| One
weekend during the summer you are playing a pick
up game of basketball or a quick set of tennis.
Suddenly you turn the wrong way and you feel something
pop in a knee or tear in your ankle. A trip to the
emergency room reveals that you have done some serious
damage and need surgery to repair the problem and
that you will be in a cast and on crutches for the
next several weeks. You are annoyed over this course
of events and are quite inconvenienced for the next
few months. Now imagine for a moment you are not
a weekend warrior but rather a top athlete perhaps
of late high school or early college age and you
suffer the same injury. We are no longer talking
about a subtle shift in life style. The essence
of who you are may be about to change. Certainly
your thinking about yourself will be brought into
question. Top athletes generally spend more time
working at their sport than at any other activity.
Even athletes as young as high school age have already
invested up to 10 years playing and working at their
craft. These young athletes may be forced to deal
with the trauma of a serious injury that may change
their view of themselves for an extended period
of time.
When we talk of traumatic events we generally refer
to them as emotional, cognitive and behavioral experiences
of individuals who have been exposed to or who have
witnessed events that are extreme or life threatening.
Volpe (1997), in giving an overview of traumatic
stress, views it as "an unexpected and uncontrollable
event that can overwhelm an individual's sense of
safety and security and leave a person feeling vulnerable
and insecure in his or her environment." When
an athlete experiences a season ending or possibly
a career ending injury we are talking about the
possible loss of self. When interviewed, athletes
will often define who they are and their level of
self-worth through their sport. The friends that
they have and most of their support groups are,
after a time, related to their sport.
In a study by Gould et al. (1997) examining season
ending ski injuries, it was found that a number
of factors contributed to the difficulty of the
experience. The areas addressed by athletes were
in the areas of psychological concerns, social concerns,
physical concerns and financial concerns. Gould
reports that the largest source of stress was in
the areas of psychological and social concerns and
that although a good physical diagnosis and rehabilitation
information is necessary, it may not be enough.
If we look at this issue from the view of a traumatic
event - one that affects all areas of life - we
can see or at least sense what the athlete is dealing
with. In his article on athletic burnout, Raedeke
(1997) addresses burnout from a commitment perspective.
He suggests that beyond the simple stress of working
too hard burnout can better be explained when athletes
do not get the rewards they are used to getting
from their sport. The athletes are no longer getting
the rewards and successes that their hard work requires
and seem to now justify being committed to "just
being athletes." They begin to doubt the value
of their sport, are feeling trapped and are making
little gain or improvement.
One can quickly see the value of looking at a severe
sports injury from a traumatic model. The young
athlete, used to getting rewards in a number of
areas (psychologically, socially, physically) is
suddenly thrust into the position of self-doubt
with long periods of time without any noticeable
rewards for their efforts. The commitment changes
from rewards to just work and the trauma of the
injury leads the athlete on a downward path toward
possible burnout. Thotis (1995), in an article examining
stress from health-related difficulties, identified
three major stressors: 1) major life events; 2)
chronic stress; and 3) daily hassles. All of these
could be related to a severe sports injury and the
first two clearly are consistent with the definition
of a traumatic stressor.
When a young athlete goes to a physician about a
serious injury it is clear that they will need a
good deal more than just being told that they will
be able to resume normal daily activities in a couple
of months. When they ask if everything will be OK
they are asking about much more than functioning
for the average person. They are asking "will
I be able to resume my life?" Can they perform
and compete at the level that made them special
and in some cases even defined them? A recent report
at the Goodwill Games underscores this issue. In
1996, Alexander Popov won two gold medals in swimming
at the Olympics. Upon his return to Russia he was
stabbed and severely wounded. After regaining consciousness,
it was reported the first question he asked was,
"will I be able to swim again?" The report
suggested it was clear he was not talking about
recreational swimming. The question was whether
he could compete at the highest levels of his sport.
I would suggest that members of the helping professions,
from physicians and nurses who will generally make
the initial contact with the injured athletes to
others (i.e., psychologists or social workers) consider
dealing with the wide range of issues from a traumatic
stress perspective. Rather than focusing on one
symptom or another, it will be important to recognize
that elite young athletes are, along with their
physical injury, possibly experiencing traumatic
stress and the variety of symptoms that go with
it. Helping the young athlete to identify some of
what he or she is experiencing and having a respected
professional provide an empathetic response will
allow the athlete to at least feel that someone
understands what they are feeling.
The physical problems of an injured athlete are
clearly the most obvious, but the emotional trauma
experienced by an adolescent or young adult athlete
may also be particularly troubling. The fear of
losing all that they have worked for is quite frightening.
Research suggests that even adult athletes, when
they are ready to retire from their sport, often
need support to deal with the myriad of changes
in their life and life style.
To help a young athlete identify and understand
some of what they are feeling, that these feelings
are normal, and that they will not be abandoned
during this period, is extremely important. The
physical process of recovery is often a long one
and may or may not be completely successful. Psychological
issues dealt with along the way vary from athlete
to athlete, but I believe that looking at the problem
from a trauma model will allow all the professionals
concerned to provide the emotional support and direction
necessary while the physical issues are addressed.
Should the young athlete need more psychological
support there are obviously a host of strategies
and techniques that can be presented over time but
they are, at this time, beyond the scope of this
article.
References
Gould, D., Udry, E., Bridges,
D.,& Beck, L. (1997). Stress sources encountered
when rehabilitating from season-ending sports
injury. The Sport Psychologist, 11, 361-378.
Raedeke, T.D. (1997). Is athlete burnout more
than just stress? A sport commitment perspective.
Journal of Sport and Exercise Psychology, 19,
369-417.
Thotis, P.A. (1995). Stress coping and social
support processes. Where are we? What next? Journal
of Health and Social Behavior, (Extra Issue),
53-79.
Volpe, J.S. (1997). Traumatic stress: An overview.
Trauma Response, 3, 8-9.
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