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Understanding the Traumatic Nature of ACL Injuries

March 11, 2023 by Robert Andrews Leave a Comment

Robert B. Andrews MA, LMFT

For many athletes coming back from a serious sports related injury is a terrifying ordeal. They have been cleared to play physically, but their fear of suffering another injury can be debilitating. These fears can cause complications with their return to play. Many suffer from confusion, anxiety, anger, shame and guilt. If they have been “cleared to play”, then why do they feel so bad? Many feel that something is wrong with them if they can’t come back confident and in a good frame of mind.Sports Injury

I was talking with a soccer player about a teammate who suffered a strained ACL. The injured athlete took time off for the injury to heal. When they returned to play they were terrified. They were afraid of injuring their knee again and played with anxiety, fear, and apprehension. They did not play all out and their hesitancy was apparent. It grew worse with each game. As their anxiety and fear grew they became more emotional during the games. It was apparent to everyone watching that something was wrong.

I began to get excited at the thought of helping this athlete overcome their sports injury trauma. As I reached for a business card for the parent of the struggling athlete I was told that during their last game the athlete had torn their ACL completely. The field was in really bad condition and their fear of re-injury was amplified. They were crying while trying to play soccer. They ended up in a fight for the ball and injured their knee. I felt my heart sink when they told me this part of the story.

Too Many Sad Stories

I was on the sidelines of a football game watching a running back who had torn his ACL the year before. He was hesitating as he ran and favoring the injured knee. After the game I told his coach that he was going to suffer an ACL injury to the other knee if he didn’t get some help with the trauma from the first injury. The next week he tore his other ACL.

I was watching a game on television and I observed hesitation and apprehension in an offensive lineman who had injured his left knee the year before. I turned the game off at half time. A few days later I called his athletic trainer and mentioned to him that I believed that this lineman was heading towards an injury on his other knee. He asked me why I felt this way. I told him what I observed watching the game. He said that was interesting and that the lineman had torn his other ACL in the fourth quarter of that game.Overcoming Sports Injuries

Is the Wrong Message Being Sent?

An athlete I helped overcome a horrific injury was interviewed about his “miracle comeback”. When they asked this athlete what they did to make such a profound come back they said they just had a “really strong attitude and mind set”. They didn’t mention all the hard work they did mentally and emotionally to overcome the trauma they suffered while injured and unable to compete. I believe this athlete did a disservice to other athletes who are trying to overcome the trauma and the mental and emotional blocks that stand in the way of a full “100%” recovery. They sent a message to other injured athletes that all you have to do is have a strong mindset and everything will be o.k.

This message can have a profoundly negative impact on the athlete who is struggling to get back mentally and emotionally. It can create doubt and confusion, and erode self confidence. Many athletes never find their way back from injury because they can’t overcome this cauldron of powerful emotions.

The New Way Back From Injury

I was watching a game on TV recently. An athlete I helped overcome a serious injury was having a great game. It was apparent that they were confident, in command, and had no fear of re-injury. The commentator said it was apparent that this athlete was back physically, but that they were back mentally too. My wife asked me to replay his comment. We listened to it again and she said “someone gets it”. This commentator could see from the way this athlete was playing that they have experienced a complete psychological recovery from their injury too.

I wish I could have helped the young soccer player before they suffered a completely torn ACL. I wish I could help every injured athlete. Treating the traumatic nature of sports related injuries puts the athlete back in charge and rids them of fear, anxiety, apprehension, depression and self doubt. They return to play mentally stronger and tougher. Not only does their attitude and outlook get better, they come back wiser and more mature. This wisdom and maturity permeates all areas of their lives. They learn a lot in the process of coming back.  Download a pdf version of this post

Filed Under: ACL Injury Recovery, Athletes mental health, Mental Aspects of Sports Injuries, Mental Health in Sports, Sports Injuries and Trauma, Sports Injury Recovery Tagged With: ACL Injuries, Athletes Mental Health, Mental impact of injuries

What Do PTSD, War Veterans, And Injured Athletes Have In Common?

May 13, 2016 by Robert Andrews 7 Comments

By Robert B. Andrews MA, LMFT

PTSD from war trauma is a terrible aftershock for soldiers who experience the horrors of war. I recently read an article about PTSD in veterans who suffer from the effects of PTSD.  I  was struck by how exact the imprinting process for war trauma is when compared to  athletes who suffer serious sports related injuries.

Overcoming Sports InjuriesI don’t mean to compare the intensity of war trauma to athletic performance, or minimize our soldiers experiences. My intent is to point out the similarities in brain functioning and imprinting between war time experiences and serious sports related injuries.

The quote below comes from an article by Nolan Peterson about PTSD in the military. Although he is talking about intense combat experiences he perfectly describes the mental imprinting process that athletes experience when suffering a serious sports related injury like an ACL, broken leg, or concussion.

“But that’s the point. The hormones released by high-stress situations instruct the brain to imprint memories more deeply.  Evolution taught us that trick: The caveman who could best remember how he escaped a saber-toothed tiger attack had a statistically better shot at surviving the next one.  That’s why time appears to slow down in a car crash or while you’re getting mugged. The adrenaline coursing through your veins triggers your brain into hyperactive memory storage. Your mind and senses go into overdrive, absorbing every sensory detail with superhuman lucidity and completeness.

Because of this, an event that might only last a split second occupies as much mental storage space as a week or a month. Years later you can recall details, feelings, colors, smells, and sounds more vividly than you can remember this morning’s breakfast.” ~ Nolan Peterson

To the Brain, Trauma is Trauma

Baseball Player DownSo sports injuries can be traumatic to the athlete.

I have spoken with athletes who tore their ACL and can remember what the grass smelled like when they laid on the field after being injured. Others recall how quiet the crowd became and how bright the lights were.  Many hold an image of their teammates all looking at them as the trainers and team physicians looked after them.

These images are loaded with unprocessed information related to the injury.

I treat injuries from a trauma based approach. We teach the brain how to process this overwhelming cauldron of high stress information. This is the critical step in a full comeback after suffering injury.

If this story resonates with you, if you have intrusive mental images that relate to your injury, if you are afraid of getting hurt again, you are not alone.

We can get you back in the game quickly with diminished fear of re-injury and restored confidence.

Contact: robertandrews@tinssp.com

Filed Under: ACL Injury Recovery, Mental Aspects of Sports Injuries, Sports Injuries and Trauma, Sports Injury Recovery, Sports Shut Down and the Mental and Emotional Impact on Athletes Tagged With: Mental impact of injuries, Nolan Peterson, Overcoming sports injuries, PTSD, Sports Injury Trauma

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

April 24, 2016 by Robert Andrews Leave a Comment

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.

Filed Under: ACL Injury Recovery, Mental Aspects of Sports Injuries, Sports Injury Recovery, Sports Shut Down and the Mental and Emotional Impact on Athletes Tagged With: ACL Injuries, EMDR, Injured Athlete, Soccer, Sports Recovery

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713.522.2200

robertandrews@tinssp.com
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2500 East T.C. Jester
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Houston, TX 77008
Find us

713.522.2200

robertandrews@tinssp.com
kierstincollins@tinssp.com
michaelheck@tinssp.com
andreaestrada@tinssp.com
galenandrews@tinssp.com

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