“The Invisible Injury” — exploring how athletes deal with anxiety, depression, or identity loss after getting injured.

Introduction: More Than a Physical Setback

Injuries in sport are becoming more common each year, with the demand put on athletes, seasons are becoming longer, trainings are becoming more intense and athletes bodies are becoming more fatigued. When an injury happens, the process is usually rest, go to a physio, identify the issue, do rehab for the recommended length of time, return to training with the hope your injury is better. But, not many people talk about the restless nights replaying the moment you got injured, that sad feeling and isolation when you have to watch your team go weeks playing and socializing without you or the feeling of loss when something you love is taken away from you. For many athletes facing long term injury, the battle isn’t just to recover from your injury, the battle can also be with your mind. There will be lots of rehab with physio, rehab by yourself and trying to push for a comeback timeline, but this is just the tip if the ice berg, underneath lies anxiety, loss of identity and even depression and isolation. This is the invisible injury and this can take a greater toll on an athlete then just a physical injury.

The Emotional Shock of Injury

An injury doesn’t just physically effect your body, it interferes with your daily routines and normality. When you first get injured, the emotions you experience may hit hard at first, disbelief that you actually got injured and denial that the injury is really that bad, thoughts may be racing through your head and you may have that unsettling feeling that you’re going to miss out on a lot. Athletes are used to playing matches through fatigue and tightness but when an athlete is forced to stop due to an injury, this can be a big shock to the system.

A few days after you get injured, one of the hardest adjustment’s for an athlete is the sudden loss of the thing you love dong the most. This doesn’t mean just kicking a ball around a pitch, this means the loss of daily routine, training schedules, match days and team environment, meeting your friends and team mates multiple times a week and pushing eachother. After an injury, when this all gets stripped away from you overnight, it can be difficult to deal with it and leaves a big gap to fill throughout the week. This can cause days to feel longer, more difficult to get up during the day and fall asleep at night as your motivation can dip and it may feel like a there a big hole been created in your life.

In many ways, being injured as an athlete is comparable to experiencing grief in your life. When people think of grief, people may think of losing somebody they loved. Although, this is different, it is still comparable as your experiencing the loss of something that your love. In sport, it is often viewed as somebody’s identity, community and a version of your life that you know and understand so well. Like grief, the emotions you feel each day are never the same, it can be like a wave, some days feel manageable and other days might bring a tough reminder of what you have lost. Recognising the emotional side of injuries and being open to expressing yourself is the first step of understanding that injuries are deeply psychological and their not just physical.

Anxiety and Uncertainty

After the initial shock starts to fade it may be replaced by a more persistent and quieter struggle, which is uncertainty. Recovering from an injury can cause constant worry, this may be caused from the lack of control you have of the situation and the unpredictability of rehab. Athletes can often put a lot of pressure on themselves by obsessing over comeback timelines, wondering whether when they return with they come back at the same level or will their place in the team be gone. This can cause uncertainty is an athlete which can cause a lot of anxiety.

The last thing athletes ever want is to get injured, but then when this does happen, a major cause of anxiety while recovering from an injured is the fear of being re-injured. Even after weeks of rehab, making sure you’re doing it right and taking the necessary time to recover, although your body knows that you’re getting stronger, your mind can often hold onto the memory of how you got injured. This can cause you to overthink movements, running, kicking the ball which all once felt automatic and normal, which now creates doubt and hesitation, this may hold you back from reaching your potential again. This mental barrier is important to recognise as it can be challenging to overcome once you return from injury.

Often when an athlete gets injured, they can feel pressure to return at quick as possible. This sometimes may come external, from coaches or team mates constantly asking “when are you back” or “will you be back for championship? We need you.” But more often than not, this pressure is internal. This internal pressure can be caused by the fear of falling behind, the fear missing out or losing your place and also as stated earlier, the emotional feeling of grief the injury caused, you just want to be able to do the thing you love again. This pressure causes anxiety for injured athletes, learning to manage the uncertainty is important, but it is something athletes may struggle with as many of them are never taught to manage anxiety in sports.

Depression Behind the Scenes

While rehab and recovery for a physical injury is tracked, you feel your muscle and movement get stronger, the emotional effect it has can often increase without noticing. Having your daily and weekly routine, interactions during training and match days, whether it is pushing hard or having a laugh with team mates, this can create a sense of isolation. What has often been your way to express yourself, connection and enjoyment all of a sudden makes you feel distant and this can be difficult to replace in your life.

As the weeks go by, this isolation can become more and more difficult to deal with. It can begin to affect your motivation, as rehab becomes repetitive and boring as the weeks go by and you feel like you don’t have the competitive excitement in your life anymore. The longer it goes on, the drive and excitement that once motivated you begins to slowly go away, you may catch yourself sitting down on the couch watching tv more often instead of being outside with your friends enjoying yourself. This isn’t about losing your discipline towards the sport you love, but rather reflects on the deeper emotional strain the injury has caused.

In many cases of injuries with athletes, all of these experiences and feelings can be related to depression. All of the uncertainty, loss of routine, loss of interest and motivation are all real experiences which have huge effects on people, yet a lot of the time it is overlooked by the physical injury as that is usually the main focus and topic of discussion. Recognising the emotional impacts the injury has on you is essential because the physical injury is only the tip of the ice berg, as rehab and recovery is not only about being fit enough to get back playing the sport you love, it is just as important to get back to feeling yourself again.

Why It Often Goes Unnoticed

Although these struggles are common and many athletes go through them, the mental impact often is looked over when it comes to injuries and athletes. In sport, there is a culture of “toughness,” this is ingrained in athletes from a young age, athletes are taught to push through pain, whether it is fitness or fatigue, athletes are constantly getting pushed harder and harder and at times when it gets tough they are told to keep going. This relates to the mental side of things as it results in athletes not wanting to look “weak” or admit to struggling.

Unfortunately, there is still a stigma around mental health. Although, it has improved in recent years and people are becoming more open to talking about how they are feeling and sports psychology is growing and becoming more popular, athletes still worry about being judged or being less capable to deal with pressure if they speak openly about their struggles. Issues such as anxiety and depression are often hidden away.

One of the issues is most of recovery programs are so focused on the physical rehab, the mental health side of recovery is rarely given the same attention or priority. This can become tough for athletes to deal with, as it may make them feel like their alone when it comes to their mental health. Without the support around the athletes mental health, athletes may often come back after injury looking physically fit but struggling mentally, making the indivisible injury easy to miss.

The Importance of Mental Recovery

It is just as important to work on your confidence, identity and emotions while recovering from injuries, not just focusing on the physical injury. Therefore, it is essential to build a support system around you, as an athlete. A support system could consist of family members, coaches, friends and team mates. This can be done by simple things such as staying connected to the athlete, regularly checking in see how they are doing, keep encouraging and making sure the athlete feel like they are still apart of the team by inviting them to team sessions or meetings. This support system can reduce their feeling of isolation.

Sometimes growing up in Ireland, people are not properly taught about how to deal with emotions and mental health issues in a healthy manner. This is why professional help can also be important for an athlete experiencing a setback. To learn healthy ways to cope with the injury, whether it is with a counsellor or a sport psychologist, these tools the athlete will learn from professional help won’t just help with the short term, but also help the athlete in the long term. It will help the athlete learn about how to cope in a healthy manner to help avoid the mental strains such as isolation and loss of identity.

Mental recovery and physical recovery should be treated with the same importance when an athlete is experiencing a long term injury. If you hurt your leg, you would go to a physio to help heal your leg, so when your mental health starts to suffer, wouldn’t it make sense to see somebody to help you with your mental health? When both physical and mental side of an injury is looked at together, the athlete will return even more healthier and driven, feeling more full and capable to get back to their best.

Conclusion: Healing the Whole Athlete

People often think of injuries as rehab, scans, weeks of recovery and return dates, but that is only half the picture. The full picture is more than just the physical side of things, it is also the mental side. Recovery from injuries is also about rebuilding your confidence, avoiding isolation and still staying involved with your team mates, holding onto your purpose and drive and addressing the emotional difficulties the injury has on you. It is important to address the emotional strains the injury has on you so you come back a strong, healthy version of yourself.

Support system for the athlete is a crucial part of recovery, this creates a safe space for the athlete to speak openly about their emotional struggles such as anxiety, depression, isolation or identity loss. This breaks down the doors of stigma and will help others do the same.

Recovering from injury will always have its ups and down, some days may feel more difficult than others. But, it can be transformative as an athlete and as an individual. When athletes have the right support, whether its support system or speaking to a professional, it becomes a more balanced recovery, which is return the athlete won’t just come back physical stronger, but the athlete will be more self-aware about their feelings and emotions and they will have learned the tools to be better equipped to handle challenges ahead.

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