LeBron James has been playing basketball since he was in elementary school. Tom Brady was throwing a football before he graduated high school. Barry Bonds was born into a family with a long history of baseball.

For athletes, especially professional ones, their sport is in many ways their life. They’ve spent not just hours, days or weeks, but years, on the field, court or their venue of choice. If it’s a professional athlete or one with dreams of going pro, their current or future livelihood is tied to how they perform. If it’s just a recreational athlete — the 30-year-old YMCA member who spends an hour a day after work playing pickup basketball games or the 45-year-old accountant who spearheaded a coed softball team — the exercise is merely just a way to stay in good health and let out some pent-up stress from other responsibilities.

However, you can still tie a large part of an average Joe’s life to his exercise or sport of choice. Larry at Saturday morning basketball games might look forward to that outing all week. Katherine on the triathlon team has been training for the next race for months. Peter is one of the best golfers in his peer group, and he’s always looking for a partner or two for a late-afternoon or early morning outing. Erin plays soccer three or four times a week and has built her entire network of friends from these games.

Even for the laid-back athletes who compete “just for fun,” suffering an injury can be a disaster. It’s not just physical pain, either, because, in addition to a broken bone or torn ligament, a person’s spirit is also affected.

Why Depression Sets In After an Injury

Numerous medical experts have devoted their time and research to uncovering the link between an injury an athlete sustains and the potential for them to develop internal pain. John Murray, a clinical sports psychologist from Florida, theorized that an injury can affect how an athlete sees themselves. He found that professional athletes are more likely to develop a severe mental illness.

“The more elite the athlete is, the more identity is …wrapped up in the athlete role,” Murray told U.S. News & World Report for a 2014 article. “When they get injured, it’s a more devastating blow to them because they’re losing something more valuable than a recreational athlete, who might just be doing it for weekend fun.”

Still, that does not mean that John Smith or Mary Joe at the gym is absolved of any depression if they are physically unable to participate in their favorite activities. Michele Filgate, a contributor for Buzzfeed, wrote in 2015 about how running helped her cope with depression. She described running as a way to “sweat out the demons” and then summarized the negative effects she felt when a hip injury prevented her from her exercise routine for weeks.

Exercise provides the electric jolt that is necessary to get moving throughout a daily routine,” she said. “But when that routine is abruptly disrupted, everything is affected.”

There’s also a chemical aspect to the connection between exercise and mental wellness. Physical activity releases endorphins, which is a chemical that makes people feel happier. According to Barbara Walker, Ph.D., and psychologist at the Center for Human Performance, the dip in endorphins makes it more challenging to manage emotions following an injury.

Yet, for any athlete, injury at some point in their life is almost unavoidable. Tears to someone’s anterior cruciate ligament in the knee often occur without contact, according to stopsportsinjuries.org. Add in contact sports or activities, and a broken hand or sprained ankle is often part of the game.

So when the inevitable happens, how can people avoid experiencing depression during their downtime?

How to Be Proactive in Preventing Post-Injury Depression

The Sports Science Institute gave reasons why an injury to a physically active person can lead to depression. The emotional responses to being sidelined for weeks or months include:

  • Sadness
  • Isolation
  • Lack of motivation
  • Anger or frustration
  • Changes in appetite or sleep
  • Not able to focus on or stay engaged in other activities

So how can people focus on their mental wellness during their time off the field or court? The answer is to focus on some of these emotional responses and understand that many of them are common for people who suffer injuries. However, some can be prevented.

Focusing on a regular sleep schedule and a healthy diet can increase energy and mood even in difficult times. Transitioning mental energy from the old physical activity toward rehab can provide a new challenge — like a personal competition — and keep people focused on recovery and the future return to the sport instead of the present situation. Keeping in contact with friends, even ones who might’ve been participants in the sport or activity a person no longer can do, often prevents a feeling of isolation, a common cause of depression.

One of the most important ways to cope with a long-term injury is to find self-worth beyond the activity. Others include picking up a less-physically taxing sport and simply talking about the difficulties and lifestyle changes with others who have shared this experience.

“Psychologists agree that seeking help from athletic peers who have had similar experiences, especially if they’ve overcome the psychological effects, can be helpful for athletes at all skill levels,” Hannah Webster writes in the U.S. News & World Report article. “And communicating your anxieties with other athletes — who can assure you that ‘life goes on’ — can be encouraging.”

Mental wellness is not the only concern for people who have suffered a physical injury. Prescriptions to painkillers are common for athletes who are sidelined, and this opens the door for an addiction to develop.

Killing the Pain: Sports Injuries and Opioid Misuse

According to the U.S. Centers for Disease Control and Prevention, opioid addiction killed around 42,000 Americans in 2016. The drug class opioids belong to includes prescription medications such as oxycodoneand hydrocodone, in addition to street drugs like heroin.

Athletes can be in more danger than others due to the culture surrounding sports and how people endure injuries and depression. Healthline revealed in a 2016 article that daily participation in sports can deter substance misuse, but more high-contact sports like football and wrestling lead to more opioid prescriptions, due to the wear and tear on a person’s body. Injuries from contact sports also are prevalent for teenagers, who do not have developed brains and are more likely to misuse the drugs, according to the National Institute on Drug Abuse.

“You don’t cry about it. You get back up. Even if it’s a serious injury, you act like it didn’t happen,” Philip T. Veliz, Ph.D., research assistant professor at the University of Michigan’s Institute for Research on Women and Gender, said to Healthline. “The level of competition in youth sports is very serious.”

When someone undergoes surgery for a serious injury, an opioid prescription is commonly prescribed to manage postoperative pain. A report on WebMD.com cites a study by Elizabeth Habermann, the scientific director for surgical outcomes at the Mayo Clinic in Rochester, Minnesota. The findings show which medical procedures lead to the most pain, including total knee replacements, spinal infusions, and rotator cuff surgery, all ones common for athletes. In a lot of situations, these types of surgeries led to refill requests.

“The fact that opioid overprescribing has fueled the prescription opioid crisis, which has recently morphed into an illicit opioid crisis, is no secret,” said Linda Richter, director of policy research and analysis at the National Center on Addiction and Substance Abuse. “The fact that it’s continuing to happen on this scale despite all we now know about the adverse consequences is frankly quite depressing.”

Athletes are highly prone to injuries, both long-term ones and chronic pain that occurs from daily exercise. Likewise, people who are physically active, either professionally or just for recreational health, could be more likely to develop a drug addiction from a painkiller prescription. Awareness of the effects of drugs such as oxycodone and hydrocodone, and how they can lead to heroin misuse, is important for athletes. Additionally, there is a strong connection between injuries and mental health disorders. Being sidelined for an extended period can lead to depression and a lack of self-identity. Discussing these fears and struggles with others, including therapists and peers who have experienced similar struggles, can help curb some of these negative emotions.

The most important part of enduring an injury is taking care of oneself physically and mentally. Whether it’s for just a few days or weeks into months, the pain will subside and the broken bone or torn ligament will heal. When this day comes, the basketball hoop, the soccer net, the football or baseball field, or simply the treadmill at the gym will still be there ready to enjoy.

a man in a purple shirt smiling at the camera.
By – Devin Golden
Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more
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The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.