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Injuries are part of sport for people at every level. Many are musculoskeletal, such as sprains and strains (the most common sports injuries in the UK), fractured or broken bones, and cartilage and ligament tears.
When a player experiences an injury like this, it can be a very stressful time. The question is, how do coaches help their players manage the stress in these situations? This summary, based on new research from academics in America, provides a range of strategies that coaches can use to actively help players alleviate the stress caused by sporting injuries.
This summary, like the original article, has been written with young participants in team sports in mind.
Introduction – musculoskeletal injury stressors
The new research on which this summary is based focuses on high school athletes in America who experience musculoskeletal injuries (injuries or pain in the body’s joints, ligaments, muscles, nerves, tendons and structures that support limbs, the neck and the back).
The researchers clearly state that the treatment of these injuries and any health-related advice are, of course, the role of healthcare professionals and not the coach. However, they identify a number of stressors that these injuries can cause, which coaches can help to alleviate by helping their players adopt a range of coping strategies.
While the research is relevant for coaches in any sport, it is particularly applicable for team sports as a number of the strategies require the involvement of the whole group, rather than just the injured individual.
The four musculoskeletal injury stressors featured in this new research are temporary physical restrictions, feelings of isolation, rehabilitation process, and anxiety about pain and re-injury. Each stressor and the associated strategies for coaches are explored in more detail in this summary, using a real-life example of a young softball player who badly injured her shoulder during a match.
Strategies for temporary physical restrictions
The research notes that, as well as becoming stressed when injury impairs their physical movements, players can become frustrated when they see their fully fit teammates not giving 100% effort during training or a match (ie if they are not taking advantage of the opportunity to play, which the injured player no longer has).
This gives coaches a difficult balancing act to manage. If they simply advise the injured player to return to training when they are able to play, it could prolong their physical and mental recovery. However, asking them to continue attending may also impact on their recovery if frustration builds from seeing teammates not giving their all.
To manage the balancing act, coaches – with the permission of those managing the injured player’s healthcare – could try involving the injured player in practices and drills if they are able to participate in limited ways. Or the coach can try to modify exercises to ensure the player can continue to take part alongside the rest of the team.
The study found that while doing different exercises from the rest of the group can be slightly frustrating for the injured player, it is worthwhile as it ensures they continue to feel a part of the team.
Another suggested alternative may be for coaches to devise other exercises for the injured player that focus on improving skills in areas not affected by the injury.
Of course, in some situations, injuries do not allow any kind of physical movement. The study encourages coaches to be creative in these instances. Could the injured player observe and critique different parts of the session, or design and run new drills to help develop one of the team’s weaknesses? Keeping the player involved in the wider group is the main focus here as it reduces the stress associated with being unable to contribute to the team.
Another creative strategy coaches can consider is the use of imagery, or in other words, advising injured players to recreate physical experiences in the mind. Practising skills mentally, rather than physically, reduces the risk of further injury while still allowing them to build confidence when preparing for their return.
Helping players with feelings of isolation
As noted previously, players can feel isolated if injury means they cannot fully participate with the rest of the group. This causes stress, which coaches can help overcome by maintaining a positive support network around the individual, starting with themselves and the player’s parents.
The researchers note the role of the coach is firstly to provide emotional, informational and tangible support.
Emotional support includes listening without judgement, and showing care and compassion to the individual, reiterating that they remain a valuable member of the team despite the injury. Informational support is more closely linked to the injury. The coach can acknowledge the work the injured player is putting into their recovery, and provide advice and guidance, drawing on their own experiences of coping with similar situations.
Finally, tangible support could take the form of a book or online article featuring an inspirational athlete who overcame similar injury problems in the past.
The idea is that the support provided by the coach is supplemented by support from parents. Coaches can firstly inform parents of the importance of the injured player continuing to attend training and matches to remain a part of the team. They can also encourage parents to be the sounding board for the player’s recovery process as it is unlikely they will want to discuss their recovery with teammates or the coach. The softball player featured in the original article found this particularly helpful when she wanted to talk about her recovery and ‘just get it out’.
Coaches who maintain this positive support structure will help minimise stress and aid player recovery.
Assisting with the rehabilitation process
Noting that most athletes set themselves a long-term goal of returning to play, the researchers suggest this can be extremely stressful, particularly if rehabilitation takes longer than first imagined, if improvements along the way are small and infrequent, or if the athlete starts to worry about whether their recovery will be worth it when they eventually return.
Coaches can alleviate this stress by helping set shorter-term goals that the injured player can work towards. Shorter-term, even daily goals can give injured players targets that will help them move closer to being fit to play.
Coaches can closely monitor how the player fares and adjust the challenge of short-term goals if they are too easy or difficult. The coach can also help injured players develop a more positive mindset towards rehabilitation by acknowledging progress and explaining that ups and downs are a normal part of the recovery process.
In cases of more serious injury, the researchers also suggest coaches develop a buddy system whereby a fit member of the team accompanies the injured player to physiotherapy sessions. The responsibility to attend with the injured player is rotated, ensuring the individual continues to feel like an important member of the team while all teammates feel like they have contributed to their recovery.
Minimising anxiety about pain and re-injury
Pain can cause injured players stress, not only when they experience it, but also if they worry about when it might return. The researchers suggest something similar in regard to re-injury. Even when reaching a healthy state, players can become stressed at the thought of re-injuring themselves.
To minimise this stress, they suggest a number of strategies for coaches, incorporating both mental and more tangible approaches.
Firstly, healing imagery is a strategy that can help injured players gain more control over their rehabilitation. This starts by advising players to imagine themselves performing specific skills. As their recovery progresses, the images can be more complex, incorporating tactics alongside the skills. The injured player can then move on to creating positive images of the injured site, such as strengthened muscles or flexible joints.
The key for the coach is to ensure the player uses imagery that aligns to where they are in the recovery process, thereby reducing the likelihood of them imagining their recovery progressing too quickly, and increasing disappointment and stress when the reality does not match.
Coaches can also help their injured players turn negative self-talk into positive self-talk. For example, if they overhear them say ‘I am going to get injured again,’ the coach should advise them to rephrase this as ‘I’m going to be even stronger now I’ve recovered.’ Self-talk can help build injured players’ confidence and keep them focused on recovery, rather than causing stress from the thought of re-injuring themselves or experiencing pain.
If players need more tangible help, coaches may ask teammates who have experienced similar injuries to talk to them about their experiences. The aim is to inspire them to get through the rehabilitation process. This worked for the softball player in the original article as it changed her attitude towards rehabilitation once she knew a teammate had made a full recovery and avoided re-injury.
Learning from the research – putting the strategies into practice
This summary, like the original article, has been written with young participants in team sports in mind. However, that does not mean the strategies included are only applicable for this group.
There are potentially a number of positive outcomes for coaches who implement these strategies with their injured players. As well as developing themselves through an enhanced knowledge of the type of stress their players may encounter when suffering common musculoskeletal injuries, coaches can help their injured players recover, and foster team cohesion by involving the rest of the team.
To help coaches put the learning into practice with their injured players, the table below summarises the strategies associated with each stressor. Coaches can quickly refer to this tool when dealing with injured players in future.
Musculoskeletal Injury Stressor
Strategies for Coaches
Temporary physical restrictions
As far as possible, include the injured player in exercises and drills:
– through limited participation or modified exercises/drills
– with exercises that improve skills in areas not affected by the injury.
Help injured players take part in non-physical ways:
– observing/critiquing sessions – suggesting drills to improve team weaknesses –using mental imagery to practise skills and build confidence.
Feelings of isolation
Facilitate a positive support network around the injured player by providing:
– emotional support (ie show care and compassion)
– informational support (ie acknowledge progress in recovery)
– tangible support (ie provide existing evidence to inspire/show recovery is possible).
Encourage parents to:
– bring the injured player to training and matches
– act as a sounding board during the recovery process.
Help the injured player by:
– setting shorter-term, possibly daily goals
– varying the challenge of goals based on how the player fares
– encouraging the development of a positive mindset
– developing a team buddy system for more serious injury rehabilitation.
Anxiety about pain and re-injury
Help players develop psychological skills, including:
– healing imagery aligned to the stage of recovery
– positive self-talk
– input from teammates who have overcome similar injuries.
Download Research Summary: Helping Players Cope with the Stress of Injury.
If you are interested in finding out more about this area, this summary is based on the article below:
Gilbert, J.N., Lyon, H. and Wahl, M. (2015) ‘Coping with the stress of athletic injury: How coaches can help’, Strategies: A Journal for Physical and Sport Educators, 28 (4).
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