By James Goodwin, PTA, CSCS
Injuries are an inevitable part of competitive sports as well as recreational activities. The recovery process and inability to return to the previous level of activity can be overwhelming and mentally frustrating for athletes. Overcoming fear of reinjury is a crucial component to consider while undergoing rehabilitation.
Often physical therapy focuses on the physical factors associated with an injury and forget to address the psychological aspects and how the latter may affect an athlete’s performance. Apprehension or fear of a specific movement (generally the mechanism of injury) can lead to poor performance or even worse set the athlete up for reinjury. It is our goal as movement specialists to not only address range of motion and strength but to also rebuild an athlete’s confidence and mental preparedness.
Imagery is a psychological intervention shown to be effective at reducing anxiety, tension and even pain. Imagery involves using the mind to visualize performing a specific skill without any overt actions. This allows the athlete to play a scenario in their mind over and over until apprehension or fear begins to diminish. Incorporating sport-specific movements later in the rehab process along with imagery is critical for an athlete to properly recover both physically and mentally following an injury.
An example of imagery can be taking a scenario/specific movement from the game that the athlete either experienced the injury or has fear of performing, and then ask the athlete to close their eyes and replay this in their mind. This can be done throughout the rehab process.
An example of sport-specific movements can be as simple as lateral acceleration over hurdles and landing technique or can involve receiving a pass, throwing a ball, or swinging a tennis racket to regain neuromuscular control over complex movements. The idea is to introduce activities that either relate to the mechanism of injury or expose the athlete to their fear of a particular movement. This is done later in the rehab process under the guidance of a skilled professional such as a physical therapist or performance specialist when the athlete has demonstrated adequate range of motion and strength gains.