It's natural to feel deeply psychologically impacted by sports injury and frustrated by the recovery process.

It's important to attend to the mental and emotional aspects of injury recovery in addition to the physical.

Sports injury recovery involves trusting the process and responding intentionally.

Values clarification, flexible thinking, emotional awareness, and establishing new routines can help.

Speaking from my experience, both as a clinical psychologist and as an ultrarunner, sports injuries are rough on mental health. Injury does not just affect the body; it also impacts identity, routine, and mood.

Running may be exercise, but it’s so much more than that:

A way to practice mindfulness

Social time with friends

Adventure and exploration

Avenue for self-growth

With that in mind, it’s only natural to feel deeply psychologically affected by injury.

Why is it so hard to trust the rehabilitation process?

Recovering from a sports injury involves uncertainty:

Uncertainty of the outcome (what will this look like once I’m recovered?)

Uncertainty of the timeline (how long will it take to get back there?)

Uncertainty around future reinjury (will this happen again?)

Athletes tend to be very goal-driven, perfectionistic, and extreme people who like results, linear progress, and concrete action steps.

Athletes don’t tend to love uncertainty. Athletes don’t love that at all.

With that in mind, of course, anxiety spikes during a sports injury.

Humans are natural “fixers”—we love solving problems. If there’s a mess on the floor, we clean it up. If my car gets a flat tire, I can replace it. Boom! Problem gone.

This approach doesn’t work as well for “problems” that happen inside the skin (i.e., anxiety). When we try to fix, contain, suppress, avoid, or control anxiety, it might work for a short bit of time… but anxiety gets worse over time.

Injured Runner X researches recovery gadgets and tools online from targeted Instagram ads for two hours and skips their PT exercises for the day. The tools don’t deliver the quick fix they promised; they’re behind in their rehab, and Injured Runner X ends up feeling even more frustrated.

Injured Runner Y avoids their running buddies even though they invite her to do non-running activities with them, because getting together makes her feel down about the injury. She ends up feeling more isolated and down at home.

Injured Runner Z typically has a healthy weekday routine with respect to meals, limiting alcohol, and prioritizing sleep. Since the injury, he has stopped meal prepping and tends to eat takeout or a pint of ice cream for dinner, and has more than a few beers at night to numb out. His sleep quality has tanked, and he feels less and less like himself.

Ask yourself: What are you doing in response to your anxiety? Are these behaviors helping you in the long run, or are they making you feel worse?

It’s also important to note the difference between anxiety and suffering in sports injury

Anxiety is a normal, understandable, and valid human emotion. Suffering is all the stuff we do in response to the anxiety that makes it much worse in recovery.

While you may not be able to control the anxiety itself, identifying aspects of recovery that you can control (including the mental aspects) is a great starting point.

How to shift your mindset in sports injury recovery:

What do you want to look back on and remember about this time in your life?

What kind of athlete do you want to be throughout this process? Because that hasn’t changed—you are still an athlete.

Values are compass points that guide action and give direction. You did not choose the injury, yet you can choose how you want to be throughout the injury.

2. Practice flexible thinking.

This one is tough for perfectionistic thinkers, who tend to think in all-or-nothing extremes:

I’m not training right now, so I’m not a runner. Rehab is taking longer than expected, so I’ll probably never run again.

I’m not training right now, so I’m not a runner.

Rehab is taking longer than expected, so I’ll probably never run again.

What’s needed here is flexible thinking, which doesn’t mean only having positive thoughts. What we’re looking for are balanced, in-the-middle-type thoughts.

PT and cross-training are how I’m training right now as a runner. It’s frustrating that rehab is taking so long, and I’m doing everything I can to move this forward.

PT and cross-training are how I’m training right now as a runner.

It’s frustrating that rehab is taking so long, and I’m doing everything I can to move this forward.

Flexible thinking gets you thinking of shades of gray, and inevitably helps build your tolerance for uncertainty.

3. Make space for all emotions.

The old adage here is true: You gotta feel it to heal it!

It’s okay to feel sad, anxious, frustrated, and restless. It doesn’t mean that you like or want your injury, or that you’re giving up or giving in. Allowing your emotions to be just as they are takes some of the weight off of them.

4. Keep some version of a routine.

As stated previously, injury can create what feels like a giant, gaping hole in your life.

Athletes organize meals, sleep, relationships, work, and other hobbies around their sport. Without it, routines can fall to the wayside. And yet, routines are extremely helpful for mental health.

Identify what parts of routine tend to help you feel better mentally, and set a couple of small goals for yourself to get back on track.

Returning to sport after injury

It is common for sports injuries to take their toll on psychological health, and attending to mental recovery is just as important as physical recovery. With mindful awareness, self-compassion, and purposeful action, you can navigate the uncertainty of injury with less suffering.

While you may not be able to control the exact timeline or outcome, you can choose how you show up for the process.

This post also appears on summerlandpsych.com.

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