The psychological challenges of recovering from long term injuries

Sport is a canvas for mankind’s imagination. A most beautiful painting where we see mental thought and creativity combine with wonderful, mind-bending feats of physical prowess. Different sports provide different things for fans to enjoy. Yet football stirs up intense passions, often far more powerful and emotive than any other game. A large part of that comes down to the fact that the beautiful game is a contact sport.

The dictionary defines a contact sport as any sport where “the participants necessarily come into bodily contact with one another.” At some level, it’s why we love the game so much. There’s nothing like a perfectly timed, full-blooded sliding tackle. There’s hardly a more exhilarating feeling than watching a creative player dribble past a maze of outstretched legs. And there’s nothing as infuriating as watching one’s team’s counter-attack be nipped in the bud by a well-timed tactical foul.

Yet while this adds drama and fuels excitement, there is always a dark side to the same. Footballers are often seeing praying before the game. Many of them want to score a goal and get a win. But nearly all of them pray to a greater power for something more basic. They yearn to come out of the upcoming 90-minute battle unscathed, with no lasting injury. It is an often repeated cliche that footballers have a short career. An awful injury can spell the death knell for a career. And while medical procedures have advanced, the damage afflicted to the player’s mental space lingers.

Once injured badly, a player may never be the same footballer or human again. If treated and back in action, moments in games can conjure up thoughts of that awful moment, making it tough for them to ever perform at the levels they once did. If put out of action forever, players need deep attention and care to find purpose in life again and discover the balm to their mental angst.

In this piece, we take a look at the psychological impact that injuries can have on players, and how the road back from injury is treacherous, and nearly always lonely. We also probe why and how that needs to change.

The following scientific publication is acknowledged as reference:

Misia Gervis, Helen Pickford, Thomas Hau & Meghan Fruth (2020) A review of the psychological support mechanisms available for long-term injured footballers in the UK throughout their rehabilitation, Science and Medicine in Football, 4:1, 22-29, DOI: 10.1080/24733938.2019.1634832

The first step in the recovery process, according to researchers, is often the overwhelming fear induced in athletes that they may be put out of action forever.

While all we often hear in the media is the story of triumphant heroes returning from the surgeon and physiotherapist’s table, we scarcely hear stories of the lows. When serious injuries occur, the player is often left to fight off the demons in his mind all on his own. This is often a crucial stage, where the mind is left to the machinations of its will. One player who was lucky to be quickly rescued from this phase was Aaron Ramsey.

Ramsey suffered a well-documented and horrific injury against Stoke City.

Years later, the player recollects, “When it happened and I saw my leg, all kinds of different thoughts were going through my head. When I was on the way to the hospital, the doctor told me straight away that we would get through this, and that I would get back to where I was. That helped me feel sure this was something I could recover from.”

While every player may not receive such a quick word of support, it has become important to put a hand around their shoulder and restore calm. In an era where social media is quick to flood players both with love and vitriol, perhaps players need their family and colleagues most at this time. A reassuring word from the boss perhaps, or a hug and a favorite meal at home from their mother can go a long way to putting a smile on their face. It can help combat the anxieties and worries that social media often escalate.

The second phase, once medical procedures have been completed, involves rehabilitation and physiotherapy. This is where the long and lonely road assumes its steep gradient. Players are often forced to work on fitness regimes and routines, separate from the group. It is quite easy to imagine the thoughts that can cloud the head:

Is the manager aware of my work? Has my replacement taken my position in the team? How long do I keep at these repetitive, boring and tiring drills? What’s the latest banter among the lads? When can I join them again?

Gervis, a researcher at Brunei University, in her work, analyses the typical staff composition at football clubs in her research sample. All the clubs she surveyed hire physiotherapists on a full-time basis. On the other hand, only 25% of clubs have full-time sports psychologists. Only close to 10% have full-time psychologists. She asserts that most treatment is therefore physical and focused on enhancing athletic performance. But there is not a lot of attention that is devoted to restoring high morale and removing worries in the mind.

Players can often find themselves cut off from their friends, superiors, and supporters. At this stage, it is therefore essential to handle them gently and in the right way. At their lowest moment, when they are short of confidence and on a slow and uncertain journey to getting better, they need the expertise and knowledge that qualified mental health professionals can offer. While sports physiotherapists can use the magic of science to certify a player ‘fit’, this may not translate into the best outcomes on the pitch. Those may arise only when the player’s confidence is restored fully.

Sports psychologist Michael Caulfield explains to The Guardian, “When everyone has left the building to train, warm-up or go for a team meeting, I always stay with the player. I don’t tell them what to do and, when and where possible, the vital ingredient and timing of humor are necessary. I try to do a combination of listening and saying very little as they are frequently angry, low, even lower than low and often depressed.”

The final phases (3 and 4) cover the player’s fears of getting injured once returning to the field, as well as a worry that their performance will not be what it used to be. Those can often mean that the player will always be hesitant to give it their all. So where does the solution lie?

We often love to think of our footballers as indestructible. Fans have crossed multiple lines in the past, taunting players viciously from the stands. The era of the paparazzi and tabloid media has meant that players and their families have often been the subject of unfounded stories that have caused personal, and very real upheaval in families. Social media has led to the era of the keyboard warrior and trolls, who represent at times, not just the worst elements of football, but also society. At the best of times, players are left to fight for themselves.

When injured, they are truly at a low both physically and mentally. Clubs have taken initiatives to make the game more inclusive and welcoming to all of us. They now need to take concerted steps to hire mental health professionals, who can work with players on their road to recovery. They need to engage in dialogue and look after the players’ welfare. Lastly, football might be a strong and rippling athlete’s game. But it should always be okay to ask for help. The game’s big wigs must engage in outreach initiatives that sensitize all its fans to this cause. Our global game has challenges. But its global fanbase can deliver truly uplifting solutions. This is our game, these are our players and their fight is all our fight.

Written by Anirudh Madhavan.

El Arte Del Futbol is an official content creator for OneFootball. Find more Original Features, Player Profiles and Tactical Analysis’ on www.elartedf.com. If you are reading this on our website, we’d like to thank you for your continuous support! Follow us on twitter to stay updated with all the latest content.