The Psychology of Injuries: Why They Happen and How to Prevent Them

As a sport psychologist, I have treated many athletes who have been injured. There are 30 million kids playing sports and 10 percent of them will get injured this year. Tennis is not quite as dangerous as football, soccer or ice hockey, but there are plenty of ankle, knee, elbow and shoulder injuries. The consequence of a serious injury to an amateur tennis player can be devastating, can end a season, and sometimes, threaten a promising career.

One of the most important questions to ask is why injuries occur. Fatigue, overuse and acute trauma leading to secondary gain are three reasons.

1. Fatigue
Accidents in sports usually occur towards the end of matches when the muscles are tired. Horses typically break down during the home stretch and so do athletes.

2. Overuse injuries
I recently attended a seminar run by Winthrop’s Dr. Mark G. Grossman and the bulk of the talk was how over use leads to injury in the young athlete. My experience with the young highly competitive athlete tells me that many tend to be obsessive compulsive and perfectionistic. When you add to this the highly competitive nature of elite or professional tennis, it’s predictable that the body will eventually give in. Tennis elbow is common, but so are ankle injuries, knee sprains, Achilles tendon problems and shoulder tendinitis.

3. Traumatic injury dictated by secondary gain
This dynamic is more deeply unconscious, but by no means, rare. In fact, I believe this is one of the prime reasons that sports injuries take place. I recall one of the first interviews I did for a sports magazine. I met the athlete who was a nationally-ranked young golfer still in his teens. When I walked into his home, I could see that he had broken his arm and he was in a full cast. When I asked him what had happened, he broke into a big smile and with a hushed voice, said “Isn’t it great … I finally get to stay home and rest for a while. I am so tired of flying around to play tournaments.” Here was a 16-year-old kid already burnt out. He incurred the injury through horseplay with his girlfriend.

These kind of odd accidents are very common. Just recall the Tiger Woods incident when he crashed his car, broke his front teeth all of which triggered one of the sports world’s greatest sex scandals. I had long felt that Woods was under far too much pressure and public exposure, but was trapped inside his own fame and success. Who can walk away from a career bringing in $100 million-plus per year. And it’s my guess that he unconsciously and desperately wanted out of the whole game. Here was a guy dying to get caught.

These accidents happen in sports all the time.

These unconsciously driven accidents are not limited to sports. Recall the rise of Bob Dylan to world fame back in 1969. Immediately following his big world tour, he nearly killed himself in a motorcycle accident. He was forced to rest for a year.

These escapes from the pressure of fame are largely unconscious, because it’s impossible to walk away from all the money and adulation so the unconscious takes over to do the job for them.

How to prevent fatigue and overuse injuries
These kind of injuries are easy to predict and coaches, trainers, parents, spouses or doctors need to intervene with the overworked tennis player. The player headed for an overuse injury will go through a three-phase process. They will first show signs of exhaustion with flat or lackluster performance on the field. This will go on for a while and if they are not forced to rest, they will then become illness-prone with increases in colds, headaches and chronic muscle pain. If this is ignored, they will then get injured and everything will come to a crashing halt. The prescription for this problem is to ensure that the athlete is well-rested, takes breaks away from the sport and avoids overwork.

How to understand the secondary gains sought through accidents
These are usually the worst injuries because they are often experienced by extremely talented and hardworking players who are surrounded by people who have a vested interest in seeing them continue to perform. The conflict of trying to please everyone, versus being in extreme anxiety or exhaustion, will produce accidents as the only way out. This is when the insight of the trained psychoanalyst is needed. Real success is always very difficult to manage because there is so much pressure and so much responsibility.

I recall meeting some of Michael Jackson’s crew in Rome in the 1990s. Michael was selling out 50,000-seat stadiums night after night, and he was on tour for a full year with a team of 210 dancers, musicians, choreographers, seamstresses, production people, etc. His opening act was being paid $8 million for the year, and the entire staff of 210 was put up in five-star hotels every night. That is what you call pressure … unbearable pressure. It was no surprise to me to learn that he succumbed to heavy drug use and death in order to escape such demands.

Fame is a tough thing to turn away from and is tough to endure, and this is why accidents are often unconscious choices as the only way out. My belief is that it’s far better to help the athlete understand this hidden conflict so that they can chose a more conscious and less self-destructive way to slow things down before they break apart. This is what is meant by “The Fear of Success.” Success is usually filled with increasing amounts of hard work and responsibility, and quite often, the talented athlete will resort to injury as the only way to get a rest.

Accidents in tennis can be devastating for the avid player and they would do well to follow the above guidelines so that they can prosper and thrive in the sport they love to play.