Should We Fear Injuries?
Written by Nicholas Hedges DC MS CCSP
Injuries can be debilitating and often inevitable in the context of high level performance in sport, but should we fear them, and would more fear benefit us by cutting our risk?
The short answer is no, we should not fear injuries. Instead we should prepare for our performances, and in doing so we reduce our risks of being injured.
Take the navy seals, marines, army etc.. These brave men and women risk their lives by going into full on combat and very frightening situations. However, they are able to perform tasks and carry out orders under extreme pressure due to the significant lengths they go through to prepare for their missions. Indeed their training reduces their fear on the battlefield. Not only does training make them more effective, but it also reduces risk of being wounded or killed. Lucky for us, our situations usually are not as dire as those on the front lines. Instead we are simply trying to maximize our performances, or our training, while reducing our risks of injury.
The best way in which we can accomplish this is through preparation and training. If we look at some of the predictors of injury i.e. previous injury, inadequate energy consumption, too much training overload, then we can see some of the areas that are of interest if we are trying to prepare our bodies to train appropriately. For instance, if I am a runner that recently had a bone stress injury (stress fracture), then in order to prep my body the best way possible myself and my coach would need to lay out a plan of action to properly stress by bones so that they can adapt and become stronger than ever (hint it's not just through running). Instead of being consumed by fear of load, we would actually do strength training, and hopping exercises to maximize bone stimulus and then strength.
If we let fear of injury alter our behavior too much, then we risk not only avoiding the stimulus we need to get stronger such as the running example, and we also risk the pitfalls of what clinical research calls fear avoidance behaviors. Fear avoidance behaviors develop usually after and injury due our brain and bodies reaction to pain and maybe tissue damage. It has been well documented through MRI studies of the brain that injuries are not only the result of tissue damage, but also include emotional responses as well. These emotional responses are present in order to safeguard ourselves from damaging activities during times of healing, but sometimes these safeguards outlast our welcome. In the clinical population this manifests as chronic pain. In the injured athlete population, this manifests as never returning to previous levels of play, or in not taking rehabilitation seriously enough to optimally return to play. We know that the re-tear rate in female athletes is 10% in women that do not return to sport and 20% in those that do(Petushek et al. 2019), but underneath that quantified (numerical) data we also have unspoken qualitative date. This data is rarely extracted but has largely to do with the quality of rehabilitation. There are many factors that can affect the quality of rehabilitation ranging from the quality of care given, to the motivation and discipline of the athlete, costs of care etc.. Instead of placing energy into the fear and anxiety around injury or recurrent injury, we should instead place our energies into the qualitative factors and habits that will reduce our risks of injury the most.
In the words of Franklin D. Roosevelt “the only thing to fear is fear itself.” This is the same ethos we inspire to create among professional, youth and weekend warriors alike. FDR gave that speech in his 1933 inaugural address, during the height of the great depression. He characterized fear as “nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance.” But FDR insisted that instead of retreating, we advance into the unknown and new ways of thinking about the problems that the American people faced at that time. In the same way we hope to instill knowledge of principles, and information that gives athletes, coaches and providers tools to boldly pursue excellence, with less fear of the unknown.
This is the true essence of what we are trying to accomplish at Art of Prevention. Our aim is not to be fear mongers trying to drive you away from doing hard things or returning to sport. Our aim is to free you to have your best performances without fear of injury.
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