| SPORT AS A STRESSOR - Stress is the positive and negative forces than can disrupt the body’s equilibrium - Negative stress tends to o Decrease the athlete’s attentional focus and create muscle tension o Reduction in flexibility o Problems in coordination o Overall decrease in movement efficiency. - Sports participation is both a physical and an emotional stressor. - Athletes bodies undergo numerous “flight-or-fight” reactions to avoid injury or other physically and emotionally threatening situations Physical Response to Stress - Wortman and Silver indicate that many stress responses area apparent when athletes adjust to a physical injury and/or undergo program of rehabilitation - Stress is a psychocomatic phenomenon - Physiologic responses to a stressor area autonomic, immunologic, and neuroregulatory - Hormonal responses are reflected by an increase in the secretion of cortisol - Initially, in an acute reaction to a negative stress situation, secretions from the adrenal gland sharply increase, creating the well-known flight-or-fight response - With adrenaline in the bloodstream, pupils dilate, hearing becomes more acute, muscles become more responsive, and blood pressure increases to facilitate the absorption of oxygen. - Physiologically the primary reaction in the acute stage is produced by the epinephrine and norepinephrine of the adrenal medulla. - Chronic stress leads to an increase of blood corticoids from the adrenal cortex PSYCHOLOGICAL REACTIONS TO INJURY - Psychological reaction of athlete who has suddenly sustained injury will depend upon the length of recovery - The profile of an at-risk athlete is as follows; o The athlete belongs to the high-risk age group, between 15 and 24 years of age o The athlete sustains a serious injury requiring surgery o The athlete is faced with a long rehabilitation period o The athlete is faced with being replaced by a teammate Personality Factors Leading to Injury - Athletes who are anxious, tense, restless, and nervous may be more prone to some injures. - A sense of insecurity reflected in low self-confidence and low self-esteem may predispose an athlete to injury SOCIOLOGICAL REPOSINSE TO INJURY Providing Social Support OVERTRAINING - Overtraining can lead to staleness and eventually burnout Staleness - Staleness is often attributed to emotional problems stemming from daily worries, fears, and anxieties - Anxiety = A feeling of uncertainty or apprehension Symptoms of Staleness - Higher blood pressure or increased pulse rate both at rest and during activities - Increased Catecholamine excretions o Active amines, epinephrine and norepinephrine, that affect the nervous and cardiovascular systems Emotional Stress The coach The Athletic Trainer - The athletic trainer must have some counseling skills The Physician Burnout - Negative self-concept - Negative job or sport attitudes - Loss concern for the feeling of others - Frequent headaches - Gastrointestinal disturbances - Sleeplessness - Chronic fatigue - Increased emotional exhaustion - Reduced sense of accomplishment - Cynicism - Depressed mood REACTING TO ATHLETES WITH INJURIES - The sports medicine team must be honest, supporting, and respectful of the injured athlete during the time of disability The Catastrophic Injury PSYCHOLOGICAL FACTORS IN THE REHABILITATION PROCESS Rapport - A relationship of mutual trust and understanding (discussion, active listening and resolution) Cooperation Exercise rehabilitation as an educational process Competitive confidence Psychological Approaches in the Phases of rehabilitation Stages - Anger - Denial - Burdening - Depression - Acceptance Immediate Postinjury Period - Fear and denial Early Postoperative Period - Disabled Advanced Postoperative or Rehabilitation Period - Fear of failure and anxiety is dealt with positive reinforcement Overrehabilitation Compliance - Mild degree of denial - Obsessive-compulsive and impulsive tendencies - Excessive risk taking - Strong need to prove worthiness Poor Rehabilitation Compliance - Scheduling problems - School, fianancial, or family concerns - Misunderstanding of treatment rationale - Mistrust of treatment choices - Mistrust of rehabilitation specialists - Fear of pain or reinjury INITIAL SPORTS REENTRY PERIOD Mental Training Techniques Quieting the Anxious Mind Meditation Progressive Relaxation Cognitive Restructuring Refuting Irrational Thoughts Thought Stopping Therapeutic Imagery (Visualization) Rehearsing the Rehabilitation Process HEALING PROCESS AND PAIN CONTROL Improving the Healing Process Techniques for Coping with Pain Tension Reduction Attention Diversion Altering the Pain Sensation OTHER CONIDERATIONS Signs of anabolic steroid abuse - Mania and depression - Bouts of anxiety and insomnia - Changes in libido - Aggressive behavior The general adaptation syndrome is a stress response theory (DR. Hans Selye) - Alarm stage; “flight or fight” response – prepare the body to take action o Adrenal glands secrete adrenaline - Resistance stage; the body directs the stress to a particular body site - Exhaustion stage; The body may become dysfunctional because of chronic stress Sudden exercise abstinence syndrome (Abrupt cessation of exercise can lead) - Heart palpitations - Irregular heartbeat - Chest pain - Disturbed appetite and digestion - Sleep disorders - Increased sweating - Depression - Emotional instability |
| Psychosocial Intervention for Sports Injuries and Illnesses |