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.
A 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 and recovery process have gone so well for this athlete that 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 knew 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 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 you 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 had 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.
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 and fear, and they attack the rehab process with more determination and confidence. These athletes return to play without the debilitating fear of re-injury.
Many athletes learn a lot about themselves during the injury or recovery process. They develop key parts of their personalities. They learn to be tougher, more focused, resilient, and grateful. They reconnect with the love and passion they experienced before the injury.