When looking at the outcomes of ACL recovery surgery (ACLR), it seems that patients who show depressive symptoms may be at risk for worse postoperative outcomes. A study believes that this may be due to the lengthy and intense rehab that comes with ACL rehabilitation. Depressive symptoms make this intense recovery period more difficult which can lead to poorer clinical outcomes.

Effect of Depression on ACL Recovery

When approaching the mental aspect of treating sports injuries, a sports psychologist is a beneficial resource to promote recovery and get an athlete back to performing. Treatment by a sports psychologist can help an injured athlete recover better from sports related injuries and develop strategies to return to pre-injury performance levels.

A clinical psychologists' role in treatment is assessments and evaluations of individuals, psychological tests and treatment methods, and follow-up care and resources. 

When looking at treatment options for an injury, it's important to acknowledge the type of treatment that each of these professions specialize in. When looking at the effect depression has on injured individuals, it could be beneficial for athletes to seek treatment for depression by a mental health professionals where therapy and pharmacological treatment could be available.

Sport Psychologist vs. Clinical Psychologist Role in Injury Treatment

For injury treatment within emergency departments, it can be practice to receive a patient, treat them, and discharge them with a referral to a specialist depending on their specific type of injury. While this practice may be effective for the treatment of injuries, it does not account for the risk of comorbidity that injuries can pose for a patient.

Depression is a diagnosable and treatable condition that can be targeted to improve post-injury recovery. It is important for primary care providers to assess their patients and be aware of potential sign of depression that may develop alongside an injury. It can be especially important to be aware of depressive symptoms early on and to treat them before it potentially develops into depression.

Depression Intervention in Injury Treatment.

Study reported that athletes that self-reported pain were significantly more likely to self-report depressive symptoms. A similar study reported that from a sample of D1 football players, 33% of injured players reported high levels of depressive symptoms. This emotion reaction could be related to performance failure in some athletes.

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Athletic injuries can trigger or exacerbate mental health issues in student athletes, including depression, suicidal ideation, anxiety, disordered eating, and substance abuse. While initial emotional reactions to injury are normal, they can escalate into problematic psychological responses.

Psychological Responses to Injury in Student Athletes

Putukian M. (2015). The psychological response to injury in student athletes: a narrative review with a focus on mental health. British Journal of Sports Medicine 2016;50:145-148. 

The Psychological Response To Injury In Student Athletes: A Narrative Review With a Focus On Mental Health

-stigma against seeking mental health services

-used to working through pain

-may not have learned healthy coping skills

Obstacles to Getting Help for Athletes

-many athletes have created their whole self-image around their sport and so feel significant loss from not being able to perform or that role is threatened by injury/illness; this is especially true with injuries with long recovery times such as ACL tears

-injuries can impact daily quality of life as well as performance in sports

-exercise is an escape or coping mechanism for many athletes, so being unable to exercise and access their usual coping mechanism due to injury can worsen the emotional impact of the injury

Why Could Injuries Elicit Such Strong Emotions Reactions in Athletes?

Association Between Injury and Depression in Student Athletes

-alterations in appetite

-sleep disturbances

-irritability

-alterations of appetite leading to disordered eating

-sadness leading to depression

-lack of motivation leading to apathy

-disengagment leading to alienation 

-pain behaviors

-excessive anger/rage

-frequent crying or emotional outbursts

-substance abuse

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