Coping with the emotional effects of injury

By LUCY ZELIC
LEARNING to cope with the hardship of physical injury can take an emotional toll on athletes who discover that winning isn’t always everything.

How does injury affect athletes?

Both quantitative and qualitative research conducted over the years has demonstrated that injury can have a profound impact on athletes. Experiments led by sports rehabilitators Lynne Johnston and Douglas Carroll found that of the 25 elite athletes interviewed in the first twelve weeks of their injury, each showed signs of intense depression, were emotionally disengaged and socially withdrawn. Further studies showed that 44% of the subjects interviewed accepted their injury in the early stages of their rehabilitation with a 5% drop towards the end of their rehabilitative programs. Similar statistics emerged within athletes competing at the club level but showed a 6.5% drop towards the end of their injury indicating that symptoms of depression and emotional distress increased with time.

Former Brumbies Academy back-rower, Tala Gray, has had two shoulder reconstructions in the past three years and most recently, tore his posterior cruciate ligament [a ligament vital for movement in the knee]. Gray says his frequent injuries catapulted him into a “seriously depressive state” and that he began to question his career choice. Other implications for athletes as a result of injury include financial ramifications due to their inability to participate.

How do they cope financially?

Depending on the professional level of the sport, club level players are left without an income and are forced to seek other means of employment while they are injured. This can be problematic because often, the injuries render the athlete unable to work due to the workplace’s restrictions on people with a disability (depending on the organization), or they are restricted to a rehabilitative environment, which hinders them from making alternative employment arrangements. Athlete’s competing at the elite level are still financially supported by their club with the assistance of outside sponsors but their salaries are reduced to the agreed minimum written into their contract. Furthermore, they are not awarded individual match bonuses for those competing at the team level. Individual athletes must rely on the royalties awarded to them through sponsorships only. What treatment is available?

According to studies conducted by the expert physicians panel of ‘Psychological Issues Related to Injury in Athletes and The Team Physician’, they believe it is essential that the physicians understand their role in the athlete’s recovery process. Recognising that emotional and psychological issues may play a role as antecedents to sports injuries, monitoring the emotional reactions of athletes during rehabilitation and educating athletes, coaches and parents regarding the emotional reactions of athletes to injury and rehabilitation are important factors. Aside from the team and or individual physicians, support networks created through the sports player associations as well as direct relationships with recommended state psychologists’ and counsellors’ are resources readily available to interested athletes.

What responsibilities do they have to their team after injury?

The responsibilities bestowed upon injured athletes vary within each sporting organisation. Former Australian soccer international, Ivan Zelic was required to attend every training session and club competition match, even after he suffered a horrific Lisfranc fracture while playing for ex-National Soccer League club, Sydney United. “It made me horribly miserable to have to sit on the sidelines and watch them do what I couldn’t,” he says. “It was a constant reminder of my injury but my coach said I had to attend if I wanted to hold my spot in the team.” Comparatively, internationally recognised Arsenal coach Arsene Wenger was quoted at a recent press conference saying: “Having injured players around my fit and ably bodied players sets a negative tone around the camp and I don’t want that. They [injured players] need to focus on their recovery, not on making it worse.”

Locally, Uni Norths Owls star fullback Michael Breen was two days away from Brumbies Academy selection when he tore his anterior cruciate ligament [sole ligament crucial for knee movement] in a game, ruling him out for nine months. Breen says that the emotional distress he experienced after learning of his impending selection was more painful than the injury itself.

“Finding out that Andy Friend [Brumbies head coach], had expressed interest in me was so exciting,” he said. “Then I injured my knee and I was completely shattered because I’d felt like I’d lost my chance. I wanted to crawl into a hole and die.”

With the injury rendering Breen unable to participate in any physical activities, the club continues to encourage him to participate in the club’s recreational events. While nothing has been made mandatory, regular social catch-ups with teammates as well as progressive updates and phone calls from the head coach mean that despite Breen’s inability to play, his position at the club is still vital and valued. Do men and women cope differently?

Although there are no distinct differences in the coping strategies adopted, researchers Lynne Johnston and Douglas Carroll discovered that women are significantly more satisfied with practical and emotional support at the beginning, and practical support at the end of their rehabilitation. Furthermore, 47% of women tend to have smaller but more intensive social networks than men do and the support they receive serves more functions and they are able to maintain social networks on a higher level.

What is being done?

Physicians, counsellors, coaches and researchers are continuing in their efforts to provide adequate care and emotional support for athletes suffering from long-term sports related injuries. Data collected from previous studies are being collated to formulate ways in which athletes can cope with the emotional effects of injuries and overcome the serious affects of it.