Minding the injury
Danny O'Dell explains the four stages an injured athlete will go through on the road to recovery.
Every athlete, regardless of his or her skill level, will go through a grieving process after incurring an injury - without exception. In 1969, Kubler-Ross first outlined the stages of grief a person goes through when facing a serious or career-ending injury, death or serious disease prognosis.
An understanding of the four stages of managing grief: denial, anger, depression and acceptance will help you in supporting the athlete through them.
In the beginning, the athlete cannot believe the injury is severe or that it will impact their ability to continue with their sport. They may still believe in the myth that "no pain means no gain". If so, they have been living under a rock for quite some time. Pain is an indicator that something has gone wrong and needs immediate attention. The realization that the pain is stopping them from participating leads to the next stage.
Denial quickly turns to anger as the reality of the situation settles in and the athlete is forced by the circumstances to alter or even stop their participation in their sport. Recovery is often not an easy path and the athlete becomes frustrated and more irritated with the pace of the rehabilitation process. At this point, the coach is in an ideal position to be a sounding board for the athlete's exasperation and help ease their aggressiveness toward the athletic trainers who are trying to get them back in shape. Realizing the athlete is angry at their loss of ability to perform, their loss of power over what has happened to them and the current situation they now find themselves in are important points to keep in mind while dealing with the individual.
Self-worth becomes an issue at this point in the process and depression sets in due to the reality of the situation now being fully realized. The athlete begins to feel as though he or she has no physical or emotional control. The team continues onward without them, which leaves a void in their life and this leads to feelings of isolation, further self-doubt and lowering of their self-esteem. Hope for a successful outcome becomes cloudy and they may not see any good coming from the rehabilitation process.
You as the coach will have the most difficult time during this stage as the athlete may stop going to rehab, to team practices or even talking to you. You must continue talking to them by encouraging them. Explain to them the progress they have made and keep them engaged in their recovery. Once they have completed the journey through this stage, they enter the final one, acceptance and recovery begin in earnest.
Acceptance of the full enormity of the circumstances they find themselves in begins the physical and emotional healing process. Once this stage is entered an attitude change is noticed and the real work towards full recovery begins.
Not one of the four stages of grief will be lit up with flashing lights and banners waving in the air. They are gradual movements into and through each one. There may even be periodic lapses back and forth into previous stages. So, expect these setbacks. In many cases, they are only temporary. However, if extremes in mood are continuous and seem to remain locked into one part of the process it is incumbent upon you as their coach to recommend they seek additional professional assistance in managing the problem.
In each instance recognition of the particular stage of grief is a key factor in helping toward the full recovery of their athletic prowess. Effective communication by the coach, providing education as to what is happening to their body, supporting the recovery and co-operatively setting goals will help ensure positive progress is made after the injury.
So how do you go about this important task?
Here are a few suggestions to follow. Bear in mind this is NOT about counselling, these are suggestions that may provide you with a little extra information to help get over the rough spots. In most cases, we are not trained mental health counsellors or athletic trainers so act with common sense and do not go beyond your educational training speciality. Remember the axiom of 'Do no harm'.
Communication skills are vital throughout the rehabilitation process and being a good and active listener will aid you and your athlete tremendously. Actively engaging in the conversation by rephrasing their uncertainties about the future, their worries, and goals into your words demonstrate you are interested in their concerns and more importantly have heard what the athlete is saying to you.
Maintaining eye contact is a simple part of good communications and should be used whenever speaking to someone, regardless of the situation. Providing an environment that is conducive to communications by ensuring privacy, low noise and no interruptions is essential. Place the phone on the answering service, turn your computer to energy save mode, and put a note on the door announcing that you are not to be interrupted.
Once in an environment that supports open communication, use good judgement in what you say to the injured athlete. Being timely, i.e. are they ready to receive the information about the injury, can be of importance depending on their state of mind. That is where knowledge of the stages of grief enters into the picture.
Communication includes both oral and written information and instructions for the management of the rehabilitation process. Encouragement for their efforts indicates your attentiveness and concern for their well-being and successful return to the sport.
Setting goals with the athlete are also important in the recovery process as it gives them a buy into the program. They now have control over their future and a mutual understanding of the importance of how these goals fit into the large scheme of the training. Coach and athlete should have the same goals, if not the coach will have to reach a consensus on them to proceed or failure will result. Monitoring the goals and recording progress at each stage of the training is a roadmap that can be referred to as the journey continues. Each objective reached along the way is positive reinforcement that the program is working, and that progress is being made by the athlete.
Support throughout the entire rehabilitation period comes from a variety of sources, family, friends, team-mates, church, athlete training partners and you, their coach. Positive comments about the progress and the recovery will help the athlete reach their goals faster.
Designing an interesting but challenging program is in the best interest of the athlete. If it is boring, no matter how good it may be compliance will surely be lacking. This is where the athlete and you have to be together on what is best for their safe return. Every athlete has their favourite exercises so include them in the training schedule. Follow these suggestions and it will not be long before you have a healthy athlete back on the field again.
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About the Author
Danny O`Dell is an NSCA Certified Strength and Conditioning coach from the USA. He is the author of several training manuals including The Ultimate Bench Press Manual, Wilderness Basics, Strength training Secrets, Composite training and Power up your Driving Muscles. Danny has published articles in national and international magazines describing the benefits of living a healthy fitness lifestyle.