In this blog, I’m going to discuss one of the biggest barriers to injury rehab and often one that holds a lot of  people back. This blog is for education purposes only.

Introduction

When recovering from an injury, you often put your focus on the physical side of rehab so focussing on strengthening, mobility, fitness and gradually returning to sport/activity.

But clinicians, physio’s and therapist often miss the importance of also addressing the psychological side of rehab! Fear of re-injury is often one of the most common things people say.

You can have all the strength in the world, the mobility to move well and the physical capacity to return to sport – but if you are lacking confidence and are scared of it happening again, you may just be holding yourself back.

I will say before we delve into this topic in more depth, it is also not easy to just one day wake up and be full of confidence again without a fear in mind. These things take time to improve!

Why does fear of re-injury actually happen?

After experiencing an injury, your brain naturally becomes protective. This is a completely normal response.

You remember the movement or activity that caused the injury, the pain you experienced and the time you spent unable to do what you wanted. As a result, your brain may associate certain movements or activities with danger.

This can lead to thoughts like:

“What if I hurt it again?”

“I don’t think I am ready yet.”

“That movement does not feel right.”

“I do not trust my body.”

“I do not want to feel like that again.”

But the problem is, by avoiding these perceived dangerous movements or activities, can sometimes increase the fear.

Pain does not always mean you are damaging yourself!

One of the most important parts of rehab is education! Understanding the difference between pain and damage is one of the things we like to focus on, especially within your first appointment with us.

Some discomfort during rehab and general movement is usually completely normal, particularly when reintroducing movements that have not been performed for a while.

This does not mean you should ignore pain or push through everything. Instead, your rehab should gradually expose you to movements and loads in a controlled way, helping you understand what your body can safely tolerate. Over time, this should be gradually increased.

Confidence comes from positive experience.

The more you safely perform a movement or activity, the more your brain begins to switch the narrative and understand that the movement is not necessarily dangerous.

Rehab is NOT just about getting stronger

A common mistake we see in the rehab world is people thinking:

“When I am strong enough, I will be ready.”

Like I said at the start of this blog, the physical side of rehab is very important, but returning to sport or normal activity also requires confidence.

By gradually exposing your injured tissues to more load and stimulus over time, allows both your body and your brain to adapt.

For example, an athlete returning to football after a knee injury may initially be comfortable performing a heavy box squat of 150kg but become nervous when asked to jump as this is what caused his injury in the first place.

That does not mean they are physically incapable as clearly very strong but it just means they have not been exposed to those movements enough yet to be fully confident in doing so.

Equally, avoid waiting until you feel 100% confident

This is a very important one. Many people believe they need to feel completely confident before retrying a specific movement or returning to activity. But in reality, confidence often comes after exposure, not before it.

You may feel nervous before your first time kneeling down again, your first run, first change of direction or first training session, and that is absolutely fine.

The goal is not necessarily to eliminate fear completely. The goal is to develop enough confidence and understanding that you can perform those movements and activities, despite some uncertainty.

Conclusion

Fear of re-injury can be one of the biggest barriers to a successful return from injury. After experiencing an injury, your brain naturally becomes protective, which is a completely normal response.

Avoid just purely focussing on the physical side of rehab, address the psychological deficits too. All of the available evidence supports this to achieving better outcomes.

Your rehab should gradually expose you to movements and loads in a controlled way, helping you understand what your body can safely tolerate, and the more you safely perform a movement or activity, the more your brain begins to switch the narrative and understand that the movement is not necessarily dangerous.