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One
weekend during the summer you are playing a
pick up game of basketball or a quick set of
tennis. Suddenly you turn the wrong way and
you feel something pop in a knee or tear in
your ankle. A trip to the emergency room reveals
that you have done some serious damage and need
surgery to repair the problem and that you will
be in a cast and on crutches for the next several
weeks. You are annoyed over this course of events
and are quite inconvenienced for the next few
months. Now imagine for a moment you are not
a weekend warrior but rather a top athlete perhaps
of late high school or early college age and
you suffer the same injury. We are no longer
talking about a subtle shift in life style.
The essence of who you are may be about to change.
Certainly your thinking about yourself will
be brought into question. Top athletes generally
spend more time working at their sport than
at any other activity. Even athletes as young
as high school age have already invested up
to 10 years playing and working at their craft.
These young athletes may be forced to deal with
the trauma of a serious injury that may change
their view of themselves for an extended period
of time.
When we talk of traumatic events we generally
refer to them as emotional, cognitive and behavioral
experiences of individuals who have been exposed
to or who have witnessed events that are extreme
or life threatening. Volpe (1997), in giving
an overview of traumatic stress, views it as
"an unexpected and uncontrollable event
that can overwhelm an individual's sense of
safety and security and leave a person feeling
vulnerable and insecure in his or her environment."
When an athlete experiences a season ending
or possibly a career ending injury we are talking
about the possible loss of self. When interviewed,
athletes will often define who they are and
their level of self-worth through their sport.
The friends that they have and most of their
support groups are, after a time, related to
their sport.
In a study by Gould et al. (1997) examining
season ending ski injuries, it was found that
a number of factors contributed to the difficulty
of the experience. The areas addressed by athletes
were in the areas of psychological concerns,
social concerns, physical concerns and financial
concerns. Gould reports that the largest source
of stress was in the areas of psychological
and social concerns and that although a good
physical diagnosis and rehabilitation information
is necessary, it may not be enough. If we look
at this issue from the view of a traumatic event
- one that affects all areas of life - we can
see or at least sense what the athlete is dealing
with. In his article on athletic burnout, Raedeke
(1997) addresses burnout from a commitment perspective.
He suggests that beyond the simple stress of
working too hard burnout can better be explained
when athletes do not get the rewards they are
used to getting from their sport. The athletes
are no longer getting the rewards and successes
that their hard work requires and seem to now
justify being committed to "just being
athletes." They begin to doubt the value
of their sport, are feeling trapped and are
making little gain or improvement.
One can quickly see the value of looking at
a severe sports injury from a traumatic model.
The young athlete, used to getting rewards in
a number of areas (psychologically, socially,
physically) is suddenly thrust into the position
of self-doubt with long periods of time without
any noticeable rewards for their efforts. The
commitment changes from rewards to just work
and the trauma of the injury leads the athlete
on a downward path toward possible burnout.
Thotis (1995), in an article examining stress
from health-related difficulties, identified
three major stressors: 1) major life events;
2) chronic stress; and 3) daily hassles. All
of these could be related to a severe sports
injury and the first two clearly are consistent
with the definition of a traumatic stressor.
When a young athlete goes to a physician about
a serious injury it is clear that they will
need a good deal more than just being told that
they will be able to resume normal daily activities
in a couple of months. When they ask if everything
will be OK they are asking about much more than
functioning for the average person. They are
asking "will I be able to resume my life?"
Can they perform and compete at the level that
made them special and in some cases even defined
them? A recent report at the Goodwill Games
underscores this issue. In 1996, Alexander Popov
won two gold medals in swimming at the Olympics.
Upon his return to Russia he was stabbed and
severely wounded. After regaining consciousness,
it was reported the first question he asked
was, "will I be able to swim again?"
The report suggested it was clear he was not
talking about recreational swimming. The question
was whether he could compete at the highest
levels of his sport.
I would suggest that members of the helping
professions, from physicians and nurses who
will generally make the initial contact with
the injured athletes to others (i.e., psychologists
or social workers) consider dealing with the
wide range of issues from a traumatic stress
perspective. Rather than focusing on one symptom
or another, it will be important to recognize
that elite young athletes are, along with their
physical injury, possibly experiencing traumatic
stress and the variety of symptoms that go with
it. Helping the young athlete to identify some
of what he or she is experiencing and having
a respected professional provide an empathetic
response will allow the athlete to at least
feel that someone understands what they are
feeling.
The physical problems of an injured athlete
are clearly the most obvious, but the emotional
trauma experienced by an adolescent or young
adult athlete may also be particularly troubling.
The fear of losing all that they have worked
for is quite frightening. Research suggests
that even adult athletes, when they are ready
to retire from their sport, often need support
to deal with the myriad of changes in their
life and life style.
To help a young athlete identify and understand
some of what they are feeling, that these feelings
are normal, and that they will not be abandoned
during this period, is extremely important.
The physical process of recovery is often a
long one and may or may not be completely successful.
Psychological issues dealt with along the way
vary from athlete to athlete, but I believe
that looking at the problem from a trauma model
will allow all the professionals concerned to
provide the emotional support and direction
necessary while the physical issues are addressed.
Should the young athlete need more psychological
support there are obviously a host of strategies
and techniques that can be presented over time
but they are, at this time, beyond the scope
of this article.
References
Gould, D., Udry, E., Bridges,
D.,& Beck, L. (1997). Stress sources encountered
when rehabilitating from season-ending sports
injury. The Sport Psychologist, 11, 361-378.
Raedeke, T.D. (1997). Is athlete burnout more
than just stress? A sport commitment perspective.
Journal of Sport and Exercise Psychology,
19, 369-417.
Thotis, P.A. (1995). Stress coping and social
support processes. Where are we? What next?
Journal of Health and Social Behavior, (Extra
Issue), 53-79.
Volpe, J.S. (1997). Traumatic stress: An overview.
Trauma Response, 3, 8-9.
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