Boston Sports Medicine and Performance Group, LLC Blog

Mind Over Matter: The Psychology of Rehabilitation

Posted by Boston Sports Medicine and Performance Group on Thu, Apr 23, 2015 @ 07:04 AM

 

This article originally appeared on www.conqasport.com by Daniel Gallan

 

 

Injury: the greatest fear for every athlete. Across any code, at any level, injury is a part of life for sportsmen and women. A torn hamstring, a broken arm, a severe concussion; all injuries require extensive physical therapy. But what about the mental battle that needs to be waged when injured? How does the psychological process measure up to the physiological one? Doctor Charlie Weingroff and Springbok captain Jean de Villiers reveal what an athlete goes through psychologically when undergoing physical rehabilitation.


Springbok captain Jean de Villiers receives medical attention after sustaining a career threatening injury against Wales last year. Image supplied by Jean de Villiers. 

 

 

Springbok captain Jean de Villiers receives medical attention after sustaining a career threatening injury against Wales last year. Image supplied by Jean de Villiers. 

On the 29th November 2014, at the Millennium Stadium in Cardiff, the South African rugby community held its collective breath when captain and 106 Test veteran Jean de Villiers fell to the floor clutching his left knee during a Test against Wales. His cries of agony could be heard over the live television feed with replays showing his leg bending at a sickening angle. A post-match prognosis indicated a broken knee cap, a torn hamstring and anterior cruciate knee ligament damage. What we had seen may well have been the abrupt end of one of the most illustrious and successful careers in the history of the sport.

“When it happened my first thought was definitely negative,” de Villiers says in an exclusive interview with CONQA Sport.  “I thought “that’s the end”. Because of my age and the stage of my career that I’m at, I immediately went to a negative place. I knew it was bad straight away.”

De Villiers is a positive person and those negative thoughts were vanquished within the first few minutes. The Springbok captain was being carried off the field on a stretcher when assistant coach Johan van Graan told him that he was still going to go to the World Cup in September. The road to recovery, and indeed the World Cup, started right there on his back.

According to de Villiers, the rehabilitation process is a mental battle from the very first day. Having a solid support base in the form of close friends and family is crucial as they are the ones that build the mind while the physiotherapists, surgeons and coaches rebuild the body.

Doctor Charlie Weingroff is someone who knows how to rebuild both. Weingroff, a certified Athletic Trainer and Strength and Conditioning Specialist holds a doctorate degree in Physical Therapy. His work with elite athletes going through rehabilitation has brought him international renown and his time with the Philadelphia 76ers in the 2005/06 season saw the East Coast franchise ranked first in the NBA for the least amount of players missing games through injury.

For Weingroff, the mental side of rehabilitation is just as important as the physical process but stresses that because everyone is different, there are no set rules when understanding the mental side of recovery. Unlike a ruptured hamstring or a broken arm, every mind is comprised of different experiences and emotions. Some players may need constant reassurance that their rehabilitation is on track; others may need as little social interaction as possible. According to Weingroff, some players are like “little mad scientists” and scrutinise over every scrap of data while others simply need to be told what to do. Some injured athletes blame coaches and trainers for their ailments and others push too hard in their pursuit of fitness. As a result of the variety of mental states, Weingroff instead chooses to solve the mental battle with a physical approach.

“The psychological side of rehabilitation is still scientifically observable,” explains Weingroff. “Spiked levels of dopamine and certain neurotransmissions can be monitored. Maintaining hormonal and neurotransmitter levels associated with positive mind-sets and positive rehabilitation is what we strive for.”

This is achieved in a number of ways. First, the mind needs to be tricked into thinking that the body is healthy. As de Villiers and Weingroff both point out, one of the major inhibitors for rehabilitation is the athlete’s frustration that high levels of performance are no longer possible while injured. Weingroff circumnavigates this negativity by focussing on another area of the body. If an athlete has injured his foot or knee, there is no reason why the upper body cannot be trained. If this happens, there is a reduced risk of central sensitisation, a condition of the nervous system that is associated with chronic pain. “The athlete does not dwell on the injured body part and the area does not occupy a larger space in the cognitive brain,” Weingroff says. “Pain is in the mind, not in the body.”

 

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Topics: Charlie Weingroff