ATHLETIC TRAINING

Psychological “R’s” of Easy Injury Rehabilitation

University of Idaho MSAT program

Understanding The Causes of Injury in Physical Rehabilitation

Most people will experience at least one significant injury in their lifetime. Fortunately, we understand more about the human body and physical rehabilitation than ever before. As we understand more about injury, we realize that there is often more to the injury than meets the eye. At first it seems as if that sprained ankle is the result of some deficiency in the structures of the body (which in some ways it is). It may be useful to think of an injury like the straw that broke the camel’s back. In this analogy, it is technically true that the straw did break the camel’s back, but what made the last straw different from the other straws? The answer is often, not much. In the rest of this article, we will discuss a few factors that contribute to injury.

There are many theories as to why we become injured and some depend on how the injury occurred. One theory is that it is often bad luck. Think of this as a freakishly BIG straw. Maybe you were at the wrong place at the wrong time. Other theorists suggest that your body may have run out of the ability to compensate from other physical issues that have not been addressed. For example, you may have had weakness in the thigh, a lack of balance, and limited movement in your ankle and when you went to jump, your body didn’t have any way of absorbing energy that you could have if the other areas in your body were working fine. In other circumstances, you may also have changed your workouts or increased load. Think of that more like the traditional straw that broke the camel’s back.

It is also possible that you have other stressors in your life that cause you to be distracted in the moment (making you not quite as athletic as you usually are), or maybe those stressors cause your body to lose energy in those areas. In the psychology of injury literature, we often talk of a concept of stress as being eustress or distress. Eustress is when a particular stress is interpreted, by the person experiencing it, as helpful. An example of this is nervous energy which allows you to marshal your resources into more focus or strength. Distress is when the person experiencing the stress feels disempowered in some way by this stress. In the clinic, we can demonstrate this kind of distress, stress quite easily. We check the strength of any big muscle. Assuming that muscle we just tested was good and strong, we have the patient think of something that bothers them (makes them feel yucky). When we retest the same muscle that we checked before, the muscle now acts weakened. This phenomenon happens instantly and is easy to try at home. If you have stress and your body reacts to it is a “distress” pattern, you will likely be at increased risk for injury. There are many ways that we can easily shift this stress and those may be topics of other blogs. For now, understanding that the mind can affect the body and stress can make you more likely to become injured or ill, is a great start!

Another cause of injury is the idea of the body as a metaphor. We have seen many examples of things like “Achilles tendonitis” or “heel cord strains” representing some aspect of a person’s life. In these situations, the injury may be slow in coming on or happen all of a sudden, but we usually find these when we ask metaphor questions. For example, in this case, “Who or what is your Achilles heel?”. Often a patient or client will immediately have something come to mind or they will have a feeling or sensation when you ask them a metaphor question. Another example of this body as a metaphor situation is sciatica (pain in the butt, that may move down the leg). It will definitely be worth asking, “Who or what is a pain in the butt in your life?” Usually, understanding that somehow our mind can influence our bodies, and our bodies may communicate what is happening in our life by creating a physical metaphor, is enough to begin to resolve the effect of the mind on the body and then allows us to treat the physical injury in a more traditional way.

In summary, although there are several categories (we mentioned just a few) and numerous reasons one may become injured, a well-rounded healthcare practitioner is capable of addressing all of these mind/body/spirit issues with an integrated rehabilitation program that will allow the patient to finish rehabilitation better than ever! Our Athletic Training programs at the University of Idaho train students who understand these influences and correctly diagnose the true and apparent cause of your injuries to get you back on the court, field, or just life in general, as soon as possible.

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