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Healing Mind and Body: Injured athletes struggle with mental health

From left, junior runner Allura Leggard, freshman football player Daniel Hutchinson, and senior swimmer Angelina Domena all struggled with their mental health after suffering serious injuries from their respective sports.

For Ithaca College freshman Daniel Hutchinson, football had always been an escape. However, a simple misstep while running turned his senior year of high school, his future and his identity as an athlete completely upside down.

Injuries are often an inevitable reality for athletes competing at the collegiate level. During their careers, 90% of student-athletes report an athletics-related injury, according to the National Athletic Trainers’ Association. However, for the athlete, the pain of an injury can go beyond being just physical and can cause lasting emotional and psychological impacts.

Hutchinson said he used football to cope with his family’s financial struggles and his father’s abusive behavior toward him, his siblings and his mother. He said that when he felt his knee pop during a football game at the beginning of his senior year of high school, he immediately knew something was wrong.

“It hurt too bad to the point where I couldn’t cry,” Hutchinson said. “I couldn’t breathe. They took me to the bench and told me I tore my ACL, and that’s when I started crying.”

Hutchinson’s injury turned out to be much more than a typical ACL tear. Hutchinson said that after undergoing surgery to repair the ligament, his doctors found a blood clot the size of a golf ball in his calf during a follow-up appointment. The clot was in a main artery connected to his lungs, so he had to have a second major surgery approximately a week after his first one.

“I spent a week just laying [in the hospital],” Hutchinson said. “I couldn’t move or do anything. I was in a dark, scary place. I needed help going to the bathroom and taking a shower.”

Hutchinson said that as an athlete he felt particularly devastated by his inability to be active and independent postsurgery. He was unable to compete for the entirety of his senior football season, and he is still completing the recovery process a year later. Hutchinson said that period of inactivity, especially in the months immediately after his surgery, allowed him to spend more time worrying and overthinking.

Chris Hummel, chair of the Department of Exercise and Sport Sciences, said the athletic training clinic at the college treats hundreds of athletes every year. He said he believes that almost every athlete who comes into the clinic with an injury struggles psychologically at some point during their recovery process.

“It’s getting better because there’s less of a stigma around psychological issues, but athletes tend to want to deal with it themselves,” Hummel said. “They take pride in being stronger than the people around them, so I think it’s harder for them to get to that point where they feel comfortable asking for help.”

A study of Division I football players found that 33% of injured athletes demonstrated high levels of depressive symptoms. Another study of male and female Division I college athletes concluded that athletes with self-reported pain or a history of injury had higher risks of developing clinically significant symptoms of depression. 

Hutchinson said because he had always used football as an outlet, he found that he had no way to manage his emotions after the injury. While Hutchinson described his mental state as depressed, he never sought professional psychological help. He said he never felt comfortable opening up about his feelings because he felt like no one could relate to his experience.

“Every time I get angry or sad I go play football,” Hutchinson said. “When football was taken away it was like, ‘What do I do now?’ I hate to admit it, but I was super depressed. I said I was sad, but I never really talked about it because I felt so alone.”

Greg Shelley, associate professor in the Department of Exercise and Sport Sciences, said it is common for student-athletes to define their identities through their athletic achievements.

“Athletes identify with their sport due to their past accolades [or] recognitions from their participation,” Shelley said. “For many college-level athletes, they have been associated with and played their respective sport since their earliest youth sport years.”

While Hutchinson said he felt ostracized from his football teammates and friends, he was able to heal psychologically through his Christian faith. Hutchinson said that he was not very religious before his injury but that a friend texted him a few months after his surgery and invited him to church. He said he was reluctant to attend at first but loved it and has gone every Sunday since.

“I had a sense of a home, a place where I could open up but not to people; to a higher power,” Hutchinson said. “I got put in a youth group, and I got to hear other stories of people who were going through depression. [My faith] redefined me and shaped who I am today.”

Senior swimmer Angelina Domena severely dislocated her shoulder in her junior year of high school right before her club swimming championship meet. She had to have surgery and was unable to swim for approximately six months. 

Domena began dealing with an eating disorder in the aftermath of her surgery. Domena said that she began feeling self-conscious about her size when she was in middle school but that while she was swimming she had been more concerned with building strength than losing weight. She said her muscles atrophied as a result of her inactivity postsurgery, and she lost a significant amount of weight. She said that losing the weight transformed her insecurities into a psychological problem.

“During that process of transitioning from training 20 hours a week to nothing I had to change every aspect of my life: what I was eating, how much I was eating,” Domena said. “I became so skinny, but I was still seeing myself as this chubby 13-year-old girl. I was always really anxious about gaining that weight back and going back to how I looked before. I was so scared of that.”

Domena said that she weighed approximately 145 pounds during this time. She was 5 feet 11 inches tall. 

Domena said the mental impacts of her eating disorder continued to impact her even after she returned to swimming. She said that during her freshman year of college, she was constantly worried about gaining the freshman 15. However, she said that at the time, no one, including her, could see that her eating habits were problematic. She said she believed she was simply eating healthy and watching her weight.

Senior Justinian Michaels is an athletic training student and a member of the men’s soccer team. Michaels said the athletic training students at the college are taught the biopsychosocial model, which frames an injured athlete as an individual beyond their physical condition. Michaels said they learn to understand how a patient’s biological, psychological and environmental factors combine to form a complete picture of their overall health. 

“We’re the first line of defense in the medical field,” Michaels said. “It’s really important to have a bond with these athletes other than just the rehabilitation and the science aspect. You’re helping the athlete overcome something that’s really tough in life, and you’ve got to have these athletes relate back to you in some way.”

As Domena’s freshman year progressed and she reacclimated to the intensity of training, she said she gained back nearly 20 pounds of muscle weight. She said this allowed her to escape the negative perception she had of her body, and she rediscovered her passion for swimming.

Junior sprinter Allura Leggard competed in her first track and field meet when she was just 5 years old. Leggard said that aside from a sprained ankle in high school, she never had a severe injury before coming to college.

Leggard competed in the long jump at her first collegiate meet, the Greg Page Relays, on Dec. 2, 2017, at Cornell University. She said she remembers taking off from the board and immediately feeling a sharp pain in her back.

“When people asked me what was going on, I kept saying that my back felt nauseous,” Leggard said. “As a firstyear, I was afraid of really expressing the pain I was in to a full extent because I didn’t want to let people down.”

Leggard said her anxiety about disappointing her coaches, family and teammates was so great that she continued to compete with severe pain until the Liberty League Indoor Track and Field Championships on Feb. 23 and 24, 2018. She said she qualified for the 60-meter dash final on the first day of competition, but, when she woke up the morning of the final, she could barely walk.

Leggard was diagnosed with a stress fracture on her lumbar three, a vertebra in the lower back that plays an important role in supporting the torso. After spending the spring and summer rehabbing the injury, she was allowed to return to running in August 2018. However, when she began training, her pain returned, and she eventually learned that the stress fracture had become a full fracture. 

“I felt like I let everyone down,” Leggard said. “I was a high prospect as a recruit, and I knew what my level could be. The fact that I wasn’t able to perform to the level I thought I could killed me. It completely busted my confidence.”

Leggard said that she also struggled throughout recovery with feelings of isolation. Because she was unable to compete for more than a year, she felt disconnected from her teammates.

“There were people who texted me asking how my injury was going, but, since you hang out with the team every single day, you form bonds, and when I wasn’t there all the time, I was excluded from that bond,” Leggard said. 

Shelley said that keeping athletes engaged with their sport is a crucial aspect of psychological recovery.

“It’s helpful to approach the injury and rehabilitation with the same focus and commitment they would normal, healthy training and competing,” he said. “In doing so, they embrace the injury, rehab-recovery and return-to-play transitions and remain focused on what is in their control.”

Hummel said that the athletic training staff attempts to keep athletes engaged with their teammates during their recovery process.

“It’s bringing them in when the rest of the team is there to do their rehabilitation so they feel like they’re still part of the team,” Hummel said. “We encourage them to talk to the coach to find out if there’s another role they can play while they’re not participating athletically.” 

Leggard said her loneliness was exacerbated by the lack of diversity on the squad, especially during her freshman season.

“I think being a person of color is the reason I had so much trouble opening up about what I was feeling,” she said. “I had like two upperclassmen and that was it. It’s like being a woman in a room full of men: You feel like you don’t have anyone to back you up or get you on that deeper level.”

Leggard said she attended several sessions at the Center for Counseling and Psychological Service and leaned heavily on her family for support. She said her mental recovery has helped her redefine her identity beyond her performance on the track. 

Leggard also said the POC community on the track team has expanded in the last two seasons, and she said she strives to be a mentor to the younger athletes.

“I just really want the other POC to understand that I’m there for them,” Leggard said. “I was so fortunate to have those upperclassmen who were there for me. I just really try to push the importance of us being such a strong group of women.”

Hutchinson said he hopes that his story will help other athletes open up about the connection between their mental and physical health.

“Mental health in the black community and for black athletes is tough,” Hutchinson said. “They don’t want to talk about things. At first, it was hard to even say a little bit about it to the black community, but, after I did, I found that they were very supportive of it and telling me we can get through this.”

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