Anguish as I’m left to rehab mentally and physically

The emotional response to injury can vary greatly. The fear is the worst thing as you question everything, most worryingly: Have I lost it?...

So just like that, game over ball burst. A fractured fibula in my ankle sustained against the English Sevens in a training game two weeks ago has ended my involvement in at least the next two legs of the Sevens World Series.

I say “at least”, because the medical experts feel I may have an idealistic target of returning in time for the last leg of the world series in Clermont Auvergne at the end of May, 10 weeks post injury.

At 28, I count myself pretty lucky for the small amount of training and playing time missed through injury. Yet as I sit with my right leg in cast, I can’t find much solace in that.

Looking back, I was never one for the ‘sick role’, even as a child. Following a cycling accident during our own Tour de France coming home from school, I ended up in Kerry General Hospital with a broken arm. The following day, I was released after manipulation under anaesthetic.

I went home and could hear the din from the school playground less than two miles away. Off I went on my bike to show off my cast and to see if I could stay for the afternoon, but the teacher cleared me as quick as she saw me!

Unfortunately, I have encountered many team-mates and friends who have suffered from prolonged periods on the sidelines. It is especially harrowing to see these players suffer setback and delayed returns, both for the individual themselves and for the team who would benefit massively from their skillset.

Now I am facing a similar period as player-turned-supporter, I am further intrigued as to the responses athletes have to injury. Surely, forewarned is forearmed?

As a physiotherapy student in UL, I remember a lecture that introduced the International Classification of Functioning, Disability and Health, a model of health constructed by the WHO.

The older biomedical model was more concerned with diagnosis and treatment of illness, and mainly focused on physical processes.

It didn’t take into account the social factors that contribute to a person’s illness, injury or disease. So in my case, the biomedical model referred to the broken bone in my ankle, and the physical consequences of this such as muscle wastage, decreased fitness level, joint stiffness etc. The newer bio-psychosocial model deals with the biological and psychological factors associated with injury. This is incredibly pertinent, I am discovering, as an injured athlete. Yes my ankle needs to be treated, but so does my mind. Treating one without the other would lead to inadequate and delayed rehabilitation on my part.

The emotional response to injury can vary greatly. While it is apparent some injured athletes struggle emotionally, not all athletes experience an observable or measurable emotional disturbance. These responses include anger, anxiety, depression, frustration and isolation.

An athlete’s sport dictates their life and is a part of their personal identity. If I meet someone I haven’t seen in a while the first thing they ask me is “how is training?” or “any matches coming up?”

I honestly don’t think I’ve ever encountered a different ice breaker. If I didn’t have this passion then what would be the fallback... the weather? Sport, like many of my colleagues, is a huge part of my identity. Take it away, well, there is a ridiculous chasm. Some studies have likened the psychological response athletes encounter when suffering an injury to that seen in trauma victims. That may seem like hyperbole, but I can certainly see the comparisons.

An athlete devotes their life to something that can be taken away in one moment, without guarantee of a return. Participation in sport provides a means of developing physical and psychological strength, self esteem, autonomy and self control. When these positive reinforcements cease abruptly, it is conceivable an athlete may question their identity and experience a sense of loss. Are they still an athlete if they are unable to compete or train? If they are no longer an athlete, then who are they?

While athletes spend hours each day physically preparing for competition, more often than not they are unprepared psychologically for the stress associated with injury. Personally, what do I do to relieve stress of any type? I exercise. So now I am in a vicious circle, where my coping mechanism has been temporarily rendered obsolete.

I believe I am pretty resilient — sport has helped develop that characteristic, but this is a new test, a physical and mental one.

Initially, I was relieved it was a clear fracture that didn’t require surgery which would prolong recovery time. What was also advantageous was the excellent and timely access to care I received through the IRFU. Likewise, as part of a high performance environment, I have access to the professionals who will help minimise the negative consequences of my injury and optimise recovery.

Rehabilitation doesn’t begin when the cast comes off, it started walking off the pitch. I can also use this window of opportunity to develop my upper body strength and flexibility, something which is lagging behind my peers and opposition.

On the other hand, the squad depart for Atlanta next Tuesday. Non selected and injured players remain at home to continue training and rehab. I’m not sure the glass will be looking too full as I wave my team-mates and house-mates off to the airport.

Then there is the fear. What if my healing is delayed? What if I can’t get on the pitch as quick as I like? Or, as is often the case, I strain something else that is taking the biomechanical stress from a stiff ankle? What if my fitness has plummeted so much that I am no longer a realistic option for the next tournament? Or worst of all, what if I’ve lost it?

That is without even mentioning the fear of reinjury. Looking back at the video of it happening, I was less than impressed.

Expecting to see something similar to a gruesome ‘youtube’ clip, the actual footage seemed innocuous enough in real time.

Something, worryingly, that could easily happen again.

Another negative aspect of being injured, when part of a team sport, is the isolation you feel away from the squad. You are doing your own gym and rehab programme. It is amazing the camaraderie you miss out on just on the walk to and from the pitch and the dressing room, or during the cool down. To an extent, it has to be this way — when injured, your focus and goals are completely different to those of the squad in general.

Psychologically, my focus has changed from skill acquisition and match preparation to healing and recovery. Back in the gym and allowed to do off feet conditioning, my short term goals are to increase my upper body lifts and develop my boxing repertoire enough to allow me to fight my way out of a tight corner!

Once I can bear some weight through my ankle, this will allow me to increase significantly what I can do in the gym and for conditioning. Once out of cast, I will have a supervised graded return to running and game specific drills.

So a quick check of the calendar, and France at the end of May, if selected, might be a romantic notion for now. More importantly, the Olympic repechage for the final qualification spot at the end of June is well within my grasp.

I am using this period to formally use visualisation as an exercise to improve my game. It is something all players do anyway, subconsciously.

Have you ever lay in bed, thinking about a game, imagining yourself executing a perfect skill? Feeling the surge of endorphins as you run back into position knowing you are in the zone? This is a form of emotional visualisation. I can’t tackle anyone right now, but I can visualise the process involved, the body position and sequence of movements that lead to a well-executed, well-timed and dominant tackle.

This form of deliberate physical visualisation could help accelerate my reintroduction to the game-specific aspects of rugby down the line.

One thing it has made me question, is how one-dimensional I am. We see many athletes forced into early retirement with injury, and at the inevitable press conference the player expresses a concern over the next step.

The life of a sportsperson is awesome, but it is a short, fickle and unforgiving one. Am I developed enough as a person to cope with that inevitable outcome someday?

I don’t know. I’ll keep an eye on the smaller picture for the time being. The bigger picture will reveal itself in time.


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