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Pre-Surgery Treatment of Mental and Emotional Aspects of Sports Related Injuries

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Working with an injured athlete prior to surgery has proven to be a game changer when it comes to the athlete’s approach to surgery, pain management, and the rehab process.

Helping athletes work through rational and irrational fears about surgery, processing concerns about the impact the injury will have on their performance, calming their anxiety about the rehab process, and gaining clarity about their identity as an athlete all help the athlete approach surgery with less fear and anxiety.

imagesA calm brain produces fewer stress related hormones so the mind and body have a remarkably different experience of surgery than the athlete who goes into surgery tense, scared, and filled with anxiety.

Recently I had the pleasure of working with an athlete as she was preparing to return to play after ACL surgery. This is an athlete that I saw a few days before surgery and a few more times as she worked her way through the rehab process.

The surgery/recovery process has gone so well for this athlete I decided to request an interview to capture and share the power and significance that pre-surgery treatment can have on an injured athlete facing surgery.

I have kept the athlete’s name private to maintain confidentiality. I will say that this athlete is a female high school soccer player who tore her ACL.

Question: How long ago was your surgery and how did the injury happen?

Athlete: About 8 months ago. I was going after a 50/50 ball on the soccer field. We collided and I tore the ACL in my left knee.

Question: How did you feel immediately after the injury?

Athlete: I felt “crappy”, devastated, scared, mad, upset, and sad. I wished it had not happened. I immediately started having all of these questions run through my mind. Questions about my future…Will I be able to come back? How long will it take to come back? Why did this happen?

Question: How did you find your way to The Institute of Sports Performance?

Athlete: My mother wanted me to have every kind of support I could have. She new I was suffering and upset so she started asking around. A therapist here in Houston told my mother about Robert Andrews, so we set up an appointment before my surgery.

Question: What was your reaction to your mother’s suggestion that you see someone to address the mental and emotional impact of your injury?

Athlete: At first I thought it was weird. I wasn’t excited. But she explained how it would help, and it made sense. Then Mr. Andrews explained everything in a way that just made more sense. After he explained how the brain works and how it handles high stress events, I was excited that I had this help going into surgery.

Question: How did you feel when you thought about having surgery?

Athlete: I was scared and anxious about the pain. I was really afraid of how painful it was going to be.

Question: Did you have any specific images in your mind about surgery, and how did you feel when you saw these images in your mind?

Athlete: Yes I did. I kept seeing images of the doctor opening my knee up and another image of me being surrounded by doctors in surgery. The images were there whenever I thought about going into surgery, and they made me feel scared and anxious.

Question: What work did you do with Mr. Andrews prior to surgery?

Athlete: We did some work with light, eye movement, and sound (EMDR) that focused on the scary images I had in my mind about surgery. By the time we finished with the first session those scary images were gone. I felt so much calmer. The fear and anxiety were gone. I was confident and ready for surgery.   I even had a new image in my mind of everything going well in surgery. The day of surgery I felt pretty calm.

Question: How did you feel after immediately after surgery?

Athlete: I felt great! I didn’t have a lot of pain. I was more concerned about the rehab process, but I saw Mr. Andrews again about that. We did some work that calmed my anxiety about rehab.  After that I was very confident and attacked my rehab process.

Author’s note– this process is not a guarantee that injured athletes will suffer less pain in surgery. There are many different types of ACL reconstruction surgeries, some more painful than others. Overall, I frequently hear reports from athlete’s saying they approach surgery calmer and with less anxiety. Many also report experiencing less pain.

Question: How do you feel now eight and a half months after the injury?

Athlete: I feel great! I continue to do my rehab with the goal of continuing to get stronger. I am back at practice, and I feel more confident. I have no pain and feel “normal”. I am definitely more confident than I thought I would have been at this stage of my recovery. Working with Mr. Andrews helped me be more patient about my rehab process. I have done great.

Question: When you think back to the point in time when you were injured, what do your think about and remember?

Athlete: I don’t really remember the injury. I see the rewritten version in my mind where I don’t get hurt. The old scary image of me getting hurt isn’t stuck in my brain anymore like it was when the injury first happened.

Question: Would you recommend this treatment process to other injured athletes?

Athlete: Yes I would, and I have. My mother tells everyone and I tell everyone. Seeing Mr. Andrews before surgery really made the difference for me. I thought I would be afraid when I came back, but I am not. I tell everyone how great I am doing. I am doing so much better than everyone thought.

Changing a Paradigm

I am grateful to this young athlete for sharing their process and experiences with me. It is important to get this information out. I believe we can dramatically alter the amount of fear, anxiety, anger, depression, and suffering injured athletes experience when injured.

After ten years of working with athletes I have seen thousands who have suffered serious injuries. These injuries include ACL injuries, Tommy John, broken ankles, legs, arms, and collarbones, shoulder injuries, and concussions. I have also seen baseball and softball players who have been hit by pitches, taken bad hops, and line drives back to the pitcher. Gymnasts and cheerleaders who have suffered bad falls and injuries, and pole vaulters who have broken ankles or suffered knee injuries also come to see me.

Savannah Jones (10) tries to shield the ball from a Lake Travis midfielder.Each of these injured athletes goes through an extremely high level of stress and possible trauma when injured. The part of the brain that is designed to protect them and keep them safe (the limbic system) is engaged. Calming this limbic system down before surgery is the key.

As a result, they approach surgery with less anxiety, less fear, and they attack the rehab process with more determination and confidence. These athletes return to play absent of the debilitating fear of re-injury.

Many athletes learn a lot about themselves during the injury/recovery process. They develop key parts of their personality. They learn to be tougher, more focused, resilient, and grateful. They reconnect with the love and passion they experienced before the injury.

Parenting Athletes and Enjoying the Journey

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Parenting your athlete can be one of the most enjoyable experiences you as a parent can have. It can also be incredibly stressful and trying, causing many sleepless nights as your athlete navigates their way through the highs and lows that come with participation in a team or individual sport.

Here are a few key pointers for parents that can help their athlete perform at a higher level, find more enjoyment participating in sports, and help parents enjoy the remarkable journey of parenting their athlete. DSCN1828

Parents must…

  • Understand how their child/athlete responds to stress and pressure
  • Understand how stress and pressure changes the way they parent their child/athlete
  • Understand how they can become an important and positive contributor to the athlete/coach/parent system
  • Understand how perfectionism impacts performance, quality of life, health, and self- esteem, and how to counter the perfectionistic personality
  • Understand how your child/athlete’s unique personality is so critical to performance
  • Understand ”Tank Filling’ versus “Tank Draining” parenting styles

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  • Understand the “Business and Personal“ sides of your relationship with your child/athlete
  • Understand how to manage their stress response by following this simple formula Event + Response  = Outcome
  • Understand Introverted and Extroverted personality styles and effective ways to parent both styles
  • Understanding of how thoughts and emotions impact performance
  • Understand the importance of time management, sleep, diet… and how they impact performance.

To have Robert Andrews talk to your parent group, Booster Club, or organization about parenting athletes contact Robert at 713 522 2200 or email at robertandrews@tinssp.com

Overcoming Tumbling Blocks in Cheer and Gymnastics

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By Robert B. Andrews MA, LMFT

Well, its that time of year again.  Gymnastics and cheer seasons are cranking.   My phone, text, and email are buzzing with calls from athletes and parents with girls who can’t backward tumble.  Beam, floor, or cheer routines are wreaking havoc in the minds and hearts of these athletes. And parents and coaches too.  In gymnastics it can work its way into other events as well.

From young ones to college age there seems to be an epidemic of these athletes suffering from serious mental blocks related to tumbling or “backward” skills.

That said I thought it timely to republish an article I wrote back in 2012: “Help I Can’t Tumble”.  It provides great inside into the causes of these blocks and provides tips to help overcome these devastating  issues when they arise.

IMG_0990From my experience with these athletes the ones who are committed to the process are able to work through the block and enjoy tumbling again.  They understand that it takes time, effort, and focus.  Just like learning a new skill they have to commit the time and energy to overcome the block.  They work on mindset, mindfulness, breathing, imagery, and are open to calming any high stress events like falls or injuries that might be creating the mental overload.

If you read the article when I first published it I think you will find the reread insightful.  If this is your first time to read it I hope you find it helpful.

ISP Sponsors Texas Invitational Volleyball Tournament

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We are proud to announce that The Institute of Sports Performance was a sponsor of The 2015 Texas Invitational Volleyball Tournament.

DSCN1850This is one of the largest volleyball tournaments in the country.  This  year there were 88 teams from all over Texas.

Being a part of this tournament puts our brand in front of over 1, 300 volleyball players, their coaches, and parents.  This broadens our ability to help athletes needing support with their mental and emotional recovery as they return from serious sports related injuries.  We are also able to reach more parents, coaches, and organizations with cutting edge mental training, team building, and development of  sports culture.

What a Final!

IMG_1062The Coppell Cowgirls won the final in a remarkable three set match over local power Clear Creek.  The level of play was spectacular. All areas of play excelled with great passing and defense, setting, and powerful hitting.

Congratulations to Pearland Coach John Turner, Dawson Coach Jason Karim, their players and parents for putting on a well run tournament.  We  look forward to being a part of The Texas Invitational next year.

Mental Toughness and Mindfulness in Sports

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For many athletes their reaction to stressful events during training, competitive pressures, and off field issues sets off an intense destructive response.  For many this reaction is so intense it impacts performance severely, impairs ones ability to focus, and depletes self confidence.   For many it feels like a wave of nervous energy and emotion has taken over their mind and body.  When something goes wrong negative responses rise up and performance often suffers.  These “Reactive Habits” can be avoided by becoming mindful or aware of how the athlete reacts to stress.

ChokingReactive habits are old programs or ways of responding that are often destructive to performance.  Many basketball players get animated and dramatic when they think a ref has made a bad call.  They throw their hands up in the air, stomp their feet in anger. Some charge at the official in a disrespectful and intimidating way.  A baseball or softball player might hang their head, look at the ground, and show poor body language as they walk back to the dugout after striking out.

For many athletes this reactive habit can be an internal reaction.  Their emotional intensity grows, their stomach knots up, blood pressure rises, and their thoughts become negative.

If the athlete has responded this way for a long time their reaction can become their default or norm when things go wrong.  They have little or no control over the reaction or its intensity.

Mindfulness – Changing Reactive Habits

Mindfulness is an awareness of what we are doing when we are doing it.  Athletes that fall into reactive habits are being mindful when under stress.  They are at the mercy of these destructive habits.  Becoming mindful creates a pause between the stimulus that occurs and the athletes reaction to the event.

Viktor Frankl, a WW II Holocaust survivor, author, and artist wrote the following profound quote:

“Between stimulus and response, there is a space. In that space lies our freedom and power to choose our response.  In those choices lie our growth and our happiness.”fj4txallncrox-01_0188

Translated into sports:

“Between events that occur in the life of the athlete there is a brief pause or space of time.  In that pause or space we have the ability to choose how we respond to the event.  Those choices decide if we succeed or if we struggle.”

When an athlete makes a mistake, is called out by a coach, or sees a teammate go down with an injury, mindfulness acts as the third person observer to help the athlete become aware of their response to the stimulus.  Noticing emotions welling up, poor body language, withdrawal, anxiety, frustration, increases in heart rate and blood pressure, or negative thinking will help the athlete recognize the reactive habit is building.

Quieting The Inner Storm

Poor PerformanceNature gives very clear signals that a storm is coming.  Dark clouds, wind, changes in temperature, thunder and lightning all tell as that a storm is eminent.  We take action to get out of harms way.

Every athlete has “warning signs” that let them know that their internal storm or reactive habit is building. Biting nails, tightening of the  stomach, changes in body language or facial tones, anger and frustration, becoming quiet and withdrawn, and over thinking are all signs that the storm is building and the reactive habit is taking over.

Becoming mindful of these warning signs helps the athlete recognize the space between stimulus and response. Breathing, correcting negative thoughts and attitudes, calming emotional responses, and making smarter and better choices help to quiet the storm before it damages confidence, impacts performance, or effects team chemistry.

Noticing when the athlete is exhibiting their specific warning signs creates the awareness for change.  We can’t change anything if we aren’t aware of what we need to change.  Learning how to acknowledge the reaction is the secret…”I am getting frustrated” “My mindset is changing”, My heart rate is getting faster”, “I am getting quiet and shutting down”… Becoming mindful honors that space between stimulus and response and with practice the athlete creates positive reactive habits.

You're outCreating positive reactive habits helps the athlete stay mentally and emotionally centered.  The centered athlete performs at high levels consistently.  They connect to their sport with focus, determination, and passion.  It is hard to knock them off balance mentally and emotionally.  They learn how to stop being the victim to stressful events and approach challenges head on.  They build confidence and have a strong self concept.

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