The Injuries You Can’t See: Lessons From 3 Sports Psychologists

When I set out to interview runners about their injuries, I anticipated learning about their medical appointments, rehabilitation process, and return to running programs. Although I did learn about these things, the psychological impacts of injury were much more salient. Nearly every runner inevitably talked about how nearly impossible it was to stay mentally well during an injury.

Recently, while more attention is being paid to our mental health, especially in response to the impacts of the pandemic, it’s a far cry from the amount of information we receive on how to keep up with our physical health. And, no matter how much we talk about mental and physical health as separate things, they bleed over into each other. When we’re struggling with physical pain, it takes a huge toll on our mental health and vice versa. 

Hopefully we’re approaching a future in which we’ll walk into our physical therapist’s or doctor’s office and be asked about our mental health, too. When that day comes, we’ll all be better off. 

For now, three sports psychologists share different ways for us to start prioritizing our mental health alongside our physical health, whether we’re suffering from an injury or not.

Dr. Ashley Coker-Cranney, Certified Mental Performance Consultant 

Dr. Ashley Coker-Cranney is a Certified Mental Performance Consultant who holds a B.S. in Psychology, a B.S.P.E. in Physical Education, an M.S. in Psychosocial Aspects of Sport, and a PhD in Sport and Exercise Psychology. She currently teaches courses for West Virginia University; is the owner of MindRight Performance Consulting, where she works with athletes to enhance performances and life satisfaction; and is a therapist at Whole Brain Solutions. 

Here are Coker-Cranney’s strategies for staying mentally well as an athlete:

Have More Than One Identity

As a general, human psychology tendency, we like to protect our self concept, says Coker-Cranney. When our entire identity is in one thing, such as being a runner, we’ll go to great lengths to protect it, including adopting damaging behaviors such as disordered eating and substance abuse. Furthermore, when we lose that sole identity, whether it’s permanent or temporarily, we’re susceptible to depression and anxiety and a host of other mental health injuries because our identity has been stretched and we lose sight of who we are. 

The differences between runners with more than one identity and those without are palpable. Those with multiple sources of identity tend to navigate injury well because they have a diverse sense of who they are, which helps them keep things in perspective. When injured, they’re better able to be patient with the process because they know that their injury is temporary and they have all the confidence in the world that they will come back from it. Because of this attitude, they’re able to turn their attention to other activities that were set aside for their running. In general, they tend to have a growth mindset rather than a fixed mindset. 

For those whose identity is solely wrapped up in running, injuries are much more psychologically difficult, which tends to prolong physical recovery, too. Because these runners are less likely to have other ways of defining themselves, the only way they can feel like themselves is to get back to running. When they can’t run, this can bring on depression and a crisis of identity. In response, they’re less likely to accept where their body is and to push it past its limits. Their fixed-mindset approach can bring about maladaptive, inflexible perfectionism that often leads to a rigid approach to their recovery. 

“It’s a constant balance for all of us to learn to define ourselves in more than one way because if, for some reason, that one way is compromised, then we have other ways of protecting how we see ourselves,” says Coker-Cranney. 

Coker-Cranney recommends that we regularly remind ourselves of the other identities our lives because we all have other roles whether that be a parent, co-worker, friend, neighbor or something else. She also recommends that we check in with our values regularly and figure out how to connect with things of importance outside of running.

Celebrate Your Past Self And Look Forward To Your Future Self

For various reasons, our athletic ability changes over time. Instead of making upward comparisons to your previous self, accepting where you are today and staying present focused can help you stay mentally well. 

Acceptance comes when we can be at ease with ourselves and find a way to be the person we want to be regardless of circumstance. Coker-Cranney calls this our unconditional commitment mindset. 

“Acceptance is about saying, ‘I don’t love that this injury happened. In fact, I’m really angry that it happened. Yet, I can accept that it happened and I will be a different person on the other side of it,” says Coker-Cranney. “It’s about being open to what the new version of yourself might look like.” 

Being present focused is about being able to meet yourself where you’re currently at. Doing so doesn’t mean forgetting everything about previous versions of yourself. You can celebrate your previous self and hold that in the same space as your current self, who may not be able to do the same things anymore. 

“When we stay in the present, it takes the judgement out of it,” says Coker-Cranney. “For example, I wasn’t any better when I placed first than when I am running recreationally with neighbors. It gives us space to experience what we are doing in any given moment and not judge any of it. When athletes find that balance of acceptance and being present-focused, you almost hear a click of, wow, this is a whole different way of being, and I don’t have to judge myself anymore.” 

Seth Swary, Sports Performance Psychology Specialist 

Seth Swary is the Coordinator of Sport and Performance Psychology at Oakland University. Swary holds a PhD in Sport, Exercise, and Performance Psychology, an an MA in Community Mental Health Counseling. He’s worked with athletes from a variety of sports at the youth and collegiate levels. 

Here is one of Swary’s strategies for helping athletes stay mentally well:

Remember Why You Run

“It’s easy for our passion to become this job or task,” says Swary. “We start running because we like running, but that can slowly turn into it being about the next goal or competition, getting a scholarship or running professionally. When we get lost in that, there’s pressure to perform well.”

While structure, goals, and even pressure can be helpful tools, it’s important to be aligned with our intrinsic reasons for running, not purely extrinsic motivators. As soon as we get lost in the outcomes of things and pressure starts to mount, our progress can be impacted negatively, as well as our mental health. When we stay connected to our personal reasons for running removed from external reward or affirmation, we often see the most progress. 

There’s a sweet spot in the amount of pressure we apply to ourselves called the individual zone of optimal functioning. This says that athletes all have a different optimal level of optimal anxiety, where we are excited and focussed, but not overwhelmed. Often, if we apply too much pressure to ourselves, our stress gets too high and falls outside our optimal zone, causing negative impacts not only on our performance, but on our mental health, too. 

To help counteract the pressure we put on ourselves or receive from others, Swary comes back to remembering why you run.

Luke Patrick PhD, Sports Psychologist 

Luke Patrick has a Master’s degree in kinesiology and a PhD in counseling psychology. He’s worked with teams and individual athletes at the high school, collegiate, Olympic, and professional levels. He’s currently on the sports psychology sub committee of USA Track & Field, the registry with the US OPC, the directory of the NFL Players Association, and is the Team Psychologist for the Portland Trail Blazers.

Here is one of Patrick’s strategies for maintaining strong mental health

Practice Mindfulness

Among other mental skills building tools, Patrick is big on mindfulness, which over the last few years has become recognized as an integral part of the mental aspect of performance. Practicing mindfulness helps us stay grounded in the present moment, allowing us to let go of some of the anxiety, tension, and “what ifs” that come with being injured. There are a myriad of ways to practice mindfulness, but Patrick suggests two simple methods to get started: focusing on your breath and scanning through your body. 

“Learning how to do a body scan and recognizing that most of your body is still intact and feels good can be really helpful with injury because it’s so easy to get focused on the area where there is pain,” says Patrick. 

Mindfulness works by facilitating a release of muscle tension that we carry around an injury as well as the general guarding, bracing, and tension that comes as a function of being stressed. By learning to be more present, the body relaxes, which reduces muscle tension and increases blood flow to the areas of the body that need it. Better blood flow brings better nutrients and oxygen needed for the body to heal. Furthermore, mindfulness helps with neuron growth in the areas of the brain related to confidence and social connection. It helps facilitate neuron communication in the brain, too, which helps move us from a fight-or-flight response to a more relaxed state.

The effects of mindfulness can happen immediately, but the more we do it, the better we reap its benefits. 

“When you have a bout of exercise, there are positive things that come immediately, but then there’s the cumulative effect that allows for better conditioning over time,” says Patrick. “Meditation and mindfulness are similar. Endorphins respond from doing a single bout of mindfulness, but as you build the skill, you receive more consistent and deeper levels of benefit.”

Patrick points out that it’s important to approach mindfulness with an openness and process oriented way rather than with a specific goal in mind. 

“It’s really about learning how to be in the present moment,” says Patrick. “The harder you try to make it happen, the more difficult it becomes.”

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All of the athletes I interviewed for this series struggled with their mental well-being during their injury, and yet none of them had any practices in place for addressing them. Instead, they more heavily engaged in their physical health until they reached a breaking point. Instead of getting to that breaking point, we can do better by caring for our mental health right alongside our physical health.

This story is the sixth and final segment of PodiumRunner’s The Injuries You Can’t See series with elite athletes discussing how injury has helped them deal with larger issues in running and in their lives. 

Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 

About the Author

Jennifer Kuhns is an Oregon native, where she graduated from the University of Oregon and currently works at Nike. When she isn’t writing or working, she can be found exploring the outdoors by foot, preferably with good people, good views, and good food.