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 When you experience a sports related injury it can be easy to focus on the accident, tackle, or fall itself as the cause for your pain.  However, sports related injuries are multi-faceted and can arise as a combination of both extrinsic and intrinsic factors.  Extrinsic factor of injury are any contributing features outside of you such as the condition of the field you play on, your shoes, even the rules of your sport.  Intrinsic factors are the things about you that might make your body more susceptible to injury like your training, your natural biomechanics, and yes- your level of emotional stress. While most athletes understand that a slippery field or poor fitting shoes can contribute to injury, few consider how life stress can contribute to their body’s success or failure.

How Stress Can Contribute to Injury

Stress can play a part in injury for both psychological and biological reasons. Some researchers suggest that when your mind is distracted by stressful life events it is limited in its ability to focus on your sport. Your reaction time is slowed and you may be more injury prone.  On a biological level, the body releases cortisol as a response to stress (be that running from a bear or an upcoming deadline at work.)  Cortisol is a vital hormone responsible for a number of functions including the regulation of your biological clock.  When your body is busy pumping out lots of cortisol it will not make enough human growth hormone, which is needed to rebuild your muscles after athletic training.  Additionally, when cortisol is high your body will produce less dehydroepiandrosterone (DHEA) hormone.  Depleted levels of DHEA can cause you to loose muscle mass and bone density and also make you feel tired or depressed.

Research has shown that life stress is directly related to injury in athletes.  One study performed on ATHLETES   showed injury rates of 30%, 50%, and 73% in athletes who reported low, moderate, and high levels of life stress respectively.  Research performed at a major dance company found that 23% of their dancers withstood 52% of the injuries. Of these dancers, those with higher reports of performance anxiety took a longer time to recover from injury.

It is important for any athlete to be aware of how stressful life events may prime their body for injury. While your coach may encourage you to leave your life off the court, be aware that your body may not actually be able to do so.

Keeping Your Mind in the Game

Far too often, athletes and dancers return to sport without adequate rest. The pressure to get back in the game comes from many sources: your team depends upon you, you’re losing money, and you are getting frustrated by not being able to do the activity you love. Your physical therapist is a wonderful source to consult about when you are ready to return all out play. But you don’t need to think of your time on the bench as time wasted. This rest period can be an incredible opportunity to build your mind-body connection. You can use your mind to help your body in the following ways:

1.) Get a good team around you.

It is perfectly normal to have an emotional response to injury. You may feel frustrated, depressed, tense, or even bored without your regular routine of physical activity. Gathering friends and family for support can help you to manage these feelings and buffer the stress-injury relationship. Study after study has demonstrated a direct relationship between social support and treatment adherence, motivation, higher life satisfaction, belief in rehabilitation, and speedy recovery in injured athletes. Social support can also help you to foster hope-defined as an individual’s perception of their ability to reach a goal. When you feel like you will never get back to running a marathon, support from others can assist you in believing in yourself once more.

2) Use Mental Imagery
When you cannot perform a sports skill physically, try imagining yourself in the game. Mental imagery has been shown to prepare athletes for a good performance by focussing their attention and helping tune out disruptive or negative thoughts. You may even take this mental practice a step further by striving to recreate theexperience of your sport with as many sensory memories as possible. Close your eyes and imagine the smell of the field, the heat of the sun, the contact of your cleats in the dirt. One study recorded that injured skiers who practiced this way had nerve activity in the muscles required to ski that matched the activity expected if they actually were skiing. This is evidence that our brains have the power to send signals all the way to our muscles just by imagining physical activity.  You can increase both muscle strength and physical skill through mental practice while injured.

3) Practice Positivity and Stress Management

The number one predictor of athletic injury is a previous injury. To prevent downtime in the future, get yourself in good mental health and practice some stress management techniques while your body is healing.   In addition to mental practice, goal setting, relaxation exercises, and seeking positive motivation can all an athlete cope with life and performance related stress. Even taking 5 minutes before a game to focus your mind can decrease your stress levels to help prevent injury.

Most athletes will experience some form of injury over the course of their playing careers. Understanding how life stress pre-disposes you to injury can make you pro-active in mediating worry before it effects your performance. Maintaining a positive outlook and a mental practice when you cannot play is a useful tool while your tissues are healing. Lastly, remember that your PT should be a trusted part of your social support system. We are here to aid you in a safe transition from rehabilitation to return to the sport you love.

Visit www.premierptny.com for more information on injury prevention and physical therapy.

Stay injury free!

Lauren Carleton, PT, DPT

References:

Lu, FJ, and Y. Hsu. “Injured Athletes’ Rehabilitation Beliefs and Subjective Well-being: The Contribution of Hope and Social Support.” Journal of Athletic Training 48 (2013).

Meeuwissee, W.H. “Assessing Causation in Sport Injury: A Multifactorial Model.” Clinical Journal of Sport Medicine 4.3 (1994).

Nippert, Angela H., and Aynsley M. Smith. “Psychologic Stress Related to Injury and Impact on Sport Performance.” Physical Medicine and Rehabilitation Clinics of North America: 399-418.

Warner, L., and ME McNeil. “Mental Imagery and Its Potential for Physical Therapy.” Physical Therapy 68.4 (1988): 516-21.