The Institute of Sports Performance

Creating Breakthroughs with Athletic Performance and Sports Injury Recovery

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Kobe Bryant, Derrick Rose, and Lindsey Vonn Injuries Reveal the Missing Link in Injury Recovery

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Kobe Bryant breaking a bone in his knee after coming back from a torn Achilles tendon, Derrick Rose tearing a cartilage after returning to play after a torn ACL, and Lindsey Vonn partially tearing her ACL after returning from a complete ACL tear all reveal the gap in the recovery process for athletes returning to play after suffering serious sports related injuries.  Athletes return to competition after being cleared to play physically but their mental and emotional readiness is not part of the current treatment model for athletes returning to play. Addressing the mental and emotional impact of sports related injuries helps athletes face surgery with  a confident and positive mindset.  They handle surgery better.  They approach their recovery process with more focus and intensity.  They also return to play absent of the conscious or unconscious fear of re-injury.

AnkleKobe suffered a torn Achilles tendon last season and attempted to return to play at the beginning of this NBA season.  Kobe was cleared to play as “100%” by his Doctors and athletic training staff.  A few games into the season he tweaked his hamstring. A few games after that his comeback and his season ended when he broke a bone in his knee.

Chicago Bulls guard Derrick Rose suffered a similar fate.  He tore his ACL last NBA season. After a prolonged recovery process he returned to play at the start of this season. A few games in he tweaked his hamstring.  The following week he tore a cartilage in his other knee.  His return to play this season is questionable at best.

Olympic Gold Medalist Lindsey Vonn tore her ACL in a skiing practice training.  After surgery and an intense rehab process she returned to training only to partially tear the ligament again.  She is trying to make it through Olympic Trials without fully tearing the ligament.

Sports InjuryWhen an athlete suffers a serious injury a part of the brain called the limbic system is activated. The job of the limbic system is to keep the athlete safe. In the case of a serious sports related injury it means keeping the athlete safe from re-injury.  When the limbic system is engaged athletes will consciously and unconsciously make adjustments to protect the injured area. With these adjustments stress and torque move to other areas of the body. From the ankle to the knee, from the knee to the hamstring or back, from the elbow to the shoulder.

I worked with a team that had six athletes suffer serious knee injuries in a thirteen day period.  I was fortunate to be able to see three of these athletes before they had surgery.  I saw two athletes right after surgery. I was able to work with the sixth athlete as they were returning to play after being “cleared”.  Working with these six athletes during their process of returning to play was a remarkable experience. In a sense I had a small sample group to test this theory.

The three athletes I worked with prior to surgery were able to work through all of their fears about the surgical procedure they were about to face.  Some of these fears were rational.   Is it going to hurt? How long will I be out of competition? What if someone takes my place while I am out?  Some of their fears were irrational.  What if I wake up during surgery? What if they operate on the wrong knee? What if they cut something else during surgery and my career is over?

Many athletes have fear and anxiety before surgery but very few are able to talk about, process, and work through these fears before surgery.  They go into surgery with their brain on full alert and overstimulated.  By processing the fear and anxiety before surgery they approach surgery in a calmer and more relaxed state.  They are relaxed mentally and emotionally before they enter the operating room.

These three athletes had remarkably positive experiences of surgery.  One athlete said that a surgery room nurse asked if they had ever had surgery before because they seemed so calm and confident.  Their recovery process was very successful. They approached rehab with a high level of intensity and mental toughness.  They all returned to play the next season and suffered no further injuries.

The two athletes I worked with after surgery said that they approached surgery with a lot of fear and uncertainty.  They suffered a lot of pain after surgery.  Their rehab process was difficult.  After just a few sessions we worked through the injury and their rational and irrational fears about rehab and returning to play.  They made a great comeback the next season.  They played well and suffered no further injuries.

The last athlete went through surgery and extensive rehab.  They endured a lot of physical pain after surgery.  Rehab had been very tough.  There were resistant to their rehab and PT.  When they were cleared to play they had tremendous fear and anxiety about suffering another injury. At this time they asked to come see me and we started addressing the injury, the pain and suffering they endured, disconnection from their team, and their fear of being injured again. They made great progress quickly.  They went on to play that season.  They did very well and suffered no further injuries.

Working with these six athletes confirmed that treating the mental and emotional impact of the injury has a profound impact on the injured athlete.  I continue to confirm this treatment model with every inured athlete I am fortunate to be able to work with.

For CoachesI have also found that the sooner I am able to treat an athlete the better their recovery process and the better their return to play. Seeing the athlete before surgery is the real key.

When I hear about Kobe Bryant, RGIII, Derrick Rose, and Lindsey Vonn I know that there is another resource they can add to their recovery process.  Working with athletes before and after surgery helps the athlete return to play stronger, wiser, smarter, more confident, and absent of the fear of re-injury.

For professional teams and agents it helps restore their contractual value to their team.  If they play better they are worth more.

But most importantly they are happier and more confident.  They love the game or sport again.  They trust their bodies to perform at extremely high levels.  They are truly “100%” ready to play.

NFL Injuries Mount Up And So Does Toll On Players

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This past Sunday NFL players went down in droves suffering an alarming number of injuries.  The serious nature of each of these injuries is a hot topic on sports radio and television programs.  What is not being discussed is the psychological toll serious sports related injuries might have on these athletes.

Quarterbacks were hit particularly hard.   Rams Sam Bradford suffered a torn ACL, the Bears Jake Cutler a torn groin, and Eagles QB Nick Foles a concussion. A torn LCL and broken leg took down Texans linebacker Brian Cushing.  This after suffering a season ending ACL injury on the same knee last season.  Colts receiver Reggie Wayne suffered a torn ACL.  Tampa Bay receiver Doug Martin suffered a torn labrum.  The Packers Jermichael Finley is out with a serious head and neck injury.  And the Bears Lance Briggs suffered a shoulder injury.

All of these injuries are serious in nature.  Some might be career threatening or career ending.

It is well documented that athletes suffer intense physical pain when injured.  There is nothing pleasant about breaking bones and tearing ligaments and tendons.  What is not well documented or being discussed is the psychological pain and suffering athlete’s experience at the time of the injury and throughout the entire diagnostic, surgical, and recovery process.

There is a spectrum of severity with sports related injuries.  Mild injuries might require time off and therapy.  More serious injuries require surgery and rehab.  The most intense can be career threatening or career ending and can place the athlete’s future participation in sports in question.

Athletes on the more severe end of the spectrum have talked with me about how bad the injury was when it occured.  But in most cases the most painful experiences while injured are the key impact moments that occur after the injury.

These after injury memories are filled with intense mental imagery and powerful emotion.  The memory and image of being carried off the field strapped to a stretcher, the Doctors diagnosis in the locker room at halftime, a phone call getting the MRI results from the team Doctor, and receiving word that the injury will require surgery are mentally and emotionally overwhelming for some athletes.

When an athlete receives word that their career might be in jeopardy the impact of the injury and the shock wave of emotion can be traumatic. Sports injury trauma is taking a toll on athletes.

Loss and Disconnection

There is a lot on the line for an athlete who suffers a serious injury. These injuries have severe impacts on Jr. High, high school and college athletes.  The impact is especially impactful to professional athletes.

Professional teams have a major goal.  To win.  Like it or not an injured athlete is not part of the winning strategy when on the sidelines.  Another player steps in and the game goes on.

This puts an athlete’s identity into question. Who am I if I am not playing the game I love? If I am not playing the sport that has defined me in so many ways then what do I do?

A lack of connection to a team or organization leaves many athletes feeing anxious and depressed.  I have heard many athletes say that the loneliest place in the world is on the sidelines watching the game after being injured.

There can also be financial or contractual issue to face when injured. I have worked with professional athletes on a one year contract or in the last year of their contract when they suffer a devastating injury. The fear, anxiety, and uncertainty these athletes experience can be overwhelming for some. Many athletes are waived and are left to try and get on with another team.  Many never make it back to playing at the level they played before being injured even though they have been cleared to play physically.

Coming Back

Many athletes have to deal with the fear and anxiety that comes with returning to play after being injured.  Advances in surgical procedures, improved skills of physicians, advances in treatment and physical therapy all help athletes return to play faster than ever before.

Coming back faster comes with the expectation that an athlete will be ready to play at a high level once released.  These athletes have been cleared as physically “100%” ready to play. This definition does not take into account the mental and emotional readiness of the athlete upon return to play.

An obvious key to a successful comeback for an athlete is to address the physical stress and trauma associated with the injury itself.  It is time to take this process further.  Addressing the mental and emotional stress and trauma the athlete suffers and endures from the time of the injury, throughout the pre-surgery, post-surgery, and recovery process, and as they prepare to return to play is a new paradigm to consider.  Expanding the “100%” definition of readiness will insure that an athlete is truly ready to play again.

DJAthletes return to play with more confidence, less fear and anxiety, and experience more trust in their injured or affected area of the body.  The fear of re-injury is diminished.  In most instances entirely.

The methodologies, treatment protocols, and technologies to treat this aspect of injuries are in place now.   With the increase in serious injuries in the NFL and all sports in general it is time to integrate this new paradigm in the treatment of athletic injuries. Athletes return to play physically, mentally, and emotionally ready to go. They are truly “100%” ready to play.

Robert Griffin III Causes for Concern

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The Washington Redskins decision to start Robert Griffin III next Monday night in the season opener raises serious red flags.  Redskins Coach Mike Shanahan has expressed “concerns” as recently as last Thursday.  His surgeon Dr. James Andrews has also expressed concerns over the last week as well.  Both signed off on his return today and as a result he will start against the Philadelphia Eagles.

Both cleared Robert to play after carefully evaluating his condition.  They are both experts in their respective fields.  Shanahan as an NFL coach, and Dr. Andrews as a national renowned surgeon for many elite athletes.   Their decision has to be respected given their experience, knowledge, credibility.

“100%” Cleared to Play

Athletes want to play period.  Robert is a fierce competitor and is paid millions of dollars to be the “Face of the Redskins”.  He will present himself as ready to play because it is his nature as an athlete to be “ready to go” on opening day.

It has been said that after consulting with Robert all concerns have been addressed.  His clearance most likely follows the traditional “100%” ready to play requirement of injured athletes before coming back from a serious sports related injury. This addresses the stability of his knee, flexibility, range of motion, ability to run, cut, jump, back pedal, and all of the other things required of Robert in the Redskins up tempo offense.

This “100%” definition does not take into account the mental and emotional trauma Robert has suffered during each of his three knee injuries.  Robert suffered a torn ACL while at Baylor University, a strained ACL last regular season, and completely tore the ACL in a playoff game in January of this year.

With each injury Robert suffers intense physical pain, followed by the pain of surgery and rehab.  He also suffers mentally and emotionally.  The brain springs into action to compartmentalize this cauldron of physical pain, horrific mental images, and the intense emotions and sensations that are surging through his body, brain, and nervous system as he is injured.. This process continues while he is carried off the field, diagnosed, and prepares for surgery and works his way through the rehab process.

Where The Mind Leads The Body Follows

Elite athletes are conditioned to compartmentalize this information on a conscious level.  You see elite athletes return from serious injuries all the time and compete at a high level.  Look at what Adrian Peterson accomplished last season after returning from a torn ACL.

What is going on in the brain and body unconsciously is what concerns me.  Look at The Chicago Bull’s Derrick Rose.  He tore his ACL and has been cleared to play at “100%”.  He has not returned to a high level of play. Could Derrick’s mind be doing its job by unconsciously holding him back to prevent another injury? I feel confident in saying that this is exactly what is going on in this case.

With each injury the neo-cortex in Robert’s brain does it’s job to process as much of this neurological information as possible.  The overwhelming information surging through his brain and nervous system overwhelms the part of the brain (neo-cortex) that processes the normal incoming stimulus that an NFL Quarterback processes during a game. The limbic system take over and stores this overwhelming information.  Its job it to make sure that Robert is safe, stays alive, and suffers no further injuries. In a sense his brain goes on full alert and doesn’t calm down until this overload is addressed and processed.

Experiencing multiple injures creates a layering of stored information in Roberts limbic system. All of the anger, frustration, despair, fear, anxiety, confusion, loss and other intense emotion, imagery related to the injury, and sensation are held in the limbic system.

When Robert goes out to play Monday night his limbic system can spring into action and unconsciously attempt to keep him safe and free from suffering a fourth knee injury.  This sets his body up to favor his injured knee, put more weight, torque, and force on his other knee.   He might play cautiously or hesitate.

One might say that you will never see Robert Griffin play that way and I agree if his neo-cortex is running the show.  If his limbic system kicks in then we might see a change in the way he plays the game and there is a possibility that he might suffer another injury.

“The New Way Back’ from Sports Related Injuries

Teaching Robert’s brain, specifically his limbic system, to process this cauldron of stored information relating to his multiple knee injuries can lessen if not prevent another knee injury.  By addressing the mental, emotional, and psychological trauma he has suffered and endured during each of his three knee injuries Robert can return to play at a high level both consciously and unconsciously with no fear of re-injury.

I have seen athletes return to remarkable levels of play after suffering serious knee injuries, broken legs, crushed faces after being hit by 95 mph fastballs, horrific falls, concussions, and many other serious sports related injuries.

In Roberts case I hope that my experiences in working with injured athletes proves wrong.  He is an electrifying player and has done so much to help the Redskins, the NFL, and the game of football.  More than that he is  an intelligent, thoughtful, and humble young man.  He honors and respects the game.

I would like to see him in the league for a long time.

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