| 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.
©1998
by The American Academy of Experts in Traumatic
Stress, Inc. |
