Understanding The Psychology Of Injured Athletes And Returning To Play

Jamie Robbins, PhD

Athletes face intense pressure to return to play when they are injured but the challenge for physicians is to have them return safely. This author explains the importance of social support and having a strong grasp of the motivations and fears of the injured athlete in order to facilitate rehabilitation of the injury and a successful return to the field of play.

Athletes are supposed to be tough and maintain a positive attitude while regularly playing through pain.1 When they are forced to sit out because of an injury, they should be focused and driven to return to play as quickly as possible. They should rest, rehabilitate and then trust that their bodies are ready to go full speed upon their return.

   This is the idealistic view of sport and injury. However, the reality is that injuries are an unavoidable byproduct of being an athlete and the transition from “active athlete” to “injured athlete” and back to “active athlete” does not always occur without complications.

   Injured athletes struggle with fear, frustration, anger and sometimes depression during their time away from sport, which may even prevent them from following their rehabilitation program effectively.2 Additionally, the return to sport itself yields a new set of adversities as athletes must navigate through personal fears and a desire to return to their pre-injury state along with team, family and coaching-related issues.

Why Social Support Is Key For Injured Athletes

Over the years, I have worked with numerous injured athletes and it is clear from our conversations that their perception regarding social support is significant to their overall well-being, attitude and effort toward returning. Athletes sometimes feel neglected and useless during their time away from sport. As a result, they may distance themselves further from those who could actually provide the support needed to improve their mood and determination to continue.

   Social support comes in various forms, ranging from emotional support to task challenge support.3 Some injured athletes need a caring person just to listen to their fears while others may prefer a challenging push to work harder during rehabilitation. Regardless of the type of support, research has found connections between social support, decreased athlete stress and improved psychological well-being.4 Studies looking at the provision of social support have found that athletes feel most satisfied with the support provided by athletic trainers in comparison to support provided by coaches or teammates.5,6

   It would appear obvious that athletes would desire support from those in a position to assist with the injury recovery process. In a college setting, this extra support is possible since teams have access to athletic trainers. However, injuries are not unique to the collegiate population, making it important to address who is or should be providing this support to younger athletes.

   Researchers who directly addressed athletes’ preferences from healthcare professionals found a desire for more information about the injury, a clearer timeline for return to play and an open environment in which athletes felt comfortable asking questions.7 In regard to athletes not fully understanding their injuries, they noted that they would have appreciated the use of models and more detailed explanations from their doctors. Respondents talked about doctors who did not talk to them and others who seemed frustrated by their questions.

   Russell and Tracey also found that injured athletes wanted their doctors to ask about their emotions and psychological reaction to the injury.7 Although that is what athletes wanted, that was not what they received and the players’ overall conclusion was that doctors did not have time for them.

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