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