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Anyone who has ever been sidelined by an injury knows recovery can be long. There might be physical therapy or even surgery. There is also the mental side of recovery, which NPR's Will Stone reports is gaining more appreciation.
WILL STONE, BYLINE: Growing up, Shelby Baez loved softball. But that changed when she was 14, after a ball hit her in the face.
SHELBY BAEZ: Knocked teeth out and gave me a concussion. That was really hard for me to go back out and play at the same level.
STONE: Fear of it happening again and knowing all that it took to recover eventually led her to quit the sport her senior year. These days, though, Baez helps athletes with this very issue as director of the Psychology of Sports Injury Lab at the University of North Carolina-Chapel Hill.
BAEZ: The first thing we need to do is to figure out - is this fear actually warranted? So early on in the rehabilitation process, after you just tore your ACL and you're two weeks post-op, probably a little fear is going to be protective.
STONE: But once someone is further along, that's where psychological readiness comes more into play. While the concept sounds a bit nebulous, research indicates it's some combination of fear, confidence, also your perception of how your injured knee or limb is doing. Erich Petushek studies this at Michigan Technological University.
ERICH PETUSHEK: Just because somebody told you your function looks great - that's only one piece of the puzzle.
STONE: New research from Petushek and Baez reinforces this point. They followed about 60 athletes recovering from ACL surgery for six months. How well a person did on physical tests, like hopping on one leg, did not necessarily predict their sense of readiness.
CLARE ARDERN: People get their strength back. They get their movement back. They, for all intents and purposes, perform well. And then a lot of people still don't get back to the sport that they were playing before they were injured.
STONE: That's Clare Ardern, a physiotherapist and researcher at the University of British Columbia. In fact, she says, 1 in 3 people who have ACL surgery don't return to their previous level of sport. Fear is often a big reason. Ardern says research shows there are similar issues with hip injuries and shoulder dislocations.
ARDERN: Any sort of serious sports injury that takes you out of your sport for more than about a month - then we start to see these psychological factors becoming quite prominent.
STONE: So what can you do about it? Shelby Baez at UNC-Chapel Hill says this depends on the individual. For some people, all of this can be quite visceral. Their heart rate spikes. Their muscles contract or guard involuntarily as a protective response. She says sometimes simple grounding techniques can be helpful.
BAEZ: Whether it's touching your wristband or tapping your chest and maybe giving yourself a cue word - some sort of mantra that you can say to help to anchor yourself in that present moment.
STONE: Another approach is meditation - for example, with an app. You can even add mindfulness to the activity itself. Baez's lab tested this in people with patellofemoral pain, also known as runner's knee. Guided mindfulness during the run led to decreases in their fear of pain. With all of this, though, she stresses, it's not about suppressing or diminishing a person's concerns.
BAEZ: If they have fear, the patient's perception is the reality.
STONE: The goal of this work, which is still in its early days, is to help shift their reality enough so they can, if they want, get back on the field.
Will Stone, NPR News.
(SOUNDBITE OF SONG, "KING OF PAIN")
THE POLICE: (Singing) King of pain. Transcript provided by NPR, Copyright NPR.
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