WWW.SPORTEX.NET

“Hot weather is always difficult for me. So visualising running in hot, humid conditions is an important part of my training. I just visualise it being hot and not feeling warm. My technique is to imagine the absolute worst case scenario and then respond positively to it.” - Nancy Ditz, Olympic Marathon runner

of imagery, with 97% of them reporting it helps their performance (2). Clarity and control enhance imagery effectiveness. Clarity is achieved by using all of the senses; what you may see, hear, feel, taste, and smell. Also feeling the desired emotion further defines the image.

Visualisation control is important to achieve the desired effect. In return-to- play following rehabilitation, an athlete may rehearse the play she was injured on to rebuild confidence. She may be plagued by visions of the injury reoccurring. In this case, visualising a smooth and strong execution of the move with confidence, intensity and appropriate focus is desired. If guiding the image is difficult, the athlete may imagine using a remote control to direct the speed and outcome.

She would start by imagining the play at full speed. When the injury begins to occur, she would ‘stop’ the image and ‘rewind’; then progress in ‘slow motion’ through the proper and successful execu- tion of the play. Practising in this way develops the image until it can be visualised in normal time.

Injured athletes who recovered success- fully report using imagery more frequent- ly than those unsuccessful in their recovery (3). Imagery aids the healing process, increases adherence, and can replace physical practice during recupera- tion (4). These recovery benefits may be due in part to the physiological changes that occur, such as reductions of stress hormones cortisol and endorphin in the blood (5,6).

Types of imagery used Performance imagery Imagery prepares the athlete for the challenges faced in training, competition and rehabilitation. A ‘mastery style’ approach may include feeling calm and relaxed before an operation; intense and motivated during the middle stages of rehabilitation; confident when returning to the athletic field; and playing aggres-

8 SportEX

sively on the recovered body part from then on.

Coping imagery ‘Coping style’ rehearsal may be used to practise specific reactions to rehabilita- tion problems. Setbacks or treatment plateaus are proactively addressed when the athlete sees herself succeeding in each circumstance. It is important to begin with a clear image of the distress that might be involved including fear, frustration and pain. The athlete then imagines the appropriate use of relax- ation, self-talk and behavioural skills to overcome this distress and progress suc- cessfully in her rehabilitation.

Healing imagery Athletes can visualise the anatomy of healing and rehabilitation, improving their sense of control over the process. This practice may begin soon after the injury occurs and continue through rehabilitation to return to play as a way of building confidence in the injured body part.

Some athletes may prefer a more symbol- ic (versus an ‘anatomically correct’) repre- sentation. For example, a torn ACL may be viewed initially as a snapped rubber band that gets reattached through surgery. As rehabilitation progresses, the rubber becomes thicker and stronger, yet more flexible.

Pain imagery Sometimes the distraction provided by relaxation and imagery is not enough to tolerate the pain involved in injury or rehabilitation. In these cases, a more associative strategy may be preferred. Defining what the pain looks, sounds, feels, smells, and/or tastes like, creates an image that can be changed to bring relief.

A sharp, stabbing pain in the knee may be imagined as being caused by a sharp knife. The rate of stabbing may be decreased while the knife becomes duller with each cut. The metal of the knife may

change to a softer plastic or clay until the pain is perceived as a slow, dull throb. It is important that these changes occur very gradually to enhance control and the body’s ability to respond.

Conclusion Relaxation and imagery are an integral part of any mental training programme. The physical downtime caused by injury offers an excellent opportunity to develop mental skills and mental toughness. Relaxation and imagery enhance an athlete’s progress in rehabilitation and return to sport. Begin with relaxation and then continue with imagery using all your senses to enhance vividness. Include kinesthetic senses (ie. feeling body movement and positioning) and rehearse positive emotions (eg. intensity and optimism despite pain during exercise).

References 1. Mandle CL, Jacobs SC, Acari PM, Domar AD. The efficacy of relaxation response interven- tions with adult patients: A review of the liter- ature. Journal of Cardiovascular Nursing 1996;10(3):4-26 2. Murphy S, Jowdy D and Durtschi S. Imagery perspective survey 1990. Unpublished manu- script, U.S. Olympic Training Center, Colorado Springs. 3. Gould D, Udry E, Bridges D, and Beck L. Coping with season-ending injuries. The Sport Psychologist 1997;11:379-399 4. Jones L and Stuth G. The uses of mental imagery in athletics: An overview. Applied & Preventative Psychology 1997;6:101-115 5. McKinney CH, Antoni MH, Kumar M, Tims FC, McCabe PM. Effects of guided imagery and music (GIM) therapy on mood and cortisol in healthy adults. Health Psychology 1997;16:390-400 6. McKinney CH, Tims FC, Kumar AM, and Kumar M. The effect of selected classical music and spontaneous imagery on plasma endorphin. Journal of Behavioral Medicine 1997;20:85- 99

Dr Edmund O’Connor, PhD, is chief psychol- ogist of the PEAK, Pain and Headache Programmes at Rehabilitation Professionals in Grand Rapids, Michigan, USA. He is a certified consultant through the Association for the Advancement of Applied Sport Psychology and a member of the United States Olympic Committee.