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Enduring the unseen battle: navigating the mental toll of long-term sports injuries
  1. Nicole Whitehill
  1. Sport Rehabilitation, Queen Margaret University Edinburgh, Musselburgh, UK
  1. Correspondence to Ms Nicole Whitehill, Sport Rehabilitation, Queen Margaret University Edinburgh, Musselburgh, EH21 6UU, UK; nicolewhitehill2001{at}

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Simply put, dealing with long-term injuries is difficult for athletes. It entails spending a significant amount of time on the sidelines, undergoing extensive rehabilitation and dealing with mental health issues that frequently go unnoticed. I have firsthand knowledge of this struggle, having suffered from multiple anterior cruciate ligamnet (ACL) ruptures throughout my football career, beginning at the age of 14. At the age of 22, I had undergone three ACL reconstructions, two with meniscal and articular cartilage repairs and one with internal plate removal and lateral tenodesis, and a double osteotomy. While physically reconstructing me, these experiences have also had a profound impact on my mental health, highlighting the hidden difficulties that come with longer-term and recurring injuries.

Overlooked mental health

Recovering from long-term sports injuries is emotionally taxing; initially, there is surprise, frustration and a genuine sense of loss. Athletes frequently conceal their difficulties, presenting a brave face as they persevere. The emotional rollercoaster ranges from excitement about returning to the game to the frustration over setbacks and fear of being injured again. What makes things more difficult is that recovery is primarily a solo journey, with a focus on individual mental strength rather than team spirit. This emotional burden affects both the athletes and their support systems. The recognition of mental strain highlights the significance of a comprehensive recovery. This includes both mental and physical recovery, as well as counselling, supportive networks and effective coping strategies. The impact on mental health serves as a stark reminder of the importance of providing comprehensive care for an athlete’s well-being during a difficult recovery process. While clinicians should prioritise athletes’ physical recovery, they must also consider psychological demands and social stress.

Dismissive attitudes towards mental health

In numerous instances, I sought support from coaches by proactively requesting individual meetings to discuss the mental health challenges I faced. Unfortunately, these efforts left me disappointed, as attempts to convey the emotional toll of my injuries, notably the sense of isolation from teammates, often resulted in dismissive remarks like, “That’s what happens when you get injured; you'll just need to deal with it.”

Even after securing an appointment with mental health services, I sensed a lack of full understanding of the profound impact of losing my sport, prompting a desire to broaden my discussions to encompass other aspects of my well-being. The absence of empathy and support from both coaches and mental health professionals shattered my trust, pushing me into a dark place with my mental health. This situation could have been avoided if coaches had received proper education on comprehensively supporting athletes.

Importance of mental health during long-term injuries

When athletes return from injury layoffs, their overall well-being becomes critical. Athletes must possess not only physical strength but also mental and emotional toughness. Successful recovery requires not only physical rehabilitation but also the development of a strong mental strategy to deal with setbacks, doubts and the difficult journey back to fitness. Emotions play a significant role in the healing process, influencing high and low levels of hope, frustration and determination. Mental well-being, which includes focus, discipline and positive attitude, is essential for an athlete’s ability to adapt and thrive following an injury. Unfortunately, the impact of injuries on an athlete’s mental health is frequently overlooked in recovery plans, with medical teams ignoring this critical component. Recognising the interconnectedness between physical, mental and emotional well-being is critical for developing comprehensive recovery plans.

A transitional journey of personal mental health reflection

Reflecting on my journey through recurrent injuries, the most formidable challenge was the battle with mental health exacerbated by inadequate professional support. Descending into a mental health spiral, the absence of guidance through the ‘seven stages of grief’ for my injury intensified the struggle. Stuck in the depression stage due to consecutive injuries and feeling like I had lost my identity, suicidal thoughts overwhelmed me, extending beyond sports to permeate everyday life. A pivotal moment came when a compassionate member of the medical team acknowledged my struggles and offered a beacon of hope. Writing down my thoughts and feelings helped me communicate with my family about my experiences, which was the most efficient way for me to get mental health help. They were my pillars of support, getting me through my worst moments. Currently working towards becoming a sports rehabilitator, I support a more thorough approach to athlete well-being by encouraging medical professionals and sports staff to give mental health more serious thoughts.

Mental health stigma

Athletes dealing with long-term injuries frequently face societal stigma related to mental health, which is deeply ingrained in the competitive and resilient nature of sports. Because of their strong attachment to sports, athletes’ mental health issues are sometimes viewed as weakness rather than legitimate concerns. This, combined with isolation from teammates and limited access to mental health resources, makes athletes hesitant to discuss their difficulties openly. High-profile athletes who advocate for mental health can help change the culture. Their efforts are critical in creating a sports environment that recognises and supports both the physical and mental aspects of an athlete’s well-being, while navigating the difficult journey of long-term injury recovery.

Simultaneously, medical professionals must pay close attention to athletes’ experiences, ensuring comprehensive treatment that addresses not only physical injury but also prioritises mental health. Long-term sports injuries require physical and mental well-being. Athletes face emotional challenges ranging from initial shock and frustration to isolation, emphasising the importance of a comprehensive rehabilitation strategy. The intrinsic link between athletes’ physical prowess and mental fortitude emphasises the importance of mental health during the recovery process. Unfortunately, stigma and insufficient mental health support persist, causing athletes to experience trivialising reactions from coaches and professionals. Understanding the interactions among physical, mental and emotional well-being is critical for developing effective recovery strategies. Athlete mental health advocacy, combined with attentive listening and appropriate actions from medical professionals, plays an important role in cultivating a supportive sports culture throughout the demanding journey of long-term injury rehabilitation.

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  • Contributors The author solely contributed to this study.

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.