Psychology of Sports Injury and Rehabilitation

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Ethics in sports

To understand the role ethics plays in sport and competition, it is important to make a distinction
between gamesmanship and sportsmanship.
Gamesmanship is built on the principle that winning is everything. Athletes and coaches are
encouraged to bend the rules wherever possible in order to gain a competitive advantage over an
opponent, and to pay less attention to the safety and welfare of the competition. Some of the key
tenants of gamesmanship are:
● Winning is everything
● It's only cheating if you get caught
● It is the referee's job to catch wrongdoing, and the athletes and coaches have no inherent
responsibility to follow the rules
● The ends always justify the means
Some examples of gamesmanship are:
● Faking a foul or injury
● Attempting to get a head start in a race
● Tampering with equipment, such as corking a baseball bat in order to hit the ball farther
● Covert personal fouls, such as grabbing a player underwater during a water polo match
● Inflicting pain on an opponent with the intention of knocking him or her out of the game,
like the Saint's bounty scandal
● The use of performance-enhancing drugs
● Taunting or intimidating an opponent
● A coach lying about an athlete's grades in order to keep him or her eligible to play
All of these examples place greater emphasis on the outcome of the game than on the manner in
which it is played.
A more ethical approach to athletics is sportsmanship. Under a sportsmanship model, healthy
competition is seen as a means of cultivating personal honor, virtue, and character. It contributes
to a community of respect and trust between competitors and in society. The goal in
sportsmanship is not simply to win, but to pursue victory with honor by giving one's best effort.
Ethics in sport requires four key virtues: fairness, integrity, responsibility, and respect.
Fairness
● All athletes and coaches must follow established rules and guidelines of their respective
sport.
● Teams that seek an unfair competitive advantage over their opponent create an uneven
playing field which violates the integrity of the sport.
● Athletes and coaches are not discriminated against or excluded from participating in a
sport based on their race, gender, or sexual orientation.
● Referees must apply the rules equally to both teams and cannot show bias or personal
interest in the outcome.
Integrity
● Similar to fairness, in that any athlete who seeks to gain an advantage over his or her
opponent by means of a skill that the game itself was not designed to test demonstrates a
lack of personal integrity and violates the integrity of the game. For example, when a
player fakes being injured or fouled in soccer, he or she is not acting in a sportsmanlike
manner because the game of soccer is not designed to measure an athlete's ability to flop.
Faking is a way of intentionally deceiving an official into making a bad call, which only
hurts the credibility of the officiating and ultimately undermines the integrity of the
game.
Responsibility
● To be sportsmanlike requires players and coaches to take responsibility for their
performance, as well as their actions on the field. This includes their emotions.
● Many times athletes and coaches will make excuses as to why they lost the game. The
most popular excuse is to blame the officiating. The honorable thing to do instead is to
focus only on the aspects of the game that you can control, i.e. your performance, and to
question yourself about where you could have done better.
● Responsibility requires that players and coaches be up to date on the rules and regulations
governing their sport.
● Responsibility demands that players and coaches conduct themselves in an honorable
way off the field, as well as on it.
Respect
● All athletes should show respect for teammates, opponents, coaches, and officials.
● All coaches should show respect for their players, opponents, and officials.
● All fans, especially parents, should show respect for other fans, as well as both teams and
officials.
The sportsmanship model is built on the idea that sport both demonstrates and encourages
character development, which then influences the moral character of the broader community.
How we each compete in sports can have an effect on our personal moral and ethical behavior
outside of the competition.
Some argue for a "bracketed morality" within sports. This approach holds that sport and
competition are set apart from real life, and occupy a realm where ethics and moral codes do not
apply. Instead, some argue, sports serves as an outlet for our primal aggression and a selfish need
for recognition and respect gained through the conquering of an opponent. In this view,
aggression and victory are the only virtues. For example, a football player may be described as
mean and nasty on the field, but kind and gentle in everyday life. His violent disposition on the
field is not wrong because when he is playing the game he is part of an amoral reality that is
dictated only by the principle of winning.
An ethical approach to sport rejects this bracketed morality and honors the game and one's
opponent through tough but fair play. This means understanding the rules and their importance in
encouraging respect for your opponent, which pushes you to be your best

Body Image and Eating Disorders in Sport


Eating disorders affect an estimated 13 to 42% of athletes, depending on sport and gender. The
number of reported cases appear to be on the rise as a result of increased public awareness and a
greater willingness of athletes to seek treatment.
The effect of eating disorders on athletes is greater than on non-athletes because of the increased
stress they place on their bodies on a daily basis. Those most vulnerable participate in so-called
"appearance" sports (i.e. gymnastics, swim, figure skating and dance), but eating disorders are
also common in endurance sports (e.g. long-distance running, triathlons, cycling) and sports with
weight classifications (e.g. wrestling). Eating disorders are subject to chronic under-reporting or
are handled in secret, due to the pressures on athletes to perform from coaches and parents (as
well as pressures the athletes place on themselves to achieve high levels of performance).

Many different forms


Eating disorders in athletes can take a variety of different forms, including:
● Restriction of calories or purging behaviors to drop weight or improve performance;
● Binge eating in response to hunger resulting from a high level of physical activity;
● Excessive exercise or vomiting to compensate for any extra calories consumed; and
● Disordered or idiosyncratic eating patterns due to the physical demands athletics place on
their bodies or training schedules.
Less is known about eating disorders among male athletes, since most studies involve female
athletes. One issue males contend with is body dysmorphia, which leads to a preoccupation with
becoming muscular, and a desire to promote size and strength. They may limit the types of foods
eaten to decrease body fat or stimulate weight loss, or increase protein intake or complex carbs to
gain muscle mass. Many males affected with the disorder go unnoticed or untreated, as they
avoid discussing their concerns, and instead attribute it to a desire for success in their sport.
Warning signs
Coaches, teammates and parents should be aware of the traditional physical warning signs of
eating disorders, which if left untreated can have serious health risks, including cardiac failure.
These consist of:
● Menstrual irregularities or amenorrhea
● Fine hair on the body
● Low blood pressure or dizziness
● Swollen or puffy cheeks
● Decreased stamina in performance
● Frequent complaints of feeling cold
● Weight loss
● Fatigue
● Bradycardia or heart arrythmias
● Hair loss
Parents whose children participate in athletics should closely monitor their child for any warning
signs of disordered eating. Consistent communication with the coach can help to ensure that the
child is being appropriately monitored, and creating an open dialogue about any concerns will
also allow the child to be accountable for their actions as they build their talents and strengths. If
you notice that your child is becoming extremely competitive, exhibiting an unhealthy
preoccupation with their ability level or feeling pressure to perform, intervention may be
necessary. Further, consult with your child's physician to ensure that they are medically stable to
perform.

Targeting eating disorders


For parents of children entering college, the NCAA has made a specific effort to target eating
disorders in college athletes, conducting research and screenings. The NCAA has posted a
53-page brochure online dedicated to the female athlete triad (which comprises disordered
eating, amenorrhea and osteoporosis), but unfortunately, there is nothing to specifically address
males at this time. More information on NCAA resources can be found at:
http://www.ncaa.org/health-safety.

Perfect storm
While sports participation itself is not necessarily the cause of an eating disorder, it may, coupled
with any genetic/temperament predisposition to eating disorders, create a convergence of risk
factors for athletes. While the research of these factors are still under investigation, experts agree
that the "perfect storm" of influences often contributes and leads to the perpetuation of
disordered eating among athletes.
● Overtraining and Burnout
● The psychology of athletic injuries
● Psycho-physiological effects of banned substances

The Psychology of Sports Injury and Rehabilitation

Participating in sports teaches athletes important life skills like commitment, discipline, and
time-management. Unfortunately, injuries are also part of competitive play. Injuries can range
from minor scrapes or bruises to career-threatening ligament tears. When an athlete suffers a
serious injury, they might experience a wide range of emotions. A player might respond with
anger directed at themselves or others. Some athletes may feel sad over how the injury will
impact their season. Other players might even experience denial. There are important keys to
managing an athlete’s psychological mindset as they recover from an injury. Understanding this
mindset is important for preparing an athlete for the challenging road ahead to recovery.

1. When Delivering Bad News, Wait for a Response

When athletes first suffer an injury, it is important to first make sure the athlete understands what
their injury is. Injury information is often filled with complex medical terminology that can be
difficult for a child or teenager to understand. When this is combined with an intense emotional
state, the athlete may have difficulty paying attention. To make sure an athlete understands the
injury, explain the injury first and wait for a response from the athlete before continuing. This
ensures the athlete is paying attention. Allow the athlete time to digest the news and release any
emotions that are bottled up.
It is important to support the athlete psychologically on their road to recovery. Remind them that
the injury is not their fault and that a return to play is likely. If the athlete is struggling, try having
them watch sports on TV to help motivate them further to work hard at their rehabilitation.

2. The Mind Often Recovers After the Body

As rehab progresses, it is common for an athlete to be physically ready for competition, but not
psychologically ready. This is often due to a lack of confidence in the surgical repair. Many
athletes become afraid that any stress on the repaired limb will only re-injure it. For example,
athletes with an ACL injury are reluctant to make cuts on the field out of fear of tearing the ACL
again. There are some important points to remember when traversing this gap in recovery.
Reassure the athlete that the surgeon took the utmost care when constructing the repair. Remind
the athlete that he or she worked hard in rehab and the muscles around the injury are strong
enough to withstand competitive play. It is also important to remind the player that any
reluctance regarding the repair will actually increase their risk of injury because it can result in
the athlete moving unnaturally.
3. Mental Visualization Can Help Ready an Athlete For Return to Play

When athletes are getting emotionally and psychologically ready to re-enter the competitive
arena, practicing encouraging imagery is a powerful technique. It is used to remind athletes of
what they need to do once they return to play. Using imagery, athletes can visualize themselves
going through the rehab exercises in their mind. They can also picture themselves performing
different drills, plays, techniques, and strategies to sharpen their skills before returning to play.

If athletes can adequately picture themselves going through important steps in their mind, they
will grow their confidence during rehab and surgical repair. Positive visualization can help any
athlete overcome the fears of re-injury.

4. Modifying Drills Can Keep Skills Sharp

Modifying sport-specific drills or techniques during rehab is another strategy for instilling
confidence in an athlete after an injury. A surgical repair often limits an athlete physically as the
repair is given weeks, or even months, to heal after the surgery. This can make it challenging for
athletes to keep skills sharp for their respective sports. To help keep these skills, modify the drills
in a way that the athlete can perform them, even when immobilized. For example, if a football
player can’t run due to a knee injury, they can practice throwing from a seated or kneeling
position. Basketball players can still shoot from their knees and baseball players can practice
hitting with a soft-toss or even practice grips in their hand.

Giving athletes drills they can perform while recovering will make them more likely to push
themselves and give them the confidence necessary to return to play.

5. All Athletes Should Set Goals During Recovery

Anyone working with an injured player should make sure to set goals. These include goals
related to recovery, return to competition, and goals once competition play has resumed. Write
these goals on a piece of paper or white board and place the goals in an area the athletes can see
while in rehabilitation. Keep athletes from thinking in a negative manner by pushing them to
reach the positive goals listed. Keeping these goals in mind will prevent athletes from focusing
on the physical limitations related to their surgical repair.

Managing an athlete’s psychology after an injury and during rehab is key for a successful
recovery. It is important to remember that although their injury may be healed, their athletic
mindset may still be hurting. Build their confidence while guiding them on the path to a
successful recovery and return to the field.
Psycho-physiological effects of banned substances

Banned or Regulated Performance Enhancing Drugs

● Amphetamines are central nervous system stimulant drugs that increase alertness and
self-confidence, improve concentration, decrease appetite, and create a feeling of
increased energy. Amphetamines such as Benzedrine, Adderall, and Dexedrine have a
high potential for addiction and are on the banned substance list of most, if not all, sports
organizations.
● Anabolic Steroids (anabolic-androgenic steroids), are synthetic versions of the male
hormone testosterone. Non-medical use of anabolic steroids is illegal and banned by most
major sports organizations. Still, some athletes continue to use them illegally in an
attempt to improve sports performance, despite evidence that using them can cause
serious health problems, such as hypertension and heart attack.​The manufactured version
of DHEA (Dehydroepiandrosterone) as well as the designer steroids, Androstenedione
(Andro) and Tetrahydrogestrinone (THG) are all precursors to hormones, such as
testosterone, and work in a similar manner to anabolic-androgenic steroids. These are all
banned substances by nearly all sports organizations.

● Caffeine is a naturally occurring substance that has been used by endurance athletes for
years as a way to stay alert and improve endurance. While generally not harmful, it does
have side effects and is banned (in high doses) by many sports organizations.
● Ephedrine is a substance found in many cold and flu medications. It is also used to treat
low blood pressure that may occur because of other medications and can improve
breathing. Currently, it is illegal to possess large quantities of it in the US. It once was an
ingredient used in diet drugs until it was found to cause headaches, dizziness, heart
irregularities, seizures, and possibly death.

● Erythropoietin (EPO) is a naturally-occurring hormone, produced by the kidneys, that


stimulates the production of red blood cells. This hormone can also be manufactured and
injected. Most recently EPO has been linked to the professional cycling world. Although
EPO is on the banned substance list, some claim cyclists continue to use it to boost
performance.

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