Psyche of the Injured Athlete

The unspoken truths of physically and emotionally injured athletes.

Posted Mar 06, 2019

     “To me, there is no better place to be than on a court with a basketball in my hand. To explain this is very difficult. It was a passion and a dream . . . Now, there is just passion and a different dream.” —Laura Miele, 1992

Laura Miele, Ph.D.
ABL try outs Emory University circa 1995
Source: Laura Miele, Ph.D.

The blissful mental state of being on the court or the playing field is like no other feeling in the world. For most, being an athlete becomes their identity; being an athlete is embedded in their soul. It is an inner life, an inner fire. When one yearns for something, they sacrifice all they can to achieve success. It is not only about the success; the fact that one can truly create something within themselves that lifts their self-worth makes an athlete willing to give up everything (e.g., family, social life) and reach for nothing more.

When an athlete with a promising future succumbs to a career-ending injury, it can be devastating. It has been hypothesized that individuals who derive their self-worth solely from their identity as an athlete are at increased risk for depression after experiencing an athletic injury (Brewer, 1993; Heil, 1993). The range of emotions that they experience is tumultuous at best. I know this, because I was one of those athletes. You go to a dark place. The physical and mental pain takes you into a world you have never been to: “Grief encompasses a culmination of reactions, including fear, rage, guilt, blame, and the tendency to be self-destructive” (Pohl, 1996, p. 117). 

AZ ST U 1990
Laura Miele, Ph.D.
Source: AZ ST U 1990

For the past 20 years, I have studied and worked with injured athletes. After a career-ending injury, these athletes fall into depression and suffer moderate anxiety that encompasses thoughts about their physical recovery and what kind of future lies ahead: “Depression occurs with events that disrupt the roles by which people define their worth, if these people lack alternative sources of self-worth” (Brewer, 1993).

While working with injured athletes, I tell them to remember what made them an athlete in the first place and begin moving forward by setting one goal at a time. Goal setting as a motivational tool allows athletes to translate commitment into specific and relevant actions (Ford et al., 1993). Goal setting can empower an injured athlete, as long as the goals are realistic and short term. The acquisition of small successes, such as getting stronger physically, leads to becoming stronger mentally. This journey takes time.

Working with injured athletes takes patience. They not only need physical assistance, but also social and emotional support. When something so personal, something you have dedicated such hard work to and sacrificed so much for, is taken away, it is a loss like no other. It is a death, a divorce, a loss of oneself.   

     “Sometimes an athlete can fall prey not just to the injury itself, but to the emotional trauma that surrounds it” —Heil, 1998, p.34

Laura Miele, Ph.D.
NYC Golden Gloves 2004-Semi Finals
Source: Laura Miele, Ph.D.

But, you keep pushing and keep on fighting.

More often than not, in order for something to be fixed physically, it first needs to be fixed mentally and emotionally. After my injury, I began researching books on positive living and thought processes, anything that would inspire me to follow a new path to fill the void. I did not have the support I needed and began to isolate myself, which was the wrong thing to do. Social support is one of the most important coping resources available to athletes to reduce the debilitating effects of the stress response (Petrie, 1993). In order for the injured athlete to perform successfully in rehabilitation and in life after, the athlete must believe things are going to be all right. This is where social support from the athlete’s teammates, friends, family and rehabilitation staff is imperative. 

The transition to becoming a non-competitive athlete was traumatic. The loss of a sports career, no matter the type of sport or how early or late in a career, feels as if the carpet has been pulled right out from under the athlete’s feet without warning, like hitting a brick wall.

Today, recovery is not just about overcoming the physical injury itself; getting over the mental and emotional injury amongst athletes is also a common problem. Recovery takes time; it takes great strength to move on and to let go. These are not always easy tasks for someone who was or felt they were on their way to a plush athletic career. The athlete experiences loss at all levels; not only does a career get lost, but the friendships and the camaraderie that were built along the way disappear as well. 

     “Without sports to help define or evaluate themselves, many athletes are left confused as to their identities, low in self-esteem and confidence—Crook and Robertson, 1991, p. 119

Sport psychologists should understand that the end of an athletic career is a traumatic transition; goals must be set to create hope and avoid situational depression, which can become chronic.  

Athletes have a fire within and a passion; their energy needs to be channeled in a positive capacity for them to realize they still have limitless potential, even if it is not on a court or a playing field.

Take-Home Points

  1. An athlete does not lose their motivation if directed and reminded that even though there was a loss, there still is so much to gain. There can always be a different or parallel dream with even more to gain.
  2. Identifying when an athlete has lost themselves will happen either by a coach, friend, or sport psychologist before the athlete even knows it themselves.
  3. The mind will only be defeated if it fails to identify its strengths.

Thank you to all the coaches who never gave up on me. You know who you are, the latest being Tony Paollilo. What an amazing boxing trainer; you made me feel like I could hang the moon. Thanks, Tony!  


Brewer, B. (September,1993). Self -Identity and Specific Vulnerability to Depressed Mood. Journal of Personality. 3(61). Pp.344-354.

Brewer,B., Van Raalte, J., & Linder, D. (1993). Athletic Identity: Hercules' Muscles or Achilles Heel? International Journal of Sport Psychology, 24, 237-254.

Crook, J. & Robertson, S. (1991).  Transitions out of Elite Sport.  International Journal of Sport Psychology, 22. pp.115-121.

Ford, J. & Gordon, S. (1997).  Perspectives of sport physiotherapists on the frequency and significance of psychological factors in professional practice; Implications for curriculum design in professional training.  Australian Journal of Science and Medicine in Sport. 29, 34-40.

Heil, J. (1993). Psychology of sport injury. Champaign: IL; Human Kinetics.

Taylor, J & Taylor, S. (1997). Psychological Approaches to Sports Injury and Rehabilitation. Aspen Publishers.  Aspen: CO.

Petrie, T. A. (1993). The moderating effects of social support and the playing status on the life stress-injury relationship. Journal of Applied Sport Psychology, 5(1), 1-16.