1. WEEK 12: 3/23/15 – 3/27/15 PSYCHOLOGY 310: SPORT & INJURY PSYCHOLOGY UNIVERSITY OF MARY INSTRUCTOR: DR. THERESA MAGELKY Integrating Psychological and Physiological Aspects of Sport Injury Rehabilitation

2. Introduction Research has found that athletes who used goal- setting, imagery, and positive self-talk recovered faster than athletes who did not use these psychological interventions When injured athletes use psychological interventions, they experience reduction in stress, pain, state anxiety, and re-injury anxiety Athletes who use psychological interventions show a better adherence to rehabilitation

3. Introduction The majority of sport medicine professionals tend not to incorporate psychological interventions into the rehab programs of injured athletes It is important for sport medicine professionals to be trained to understand and be able to use a wide array of psychology skills and interventions throughout the rehab process

4. Three Phases to Rehabilitation: A Holistic Approach to Healing Injured Athletes 3 distinct phases of the rehabilitation process: 1. Phase 1: Reaction to Injury – athletes to injury, including physical& psychological factors 1. Athlete forms cognitive appraisals of the injury occurrence (positive or negative) and is consumed with the pain it has produced 2. Phase 2: Reaction to Rehabilitation – characterized by physical factors of strength, balance, and mobility, AND psychological factors of motivation and hardiness 1. This phase tends to be most challenging for athletes because it is longest phase for more severe injuries 3. Phase 3: Reaction to Return to Play – marked physically by completing strength and proprioceptive (balance) gains and beginning sport-specific agility drills and movements 1. In this phase athletes deal primarily with self-confidence issues and managing their fears or re-injury as they approach their return to play

5. Rehabilitation Profiling Rehabilitation involves assessing both the athlete’s personal and physical factors that have an impact on both the time and quality of the rehabilitation process This allows sport medicine professional and athlete to gain a better sense of where athlete rates him/herself on important factors that impact the rehabilitation process Personal profile includes 12 psychological, emotional, and social factors Physical profile includes 12 injury-specific and health-related factors

6. Rehabilitation Profiling (cont.) The 12 Personal Factors of Rehabilitation Profiling: 1.Confidence – how much you believe in your ability during rehab 2.Motivation – your current level of motivation in rehab 3.Anxiety – physical anxiety you experience regarding your recovery 4.Focus - degree to which you stay focused on your rehab 5.Expectations – positive expectations you have regarding your recovery 6.Worry – degree of uneasiness, concern, and doubt you have about recovery 7.Emotions – degree you feel emotional about your rehab 8.Identity – degree you currently view yourself as a physical being and athlete 9.Adherence – degree to which you adhere to your rehab program 10.Understanding – degree of understanding you have of the rehab process 11.Pain tolerance – degree to which you can tolerate and control pain during rehab 12.Social support – degree of social support you are receiving from others including the sport medicine professionals, family, friends, coaches, and teammates

7. Rehabilitation Profiling (cont.) The 12 Physical Factors of Rehabilitation Profiling: 1.Range of motion – quantity and quality of movement you have in the injured area of the proximal or distal joint 2.Strength – amount of force you can generate through injured area 3.Stability - degree of firmness and steadiness you feel in injured area 4.Coordination – degree to which you use different muscle groups together to produce a certain movement 5.Balance – degree to which you can maintain equilibrium that is required to the injured area 6.Swelling – amount of fluid in the injured area 7.Pain – degree of discomfort and soreness you feel in injured area 8.Function – degree to which you can carry out sport-related activities involving injured area 9.Daily Activities – degree to which you can carry out typical daily activities 10.Sports participation – degree to which you can participate in your normal sport activities 11.Health – degree of your general good health, free of fatigue, illness, minor injury 12.Sleep – how much you are sleeping

8. Gould’s (1993) Reasons to Use Rehabilitation Profiling: 1. Sport medicine professional will be able to better design more effective rehab program for the athlete 2. Sport medicine professional will have better understanding of psychological and physical needs of athlete 3. Athlete will have a graphic representation of where they are in rehabilitation process, both physically and psychologically 4. Sport medicine professional will be able to determine the athlete’s needs and goals 5. Sport medicine professional will have better understanding of which psychological issues will both help and hinder the rehab process 6. If an assessment is not used, the sport medicine professional may miss important information that impacts the athlete and their engagement in rehabilitation 7. In general, sport medicine professional will be more effective in working with the athlete

9. Incorporating Psychological Skills into the 3 Phases of Rehabilitation The various psychological techniques we have covered (goal-setting, imagery, relaxation techniques, positive self-talk, social support) can be incorporated into the 3 phases of rehabilitation (reaction to injury, reaction to rehabilitation, reaction to return to play)

10. Conclusion The athlete must be both physically and mentally ready to return to play The professionals responsible for rehabilitation have a role to ensure this takes place A holistic approach is ideal, in which both physical and psychological skills are integrated into the three phases of rehabilitation

11. References Arvinen-Barrow, M., & Walker, N. (2013). The Psychology of Sport Injury and Rehabilitation (1 st ed.). Routledege.