| 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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