Fractured: how sporting injury affects psychological states

10/01/2014  -  2.11

Professor Andrew Lane, Professor of Sports and Exercise Psychology

Fractured: how sporting injury affects psychological states

For Theo Walcott, the first sound he heard would have been the savage twist of gristle and the next his own screams of pain. The very moment the 24-year-old striker hit the turf in Arsenal’s recent FA Cup game against Tottenham Hotspur, he must surely have known how serious his injury was.  The hope of performing on the big stage, the excitement in what that brings, the months of training in in the build-up were, he must have acknowledged, all lost in that brief moment in time.

For England supporters, Walcott’s announced absence from the World Cup squad after suffering a cruciate ligament injury was a wincing blow to hopes of success.

But what about the effect on the player himself?

Injuries occur in sport and most athletes have experienced them. The severity of the injury is not only physical but also psychological and the time it takes to come back psychologically can be longer than it is physically. Playing sport makes most people nervous; some people are more nervous than others but it’s a common emotion to experience.

People get nervous because sport is uncertain and you never know how well you will perform until the whistle blows or the gun fires. It’s not just elite athletes who experience emotion but athletes from the full spectrum of age and experience. People also get nervous because playing sport is important; sport offers an easy way to test yourself and set goals whether  this is to run your first marathon, achieve a certain finish time, score a number of goals or take part in the World Cup. People set goals to achieve high standards and invest a part of their self-esteem and often a lot of their time in trying to achieve these goals.

When someone gets injured all of this planning – this sense of hope can be shattered. It’s common for people to experience intense emotions; denial in the first stages as you attempt to disbelieve the evidence that something is wrong; anger as a reaction to what has happened characterised by thoughts such as “Why me?” and “It’s not fair”. After that comes a bargaining process of thinking: “If I do this then maybe it will be fixed really quickly”.

But if the injury is severe then feeling depressed is the dominant emotion as the person begins to come to terms with the loss; usually a loss of opportunity. This is finalised by accepting what has happened and coming up with a plan of what to do. The process of going through an injury can be difficult especially as on getting injured many athletes lose connection with other athletes or team mates, and these people had lots of other functions.

For example team mates can provide support about how well you are playing (“well done”) or a distraction from the activity via joke telling other humorous acts, or a direct source of social support via arranging evenings out. People on the fridges of the group tend to miss out and injured people tend to be on the edge of the group. This is often not deliberate but injured players simply aren’t there at the end of a game or race when an impromptu social is organised or part of the banter between players that emerged on how the team played.

Can people get back to the same level of performance? If the physical injury repairs itself then, yes, they should be able to. However to be able to do so the athlete needs to perform without being crippled by fear of re-injury. Athletes should be concerned by the thought of getting injured and these thoughts and worries act as a reminding to concentrate on what you are doing and not behave in a reckless manner.

The legendary Paul Gascoigne’s tackle in the FA cup semi-final that significantly injured his knee arguably became a turning point in career and the heady heights of his performances in 1990 were not seen again. Other athletes careers that also appear to turn on the consequence of an injury include Michael Owen whose hamstring injuries seem to dampen his confidence to make darting runs. This is speculation of course. An observer cannot read the mind of an individual and so introspect to how you lined up on the start line of a race for first time after suffering a major injury and the sense of fear of being re-injured can serve to thwart maximum efforts and typically it’s those athlete prepared to give their all who succeed.

And so in World Cup year we have players whose injuries could signal worries of missing out on the big stage. Will this bring a sense of caution to their game? But if it does will their game suffer and they risk not being selected? Injury can occur where you least expect it. We looked at emotional profile of athletes performing successfully, performing badly and contrasted these with how they felt when they suffered an injury (see Devonport et al., 2005; at This study showed that many athletes suffer an injury when performing near the top of their game; not surprising as achieving a personal best means doing better than you did before and thus by definition, extending yourself and as a consequence, running the risk of injury.

As it happens, I have more than an academic knowledge of sporting injury.  My own experience came on Sunday, during a five-mile race with the result a broken fifth meta-tarsal, my leg in plaster for four weeks and preparation for the London marathon and the hopes I had of doing a good time smashed in a moment. With 13 weeks to go and after completing a marathon on New Year’s Eve, I was building the basis for a decent performance on April 13. I qualified for London by achieving a certain time in a previous marathon. Was it important for me? Yes; lots of friends are doing it, the weekend planned, and the performing in endurance events is an area I research. Psychologically I will still be coming to terms with the injury and trying to rationalise what has happened and what I can do; and one coping strategy is to work harder at my job.