For the majority of people, the fear of injury hinders them from taking part in any form of exercise, and for those of us who do exercise, you will either know someone who is carrying some form of injury or you yourself have sustained an injury.
Little et al, (2013) studied that of 167 participants (63 men and 104 women) for 12 month whilst they did some form of physical activity, it was reported that 14% picked up injury by the end of the study, 41% of which were lower body. 70% of those injuries required medical treatment and by the end of the 12-month study 44% of those injured were not able to continue and did not return to activity.
It really is part of the lifestyle, putting your body under stress to attain the ironic goal of becoming fitter and healthier.
But what happens when you do get injury, what do you do when you work towards your goal putting in the hours, the sweat, the sacrifices and to then abruptly being stripped of your identity as a “healthy person”
During my years at Uni I learnt a lot about the psychology behind an injury, how to set realistic targets during rehab, keeping your mind busy, looking at stepping stones towards recovery, positive thinking, connecting with others. And I can honestly tell you right now that all of that studying and hard work that went into writing essays and doing exams, went straight out the window the moment I woke up from surgery and I realised I wouldn’t be able to run for a very long time.
3 weeks ago I had a complete ACL reconstruction, an MCL reconstruction and some meniscus repair work done. Now I am very lucky, my injury was on the Saturday and I managed to get into to see a consultant, via an amazing physiotherapist, 4 days later. He took one look at my knee and said he would get me into an MRI straight away (and if you know the NHS that’s a rarity). After coming out of my MRI, he looked at me and had some good news and bad news:- the bad news was it was quite severe and I needed some serious surgery and the good news…. He could fit me into surgery in AN HOUR. I sat there in the hospital alone, looking at my phone wondering how to explain to my family and friends that a consultation had turned into something quite serious. If I’m brutally honest I was pretty scared and I’m not afraid to admit that, sitting there not knowing if I would wake up to my family being there because it was short notice, not knowing much about the surgery, was it that serious, how would I be after, what if it wasn’t successful, what if they hit a nerve, what if they had to take my leg off…. All seemed pretty logical at the time.
The 2 weeks that followed from my surgery was a real struggle and its not the physical pain, that’s easy to deal with, that a quantifiable thought, I’m feeling pain therefore there is pain, it will fade it will pass. For me, personally, my top 10 hardest thoughts going through my mind where mainly psychological.
- Relying on others to help me
- Smiling in the face of grimace
- Having my identity stripped as being a fit person
- Not knowing how long it will be till I can do the basics.
- How will it affect my work capacity? (Motivation)
- How will it affect me psychologically when I start to train again?
- Will I be mentally ready to play another game of rugby?
- Should I go on a holiday or will I hinder my friend?
- Does my girlfriend want to end it with me as I’m such a burden at the moment?
- The thoughts about how long it takes to do the simplest of tasks.
I tend to think of myself as a positive person but it was as I was sitting on my sofa watching the latest Jeremy Kyle extravaganza I couldn’t help but let my mind sink into some pretty tough thoughts. BUT! That being said as I sat there watching a young girl argue with her mother about having relations with her boyfriend I realised “it could be worse.” And I started to look at what It is that is going to help me stay positive and what will get me through this slump.So I did a bit of research I looked into tactics and theories on what can help with a positive rehabilitation programme and from all that research:-
Here are my 5 tips on getting over yourself.
- Surround yourself with people who make you smile and happy.
A study by Fowler and Christakis, (2008) found that of 4739 individuals followed from 1983 to 2003 those individuals who associated themselves with cheerful people have a happier demeanour and therefore a better sense of wellbeing. A person’s happiness influences others moods. And the closer you are to these people emotionally the longer and stringer the effect. Even more so between individuals of the same sex. The conclusion of the study states that we should start seeing happiness, like health, as a collective phenomenon.
- Look to the future of the injury and take it as a learning experience rather than just thinking of the now.
Brew et al. (2010) found that rehabilitation interventions such as guided imagery (i.e. mental rehearsal), relaxation, goal setting and biofeedback can be used to improve emotion regulation and reduce the emotional trauma that accompanies injury. So, looking ahead, and think about the positives of the rehab and not to look to the negatives focus primarily on the moment of achievements rather than the moments you will lose out on.
- Look into the rehab what the possibilities of returning to pre-injury fitness are.
Joanna et al. (2005) found that Fifty-three percent of the patients returned to their pre-injury activity level after an ACL reconstruction. The patients who did not return to their pre-injury activity level had more fear of re-injury, only 36% of athlete who did not return to pre-injury sports did so because of limited knee function the remainder did so because of fear of re injury. Clare et al, (2016) found Postoperative rehabilitation has a strong focus on recovery of the physical capabilities necessary to manage a return to sports and on average, athletes achieve good physical function after surgery, However the return to sports rate is disappointingly low due to the fear of re injury. This being said the rate of recovery therefore quite high but the psychology behind the injury is the detrimental factor. All that stops you from returning to how you are is yourself with a good physio plan and some active recovery you can return to pre-injury fitness.
- Plan ahead (what can I do next year that will make appreciate being back to pre-injury).
In one study (Collicutt et al, 2009), researchers found that appreciation of life, new possibilities, and a patient’s own personal strength, greatly contributed to positive personal growth during injury. It can seem like a difficult task, drawing internal strength after something serious, but it can be done and it was shown to have a positive effect on injury time and rehabilitation. Set plans to return to return to normality and make sure these goals aren’t unachievable, I’m not looking at running a marathon but I am looking forward to walking without crutches by April for a holiday to Barcelona.
- Talk to people who have been through an injury
There is no research needed for this one, talk to those around you who have injuries and come out the other side. Knowing about what’s to come and speaking to people who have shared I’m fortunate to be in an environment where I know many people who have had an ACL reconstruction some have returned to sports some have not but all of those I have spoken to have said the same things : rest, recover, take your time as patience is the key. If your injury is big or small the feelings you are having are normal and guaranteed that others have felt them too, who else can you share experiences with than those around you who already have. Look online to a forum, go to a club or speak to someone random, talk about it.
I have a long 12 months to full recovery and I’m sure there will be more dark moments of annoyance, thoughts of feeling useless, more having to rely on others. But ultimately there will be positives, the first time I’m able to walk without crutches, when I can finally drive again, when I can run again, when I can do my first revolution session again and finally the day I step back onto the rugby field again. Surround yourself with positivity as negativity will breed negativity, I am 3 weeks into my recovery and I have some of the best people around me for support, a great work team, some amazing friends and family, and one very patient girlfriend. What I am taking from my experience is the humbling realisation of those around me. Whether you use my 5 top tips is up to you but take them into consideration next time you have an injury from physical activity.
- What is the evidence to support a psychological component to rehabilitation programs after anterior cruciate ligament reconstruction? Ardern, Clare L. PT, PhD; Kvist, Joanna PT, PhD Current Orthopaedic Practice: May/June 2016 – Volume 27 – Issue 3 – p 263–268 doi: 10.1097/BCO.0000000000000371 SPECIAL FOCUS: Sports Medicine (2016)
- Dynamic spread of happiness in a large social network: longitudinal analysis over 20 years in the Framingham Heart Study Dr James H Fowler, associate professor1, Nicholas A Christakis, professor BMJ2008; 337 doi: https://doi.org/10.1136/bmj.a2338 (Published 05 December 2008)Cite this as: BMJ 2008;337:a2338 (2008)
- Post-traumatic growth in acquired brain injury: A preliminary small scale study Joanna Collicutt McGrath& Alex LinleyPages 767-773 | Received 24 May 2005, Accepted 11 Jan 2006, Published online: 03 Jul (2009.)
- Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction.Source:Knee Surgery, Sports Traumatology, Arthroscopy . Jul2005, Vol. 13 Issue 5, p393-397. 5p. Author(s): Kvist, Joanna; Ek, Anna; Sporrstedt, Katja; Good, Lars (2005)
- ACL Injury Rehabilitation: A Psychological Case Study of a Professional Rugby Union Player. Source:Journal of Clinical Sport Psychology . Mar2008, Vol. 2 Issue 1, p71-90. 20p. Author(s): Carson, Fraser; Polman, Remco C. J.(2008)
- Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery Author links open overlay panelKate E.WebsterJulian A.FellerChristinaLambros Show morehttps://doi.org/10.1016/j.ptsp.2007.09.003 (2007)