Sports Injury & Rehabilitation

Introduction to Sports Injuries

The term “sports injury” refers to the kinds of injuries that most commonly occur during sports or
exercise, but they are not limited to athletes. Factory workers get tennis elbow, painters get shoulder
injuries, and gardeners develop tendinitis, even though they may not participate in sports. Ultimately,
however, “sports injuries” refers to those that occur in active individuals.
Sports injuries are divided into two broad categories, acute and chronic injuries. Acute injuries happen
suddenly, such as when a person falls, receives a blow, or twists a joint, while chronic injuries usually
result from overuse of one area of the body (repetitive overload) and develop gradually over time.
Examples of acute injuries are sprains and dislocations, while some common chronic injuries are tennis
elbow and stress fractures.
Common Types of Sports Injuries
Sports injuries are broadly categorized into two kinds:
 Acute injuries, which happen suddenly.
 Chronic injuries, which are usually related to repetitive loading or overuse and develop gradually
over time. Occasionally, wear and tear from overuse injuries can set the stage for acute injuries.
Types of Musculoskeletal Injuries
1. Fractures: A fracture is a break in a bone that occurs from either a quick, one-time injury,
known as an acute fracture, or from repetitive stress, known as a stress fracture. Growth
plate fractures are unique to children who are still growing.
2. Dislocation. When the two bones that come together to form a joint become completely
separated, the joint is described as dislocated.
3. Sprain. Sprains can range from minimal stretching of to partial or complete tears of
ligaments, the bands of connective tissue that join the end of one bone with another to
stabilize a joint. Sprains are caused by trauma such as a fall or blow that stresses a joint out
of position.
4. Strain. A strain is a twist, pull, or tear of a muscle, muscle-tendon juncture (where muscle
and tendon connect), or a tendon itself. Athletes who play contact sports can get strains, but
they can also happen from repeating the same motion again and again, as in tennis or golf.
5. Tendinitis. Tendinitis is inflammation of a tendon, a flexible band of fibrous tissue that
connects muscles to bones. It often affects the shoulder, elbow, wrist, hip, knee, or ankle.
Tendinitis can be caused by a sudden injury, but it usually results from carrying out the same
motion over and over. People such as carpenters, gardeners, musicians, and certain types of
athletes, such as golfers and tennis players, have a higher risk of tendinitis. Tendons become
less flexible as you age, so you are more likely to get tendinitis as you get older.

Common Sports injuries include: Shoulder injuries, Knee injuries, Elbow injuries, Leg injuries & Ankle
injuries.
 1. Causes and Risk Factors
Anyone can suffer a sports injury, but several factors can increase the risk of sustaining injury.
The risk factors for sports injuries include:
 Not using the correct exercise techniques.
 Overtraining, either by training too often, too frequently, or for too long.
 Increasing your intensity of physical activity too quickly.
 Playing the same sport year-round.
 Running or jumping on hard surfaces.
 Wearing shoes that do not have enough support.
 Not wearing the proper equipment.
 Having had a prior injury.
 Having certain anatomical features specific to each joint or poor flexibility.
 Taking certain medications, such as fluoroquinolones, a class of antibiotics linked to tendinitis and
tendon rupture.
The type of injury you are most vulnerable to depends on the type of activity you participate in,
your age, and your sex.

Symptoms of an acute injury include:

 Sudden, severe pain.
 Extreme swelling or bruising.
 Not being able to place weight on a leg, knee, ankle, or foot.
 Not being able to move a joint normally.
 Extreme weakness of an injured limb.
 A bone or joint that is visibly out of place.

Rehabilitation Process and Phases

Phase 1- Rest and Protect the Injury: The only goal in the first phase of rehabilitation is to alleviate
pain symptoms, offload any movement, rest the injured area, and protect it from further trauma. Rest
does not always imply bed rest or total cessation of everyday activity. According to research, it is
critical to continue to engage in functional movement in various ways. Just keep in mind that your level
of activity will be reduced, and the activities themselves will be changed to relieve pressure on the
damaged area.

Phase 2- Mobility and Movement: Joint mobility and range of motion are essential for muscular
strength. Muscles and joints work together to flex, stretch, strain, and respond. The wounded area is
likely to feel stiff after an accident, whether owing to tissue repair or simply inactivity and moving it
may cause some discomfort or pain at first. The goal of this phase of rehabilitation is to regain joint
flexibility and mobility. A physical therapist (physiotherapist) will utilize muscle stretching, flexibility
training, and therapeutic exercise to restore mobility and range of motion. You can restore movement
and mobility to the damaged area by doing a few basic workouts and exercises at home.

Phase 3- Strength and Stamina: The subsequent stage of rehabilitation focuses on regaining muscle
strength, endurance, and stamina. Simple bodyweight exercises can help an individual athlete regain mid-
body connectivity, while isometric exercises can help rebuild strength in a specific location. Once you're
ready, low-load exercises or even novel modalities like blood flow restriction therapy can be used to
generate high muscular weariness. As breath is such an important part of endurance and strength, a
physical therapist (physiotherapist) will use signals during training to ensure that a patient is keeping
proper exercise form and posture without gasping for air indicating that the patient has been overworked.

Phase 4- Reconnecting to Coordination: Sports-related injuries can occasionally affect our

proprioception, the rehabilitation of sports injuries should address reconnecting and coordination next.
Trauma to the musculoskeletal system can often throw our spatial awareness and coordination off
following an acute injury. We usually associate these issues with concussions, but even hip joint injuries or
healing from a knee injury like an ACL surgery can alter our body's balance, coordination, and muscular
motions. Exercises and motions designed to restore neuromuscular control may be included in your
physical therapy (physiotherapy).

Phase 5- Rebuilding Sport-Specific Technical Movements: You'll bring all of your progressive healing
and gains together at this level of rehabilitation to get back to performing sophisticated sport-specific
motions. Athletic trainers with a background in physical therapy will assist you to perform exercises in the
context of their sport. If this is the site of your injury, your sport-specific training will focus on avoiding the
same conditions or motions that first caused the damage or aggravated the area. Only by concentrating on
mastering sport-specific technical motions under the supervision of an expert and compassionate physical
therapist can you anticipate a safe return to competition.

Psychology of Injury
Injury is more than physical; that is, the athlete must be psychologically ready for the demands of his or her
sport. Sports Injuries do threaten athletes’ career and success and can end a career and have various
consequences on athletes’ quality of life. The most immediate emotional response at the point of injury is
shock. Its degree may range from minor to significant, depending upon the severity of the injury. It is
important to note that denial itself is an adaptive response that allows an individual to manage extreme
emotional responses to situational stress. Many individuals assist athletes through the recovery process
and can foster psychological readiness, but they can also identify those who are physically recovered but
require more time or intervention to be fully prepared to return to competition. Thus, rehabilitation and
recovery are not purely physical but also psychological.
When an athlete is injured, it does not affect his physical capabilities exclusively, but also contextual and
psychological aspects. In fact, in given situations, injuries can deprive athletes of their compensation
increasing life-stress, and determine fear to reinjury, sensation of loss, negative emotions, and other mood
disturbances.
Sport injuries can have significant psychological effects on athletes, impacting various aspects of their
mental well-being. Some key psychological aspects of sport injury include:
Emotional Response:
Athletes may experience a range of emotions in response to their injury, including shock, anger, frustration,
sadness, and even depression.
The sudden loss of their ability to participate in their sport can be distressing and may lead to feelings of
helplessness or hopelessness.
 • Fear and Anxiety: Fear of re-injury or concerns about their ability to return to their previous level of
performance can lead to heightened anxiety levels among injured athletes.
This fear may be exacerbated by uncertainty about the recovery process and the potential long-term
consequences of the injury.

 Loss of Identity and Self-Esteem: For many athletes, their sport is a central aspect of their identity, and
an injury that prevents them from participating can result in a loss of self-esteem and feelings of identity
crisis. They may struggle with a sense of purpose and meaning in the absence of their sport.

 Social Support and Isolation: Injured athletes may feel socially isolated from their teammates and support
network, especially if their injury requires them to withdraw from training and competition. This sense of
isolation can further contribute to feelings of loneliness and depression.
• Coping Strategies: Athletes may employ various coping strategies to deal with the psychological
challenges of injury, such as positive self-talk, visualization, goal setting, and seeking social support.
However, some athletes may also resort to maladaptive coping mechanisms, such as denial, avoidance, or
substance abuse.
Mental skills in sports are often viewed as part of an individual's personality and something that cannot be
taught. Many physicians feel that injured athletes either have or do not have the mental toughness to
progress through rehabilitation. Mental skills, however, can be learned. One example for this is to provide
proper goal setting, which has a very important role in sports rehabilitation, because it can enhance
recovery from injury. Goal setting needs to be measurable and stated in behavioural terms. The research
indicates that goals should be challenging and difficult, yet attainable. It is important for physicians to help
them focus on short-term goals as a means to attain long-term goals. For example, to set daily and weekly
goals in rehabilitation process which will end in long-term goal like returning to play after an injury. It is
important for sports medicine physicians to assist patients in setting goals related to performance process
rather than outcomes, such as returning to play.
Psychological Readiness to Return to Sport: The process of returning to sport after an injury involves not
only physical rehabilitation but also psychological readiness. Athletes must regain confidence in their
abilities, overcome fear of re-injury, and trust their bodies again before returning to competition fully.
Psychological Interventions: Psychological interventions, such as cognitive-behavioral therapy, relaxation
techniques, mindfulness, and goal setting, can help injured athletes cope with the psychological challenges
of injury and facilitate their recovery process.
Additionally, maintaining communication with coaches, teammates, and healthcare providers can provide
valuable social support and guidance throughout the rehabilitation journey.

Sports injuries are not just a result of physical strain or trauma; they also have a psychological component.
Our thoughts, emotions, and mental state can influence how we perform, recover, and even prevent
injuries. There is plenty of research that suggests athletes with high levels of stress, anxiety, or low self-
esteem may be more prone to injuries. This mind-body connection highlights the importance of
addressing psychological factors alongside physical training to reduce the risk of injuries and is one of the
factors as to why many professional sports organisations include the figure of a sport psychologist among
their key personnel.
Psychological factors influencing sports injuries

As we know, sports injuries go hand-in-hand with psychological factors. So let’s look at the the common
factors that could impact an athlete:

 Stress and Anxiety: High levels of stress and anxiety can have a significant impact on an athlete's
performance and injury susceptibility. When athletes are stressed or anxious, their attention and
focus may be compromised, leading to decreased awareness of their surroundings and an increased
likelihood of accidents or overexertion.

 Personality Traits: An athlete's personality traits can also play a role in their injury risk. Certain
personality traits, such as perfectionism or a high need for achievement, can lead athletes to push
themselves beyond their limits. While determination and drive are admirable qualities, they can
sometimes result in overtraining, inadequate rest, and ultimately, injuries.

 Self-esteem and Confidence: Self-esteem and confidence are crucial psychological factors that
affect an athlete's performance and injury resilience. Athletes with low self-esteem may doubt their
abilities, leading to hesitations, lack of assertiveness, and increased risk of injury. On the other
hand, athletes with excessive confidence may underestimate the risks involved in certain
movements or neglect proper technique, putting themselves at higher risk.

Psychological Aspects of Recovery

There are seven principles of rehabilitation; principles are the foundation upon which rehabilitation is
based. This mnemonic may help you remember the principles of rehabilitation: ATC IS IT.
Avoid aggravation
Timing
Compliance
Individualization
Specific sequencing
Intensity
Total patient: rather than just rehabilitating the injured area, will help you better prepare the patient
physically and psychologically for when the injured area is completely rehabilitated.
Psychological Factors For Sports Injury Rehabilitation
There are five key psychological factors – goal-setting, imagery, positive self-talk, relaxation and social
support – that play an integral role in the recovery process.
Goal Setting
Goal-setting is the first important of the five factors that have to be established clearly. The remaining four
factors are important in that they aid goal attainment.
Studies have shown that injured athletes using goal-setting exhibit greater performance improvement than
those not using goal-setting.
Imagery
Mental imagery is the process of using the imagination to rehearse, imagine or replay situations in the
“theatre of the mind”.
Positive healing and/or sports performance imagery has been shown to be correlated to faster recovery
times. Unsurprisingly, negative imagery has the opposite effect. Examples of negative imagery include
replaying the injury scene excessively.
Positive Self-talk
Positive self-talk is the process by which the athlete’s negative thoughts are predicted into positive, task-
oriented thoughts and affirmations. Many athletes have the tendency to dwell on negative or irrational
thoughts and beliefs about themselves. This is especially so in areas such as their injury, or their return to
performance. Following injury, positive self-talk techniques are useful to help counteract the problem of
low self-confidence in athletes.
Relaxation
Relaxation training is a recommended psychological tool for use with injured athletes during rehabilitation.
This is done in conjunction with other techniques to relieve pain and stress. Staying loose and relaxed
facilitates recovery.
Social Support
Social support systems for athletes include family and friends, and relationships with teammates, coaches,
and therapists. It is found to be effective in helping the athlete make a better appraisal of their situation
(towards positive imagery) and through the emotional adjustment process.

Prevention and Rehabilitation through Psychology

Being able to recognise the psychological aspects of sports injuries opens up new avenues for prevention
and rehabilitation strategies, which is why the figure of a sports psychologist is so important today within
sports clubs and teams. Sports psychologists work closely with athletes to enhance their mental resilience,
coping mechanisms, and overall well-being. The following is just an example of some strategies they
employ:
 Mindfulness and Stress Reduction Techniques: Teaching athletes about the importance of
mindfulness and stress reduction can help them manage anxiety and maintain focus during high-
pressure situations. Practices such as meditation, deep breathing exercises, and visualization can
promote mental clarity and reduce the likelihood of injury-inducing distractions.
 Goal Setting and Positive Self-Talk: Setting realistic goals and adopting positive self-talk can
significantly improve an athlete's self-esteem and confidence. By setting attainable objectives and
replacing negative thoughts with encouraging self-talk, athletes can develop a resilient mindset and
reduce the risk of injury due to self-doubt or fear.
 Injury Rehabilitation Support: Psychological support during the rehabilitation phase is essential for
athletes recovering from injuries. Coping with the mental and emotional challenges that arise from
setbacks and the fear of re-injury can be crucial for a successful recovery. Sports psychologists can
provide valuable guidance, helping athletes navigate these obstacles and regain their physical and
mental strength.