REHABILITATION PSYCHOLOGY

SPORTS SKILLS APPLIED TO REHABILITATION: RELAXATION & IMAGERY

By Dr Edmund O’Connor, PhD, sports psychologist

Rehabilitation of a sporting injury is fre- quently a time of stress, fear and pain. These experiences slow healing by excit- ing the body’s fight or flight response, increasing the body’s arousal level. Psychological effects include decreased concentration and anxiety that can lead to poor rehabilitation execution and non- compliance. Physical effects include exces- sive muscle tension, a natural tendency to tighten muscles as a way of isolating and protecting an injury. This guarding behav- ior increases pain through excessive wear and tear on the muscles involved and risks a chronic injury pattern.

Relaxation The relaxation response is the physiologic opposite of the fight or flight response.

Research shows it produces reductions in pain, insomnia, hypertension, anxiety, medication use across multiple popula- tions, diagnostic categories and settings following relaxation (1).

Diaphragmatic breathing is one the most commonly used and effective relaxation techniques. Athletes typically use their breathing to control their optimal level of arousal during competition. Breathing serves as the ‘on/off’ switch to the body’s excitement level. When breathing becomes rapid and shallow (ie. mainly chest breathing), it serves as a signal to the body to activate the fight-or-flight response and increase arousal (eg. muscle tension, increase heart rate and blood pressure). This may be desirable to ‘get up’ for the game, but it is rarely desired during rehabilitation. Instead diaphrag- matic breathing is preferred as the athlete

draws her breath deep into the diaphragm and feels her stomach rise as opposed to her chest. Ideally, breaths will be taken into the diaphragm at a rate of 8-12 breaths per minute. This stimulates the relaxation response and promotes recov- ery by decreasing tension and increasing blood flow to the affected area. The injured athlete is encouraged to practise this breathing technique before and dur- ing rehabilitation exercises to maximise the effect of physiotherapy. Relaxation done before imagery also enhances the effectiveness of visualisation.

Imagery Imagery, or visualisation, may be thought of as a goal-driven, controlled daydream. Athletes commonly use imagery to enhance relaxation and improve physical performance. Ninety per cent of US Olympic athletes report using some form

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