Sep 27, 2017
Psychology of Injury: Part 3
Timothy Neal

Check out part 1 or 2 of this article to see how athletic trainers should address mental health immediately after injury and during rehab.

To care for an injured athlete, it is just as important to care for their brain, as well as their injured joint or muscle. Holistic care of our patients is the goal, and caring for the mind by developing mental health awareness and skills is just as important as learning a new hands-on technique or new modality.

If I knew an athlete had a mental health issue and was injured, I was especially vigilant to any exacerbation of that condition or the development of a comorbid mental condition.

When an athlete is sidelined, athletic trainers must be observant for an mental concerns triggered by the injury. In some cases, the athlete may have a history of a mental health issue or an underlying or non-disclosed mental health disorder. If I knew an athlete had a mental health issue and was injured, I was especially vigilant to any exacerbation of that condition or the development of a comorbid mental condition. In other athletes, I was observant for behaviors that indicated any development of a mental health issue during the injury and recovery process.

Occasionally, there were athletes who did develop full-on mental health disorders or experienced an exacerbation of their previously known mental health disorder during an injury. It is prudent to have in place a referral system of mental health care professionals who have experience working with athletes. Then, you can refer athletes to these professionals so they get the mental health care they need to fully recover from an injury.

Being concerned for an athlete’s mental well-being doesn’t stop when they are cleared to return to play. Studies have shown that nearly 50 percent of female athletes and 25 percent of male athletes who sustain a time-loss injury are fearful of being re-injured. This fear is understandable and should be discussed with each athlete re-entering full participation following a time-loss injury, especially one where arduous rehabilitation took place for months.

My strategy was to always discuss with the athlete that it is normal to have some return-to-sport anxiety, but I pointed out how prepared they were to return to sport based on objective data, which was reassuring to them. For the most part, I was on-scene when an athlete I treated returned to sport to subtlety encourage them and talk with them about things besides the injury, such as their team and season, helping them get back to their pre-injury mental routine.

Image by Ron Cogswell

Timothy Neal, MS, AT, ATC, CCISM, is Assistant Professor and Program Director of Athletic Training Education at Concordia University Ann Arbor. Previously, he spent more than 30 years at Syracuse University, serving in a variety of sports medicine roles. He can be reached at: [email protected].


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