November 18, 2018

The Dark Side of Athletic Injury

I’m sixteen years removed from graduate school. The running joke in my family is I have a Master’s degree, thesis pending. True, I completed my coursework with flying stars and started my thesis… but never finished it. Life events got in the way and I had to focus on other priorities.

Anyone in academia knows the key to having a worthwhile thesis is to have a really long title to it.  Mine was “Certified Athletic Trainers’ Knowledge, Attitudes, and Beliefs About Post-Injury Depression”.  That was a bit on the short side, so it was probably doomed from the beginning.  All joking aside, however, the topic of post-injury depression still intrigues me today.

I have many years of experience in a high school athletic training room and have seen first-hand what a season-ending injury can do to a young person. They do not get through the process emotionally unscathed. 

The Dark Side of Athletic Injury, Athletes' Training Center

I remember a particular athlete and watching her story unfold.  Her dad stopped coming up to practices so she felt she lost her relationship with him.  His approval seemed to only be for athletic achievements.  Two of her “best friends” abandoned her.  Her boyfriend broke up with her because he was not capable of supporting her through the emotions she was experiencing.  Her grades began to suffer and I saw her starting to make choices with alcohol that were going to be damaging.  Thankfully, her story turned out okay, but what about all those athletes who don’t have anyone around them to connect the dots and get them help?

Here are just a few of the things athletes go through in this situation (definitely not all-inclusive). 

  • Loss of identity 
    Most athletes’ identities are rooted in athletics, especially if they are not involved in other activities.  An injury happens and they are no longer an “athlete”, so who are they now?
  • Loss of friendships and their support system 
    The athlete is injured, but the team can’t just stop.  The team has to go on and continue to practice, battle together in competition and develop the bonds that athletics creates.  If the injured athlete is spending considerable time on rehab or doesn’t get to travel with the team they miss out on these opportunities and drift from their friends and teammates.
  • Extreme feelings of guilt 
    The athlete feels they are letting their team down.  They can no longer contribute to the team’s success or goals and they have to miss team activities or practices due to balancing time in rehab.
  • Impatience, irritability, and rapid mood swings 
    There is a lot of emotion swirling around during this time and many athletes lack coping skills outside of physical activity .  Having to be dependent on others, the slow pace of rehab, not having control over the situation, and the general state of where things are at contribute to these feelings.  Sometimes, it’s made even worse by pain and/or pain control medication.
  • Increased risk of suicide, alcohol or drug dependency, or other self-harming activities 
    Unfortunately, most athletes are already considered to be part of a high-risk age group for these things.  So, when compounded by a significant injury at a time where they have little to no coping skills can be a bad recipe.  It is very important for the people around the athlete to be diligent in recognizing the warning signs of these types of behaviors. This link provides some additional sites and organizations that can be used as resources:

During long rehabs I took some very intentional steps with athletes, including finding them a role with their team, setting lots of short-term goals so we had lots of “wins”, and connecting with their friends and family outside of the sports platform.  I also was not afraid to refer someone for professional help.  Just as someone would seek a surgeon for a torn ACL and a therapist for their rehab, it is okay to address the mental health side of the injury with an expert in that area.

And, lots of times, I just had to be there for them while they felt their feelings.

The good news is the sports community is talking about athlete mental health more than ever before.  In recent years the NCAA recognized the importance of addressing mental health issues in athletics and enhanced available resources.  Today, there are so many phenomenal resources available to athletes struggling with depression and other mental health issues.  I recently learned about Athletes Connected and it has quickly become one of my favorite resources available to athletes, especially the videos that share real athlete’s stories about battling depression or other mental health issues.  (Thank you Dr. Erin Haugen of for the reference).

If you are a parent and have a child that is enduring an injury, don’t forget this aspect of their care.  If you are an athlete, you are not alone and there is help out there for you!

Question: If you’ve experienced a season ending injury, what things did you experience?

Written By: Danielle Kleber, ATC

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