Corporate Fitness and Active Aging

The Psychological Approach to Overcoming Injury

GettyImages-2182813644Experiencing an injury of any kind can be an immense setback. You went too fast too soon with your program? Had incorrect form that led to the worst possible outcome? Experienced a slight misstep on your run…whatever the cause, experiencing an injury is something up to 40% of active adults will face each year. This leads to physical disruption in your training plans, but sometimes what lingers even longer than the physical is the mental block that occurs—the perceived wall that prevents you from truly getting back on track. When we experience an injury, a physical therapist or knowledgeable trainer often prescribes a program that maps out physical actions you can take to get back to health.

What isn’t often given is a mental map that will aid you in your return—to guide you when you are afraid to do certain movements that you believe will cause your injury to recur, or how to feel motivated when you are back to square one after putting so much effort into getting to where you were. After reading this blog, you will be equipped with an understanding of certain psychological barriers you may encounter through injury rehabilitation, gain knowledge of how to overcome those barriers, and be provided with practical applications in the form of a workbook to sharpen your mental skills.

Known Psychological Barriers

To start, we must discuss what barriers people often face when trying to overcome an injury. The first is one most of us can relate to who has experienced a serious injury—the fear of re-injury. This can be a very real, plausible feeling. As you start your journey to recover, this is something you should keep in mind while going through your physical therapy program. This feeling becomes faulty when the reality of injury recurrence is minimal and we are not progressing with our program. What starts off as a natural feeling that aids in protection and is a wise, modest approach to rebuilding becomes erroneous when your body is capable and you have not adapted your mindset to reality.

This seed that is planted in your mind can become deeply rooted if it is not challenged.

Have you ever accidentally burned yourself on the stove? Maybe as a child, you reached across and felt the stinging heat cut through your skin barrier. Usually, it takes just one time for us to learn not to touch a hot burner. We call this “pain memory.” Our nervous system stores and recalls painful experiences, serving as a protective layer for our body and mind. Our mind can act in the same way when we suffer an injury. It tries to protect us from experiencing the same injury again. Once again, this becomes maladaptive when we are not in jeopardy of injury, but we avoid and dismiss exercise, thus preventing us from progressing or maintaining a healthy training program. Mental blocks, or the inability to continue with a task due to (conscious or unconscious) stress, anxiety, or emotional tension, can be a result of pain memory. This can cause you to feel stuck, confused, frustrated, and irritable—especially when it stems from an unconscious standpoint.

The Mental Comeback Plan

Maintenance
One of the most important shifts during injury recovery is understanding what progress looks like. Unfortunately, many fall into believing that if they cannot train at full capacity (or where they were before their injury), they have lost all their progress. This mindset can lead to frustration, disengagement, and even a complete halt in activity. Rather than getting caught up in what you currently can’t do, shift your focus to “what can I maintain or adapt?” or “what can I still do?” Whether it is training another area of the body, shifting more toward mobility, modifying what type of conditioning you can do, or prioritizing active recovery, these are all ways to continue to progress. The ability to maintain a routine, even while having to adapt a bit, allows your body and mind to preserve your physical qualities as well as your identity as a consistent and committed exerciser.

"I'm here… I'll make some tweaks, some changes, but I'm still coming."
– Kobe Bryant

Positive Self-Talk and the Power of Affirmations
Utilizing short, deliberate statements that reinforce positive beliefs about your body and recovery can aid in counteracting negative thought patterns and ultimately increase resilience. While affirmations alone do not drive recovery, they serve as a useful accompaniment to other psychological tools and training.

Imagery
Imagery is a powerful tool that has been proven (when practiced consistently) to reduce anxiety, accelerate healing, and aid in reducing fear associated with re-injury. By visualizing yourself successfully completing movements or returning to activity, you can reinforce neural pathways associated with those actions. Utilizing imagery to reduce anxiety surrounding exercise or certain movements allows your mind to rehearse the movements before physically engaging in them. This promotes a greater sense of internal control. The more familiar something feels in your mind, the less daunting it becomes when you go to perform the movement or exercise.

Goal Setting
Long-term goals (outcome goals) can feel bleak or distant after suffering a setback in the form of an injury. This is why having a plan ahead of time that considers setbacks is essential, but if you did not plan, this is your time to break your larger, big-picture goals into smaller, process-oriented goals. Instead of focusing on getting back to where you were, think about the daily actions you need to take that lead to weekly accomplishments—maybe that is completing your rehabilitation exercises, showing up to the gym consistently, or steadily measuring and improving your range of motion.

Shorter-term SMART goals allow you to have a sense of direction on your journey to full recovery. Without a map or plan, it is easy to get lost in all that your mind can throw at you. Having a tangible plan allows you to see past your inner doubts and helps bridge the gap between where you may currently be and where you plan to be. Lastly, it is completely okay to shift your outcome goals at any time. What you may have planned before may not match your current state, so give yourself grace and allow yourself to adapt and adjust.

Maintaining a Social Support System
If you are an avid social group exerciser or have a typical group of people you see and converse with at the gym, having an injury can result in something that goes beyond the physical and mental aspects of health. Your emotional health may suffer if you are unable to be around others you were once so used to seeing each week. Though you may be unable to participate as before, it is vital to maintain connections, as social support and accountability go a long way in aiding recovery. Social support allows for a sense of accountability, encouragement, and the feeling that you are not alone in your journey, even if it means you may not be a part of your social network in the same capacity.

Recovery is a journey, and it should never be navigated alone.

Regaining Confidence
Confidence can be one of the first areas that suffers after an injury and can be the last to return. Though you may reach a point where your body is capable, your mind can still hesitate. This is when intentional, small steps become so important. Begin with movements that feel very controlled and safe. As you get back into your lifting routine, start with successful repetitions with proper form rather than high intensity or volume. Confidence blossoms when you can gather momentum. Each successful experience builds into the belief system that movement is not dangerous. Over time, confidence will grow, and your perception will begin to mirror reality.

Practical Application
When you truly think about it, injury has a way of forcing you to slow down, reflect, and rebuild. This can be a challenge physically and mentally, and while it may feel like a setback in the moment, sometimes it can actually be an opportunity to develop a better training style, deeper awareness of your mind and body, and a more intentional routine. This workbook is designed to guide you through the psychological barriers discussed in this blog and aid you in adapting your routine while developing mental skills to assist you throughout your recovery journey.

 Click HERE to access the workbook!

Topics: employee health and wellness rehab recovery

The Senior Fitness Center – Physical Therapy Relationship

If you are a fitness professional working with seniors, you’d better have a good relationship with your physical therapy department. According to the Centers for Disease Control and Prevention, one in three seniors over age 65 falls each year, with 20 to 30% of those falls resulting in severe injury.

After a severe fall the senior may need rehab, but there are times when they do not want to go. The three reasons I hear most often about why they’re not going to therapy are

  • “I’m not going to therapy because I can’t afford it.”
  • “I’m not going because I don’t have time.”
  • “I’m not going because you can do it.”
I feel we, as fitness professionals, should have a positive relationship with the therapy department, and we should have a basic understanding of physical therapy protocols, such as Medicare limits. Knowing this basic information may help change the mind of a person who is trying to avoid therapy for one reason or another. When fitness staff and therapy work well together, the client/patient always wins, and that’s our ultimate goal.

The next time you hear one of the aforementioned reasons for not going to therapy, here is some information you can provide that they may not have known.

“I’m not going because I can’t afford it.”

Physical therapy, speech therapy, and occupational therapy are covered under Original Medicare; the therapy caps for 2015 are $1,940. If this is the option they would like to go with, Medicare part B will pay 80% of the services and require them to pay 20%. Their cap resets after each calendar year, something many seniors don’t realize, so they may be fearful that they will have to pay 100% of the costs when in fact that isn’t true.

If the person has Medicare Advantage plan or any other detailed questions, I would suggest sending them to this section of the Medicare website, or to the therapy department. After all, we are laypersons in the field of Medicare, but our primary goal is to help them, so having this small amount of information along with other resources they can use may be enough to get them on the path to therapy.

“I’m not going because I don’t have time.”

When I hear this, I often follow it with one of my favorite fitness quotes from Edward Stanley:

“Those who think they have not time for bodily exercise will sooner or later have to find time for illness.”

We make time for the things in our lives that we view as most important. All we can do as fitness professionals is stress how important their body is; it’s their choice to agree and make the time to take care of it.

“I’m not going because you can do it.”

This might be the reason I hear most often. It is definitely flattering to hear the faith they place in your abilities, but we are not therapists and we must not overstep the scope of our training. Some people are really resistant to change, and their comfort level with you may be the reason they ask you to perform their therapy. I have found that if you show faith in therapy, and can suggest a therapist who you know is liked and gets positive results, it goes a long way in getting the person to consider therapy.

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Neither department is more important than the other, but both are necessary for a successful and lasting recovery. The best fitness-therapy relationships are symbiotic, with both sides helping one another and referring clients. For more on strengthening this relationship, get this Quick Read.

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Topics: active aging physical therapy senior fitness injury rehab