Managing Fear of Reinjury

Almost every athlete, at some time in their career, will face the fear of reinjury after initiating a return from injury. Injury is difficult to manage in the first place: physically, psychologically, socially, emotionally, and in terms of planning, scheduling, and living day-to-day. Then, upon returning from injury, a new set of fears may interrupt your performance, especially after injuries that require significant medical interventions (surgery) and extended recovery times (with limited engagement in your sport). After an athlete has spent so much time attempting to overcome the adversity of injury, the fear of going through the whole process again (pain and all) may severely limit their performance.

Changes in Performance

A primary fear upon returning from injury is the fear of reinjuring the area that has just rehabilitated. You may second-guess yourself and your abilities. This can throw off the timing of actions and sequenced skills, limiting your performance significantly and sometimes leading to a vicious cycle of self-doubt. Alternatively, you may hold back on execution and intensity; knowing that you could push harder but don’t. Finally, you might try to adjust your game to perform with the “safer feeling,” which results in having to relearn much of what was previously natural or automated through development and training. None of these strategies are helpful but they all may feel more appropriate to avoid a reinjury.

Alternatively to holding back, you may push too hard too early and reinjure the area. As if the lost time of recovery must be made up in the first few weeks upon return! Re-injury is tragic and frustrating. Medical clearance to re-engage in performance is only part of the rehabilitation process and it is important to respect medical advice and trust in your providers. Trying to return to your previous performance level before you are sufficiently recovered can lead to retirement, stepping away from your sport life, changing your sport, or focusing on a different aspect of it (e.g., coaching). Psychological return to performance is just as, if not more, important. Allowing yourself to re-enter the mindset and mental game can significantly reduce the risk of re-injury or pushing too hard, too early.

There is a fine and delicate balance between holding back to avoid reinjury and pushing too hard, causing reinjury. Depending on what type of athlete you are, you may need others to encourage you in either direction. Social support and guidance can be a life-saver during this difficult and taxing transition. Ultimately, it is up to each athlete themselves; but coaches, teammates, and medical providers can provide invaluable insights and support.

A Plan of Action

Re-engaging in exercises, actions, and skills that cause hesitation or fear should be approached step-by-step and progressively to help mitigate the fear. For example, if returning from a knee injury an athlete has reservations about heavy squats, they should start with body-weight squats and work their way up to returning to heavier weights over time. Eventually, the athlete may return to plyometric exercises without fear or hesitation, but taking it slowly (similar to learning the exercises in the first place) allows the psychological rehabilitation and re-entry to play out appropriately.

Working with a sport psychologist to navigate this difficult time can reduce the time needed, enhance the feeling of well-being, increase confidence, and make the process more streamlined and smooth. As much as we would love to tell ourselves we can handle whatever we want to handle as athletes, there is much that can be ameliorated with the right support and guidance.