| 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.
©1998 by The
American Academy of Experts in Traumatic Stress,
Inc. |
