The Road to Recovery: Athletes need emotional and physical support to return from injuries

Junior photojournalism major Nadira Fatah regularly practices exercises in the Athletics Pavilion to help rebuild her strength after a serious athletic injury in 2014. The injury damaged two of her vertebrae and the cartilage surrounding them in her lower back; her exercises include planking, stretching, lat pulldowns and weighted punches. / by Cierra Boess
Junior photojournalism major Nadira Fatah regularly practices exercises in the Athletics Pavilion to help rebuild her strength after a serious athletic injury in 2014. The injury damaged two of her vertebrae and the cartilage surrounding them in her lower back; her exercises include planking, stretching, lat pull downs and weighted punches. / photo by Cierra Boess

by Jose Brambila
photography by Cierra Boess

Part one of a two-part series.

Nadira Fatah 22, a photojournalism major at the University of La Verne, was a volleyball player at her high school in Dubai.

During her senior year of high school – and her last game of the season – she fell on someones knee after spiking the ball over the net. The injury left her paralyzed from the waist down for a month.

Fatah was diagnosed with a pinched nerve and hyperlordosis. The cartilage between two vertebrae continues to be “off,” and a pinched nerve still affects her movement of her left leg. Her neck and back are out of alignment, and right knee compensates for her left knee, which is turned inward – as a result of that fateful game.

Fatah took not being able to play volleyball extremely hard, suffering from depression, she believes, though it was never diagnosed.

“I used to play 5-6 days a week for 4-5 hours a day after and during school. It was a way of life. When I first got injured I thought I’d be back after three or four months,” Fatah said. “When they told me I couldn’t play at all, I went through a rough patch because I saw my body changing and gaining weight because I wasn’t exercising as much as I did when I had volleyball.”

“Although, I wasn’t officially diagnosed with depression, I saw a lot of signs and went through phases of overeating and phases of barely working out and barely eating anything at all.”

Despite going through this and being advised to see a psychologist in Dubai, she opted not to see a psychologist, a decision she now regrets.

“I didn’t go to a psychologist because at the time I believed that I would not have been able to open up at all,” Fatah said. “Now I think seeking psychological help would have definitely helped.”

Being a student athlete can consume every aspect of your life. Athletes put in thousands of hours, often sacrificing social lives, relationships, and the opportunity to be kids.

Their sport can merge with their identity, and they will do whatever it takes to succeed, said Megan Granquist, associate professor of kinesiology at the University of La Verne.

Their training can be punishing – as they subject their bodies to whatever it takes to excel. With this intensity, student athletes can feel lost – or worse – when an injury requires them to pause or end their athletic career, according to a recent study by the Scandinavian Journal of Medicine and Science in Sports.

Joey Stirling, 20, a public relations major at Cal Poly Pomona, was a star pitcher at Colony High School in Ontario – on track to play baseball in college and possibly professionally. But a birth defect that made the left side of his body grow faster than his right, kept him from reaching this dream –which he’d held since he was 4 years old. His slightly longer left leg caused a strain on his lower back and hip, ultimately leading to scoliosis of the spine. His doctor advised him to quit pitching or risk seriously damaging his spine.

At first walking away from baseball was not very hard, Stirling said.

“When you are doing something for your entire life it seems routine and regular. You don’t quite realize how much it means to you,” Stirling said, of the decision he made at age 16.

It felt, at first, like it was just going to be for a few months then he’d be back to the ball game.

When those months turned into a year and he actually wrapped his head around the idea that his retirement from baseball would be permanent, he felt like a piece of him was lost.

Although he did not see a therapist then, he said he wishes he had.

He said he hadn’t realized what his love for the sport meant to him and what baseball did for him.

“You might not realize what you are going through because it (seems like) nothing major in your life,” Stirling said. “You concentrate on people that you care about, like your family and friends, and this doesn’t seem big in the grand scheme of things.”

Today Stirling said he is at peace with how everything happened. It comforts him to know that because the injury had evolved from a birth defect,there is nothing he could have done differently. He has no regrets, and is still grateful for having played, although he wishes his career could have lasted longer.

According the Scandinavian study, “Coping strategies among long-termed injured competitive athletes: A study of 81 men and women in team and individual sports,” published in 2013: “athletes tend to possess special or ‘favorable’ personality attributes that enable them to handle stress better than non-athletes do (and they are better) prepared psychologically to face such sports related difficulties as injuries and disappointments stemming from poor results or from being forced to sit out.”

Granquist, who is also director of athletic training at the University, believes that athletes should routinely have emotional and mental health support with their physical health support structure within the athletic facility. This could eliminate any barriers or stigma associated with athletes needing emotional support, particularly after an injury.

Granquist would like to see athletic training facilities here adopt a similar approach to what they have at the University of North Carolina, Greensboro, where she earned her doctorate in sports psychology.

UNC takes an integrated approach, Granquist said, adding that the school staffs a sports psychologist as part of an athletics integrated team. This makes the athlete feel like he or she is not a special case, or damaged, but rather that psychological treatment and health are integral for athletes.

“What we did (at UNC) is all athletes that had a severe injury or a long-term rehab (program) would meet with me as the sports psychology person because I was part of their integrated team,” Granquist said. “They would meet with their orthopedic surgeon, their athletic trainer, their nutritionist, their massage therapist, and me. They wouldn’t have to keep coming to see me, but I would outline how to supplement their physical rehab with psychological tools and skills that they know work – like stress management, coping, and goal settings.”

On campus Granquist teaches a course on the psychology of sports injury in which she educates future athletic trainers in how to integrate their skills. She teaches them how to identify red flags for somebody that needs additional support. She says if the emotional effects following a sports injury are interfering with an athlete’s daily function, then the athlete should seek mental health services.

“It is not the big red flags of suicide adulation, and things of that sort … It is probably (just something) interfering with their rehab, in their sport, with their school and daily life in other domains,” Granquist said. “When we think about what are daily functions … Well they have to get up and get out of bed, they have to go to school or work, they have to eat, they have to sleep, they have to have different social relationships and interactions, they have to go to practice.”

Granquist said that athletic trainers or coaches should not approach athletes like something is wrong with them. Instead they should try to identify depression or anxiety to help with their daily function. That way they can approach it as a “performance perceptive” which she said means something that helps you in your performance.

“With athletes when we approach it (like) something’s wrong with you, (that’s) detrimental,” she said. “They have the perfect nutrition… that perfect training, they are tracking their heart rate and all sorts of physiological functions,” Granquist said.

She said that athletes are always looking to be the best version of themselves to have the best performance, addressing any mental or emotional health issues should be an extension of their self care, and part of their training regimen.

“Just as you would see a nutritionist or dietician … to optimize your nutrition,” she said, “seeing a sports psychology consultant or mental health professional can optimize that part.”

Granquist said as a result of already having a relationship with the sports psychologist, when the more clinical mental health issues come up the athletes are already comfortable with the sports psychologist, and when more serious issues come up, they are easier to diagnose.

The Scandinavian Journal study backs up Granquist’s assertion. The study finds that few athletes prepare themselves psychologically for a possible injury, and it suggests that mental health support is critical during the rehabilitation process, because “these athletes just had their worlds turned upside down they need all the help coping they can get.”

Fernando Mendoza, 20, a car salesman in Ontario and a former soccer player for Arsenal of the United States Developmental Academy and Colony High School in Ontario, suffered an ACL tear in a practice scrimmage at age 17 during his junior year of high school. A player was shielding the ball and Mendoza tried to get over his foot, but when he took a step his knee gave out and twisted.

Fortunately, Mendoza has fully recovered from his injury and is feeling better than ever, but he feels like his recovery process could have been handled better. He said his doctors did not give him enough moral support. He was offered physical therapy, but no mental health support.

“A lot of negative thoughts that begin to creep in your head and negative things are being said about you because you are injured,” he said. “Sports are 80 percent mental and 20 percent physical,” Mendoza said.

Jose Brambila can be reached at jose.brambila@laverne.edu or on Twitter @jozy_brambila7.

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