By Dhrumil Shah, LEAD fellow and VIP Guest Blogger
In my experiences working with rehabilitation patients who were athletes in their younger years, I sometimes learned of the unaddressed sports traumas that were associated with their injuries later in life. A knee replacement was not always a result of years of physical inactivity, but a byproduct of overworking their minds and bodies in their youth, especially without proper rest and rehabilitation. Approximately 50% of all injuries seen in pediatric sports medicine are related to overuse and overtraining.¹ Overtraining and athlete burnout are also strongly correlated to mood disorders like anxiety and depression, and are likely to be correlated with other psychological disorders such as substance misuse, anorexia/bulimia and more.² The patients’ mental and physical wellbeing were not separate, and we approached their treatments accordingly. When athletes begin to “push through the pain” and experience chronic mental health challenges as a result of their training, the consequential damage can be far lasting into retirement.
In 2016, The National Collegiate Athletic Association’sAssociation’s (NCAA) Sport Science Institute released guidelines to promote “Mental Health Best Practices: Best Practices for Understanding and Supporting Student-Athlete Mental Wellness,” to provide evidence-based, in-depth resources to help coaches approach mental health challenges and dialogue in their student-athletes. This is a big step in the right direction, and now it’s crucial we do our part in sustaining this culture of fostering community-resilience through vulnerability. Here are three significant reasons for why coaches should discuss mental health with their athletes:
1. Address Performance Stress
Stress is a regular and integral part of sports. Pre-game jitters mean that you want it bad enough, and they are creating energy to help you execute on that vision. But what happens when you have too much stress? Psychological stress to perform and execute is associated with an increased risk of injury and increased time in rehabilitation before returning to sport.³ The primary sources of these challenges include a fear of failure, concerns about others opinions (largely the coach), lack of preparation to perform, and a shift from internal to an external locus of control.³ Understanding these challenges is a foundational step into guiding your athletes in addressing these situations during the pre-game warmups. Approach this by bringing up these topics proactively and create an encouraging atmosphere that will evaluate their performance based on merit and results.
2. Build Community Resilience
Accompanied by the mental health challenges affecting athletes is a comorbidity of athlete burnout. Athlete burnout occurs when an athlete experiences chronic physical exhaustion, a reduced feeling of accomplishment from their performance, and a tendency to give less value to their sport, leading to compromises with engaging in later physical activity.² Since these challenges are strongly correlated to mood disorders and other psychological difficulties, a supportive community culture surrounding mental health can build resilience between teammates and athletic staff. This strengthens bonds between coaches, athletes, and other staff, making it easier to observe any of the following criteria of burnout experienced in athletes. It has also been shown that educating athletes on coping strategies is an effective way to develop resilience. Some of these coping strategies include problem-solving, planning to minimize failure and how to respond to it, seeking social support, and even using imagery and visualization to play out a potentially stressful scenario.
3. Create Healthy Dialogue
A team environment that promotes holistic wellbeing can create a more supportive and engaging environment for athletes to perform better and reduce risk. According to the International Olympic Committee, “Coaching education should emphasize the importance of creating autonomy-supportive, mastery-oriented sporting climates that result in less stress and more intrinsic motivation.5” When coaches open up the dialogue for mental health advocacy, they can enlist greater trust and openness between the player and the athletic staff. An athlete who can feel equipped and supported with the tools and resources to handle their mental health challenges will ultimately perform better and reduce the risk of injury.
Coaches and other athletic training staff must be trained with the knowledge and skills needed to observe warning signs and navigate athletes to the proper professional resources. This proactively addresses mental health challenges before a crisis can occur and may even provide a game plan for staff during a crisis (i.e., panic attacks). Mental health challenges are more than the extreme cases we see in the news or movies. Often, undetected and unaddressed situations may even be occurring in the people who are closest to us. Are you ready to address mental health in your team?
- Dalton, S. E. (1992). Overuse Injuries in Adolescent Athletes. Sports Medicine,13(1), 58-70. doi:10.2165/00007256-199213010-00006
- Hughes, L., & Leavey, G. (2012). Setting the bar: Athletes and vulnerability to mental illness. British Journal of Psychiatry, 200(2), 95-96. doi:10.1192/bjp.bp.111.095976
- L. Hardy, Psychological stress, performance, and injury in sport, British Medical Bulletin, Volume 48, Issue 3, 1992, Pages 615–629.
- Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The Mental Health of Elite Athletes: A Narrative Systematic Review. Sports medicine (Auckland, N.Z.), 46(9), 1333–1353. doi:10.1007/s40279-016-0492-2
- Bergeron MF, Mountjoy M, Armstrong N, et al. International Olympic Committee consensus statement on youth athletic development. British Journal of Sports Medicine 2015;49:843-851.