The Mental Side of Injury
This past week we saw our USWNT play a friendly game against Ireland. Unfortunately in that game, our current top goal scorer for the US, Mallory Swanson, suffered a patella tendon tear. This is a devastating loss to our USWNT while only months away from the Fifa Women’s World Cup. But most importantly it's a traumatic loss for Swanson herself to endure.
An injury like this while playing at the top of your game is something that happens too often in our sport. And while there is much to be discussed on the physical side of an injury like this, we will plan to stay in our lane and discuss the mental side of a devastating injury.
Immediately after a serious injury humans can go into shock. The physical signs of shock are low blood pressure, rapid heart rate, nausea, weakness. The psychological signs of shock are confusion, emotional detachment, muteness, disorientation, memory loss and unresponsiveness. If an athlete goes into shock immediately after injury, it is more likely they will experience traumatic stress symptoms and future fear or anxiety when taking similar risks.
Traumatic stress can affect athletes after injuries involving shock or severe pain. Traumatic stress also has both physical and psychological symptoms. The Psychological effects of traumatic stress are: intrusive thoughts, memories and dreams of the event, poor concentration and memory, confusion, avoidance of reminders of the event, social withdrawal, loss of interest, emotional numbness, low mood, guilt, irritability, anger and anxiety. Prolonged traumatic stress can increase one’s risk of developing depression and other mental and physical health issues.
Grief & Loss
Another area that affects athletes when they endure a serious injury, is grief and loss. Understanding the five stages of grief and loss provides the athlete and those around the athlete with a better perspective on how to handle the injury. Injury can mean loss of one’s sporting identity (temporary or long term depending on the injury). This loss can feel like grieving the loss of someone close to you. It is important for athletes to know that it is natural to go through these stages. If someone gets stuck in a stage for too long, support may be helpful to move on.
Denial and isolation– Denial protects us when emotions and shock are too great for our coping resources. We resist and withdraw from anyone or anything that makes us face the facts, leading to isolation.
Anger– Once denial wears off, it is common to become angry, as a way of deflecting emotional pain. It’s easier to turn our attention outward for the pain we find ourselves in. It may be an irrational response, but it is very human. This anger can lead to guilt quickly.
Bargaining– Once the reality of the injury has sunk in, we feel helpless and grasp at any possible, even impossible, idea of how we can salvage or reverse the loss. We repeatedly imagine how it could have been different in our minds.
Depression– When bargaining fails reality really kicks in leading to sadness and concern about the changes and uncertainty we face. This depression is defined by the “letting go” process (your season goal, events, your riding time at training).
Acceptance– The final stage of grief and loss is the ultimate acceptance of the reality of the injury. Acceptance is not a happy shift, but it is quite different from depression in that it is making peace with the reality that allows us to let go of struggle and move on.
As an athlete moves through the stages of grief, it's important that they have other avenues of support in place. A few tips that may help are:
Visualization techniques to reframe thinking.
Breathing exercises to move through stress and anxiety.
Give them space to communicate about their injury so they feel less isolated.
Give them a “new role”- most athletes need to feel purpose and a sense of accomplishment when they are struggling through an injury.
Counseling- provide clinical support with a trained professional if needed.
Devastating injuries are hard, painful and traumatic. And also very common for female soccer players. The more we discuss the mental side of coping with these types of injuries, the more we normalize the feelings behind the injury. And when things feel more normal, we feel less alone and able to cope.