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;

Story

Mental health in injured athletes: Elle's story

by Elle Finch

Stories/769 , Issues/Mental Health

28th Jul 2020

Elle was a dedicated runner and AFL player before the high abruptly came to a halt after serious injury.

Injury is a risk we all take when we participate in sport. Whether you’re a professional or an amateur, no one is immune. These injuries take many different forms, from impact (in contact sports such as football) to overuse injuries (incurred as a result of repetitive motions). The emotional journey that any sports participant experiences during a season cover a broad spectrum, from frustration and disappointment to excitement. However, the sense of solidarity, friendship, and even elation inherent in team sports usually overshadows any potential injury concerns.

There is no shortage of research that indicates physical activity has a strong and positive influence on general mental wellbeing, with benefits ranging from reduced stress and anxiety to increased self-esteem. I can relate - I have suffered from anxiety for most of my life, and have found running a necessary coping mechanism and form of escape. However, although long-distance running strengthened both my physical and mental endurance, I was not immune to the feelings of isolation that such an individualistic sport (if you’re not involved in a running community) can have. With AFL (Australian Football League) having one of the highest average distances covered per game, coupled with increasing female participation and representation in the sport, I was naturally drawn to this growing community and joined a team in January 2019.

As the season progressed, I found that I became known as the runner amongst my team. I was placed on the wing during a game (a position that requires a lot of running) and even clocked up 12kms before a game. I was riding a high and found myself increasingly comfortable identifying myself as a runner - a concept that initially didn’t sit well with me as I'd never competed in running events as an adult.

This high came to a sudden halt when I became one of the statistics of Australia’s most dangerous sport – AFL. A report by the Australian Institute of Health and Welfare (2014) indicates that injuries sustained from AFL accounted for 9% of sport-related hospitalisation in 2011-2012.

It occurred when I rolled my ankle as I was running towards a tackle. Whilst I experienced significant immediate pain and was carried off the field, after the initial shock, I was able to bear weight. Following a thorough strapping by the team’s physiotherapist, I returned to the field and played the entire second half (a total of 36 minutes of intense activity). It was the following morning when I woke up that I noticed that my ankle was twice it’s normal size, and significantly bruised, so I sought medical treatment.

I was relieved (and somewhat embarrassed) when the doctor sent me home with an ‘Ankle Sprain Information’ pamphlet and told me to follow the exercises on the back page. That feeling proved short-lived when, two days later, the doctor called stating that she had a specialist look at the x-rays and I had two fractures. My heart sank. An MRI revealed ‘intermediate degree’ tears to two ligaments and two ‘avulsion fractures.’

As it turns out, AFL has the highest population-based rate of injury hospitalisation. The most common injuries are fractures and soft tissue injuries, and the most commonly affected body regions are the knee and lower leg. My injury was a textbook case.

With a moon-boot, crutches, and very low mobility, I found myself battling elevated feelings of anxiety, frustration, and isolation, exacerbated by a break of routine, postseason isolation (i injured myself in the final game), an inability to run and uncertainty of rehab timeframes and financial impacts. The long-term impact seemed to be on my self-identity and sense of self-worth. Consequently, I found myself researching and reading about other athlete’s experiences, and realised that my psychological and emotional response to injury was rather normal.

Although athletes (and I use that term to refer to anyone who participates in sport) differ in their response to injury, an article in the British Journal of Sports Medicine (Putukian, 2016) indicates that the most common responses to injury are sadness, isolation, irritation, lack of motivation, anger, frustration, sleep disturbance, and disengagement. Whilst these emotional reactions to injuries are normal, it is important to note that they can be problematic if they do not subside as the injury heals, if the severity of the emotional response is disproportionate to the injury or if they worsen over time. An example of a problematic reaction would be an athlete significantly restricting their energy intake because they are temporarily unable to train, or sadness transforming into longer-term depression.

In addition to these responses, it is important to note that athletes are also less likely to seek help for mental health issues than non-athletes, therefore exposing them to a greater risk of long-term psychological issues and increasing barriers to seeking self-care. This is primarily related to being accustomed to persevering through pain and subsequently not wanting to appear weak.

Based on academic research and my own personal experience, the importance of reaching out to injured teammates, not only to check-in on them but to continue to include them in events, can’t be underestimated. I was elated when teammates offered to pick me up en route to a GWS Giants game, and am still touched when people ask how my ankle is going. It is gestures such as these that make me feel truly part of a sports community.

Following my injury, I am now more determined than ever before. I have decided to take a break from playing AFL in 2020, although I am still able to participate in training sessions and volunteer on game days. I am instead focusing on running, and have joined a running community, converting my prior individualistic mentality into a social event. As part of a running community, I am covering distances that would not be possible had I continued to train by myself. I have pushed my physical and mental boundaries and challenged myself like never before. I completed my first ultra-marathon on 18 July 2020 through NSW Royal National Park (Bundeena to Oatley, and back again), a whopping 54(ish) kilometres (depending on your brand of sports watch), and am now training for a 90 kilometre Ultra along the 6 Foot Track (Katoomba to Jenolan Caves, and back again). I am actively seeking opportunities to prove myself as a runner, and as someone who is able to fight back after an injury and better myself. It hasn’t been easy, but life always throws curveballs (as 2020 is demonstrating), and it’s these curveballs that really make you appreciate the highs when they happen.

I encourage any athlete that experiences injury to remain connected to your teammates. It is through these connections that you will continue to be part of a larger community, and leverage this solidarity to come back stronger than ever.

From left to right: the day I was fitted with a moon-boot, post-54 km run, exploring Sydney trails with a small group of AFL friends. — Pictured: The day Elle was fitted with her moon-boot.

References

Australian Institute of Health and Welfare (2014), Australian sports injury hospitalisations 2011-2012, Media Release, Flinders University, accessed online: https://www.aihw.gov.au/getmedia/5079eecc-944d-4c7e-8e4f-04f03dbd7c97/18053.pdf.aspx?inline=true

Putukian, M. (2016), The psychological response to injury in student athletes: a narrative review with a focus on mental health, British Journal of Sports Medicine, 50(3), pg. 1

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