Tag Archives: Wrist injury

31May/16

Wrist injury for Nadal

Wrist injuryThe wrist injury for Nadal has been heavily reported in the media. This must be immeasurably disappointing for Nadal, who has suffered with a catalogue of problems over the years, as he seeks to overcome the pain and injury.

Playing sport at this level means that your body is your business. I am going to qualify the term ‘body’ for it is important to consider the body as part of the whole and is in no way separate from the concept of mind — we are our mind; we are our body; the unification has no beginning or end, just emerging as ‘me’, the self.

As we know, to play top flight sport requires immense fitness that necessitates training that blends with that of technique. Nadal has always played an extremely physical game, which is his style, his tennis character or persona. From the first step onto court until the final stroke, physicality predominates but the notion of physicality is not only in the muscular frame, but emerging from the man himself. We can see his body move, but it is he, the man who moves and lives that experience. The point here is that a body does not move in isolation from who we are, what we think and feel emotionally. This factor starts to provide some insight into how we must approach recovery from injury, especially when there are a string of injuries that can appear to be unrelated. I would argue against this, suggesting that there is a commonality in the way we respond to injury and how this governs the recovery.

The way we respond to injury and pain (the two are unreliably related) is individual and dependent upon our beliefs and what we think according to what has happened before. If I believe that pain is related to tissue damage, still the predominant thinking, then I will act in a particular way, and if I know that pain is a normal part of a protective response related to the level of predicted and perceived threat, I will act in another. This highlights the importance of the person understanding their pain to get the best outcome.

When an athlete or a non-athlete suffers on-going injuries or repeated injuries, even in different body locations, one must consider why this is happening and why they are not fully recovering despite their apparent health. One could also ponder on the question of whether they are as healthy as they can be? Chronic stress, where the person consistently perceives threat thereby feeling anxious and tense, changes our chemistry as we operate in survive mode. This does not allow for the most effective healing process as our resources are diverted elsewhere. The athlete in a stressed mode who then sustains an injury will have a different response to the athlete who feels empowered, who is in control and has a high level of resilience at the moment of injury. This is why looking at the whole context of the injury is so vital as important influences and vulnerabilities can be overlooked. Understanding these means that the person and the team can fully address the problem.

Priming or kindling is a good way to think about persistent injuries or the string of injuries scenario. An initial sensitisation is a learning experience for the systems that protect us, meaning that it has a bearing upon the next injury or pain and so on. A string of injuries suggests that a vulnerability has arisen, often due to the prior recoveries not reaching full resolution; i.e./ there remains a perceived threat and on-going protection. In this situation, a further injury, either actual or potential, creates a context for the body systems that protect us to kick in, emerging as pain, altered body sense and movement, a story that we tell ourselves, all unifying to create a change in the sense of self, and not one that is congruent with desired performance outcomes.

The story of a player or athlete being plagued by on-going problems is common in sport as they patch up one area after another. Investigations, treatments, injections etc etc., yet not fully shifting from protect mode to health mode. This must be at the heart of a rehabilitation and recovery programme — the person must get better as a unified experience. I must feel myself again, which means that I am the performance, I am the shot I play rather than over-thinking to anticipating or focusing on another factor that interferes and distracts me from what I am doing.

In summary, completeness of recovery is key and this begins with understanding pain and its poor relationship with injury before creating the right conditions in thought and action. The programme must include threat reducing experiences including the way we think, how we attribute sensations, what we tell ourselves, redefining precise body sense (where I am in space and how I move in relation to the environment) and movements to say the least. Maintaining the desired outcome in mind, remembering that you are your mind (it is not just behind your eyes) and that some of your thinking is done with your body and its movements, both motivates and allows one to question if you are heading towards this or being distracted. Learn and take every opportunity to be on the path of change towards this desired outcome, persevere and dare to be great at what you are doing.

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