undoubtedly INJURIES SUCK!
Okay, now that we all agree, you can become part of an ELEVATED healthcare team. What this means, now is the time to help your athlete grow by providing more than just physical care. Already you do this. So, why not learn specific tools that you can implement on day 1 of working with your athletes? They are going to struggle throughout this journey. I want to give you some insight into what you can do to help them become better through this process.
In rehab your athlete has 3 options moving forward:
- Let the injury control them. Do the minimum. Put in what you need to get out of the rehab facility.
- 50/50 split between them and the injury. Push yourself every day in rehab. Push the athletic trainer or physical therapist to give you challenging exercises. Do your exercises at home. Go slightly above expectations.
- Them controlling the injury and the outcome. Learn through your injury. You can take this time to learn Sport Psychology techniques (This blog for example). You can work on aspects of your game that may be limited. You can teach non-injured areas how to do things better and take control.
Take Control
An important thing to remember (unless their injury is career-ending which is a whole other beast), they will get back to playing their sport or any sport. Everything that you and they do from this moment on will impact how well they return to playing their sport. As a healthcare team you cannot control which of the three they choose; but, you impact what they feel like doing when they leave the rehab facility.
Take a second, find a piece of paper, and write down 5 things that you believe are out of your control. What can you not control about the athletes’ recovery? Also, think about what your athletes would put on that list.
What does this list consist of? Things such as physical or emotional? Were there other people? Did you include healing time? Past, present, and future? To summarize like they cannot control every aspect of their sport they cannot control every aspect of their injury, no matter how much they may try to control it all.
What they can’t control
To list a few things that are out of the athlete’s control:
- When the injury happened.
- How the injury happened.
- The severity of the injury.
- What do their teammates and coaches say/think?
- If they need surgery or not.
- If they need crutches or a sling.
- When surgery is.
- How quickly the body heals?
- If the body has a setback.
- When you (the healthcare team) clear them to play.
- When there is pain.
- When they finally get cleared to play.
These things out of their control cannot be their focus. These will show up, they will try to tear your player down, and they will hold them back if they become the focus. DO NOT LET THEM! Instead, give injured athletes help to find things that they have control over to focus on.
Take another 30 seconds on another piece of paper and write down 5 things that they can have an impact on. You should notice that these things all come from the brain. You cannot control things that are outside of the mental approach even if they may be an injury within your body.
What they can control
Additionally, here is a list of things that the athlete can impact:
- Their thoughts
- Their feelings
- Their Attitude
- Their Intensity
- Their determination
- Their effort
- Their desires
You/they cannot control how fast their body heals but you/they can Impact the environment to heal quickly.
There is no way to control when there is pain but they can Impact its limitations.
You/they cannot control what other people say or think about their injury but you/they can impact their effectiveness.You/they cannot control the past, present, or future but you/they can help Impact how the future turns out.
I want you to make, change, update, and improve your lists so that you can understand what an athlete might be thinking when they come in for a rehab session. Encourage your injured athlete to make list as well. Certainly encourage them to take control of the things that they can and let go of the ones they cannot. Things are always going to be changing throughout the injury-healing process.
For your athlete to have the most impact on their injury and to minimize the effect of the things they cannot control there are 4 broad sport psychology techniques I believe need to be added to their rehab journey. Those 4 skills are Goal-setting, imagery, relaxation, and confidence-building. These all give purpose, provide a good healing environment for the body, and move the mind from thinking about the injury to thinking about the return. The more they are thinking about the return the more fun you’ll have in this journey. In future posts will dive into the in-depth but for now, I want to give a brief introduction to each of these topics.
Goal-Setting
As a member of the healthcare team, you have physical goals/benchmarks that you need athletes to hit. Your athletes usually have season goals and personal goals for themselves. Why do you make these goals? Generally, to give provide something to look forward to, something to achieve. You need to make goals with your athletes that go beyond measures. Every individual in the healthcare team and the athlete should know what the athlete wants to achieve and then work to make that happen. Think about going beyond ROM, strength, and function. So, there have to be different kinds of goals, ones that will help daily and ones that will help down the road, and for sure ones that will help as they get back to playing. Below are 4 types of goals that I like my athletes to set when they get hurt.
Daily goals: Present-focused. Achievable every day. Creates daily successes. Short-term goals: Near-focused. Leads to long-term goals. Quick hitting.
Long-term goals: Future-focused. Provides direction. Desired results. Exercise goals: How athletes perform specific exercises. Controlling the details of physical therapy sessions.
Rehab goals: Determines what success looks like at the end of every physical therapy session. How the athlete reaches their highest standard.
Return to play goals: The desired result of physical therapy. What athletes need to have the highest confidence for returning to sport.
DAILY GOALS:
If I do __________________ today, I know I will achieve __________________.
If I do __________________ today, I know I will achieve __________________.
Setting daily goals is an easy way to start setting goals if you are not in the habit of doing so already.
Imagery
Using imagery can be a helpful way to show the body how to heal. You know how the body heals and what it takes to physically heal. Your athlete does not. But, you can give them basic information that they can use. They can use this to imagine the results happening with the body. They can imagine blood flowing, tissue healing, movement happening, strength returning, etc.
Imagery is much like practice. Players walk through their plays or through motions of the sport to get muscle memories so that they don’t have to think about the motions when in the middle of a game. Provide your injured athlete help as they learn to imagine things such as their muscles/bones healing and as they get more practice they can work on imagining their return to sport so that their body/brain is not surprised when they are pushing their limits.
Imagery is difficult and it takes a lot of practice. This is a very simple example that I like to give my injured athlete to help start with and work on for only a couple of minutes a day. Then they can build up their skills and increase the complexity of the images.
Firstly, imagine shapes. Stick with each shape for 5-10 seconds:
- Circle
- Square
- Triangle
- Rectangle
Secondly, imagine colors. Stick with each color for 5-10 seconds:
- Blue
- Red
- Yellow
- Green
Relaxation
Relaxation is another good way to help the body heal as efficiently as it possibly can. The most efficient body equals the quicker the body can get back to playing. There are so many different relaxation techniques and you have to find the one that fits you the best. Examples are yoga, meditation, breathing, progressive muscle relaxation, and many others. Later on, I will break down the ones that I like to use the most and how to use them.
For this basic intro. I want to talk about square breathing. It is easy to remember. Hold a breath, inhale, hold a breath, and exhale for the same amount of time on all sides. Usually, I suggest starting with 3-second intervals so that you can get the process down.
Confidence Building
As a healthcare team, you play a unique role in the athletes’ return. You have so much influence on their confidence level. You know how important it is; show them how to build their confidence. Confidence building will be important throughout the healing journey. It will be vitally important once the athlete gets closer to their return date. Fear is going to be popping in and out throughout but will probably intensify when they are starting to do things similar to what caused the initial injury. All of the above skills will help to build your confidence. Learning what cannot be controlled and how they can impact the things that they have control over also will help.
One thing that may not be expected at this point is all the negative talk that will be going through the athlete’s mind. Like, “I can’t do this.” “This is too hard.” “I’m a failure.” “Why me.” etc. There will be a lot of them and they need to realize them when they come. One thing you can encourage your athletes to learn to do is to take those thoughts and make them positive. “This injury sucks” needs to change to “This injury is making me better”.
Stepping Stone Thoughts
It is not always easy when you are in the midst of a mental battle to go from negative to positive. You have to get from one side to the other so I suggest stepping-stone thoughts. These are the stepping stones that will get you from the negative to the positive. Firstly, this injury sucks becomes this injury is just a block. Secondly, changes to this injury is improving. Thirdly, changes to this injury is allowing me to work on my weaknesses. Finally, becomes this injury is making me a better athlete.
Encourage them to write down their negative thoughts, then write down the positive thought that they want to have, and finally write the steps that will get them there. Have them visit Negativity Flush to flush these negative thoughts. Then they can visit the Positivity Climb to encourage positive thoughts to flow as they climb up the mountain to return.
As I said at the beginning and as you know as a member of a healthcare team…INJURIES SUCK! But they do not define anyone. Your player has the ability right now to decide whether they let the injury control the outcome or will they control the injury and the outcome. You need to do everything in your power to encourage them to control this injury, have the best recovery possible, and return to playing better than when they left. Your injured athlete needs help to make this the best injury they could have had.
Control the injury and have a better recovery.
Learn more about what my hopes are for this blog and what I want to you gain from reading these blogs by checking out the What is an ELEVATED sports injury page. Overall, leave any comments and questions about what case you may be struggling with or general issues you are seeing with your athletes. This is a space where everyone understands what you are going through.
