The Link Between Injuries and Depression

When an athlete suffers an injury, many only think of the physical toll it takes on their body. However, it is often forgotten that injuries also have an affect mentally.

One of the most essential things to understand about an injured athlete is that they have several emotional responses to realizing they will not be able to play for however long the duration is. These responses are normal and should not be judged because it is very frustrating to watch teammates play while sitting on the bench unable to participate. They usually begin when they first hear that they will be missing time from their respective sport.

The most common of those emotional responses is sadness. Whether the athlete is playing professionally or just for fun, it is never a good feeling to be injured. They feel left out and possibly ostracized because they cannot take part in the team’s games and the emotions flowing through. That brings me to another response, isolation.

An injured athlete can feel like no one understands what they are going through and therefore makes it hard to connect or communicate with them. Another side affect of injury response is frustration; however, that can take some time to realize. It usually comes to fruition during a long-term injury because athletes are not able to do what they want. The feeling may take a while to appear because the tension has to build up enough for it to explode into the frustration. While anyone, not just athletes, can get frustrated, it is best to stay calm and to try to understand why they are feeling this way instead of overreacting because this is not their real self. They have lost an outlet of their stress and irritation, so unfortunately sometimes the caretakers receive the anger and mood swings.

A prominent response includes lack of motivation. It is hard for an athlete to stay motivated when they cannot see the fruits of their labor. For example, one does not get the same thrill and feeling of satisfaction from adding repetitions on their physical therapy workouts compared to say scoring more goals or points or increasing a batting average. Therefore, an injured athlete may suffer from lack of motivation because the challenge is not what they are accustomed to. They have to change their mindset from “I want to improve in my sport” to “I want to return to my previous level of play”, which is not an easy task.

Westmont College senior outfielder Justin McPhail hurt his arm when he was only 12 years old. Back then, playing and pitching on three teams he believes he was overworked. He had been having pain for quite a while before he eventually was checked out. McPhail fell victim to the theory of “normal pain”, but normal pain does not last for months.

He explained, “Before I was diagnosed, I was told to play through it; that the pain was normal.”

He heard that from coaches and other people he asked, but they were all wrong. Luckily, it was not that serious of an injury. He ended up being diagnosed with biceps tendonitis, which requires a period of non-activity for the arm, so he needed to take a break from the game for about a month and a half. For a 12-year old, that is a long time to wait and it had him feeling down.

“I was depressed that I could not pitch because I felt whenever I was on the mound that we would win,” he said.

McPhail wanted to help his teammates win and he could not do that for the time he was injured. Something he struggled with while coming back was trusting his arm again. He explained, “It felt great to be back pitching, but I was cautious as I did not want my injury to flare up again. I did not like that my innings were limited and having the idea in your head that you were injured plays with your self-confidence. It took some time for me to trust that my arm was 100%.”

That is another struggle athletes face upon their return. Trusting that the rehabilitation process worked and that they can return to play as they were. Although not for McPhail, this can prolong the injury depression because the athlete is afraid to re-injure their body.

A lesser known emotional response to injury is a health side effect that many people do not look for or anticipate. An athlete’s appetite can change dramatically while they are not able to play their sport. If this happens, it is a red flag for a possible eating disorder forming, which is not something to take lightly because it can continue even after the rehabilitation into the sport is complete. In most cases of eating disorders forming from injury, the athlete will restrict their caloric intake due to lack of exercise. They believe that they should not eat as much because they are not able to burn the same amount of calories, which is a sound rationale.

However, some take it to the extreme level causing an eating disorder. Those athletes have a mindset of if they are not doing strenuous activity, they do not deserve to eat. They are also afraid of losing muscle that they had worked very hard for already and gaining weight that they worked hard to lose and maintain. If an injured athlete develops an eating disorder, they are extremely likely to have depression as well because as it progresses, the more likely it is to develop self-hatred for the bad eating habits.
A not-so-fun fact of injury depression is that it can actually hinder the athlete’s recovery. It works like the recovery of any bodily harm, akin to a cancer-patient with a positive attitude has a better chance of beating the disease. Depression also can be related to performance failure. When someone is depressed, they do not see themselves in a positive light. In sports, the athletes needs to have confidence in themselves in order to play well. When a player suffers from depression, it will tend to show in their performance.

An athlete’s world revolves around the sport(s) that they play. When an uncontrollable circumstance like an injury takes that aspect of their life away, it is very hard to accept or get used to. They can head into a downward spiral because they do not know what to do with their time. Many athletes take this in stride and make their own motivation to rehabilitate themselves as hard and fast as they can, but not everyone takes injury this well. With the decrease in quality of life, especially due to long-term injuries like torn ligaments or permanent disabilities, there is an increased risk of depression.

Unfortunately, Seton Hall University pitcher Andrew Politi had to go through the long, arduous road to recovery. He hurt his right arm from pitching and went to get an MRI. This told him the thing every pitcher dreads hearing, he had structural damage in the ulnar collateral ligament (UCL). This is what causes players to undergo the infamous Tommy John surgery, however in recent years a new treatment option has emerged.

Politi decided to undergo platelet rich plasma treatments; which has becoming more popular among major league ballplayers since Yankees starter Masahiro Tanaka has had success since he underwent the treatment. He recalled that he was upset when he had to forego and redshirt his freshman year (2014-2015) in order to heal. There was some relief, however, knowing that he did not need to have Tommy John surgery.

“Having to be sidelined was very frustrating for me,” Politi said. “Having to put in all that work only to not have the ability to play was very hard for me…watching my teammates play and travel every week was difficult.”

These are the aforementioned normal feelings of an injured athlete. It is hard to watch the team play while stuck on the bench, unable to help or play the game they love. Politi also had the best outlook possible on his injury: “I was a little depressed, but I just tried to stay positive each day,” he said. “I knew the more focused I stayed, the better I will be when I return.”

That has to be the athlete’s attitude on their injury or else it could get the better of them. Politi’s case is also an example of how the depression is usually temporary until the return to play. “It felt great when I returned sophomore year,” he said. “Being away from the sport I loved made me appreciate the game and all the hard work that goes into it much more.”

When someone is going through a pain and loss like this, it is important to help them. It may not be something they can deal with on their own and they need to know that there are people who understand and care about them. Many athletes would not want to seek treatment, partially because this topic is not stressed enough or even talked about.

In some cases, when an athlete can no longer play due to deteriorating performance or injury, they go through a “loss.” It is as if they have lost a loved family member. The sport is part of them and their identity, as I mentioned before. It is as if someone has died because they have not created an identity separate from their sport.

Using an example of a professional baseball player, one would start as a kid playing tee ball between the ages of 4-6. After some progression, then they progress onto the Little League Baseball or Cal Ripken Baseball system until they are 13. After they turn 13, they start playing 50/70 length to prepare them for the distances of the regular lengths of baseball, which is 60/90. Then comes middle school baseball, when their bodies are developing and they are finding out just how good they are. That is when most start to seriously dream about becoming a professional player. High school baseball is when the best players really emerge and start looking to play in college.

Some players like Los Angeles Angels center fielder Mike Trout get drafted out of high school. Washington Nationals right fielder Bryce Harper dropped out of high school to attend Junior College just to speed up his process in order to be drafted as soon as possible. Many players go to college first before being drafted, however.

After college, they go into baseball’s extensive Minor League system in which there are several teams to work one’s way up to the Major League team. Therefore, the point to illustrate is that the athlete has gone through every stage of their life playing baseball. While their mind was growing and their body was forming, baseball was there. While their body was deteriorating, baseball was there. Once an athlete can no longer do something that has been there their whole lives, it takes a meaningful thing out of their life and creates a deep void. Many people go through therapy dealing with the loss of a loved one, so it is not farfetched at all to go to a sports psychologist to discuss how to deal with not being able to play a sport again.

There is a strong link between injuries and depression and it is important to know how to handle someone who is depressed. An injured player needs to be watched closely, especially when they have a concussion because that injury comes with an increased risk. Athletes may seem like they are larger than life and have it all, but it can all come crashing down in an instant with a devastating injury. At that time, no matter how much money or fame they have, they need support.