Join Now | 
HomeAboutContact UsPrivacy & SecurityAdvertise
Soccer America DailySoccer World DailySpecial EditionAround The NetSoccer Business InsiderCollege Soccer ReporterYouth Soccer ReporterSoccer on TVSoccer America Classifieds
Paul Gardner: SoccerTalkSoccer America ConfidentialYouth Soccer InsiderWorld Cup Watch
RSS FeedsArchivesManage SubscriptionsSubscribe
Order Current IssueSubscribeManage My SubscriptionRenew My SubscriptionGift Subscription
My AccountJoin Now
Tournament CalendarCamps & AcademiesSoccer GlossaryClassifieds
Injury Recovery: Listen to the 'Voice In The Back Of Your Head'
by Dev Mishra, September 29th, 2013 10:24PM

MOST READ
TAGS:  youth boys, youth girls

MOST COMMENTED

By Dev K. Mishra, M.D.

If you've had any kind of significant injury that's caused you to miss playing time you probably know that you need to be healed from your injury and then you need to regain fitness for your sport before you can successfully get back to your game.

But there’s a very important third component in determining readiness for return to your sport: Are you psychologically ready to play?

Psychology doesn’t matter much for minor injuries like a finger fracture but psychology plays a big role in return from major injuries like ACL tear, shoulder dislocation, or concussion.

When I counsel young athletes about a major injury, such as recovery after ACL reconstruction, I will typically tell them that it will take several months, maybe even a year before they are really ready to return to competitive sports. At that point I usually hear “but Dr. So-And-So told me I’d be ready in six months. …” Maybe, but not likely.

Let’s look specifically at ACL reconstruction. From the surgeon’s standpoint we like to see that the knee has fully recovered from surgery through observations such as no swelling, normal motion, normal strength, and stability on testing the ACL. From the physical therapist and athletic trainer’s standpoint we like to see that speed, agility, power and sport-specific movements have fully returned with no discomfort for the athlete.

In spite of those components, many athletes have still not returned to their pre-injury level of competition by a year after surgery and the cause is often what I call “the voice in the back of your head.” In other words, there is a lack of confidence, fear of reinjury, or simply not feeling ready. These are psychological aspects that are not easy for us to measure but are easily experienced by the athlete who had the surgery.

In an article published earlier this year in the American Journal of Sports Medicine researchers from Melbourne, Australia studied the psychological factors responsible for return to pre-injury sports level after ACL reconstruction. Among the findings from this paper are these:

* At one year after surgery only 31% of the athletes had returned to their pre-injury level of sport participation, in spite of being “healed” from surgery

* Several factors were identified as possible negative predictors of return to sport including psychological readiness, fear of reinjury, mood, etc.

* Most interestingly, the study suggested that an athlete’s perception of return to sport before their surgery influenced their actual return to sport after surgery.

Young athletes have a very wide range of psychological maturity so there will of course be a wide range of responses to injury. But the take-home message is pretty clear: after major injury, listen for the voice in the back of your head. If it’s yelling at you “don’t play”, you’d be wise to listen. And if you’re cleared by your doctor and physical therapist with a confident feeling about your recovery, then it’s go time.



(Dr. Dev K. Mishra is the creator of the SidelineSportsDoc.com injury management program for coaches. He is an orthopedic surgeon in private practice in Burlingame, Calif. He is a member of the team physician pool with the U.S. Soccer Federation and has served as team physician at the University of California, Berkeley. This article first appeared on SidelineSportsDoc.com.)


1 comment
  1. andrew yaletsko
    commented on: October 8, 2013 at 9:58 a.m.
    Excellent article. My 9 yr old daughter fractured her hip playing soxcer, high level league if there can be for 9 yr olds. She recovered fully but still 7 months later, she is still afraid of that hard challenge on the ball. With the patience and help of her coach and trainer I can see she is getting back to her normal level of play. I just didn't realize how the injury really affected her.


Sign in to leave a comment. Don't have an account? Join Now




AUTHORS

ARCHIVES
FOLLOW SOCCERAMERICA

Recent Youth Soccer Insider
Small-Sided Games: A Key to More Technical Players    
"It was the same every single day. There was no tactical work, none whatsoever. All the ...
Qatar clash recalls USA's first U-20 World Cup     
With the countdown to the kickoff of the 2015 U-20 World Cup down to 38 days, ...
The Skin Cancer Dilemma for Refs     
I started refereeing in 1978 so I have been officiating for 37 years. The only regret ...
Tab Ramos eyes additions for U-20 World Cup roster    
Coach Tab Ramos has a month to finalize his roster for the U-20 World Cup that ...
Hazing horrors -- and how to prevent them     
Last year, the University of New Mexico women's team made national news for hazing that resulted ...
Alex Morgan's Advice to Parents: Be Supportive, Respect Boundaries    
Ask her coaches past or present to describe Alex Morgan's attributes and the answers are always ...
George Weah's son progresses in U.S. national team program     
Timothy Weah, the son of former Liberian great George Weah, the 1995 World Player of the ...
U-20s aim to spawn another Alex Morgan     
The Alex Morgan we'll see at this summer's Women's World Cup got her national team break ...
How Refs Make the Whistle Work For Them     
Soccer referees carry their whistles in their hands, not in their mouths. In raising the whistle ...
Coaches can decrease ACL injury rate (Dr. Bert Mandelbaum Q&A)    
Dr. Bert Mandelbaum, a U.S. Soccer Federation team physician for more than two decades, has been ...
>> Youth Soccer Insider Archives