Sports Injury

What Kevin Ware’s Injury Can Teach Us About Sports Injury Trauma

April 3, 2013 by Robert Andrews 3 Comments

Kevin Ware‘s injury during the Duke/Louisville NCAA basketball game was the most horrific sports related injury I have seen. I cringed and looked away from the TV but I found myself drawn back to the images of teammates, coaches, trainers and fans agonizing over the shocking scene playing out before them.

Kevin suffered a compound fracture of his lower leg when he leaped to block a Duke players shot and landed awkwardly in front of his own bench. His lower leg snapped and a bone tore through the skin. His reaction to seeing his injury was tragic, but seeing the reaction of his teammates on the bench let me know that most in the arena were seeing something that the mind could not comprehend. Players from both teams fell to the floor, cried, and held each other. Coach Rick Patino’s face was white from the shock of seeing Kevin’s lower leg turned sideways and hanging in the air.

Fans in the stands were visibly shaken and many were crying. Obviously traumatized by what they had seen. The Louisville trainers were remarkable in the face of this tragedy. They covered his leg so no one could see it, especially Kevin. But for Kevin, those in attendance at the game, and those of us watching on TV the imprint in all of our minds had already been burned in.

Mental images of a traumatic injury like this are deeply burned into the mind of the injured athlete. They are also burned into the minds of his teammates, Duke players, coaches, fans, media representatives, cheerleaders, and TV viewers.

These images or “holographic imprints” contain incredible amounts of information. Kevin’s brain now carries the image of seeing his leg in that state. That image or imprint also stores the intense physical pain he experienced, physical sensations of shock in his body, the sound of his bones snapping, the light in the arena, the gasp of those close to him on the court, the look of concern on the faces of trainers and other medical personnel caring for him, and other significant sensory information.

The more of Kevin’s senses that were stimulated when suffering his injury, the more shocking or intense his emotional reaction, and the more intense his physical pain the deeper the neurological imprint in his brain and nervous system.

When a traumatic injury like Kevin’s occurs the Limbic System of Kevin’s brain takes over to help him survive the overwhelming shock and pain his system has suffered. This information is now deeply imbedded in his brain. Add surgery, the prospect of a monumental recovery process, the loss of a final Four experience as a player, disconnection from his role on the team, uncertainty about his future in basketball, and loss of his identity as a player, and the imprint and stored information is compounded.

Kevin’s long road to recovery will not be just physically in nature. It will require specific mental and emotional processing to teach his brain and nervous system how to integrate this traumatic experience. Addressing his injury from a psychological perspective can help him process the trauma related to the injury. If he is able to return to play he can come back without the fear of re-injury.

With so many people witnessing his injury, and the frightening images the TV cameras provided all of us as viewers, we now have an inside look at the traumatic nature of sports related injuries. We all experienced vivid holographic imagery, intense emotional reactions and physical sensations in our bodies. In a sense we all might be traumatized to varying degrees by witnessing his injury. Whether on the bench as a teammate, in the stands as a fan, or watching on the TV we all now have a shared traumatic experience that is related to a very intense sports related injury.

I know Kevin is receiving the physical care he needs from Doctors, nurses, PT’s, and trainers. I hope Kevin and any of his teammates who might need support receive the psychological care they might need to overcome this catastrophic injury.

Intrusive Parents in the Training Room

November 15, 2011 by admin Leave a Comment

“I spend a lot of my time taking phone call and emails, and tending to visits to the training room from parents of injured athletes I am treating. It takes up a lot of my time. How can I take care of this problem?”

There is a saying that says we teach others how to treat us. This means that through our actions and inactions we teach others what we will tolerate and not tolerate in our relationships.

Somewhere in your relationship with these parents you have given them the message that it is alright for them to take up your time and energy tending to their concerns.

Parents of injured athletes are scared and this fear can show up as control in their interactions with you. They may try to control their son or daughters healing process to help both the parent and the athlete feel better. Phone calls, emails, repeated questions, and training room visits are all signs of stress and concern.

Think of your training room as a castle with a gate and a mote. You decide who comes into the castle. If your mote is dry and the gate is always open you are going to have problems. With a full mote, and a guard at the gate parents, coaches, and athletes will quickly get the message that your training room is not a place to stroll in and out of. They will get the sense that you mean business and that you take your role as team trainer seriously. They will learn that your time and energy are valuable resources in the recovery process of the athletes you treat.

I am not saying to cut off all contact with parents. It is reasonable for parents to want to know how treatment is going. It is up to you to decide when this concern moves beyond reasonable and becomes an annoyance.

Set aside specific times to visit with parents about their concerns and place time limits on these conversations. By setting strong boundaries about training room policies you will avoid many problems down the road.

Concussions: Invisible Injuries

November 8, 2011 by admin Leave a Comment

There has been a lot of attention given to the topic of sports concussions over the last few weeks. Mike Leach the head football coach at Texas Tech University was suspended and later fired over his alleged treatment of Adam James, a Tech player who suffered a mild concussion. Adam happens to be the son of ESPN analyst Craig James. And recently the NFL and Congress have created committees to discuss the treatment of concussions, and the link between head injuries in sports and long term brain damage.

Not Your Normal Sports Injury

I for one am glad to hear this. Concussions are a different type of injury and are not as easily detected as other injuries. Unlike a knee injury, a broken arm, or a separated shoulder, there is no apparent physical evidence that anything is wrong with the athlete when they suffer a concussion. With knee injuries or other obvious sports related injuries there are crutches, knee braces, slings, or cast that tell doctors, coaches, teammates, trainers, and fans that something serious has happened to the athlete. It is obvious that rehabilitation and time are required for healing to take place and for the athlete to be able to return to competition.

What is a Concussion?

Concussions are in effect a bruising of the brain. When an athlete suffers helmet to helmet contact, or hits their head on the field or court the brain slams against the skull [which can cause bruising]. The more serious the concussion, the more serious the resulting swelling and bruising of the brain tissue can be. This swelling and bruising causes memory loss, headaches, poor reaction time, impaired thinking, confusion, slow recall, and other serious symptoms.

Current Treatment

Treatment requires literally turning the brain off. Athletes are required to stay out of school, stay away from television, computers, video games, or other activities that create stress on the damaged brain. IMPACT testing is utilized to identify deficiencies in brain functioning. This test also shows when the athletes brain functioning returns to normal levels. Physical activity is monitored looking for symptoms like headaches, dizziness, and nausea. When the athlete is symptom free and testing shows a return to normal levels of brain functioning the treating physician and athletic trainer give the green light to return to competition.

The Mental/Emotional Aspect of Sports Injuries

I believe that there is a mental/emotional component to concussions as well. In my work with injured athletes I have found that athletes who suffer concussions all experience intense mental and emotional reactions to their experiences. In most cases these reactions are traumatic.

I have worked with athletes who have been hit so hard they were out cold for over a minute. Some have no memory of the hit that knocked them out, but they have images in their mind that are created from what people tell them happened, or what they see on game film. They talk about the terrible confusion, fear, and embarrassment they feel when they recall sitting on the bench knowing something very serious has happened but not remembering anything about the injury. These images are incredibly vivid and disturbing to the athlete.

Other athletes have very clear memories of the experience. They have told me what it was like to be strapped to a stretcher, immobilized, and taken by ambulance to the hospital. I have heard numerous stories from athletes who return to play, threw numerous interceptions, and were booed off the field. These experiences are all filled with incredible intensity and have a profound impact on the mental and emotional state of the athlete.

These same athletes also tell me about coaches, teammates, and fans who tease, ridicule and humiliate them for sitting out of practice and games.

Sports injuries, particularly concussions are never just physical in nature. When we create a space for the injured athlete to tell their story and help them process and integrate the psychological impact and trauma of the concussion, athletes get better. Their “lights turn back on”. Their mind clears and their self confidence returns.

Now imagine Adam James standing in a dark shed for three hours, unable to sit down or lean against anything. What was the message being sent to him and other Tech athletes who might suffer a concussion? I can’t imagine anything therapeutic coming from this type of treatment. Imagine the pressure put on the athletic trainers to follow orders demanding this type of treatment for an athlete. Sadly, this story sounds like so many other stories I have heard about the treatment of a concussed athlete. This treatment was meant to humiliate, degrade, and punish Adam for sitting out of practice with a concussion.

Time For Change

It took Adam being the son of a high profile, nationally recognized sports analyst to bring attention to the treatment his son endured after suffering a concussion.

Along with the NFL playoffs, bowl games, and the BCS National Championship, the eyes and ears of the sports world are now focused on the treatment of athletes who suffer concussions. I am elated to hear that mandatory guidelines are being put in place by the NFL for teams to follow when providing care for athletes who suffer a concussion. I hope the NCAA and high schools throughout the country follow their lead.

These injuries are real and very serious. The athlete who suffers a concussion deserves to be treated with the same care and dignity as any athlete who suffers any other type of sports related injury. Download a pdf version of this post

Fear of Re-injury in Recovery: Finding A New Way Back

November 1, 2011 by admin Leave a Comment

Sports Injury By 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.

I was talking with a soccer player and one of their parents 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.

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

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

FAN Inc – Help For Former College Athletes Who Suffer Injuries

October 24, 2010 by admin Leave a Comment

FAN Inc., The Foundation for Athletes in Need (www.faninc.org) is a non-profit organization that provides resources to former college athletes who were injured while participating in college athletics and are suffering in some significant way. I am grateful and blessed to be a member of the Board of Directors of this wonderful organization.

Two weekends ago FAN Inc. had a board meeting and luncheon at the University of Michigan in Ann Arbor, Michigan. My wife Gisele and I attended. We were hosted by the University of Michigan Lettermans Club. They provided us their historic Lettermans Club Room at the University of Michigan golf course for our events.

The University of Michigan catering department provided us with a wonderful lunch. The luncheon was an opportunity to tell many of those involved with athletics at Michigan about FAN Inc. and the vision those of us on the board share for this organization.

I was asked to speak on the psychological impact of traumatic sports injuries. Other speakers were Brandi Winans on the impact of sports injuries on the family members of athletes who suffer severe injuries and Kurt David who spoke about the difficulty many athletes, especially injured athletes face transitioning out of their respective sport.

I was profoundly moved by how the university and many former athletes took us in and treated us so warmly. Athletic Director Dave Brandon has written a letter of endorsement for FAN and the Letterman’s Club is excited to help out in any wathey can. I met alumni, students, coaches, a marketing specialist, faculty, and athletes who are all excited about the vision of FAN.

The University of Michigan sets a very high priority on the well being and care of their student/athletes. Michigan has representatives who work closely with different teams to make sure that student athletes have the resources they need to have a successful college experience. If they need help with life skills, academics, nutrition, counseling, or any other facet of life they direct them to available resources. Their willingness to look out for the well being of their student athletes helped those we connected with see the value and the power of FAN Inc. It is clear that the mission of FAN Inc. is vital and important cause and will have a profound impact on the lives of those athletes we touch.

The “Big House” and Michigan Tradition

The University of Michigan is a wonderful place. It was buzzing with energy about Saturdays showdown with rival Michigan State. Gisele and I arrived on campus for the game at 9:00am. We wanted see the campus and facilities and take in the energy on game day. We spent an hour and a half watching and listening to the Michigan band rehearse prior to the game. We attended the Michigan Football Lettermans Cornbread and Chili Outing prior to the game. Our view from the stadium pavilion allowed us to see both teams enter the stadium and watch the Michigan State band march in. I had tears in my eyes as I watched these rich traditions displayed by each school.

Attending a football game in “the Big House” has been on my “bucket list” for a long time. Walking into the massive bowl with brand new luxury suites was an amazing experience. I have never seen a stadium so big. And when it filled up there was a sea of maize as over 113,000 fans showed up to watch two ranked teams. Seeing the players come out of the tunnel and touch the “Go Blue” banner was another moving experience.

Michigan State won 34 to 17 after pulling away in the second half. The whole experience of the bands, passionate fans, a great game, and the rich traditions made this a memorable trip.

Thanks This trip was a great kick off for the FAN Inc. vision. Looking down the road we see other universities from around the country, letterman’s associations, and professional athletes joining in and supporting this great cause. There are thousands of former college athletes out there suffering in some way and we want to help.

I want to thank my fellow FAN Inc. Board members, the staff and faculty at the University of Michigan, the Michigan Lettermans Club, especially Jim Betts and Gerald White for showing us such a great time in Ann Arbor and I look forward to a very bright future for FAN. Download a pdf version of this post