Sunday, August 2, 2015

Dealing With Major Injuries

Sport is inherently dangerous and as such the risk of injury exists.  On occasion, this injury may be traumatic and may be cause for an athlete to fall under the diagnosis of acute stress disorder.   According to the DSM-IV (2000) acute stress disorder occurs after an extreme traumatic event.  There are a number of symptoms such as anxiety, detachment, re-experiencing the event, and interference with normal functions.  This can last anywhere from 2 days to 4 weeks; any longer and the DSM-IV suggest that a diagnosis of posttraumatic stress disorder may be prudent.  The athlete may feel a sense of hopelessness or despair that may lead to the additional diagnosis of major depressive disorder.  The injury may be so severe the athlete may also have suicidal tendencies and engage in impulsive and risky behavior.  “Symptoms can also occur after an extended time period and are then referred to as delayed post-traumatic stress disorder.”  (Asken, 1999, as cited in Ray and Wiese-Bjornstal, p. 300). 
Some of the signs to consider are:
1.       Avoiding or withdrawing from the sport
2.      Diminishing interest in social groups or co-workers
3.      Performance in work, sport, or rehabilitation is lacking
4.      Reoccurring thoughts or visions of the injury or events leading up to the injury
5.      Zoning out
6.      Decrease in motivation within and outside of sport
7.      Difficulty feeling rested after sleep
8.      Feelings of how could the injury or event could be avoided
            In a rehabilitation setting, coaches, trainers, teammates, and other social support groups should understand that an athlete who has experienced a catastrophic injury may show some of the above signs and symptoms and they may be in need of psychological interventions.  The support from those important to the athlete is vital as they progress through their rehab process as they transcend through the healing phases.  The healing phases according to Flint (as cited in Pargam, 2007) are acute or inflammatory, fibroblastic, maturation phase, as well as discharge parameters and prehabilitation.  Macro and microtramatic injuries relate to the acute phase due to the cause of the injury.  Flint also states, macrotrauma is caused by a specific event and is easily identified, while microtrauma is caused by small amounts of injury over time and is not quite as noticeable, such as an overuse injury (as cited in Pargma, 2007). 
            The acute phase can last between two to four days and during this time the body works to manage the damage caused by the injury.  The key signs of this phase are inflammation, heat, and skin color changes (Flint, 2007).  During this phase, the athlete should begin to form a support group with others who are also injured.  This group discussion could help athletes empathize with each other and allow for them to talk about their frustrations.  According to Sternberg, video games or other forms of friendly competition introduced during rehab may reduce the pain by interrupting the pain sensors (as cited in Pargma, 2007).  Other forms of pain reducing techniques include the use of imagery, distraction, or for some athletes, focusing on the pain.
            The second phase of healing is the fibroblastic phase and may begin five days after the injury until three to four weeks.  During this phase tissue is being created to heal the injured site.  The athlete may believe they are ready to return to their sport because they are feeling better and injury site has a visual improvement.  This may be frustrating to the athlete because the progress during this phase may be minimal and to aid the psychological wellbeing of the athlete, goal setting should aid in their recovery and put boredom at bay.  Coping cards, cognitive behavioral therapy (CBT), imagery sessions, progressive muscle relaxation, and a dysfunctional thought record (DTR) may be implemented in their rehabilitation.  It may be necessary to work with the athlete by discussing the pros and cons of the coping card, when they should be read, and the automatic thought generated (Beck, 1995).  Additionally, the fibroblastic phase is “a perfect time for a psychological strategy called Rational Emotive Therapy or ABCDE technique” (Flint, 2007, as cited in Pargman, 2007, p. 329).  This type of therapy is very similar to CBT by recognizing the stressors (antecedents) and disputing the irrational beliefs or thoughts associated thereby changing the behavior or outcome.
            The final phase of the healing process is the maturation phase, and can last up to 18 months.  The major characteristic of this rehabilitation phase is the sport specific rehab which develops range of motion and strength.  During this phase, psychological interventions such as goal setting should be revisited as the athlete prepares to reenter their sport.  Depending on the severity of the injury and the recovery time, expectations of their performance should be discussed.  The athlete needs to be patient with the rehab and understand it is a process and they may encounter setbacks.  If they do encounter setbacks, the coping strategies and anxiety reduction techniques implemented during the fibroblastic phase should be continued.   
            Prehabilitation is the period of time between the injury and surgery, and can be very frustrating for the athlete.  They may feel as though there is no point in doing rehab only to have surgery and go through rehab again (Flint, 2007 as cited in Pargam, 2007).  The support group as well as the professional should emphasize the importance of adhering to the rehab program and how it will relate to them getting back on the field.  If the injury is career ending, the support groups will be very important and should consist of other athletes in a similar situation.  This support will be a valuable tool in their healing process.
American Psychiatric Association:  Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.  Washington, DC, American Psychiatric Association, 2000.
Asken, M .  (1999).  Counseling athletes with catastrophic injury and illness.  In R. Ray and D. Wiese-Bjornstal, (Eds.), Counseling in sports medicine, (pp. 293-309).  Champaign, IL:  Human Kinetics. 
Beck, J.  (1995).  Cognitive therapy:  Basics and beyond.  New York, NY:  The Guilford Press.
Flint, F.  (2007).  Matching psychological strategies with physical rehabilitation:  Integrated                      rehabilitation.  In D. Pargman, (Ed.),             Psychological bases of sport injuries (3rd ed.), (pp.     319-334).  Morgantown,  WV:  Sheridan Books.
Sternberg, W.  (2007).  Pain:  Basic concepts.  In D. Pargman, (Ed.),  Psychological bases of         sport injuries (3rd ed.), (pp. 305-318).  Morgantown,  WV:  Sheridan Books.

Wednesday, September 10, 2014

Back in the saddle again

Hitting the reset button in life can sure be stressful! New job, new state, change in relationships, etc. and as it's been stated, "doctors make the worst patients."  

But it's not all craziness...

The new job is great!!! In addition to my current coaching and sport psych consulting work, I have the opportunity to work for Trek Bicycles in Naples, Florida! Helping people find their freedom on the two-wheeled, self-powered machine that fits their cycling needs is quite rewarding! 

Saturday morning group ride from the bike store (I'm a horrible photog) 

Over the last couple of weeks I've been internally reflecting on "what the hell is wrong" and have come up with a pretty short and simple list. 

I love a schedule! I love routine. When I'm not a routine, then I just feel out of balance. My former routine of swim/bike/run has been replaced with going to the local pub just about every night after work. Totally not healthy, I can't afford it, clothes don't fit, and I miss training. 

I finally am at a point where I really do miss the constancy known as the grind. 


Now that I'm completely out of shape and my liver is crying uncle, I'm ready to get back in the saddle, pound the pavement, start adding up those yards in the pool. 
Time to get ready for Rev3 Florida!!

Monday, September 8, 2014

A glimpse

Here is a note that I wrote in my phone a few months ago. I needed to put feelings out on "paper". 

A glimpse into "me".  

As I sit here, I wonder, "how did I ever let it get this far? Get this bad? Why didn't I address this earlier? Why wasn't I able to do anything?"

If you were to ask me if I ever saw myself here, the obvious answer would have been, no. But here I am. It's a struggle. Feelings are involved and need to be considered, but for the first time in a long time the only feelings I will need to consider are my own. It will be nice to rediscover who Ryan is and where his life is taking him. 

My life seems like a book filled with various short stories from other authors. 

Sunday, April 6, 2014

16 Anxiety Reduction Tips for Increased Sport Performance

1. Develop a pre-performance routine.  This should help you relax and do the same thing each time.
2. Yoga.  The stretching will help physically, but the deep breaths will also aid in releasing stress.
3. Regular sport massage.  This will help release some of the build up within your muscles, but is also a nice way to reward yourself for a hard weeks training.  ART is great, but sometimes just a little petting is very relaxing.
4. Imagery.  Imagine yourself performing the training or race.  Identify what stressors there may be and formulate a positive plan before the event.
5. Set process goals and congratulate yourself when you accomplish them.
6. Establish a connection with the trainer, masseuse, & chiropractor.  Ask for feedback on your body and solicit improvements.  This will help with your confidence.
7. Manage your time.  As an athlete, it’s important to balance your training with life’s other commitments.
8. Surround yourself with positive people and encourage your peers.
9. Set up a day/time that is “your time” and do something fun or nothing at all.  It’s your time!
10. Don’t be afraid to seek out help.  You have a coach for your physical performance, don’t neglect the mental aspect.
11. Get plenty of rest.  Sleep helps you feel better.
12. Practice breaking the event up in smaller manageable sections. 
13. Progressive muscle relaxation.
14. Identify the stressors and establish coping skills
15. If required, discuss stages of grief.
16. Stay hydrated and monitor electrolyte intake.

These are just a few tips to reduce anxiety....Do you have some that should be added to the list? 

Friday, February 21, 2014

Talent & Excellence

This winter has been really killer--as in freezing, snowy, and (in my opinion) just plain 'ol stupid.  That's the only way I can classify this weather, "stupid"!  I guess if I lived some place I could ski or something, it might be different, but this has brought much (all) of my swim, bike, run training indoors.  This indoor training is great, but after months of it, can be quite taxing on the mind.  This is especially true as most of "us" are either still in or just coming out of our base phase of training.  This repetition has been termed the grind, or as I prefer to call it, the mundanity of excellence.  

After reading an article regarding Olympic swimming routines, I felt it might be good to remind others and myself, that these seemingly mundane, boring, same bull shit everyday type activities or training actually may lead to excellence.  And probably more importantly, at least anecdotally, Olympic athletes struggle/cope with similar obstacles that average-joe does!     

The author suggests that excellence is achieved through consistency and states, “excellence does not result from some special inner quality of the athlete” (Chambliss, 1989, p. 72).  Chambliss (1989) discusses the misconception that some individuals are born with a special ability, talent, or athletic gift, but suggests that other factors may influence excellence.  Every day, individuals achieve some form of excellence in something, but athletes share their excellence to the masses on stages periodically, and therefore the audience only sees glimpses of their excellence.  Talent is also purposed in the opposite direction, stating that if an athlete’s excellence is due to talent, then why is only noticed after they  have achieved success? 

The mundane aspects of achieving excellence are the little things that are repeated over and over, until they become habitual.  The author discusses the breakdown of the flipturn and various stroke mechanics as the mundane.  These mundane activities may be labeled as very short term/immediate process goals to achieve a much larger goal.  Interestingly, these mundane activities can also be applied to any circumstance in which an opportunity to improve presents itself—whether it is shaking hands more firmly, speaking more confidently when asked a question, or any other task.

There are other factors that are suggested to have an influence on the attainment of excellence besides the mundane.  The author lists these as genetic make-up, geographical location (is the athlete in the best climate for their sport), is the family able to meet the financial investment required, and the coaching ability/level of the coach.  There is also a time commitment that is involved, and when younger, the athlete will need to rely on the transportation of others.   Similar to Jonny Law’s story of overcoming adversity and injury (Law, Coleman, & Orlick, 2008) a “crucial factor is not natural ability at all, but the willingness to overcome natural or unnatural disabilities of the sort that most of us face…” (Chambliss, 1989, p. 80).

Chambliss, D. F. (1989). The mundanity of excellence: An ethnographic report on stratification                and Olympic swimmers.  Sociological Theory, 7, 70–86. Retrieved January 14, 2010,    from Academic Search Complete Web site:            df/1989/86G/01Mar89/15440384.pdf?T=P&P=AN&K=15440384&S=R&D=sih&Ebsco            Content=dGJyMNLe80Sep7I4yNfsOLCmr0iep7ZSsqa4SLGWxWXS&ContentCustome            r=dGJyMPGrsU2vp65KuePfgeyx44Hy7fEA

Law, J., Coleman, J., & Orlick, T. (2008). Embracing the challenges and gifts of big mountain free skiing: An interview with Jonny Law—world tour champion. Journal of Excellence,  12.  Retrieved January 13, 2010, from Journal of Excellence Website: 

Sunday, December 15, 2013

100 by 100

Working on a bit of a bucket list here...

1.       Visit Stonehenge
2.       Go to The Roman Coliseum
3.       Walk along the Great Wall of China
4.       Hike Mt. Fuji (’99)
5.       Do the no pants subway ride in NY
6.       Get my picture taken in front of the Taj Mahal
7.       Pyramids of Egypt
8.       Sphinx of Giza
9.       Visit Cinque Terre
10.   Hike Appalachian Trail
11.   Go to Napal at Everest Base Camp
12.   Go to all four of the Tennis Grand Slam events (US ’10)
13.   Run with the bulls
14.   Visit Rome
15.   Scuba the great barrier reef
16.   Scuba Truk Lagoon
17.   Feed whale sharks (’00)
18.   Bike across the country
19.   Attend the winter Olympics
20.   Attend the summer Olympics
21.   Bike tour during the TDF
22.   Run a trail marathon
23.   Times Square for New Year’s
24.   Live on the beach
25.   Visit New Zealand
26.   Be an aid to a sight challenged athlete during a race
27.   Pilgrimage to Kolkata to Mother Teresa’s Tomb
28.   Ride in a gondola in Venice
29.   Visit Machu Picchu
30.   Celebrate St. Patrick’s Day in Ireland
31.   Throw a fish at Pike’s Place market
32.   Attend the lighting of the Rockefeller Center Christmas Tree
33.   Have a child
34.   Teach my child to ride a bike
35.   Visit all 50 States  (Need:  ME, VT, NH, MA, RI, DE, ND, SD, MT, MN)
36.   Backpack through Europe
37.   Explore Amsterdam (’97)
38.   See the Northern Lights
39.   Visit Argentina Iguazu falls
40.   Go to Bali

41.   Hike in the Amazon Rain Forest
74.  Learn to play golf. 

Still have a few to add, but it's a pretty good start.  Thanks for the inspiration Maggie, Meredith, Stu, and Tracy

Tuesday, December 3, 2013

10 Gift Ideas For Your Athlete!

Some must have ideas for the athlete in your life!!

1.  TRISLIDE or TRISWIM $3.60+


 Anti-friction products are a must during the colder months!  With all the layers on, rubbing occurs and the stick product may be too hard to apply easily.  Give TRISLIDE a go!  It's small, aerosol can applies a slick coating to prevent chafing...just know that it works really well and don't apply on smooth floor surface.  They will become slippery!

The same company, SBR Sports, Inc. makes a line of swimming products to get ya clean and free of itchy, stinky chlorine! Shampoos, conditioners, lotions and more!!  The smaller bottles fit nicely in your swimming bag.

2.  Pearl Izumi Running Tights $50+

The new line even comes with a thermal layer & a built in liner (underwear)!!  The sizes seem true to size, expect for the 3/4 length.  I would order a size up.  The women seem to have the cool colors on this one!!

3.  Hand Warmers $10-$25.

Heading out the door for a cold run sure is easier if your digits and piggies are toasty!  These also make pretty awesome stalking stuffers!!

4.   Yaktrax $5-$47

Running in the snow and ice can be dangerous!  Ain't nobody got time for an injury!!  Give these fellas a try to help keep that traction!

5.   PowerBar Gels $1.35+

Sometimes when it gets cold out, we forget about our nutritional needs!  You still need to keep fueling the body, even when it's cold!!  For ease of use, I would recommend keeping your nutritional products in a warm pouch, or close to your body.  There's nothing like trying to eat a frozen PowerBar!

6.   GPS Watch $45+

There are tons of watches out there.  I'd look at what the needs are:  GPS?  Heart rate?  Waterproof? Multisport use, or just running?  And then there is price!!  These things can be pretty pricey & now they are offering more than just the boring black to add a piece of flair.  I do really like the Garmin line of products!

7.  Smartwool Running Socks $18+

Keeping those tootsies warm is sooooo important!  If you need to add another wicking layer cuz your feet sweat like crazy, try a thin dress sock as your base layer.  The outdoor light micro are great to run in, and I'd consider getting a sock that at least covers your ankles.

8.  Coffee Shop Gift Card $10+

Seems like coffee shops are a magnet to endurance athletes...well, I guess maybe people in general!  Even if your someone doesn't dig coffee, the aroma is nice and most have great teas to choose from!  And if they don't like tea either, you may consider getting new friends.  :)

9.  Magazine Subscription $25+

Athletes are geeks!  We like to read about what others are doing, what the trend is, the newest greatest gadget, and of course, where the next Rev3 race will be!  Runners World, Triathlete, Lava, Sports Illustrated, Bicycling, Outside, Coach & Athletic Director, Men's Health, and Cosmo...yes cosmo!

10.  New Helmet or Sunglasses $67+

Rudy Project tends to have really great deals this time of year!  There products are also reasonably priced, tested, and quite trendy!  They also have smaller lids for the peanut and monster helmets for those who have a giant gourd like me.  (Mom says it's cuz I have a big brain!)