The Emotional Impact of Injuries

emotional impact of injuries

By Tara Hackney, PT, DPT, OCS, KTTP for Athletico Physical Therapy

As much as we would like to prevent injuries, they do occur. In an ideal world, an injury would not disrupt our regular activities or participation in sport. But many times injuries lead to shifts in our regular activities. For many athletes, this injury can trigger an emotional and mental response.

Emotional responses that can occur after injury:

  • Sadness
  • Isolation
  • Irritation
  • Lack of motivation
  • Anger
  • Frustration
  • Changes in appetite
  • Sleep disturbance
  • Disengagement

There is no correct way for an athlete to respond to an injury; every athlete is an individual and their response will vary. It is important to note that the emotional response to injury may change throughout the course of healing. It starts at the time of the injury but continues throughout rehab, and into the return-to-play phase as well. The healthcare team should be aware of emotional responses and be on the lookout for athletes who may not have proper coping to these intense emotions.

Some emotional responses may become problematic, particularly if an athlete needs help and does not know how to ask for it. Depression for example, can impact recovery and magnify other emotional responses. Depression can be related to feelings of performance failure. Elite athletes have shared their personal experiences with depression after injury that kept them from their sport for an extended length of time. When an athlete is injured, they may not only lose their physical independence, they may also feel like they are being punished or isolated from their sport and/or their team. There can be a large change to their social environment and this can affect them mentally.

How Can We Help Injured Athletes Emotionally During Recovery:

  • Athletes may not want to share their feelings as it may be seen as a sign of weakness. The coaches, trainers and doctors should work together to provide a support network for the athlete and counseling should be considered as well.
  • Try to keep the athlete involved with their team. They can attend practice, go to games, sit on the bench or keep statistics so they still interact with their teammates and don’t feel isolated.
  • Allow the athlete to help set goals for recovery and rehabilitation and make sure they are aware of the timeline of their healing.
  • Use a team approach to recovery – coaches, parents, physicians, athletic trainers, physical therapists and other members of the healthcare team should stay in contact with each other to make sure the athlete is coping well and has the support needed for recovery both physically and mentally.
  • Try to discourage a “tough it out” mentality because this can add to the stigma around mental health issues, and athletes may retreat further into themselves rather than seeking help.

By being aware of the emotional response to injury as well as the physical injury itself, we can help athletes have optimal recovery. If you are an athlete dealing with an injury, request an appointment at a nearby Athletico location so our experts can help you get back in the game.

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How Exercise Might “Clean” the Alzheimer’s Brain

How Exercise Might "Clean" the Alzheimer's Brain

For the 50 million individuals worldwide ailing from Alzheimer’s disease, the announcements by pharmaceutical giants earlier this year that they will end research on therapeutics were devastating. The news is even more devastating considering projections that 100 million more people will be diagnosed with Alzheimer’s disease across the globe by 2050, all potentially without a medical means to better their quality of life.

As it happens, though, the pursuit of a therapeutic has been given a lifeline. New research shows that physical exercise can “clean up” the hostile environments in the brains of Alzheimer’s mice, allowing new nerve cells in the hippocampus, the brain structure involved in memory and learning, to enable cognitive improvements, such as learning and memory. These findings imply that pharmacological agents that enrich the hippocampal environment to boost cell growth and survival might be effective to recuperate brain health and function in human Alzheimer’s disease patients.

The brain of an individual with Alzheimer’s disease is a harsh place filled with buildups of harmful nerve cell junk—amyloid plaques and neurofibrillary tangles—and dramatic loss of nerve cells and connections that occur with severe cognitive decline, such as memory loss. Targeting and disrupting this harmful junk, specifically amyloid plaques, to restore brain function has been the basis of many failed clinical trials. This futility has led to a re-evaluation of the amyloid hypothesis—the central dogma for Alzheimer’s disease pathology based on the toxic accumulation of amyloid plaques.

At the same time, there have been traces of evidence for exercise playing a preventative role in Alzheimer’s disease, but exactly how this occurs and how to take advantage of it therapeutically has remained elusive. Exercise has been shown to create biochemical changes that fertilize the brain’s environment to mend nerve cell health. Additionally, exercise induces restorative changes relevant to Alzheimer’s disease pathology with improved nerve cell growth and connectivity in the hippocampus, a process called adult hippocampal neurogenesis. For these reasons, the authors Choi et al. explored whether exercise-induced effects and hippocampal nerve cell growth could be utilized for therapeutic purposes in Alzheimer’s disease to restore brain function.

The researchers found that exercised animals from a mouse model of Alzheimer’s had greatly enhanced memory compared to sedentary ones due to improved adult hippocampal neurogenesis and a rise in amounts of a specific molecule that promotes brain cell growth called BDNF.  Importantly, they could recover brain function, specifically memory, in mice with Alzheimer’s disease but without exercise by increasing hippocampal cell growth and BDNF levels using a combination of genetic—injecting a virus—and pharmacological means. On the other hand, blocking hippocampal neurogenesis early in Alzheimer’s worsened nerve cell health later in stages, leading to degeneration of the hippocampus and, subsequently, memory function. This provides preclinical proof of concept that a combination of drugs that increase adult hippocampal neurogenesis and BDNF levels could be disease-modifying or prevent Alzheimer’s disease altogether.

With this work, things don’t look promising for the amyloid hypothesis—that Alzheimer’s disease is caused by the deposition of amyloid plaques. In this study, it was shown that eliminating amyloid plaques were not to necessary to ameliorate memory defects, which is consistent with evidence that plaques can also be found in the brains of healthy individuals. On the contrary, we may be looking at a new and improved fundamental theory for Alzheimer’s disease based on promoting a healthier brain environment and adult hippocampal neurogenesis.

However, this inspiring news should be taken with an important caution—mouse models of Alzheimer’s are notorious for failing to translate into humans such that treatments that have worked to remedy mice have failed for humans. Besides, even if these findings translate into humans, it may apply to a fraction of Alzheimer’s individuals with relevant genetic components to the mouse model utilized. Future studies will need to replicate these results in mouse models emulating the range of known Alzheimer’s disease genetic milieus and, more importantly, prove its medical relevance to human disease.

Before translating these findings into human patients, there remains significant research to establish that a medication or drug could mimic the effects of exercise—exercise mimetics—by “cleaning up” the brain with BDNF and stimulating neurogenesis to combat Alzheimer’s disease. Currently, the method for administering BDNF to animals in the lab—by direct injection into the brain—is not ideal for use in people, and a hippocampal neurogenesis stimulating compound remains elusive.

Future attempts to generate pharmacological means to imitate and heighten the benefits of exercise—exercise mimetics—to increase adult hippocampal neurogenesis in addition to BDNF may someday provide an effective means of improving cognition in people with Alzheimer’s disease. Moreover, increasing neurogenesis in the earliest stages of the disease may protect against neuronal cell death later in the disease, providing a potentially powerful disease-modifying treatment strategy.

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Addiction Can Happen to Anyone—Including Athletes

The author, pitching in a baseball game

Dr. Nikhil Verma and Steve Kashul talk with Gary Mendell, Founder and CEO of Shatterproof about assisting athletes with opiod addiction; the opiod epidemic and its affect on sports; the importance of eliminating the stigma around athletes seeking help for addiction.

Whenever news breaks that a famous athlete is struggling with addiction, most people shake their heads and wonder, how can that happen? In our culture, athletes are revered as heroes and role models. Their skills, their power, and even sometimes their looks all help them gain fame and prestige, both on and off the field or court. So the fact that these “perfect” people can deal with substance use disorder often comes as a surprise.

Famous athletes like Darryl Strawberry, Michael Phelps, Andre Agassi, and the great Lawrence Taylor have struggled with addiction. The use of performance-enhancing drugs or painkillers, the partying that comes with fortune and fame, and the adjustment period involved in life after an exciting sports career all can put athletes at risk of addiction.

Many sports are mental games. So why would these professional athletes who have worked so hard to get to this place in their career put substances in their body that affect thinking, as well as their physical performance? The answer is that everyone one of us is human and therefore impressionable. No one is immune. We can all fall prey to a very clever and insidious disease that can take over your life from the very first time you try drugs.

Learn more at https://www.shatterproof.org/

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Movement as a Treatment for Illness, Disease, Anxiety and Depression

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Dr. Trivedi-PurohitBrian Cole MD of Midwest Orthopaedics at Rush, Steve Kashul and Dr. Ritu Trivedi-Purohit discuss the benefits of movement for those coping with illness, disease, anxiety and depression.  Dr. Trivedi-Purohit is a health psychologist and founder of The Center for Behavioral Health & Wellness. Dr. Trivedi-Purohit received her Master of Arts from Loyola University. She earned her Doctor of Psychology from Illinois School of Professional Psychology- Chicago.

Sports Medicine Weekly on 670 The Score

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