A year ago, I had a skiing accident which left me with four fractured vertebrae in my neck. Finding myself on the other side of the patient/physio relationship has taught me a lot about what it takes to achieve successful rehabilitation.
In my last blog on the topic, just three months after my injury, I talked about the discipline required for recovery and why we shouldn’t coddle people who are injured and instead support them as they get back on their feet.
This time, I want to talk about the mental health aspect of rehabilitation.
Injuries are a traumatic experience. Like all trauma, there are psychological consequences that you have to manage, and overcoming those is just as important to successful rehabilitation as doing your exercise.
One of the most common psychological obstacles you have to overcome during rehabilitation is fear avoidance.
It’s easy to become phobic of whatever activity, environment or other factors which were responsible for your injury. Once response is to avoid putting yourself in a situation which triggers that fear.
For example, someone who hurt themselves after falling off a bike might avoid cycling, or someone who fell down the stairs on a bus might avoid the top deck.
I knew going in to my rehabilitation that my mind would try and steer me away from fear-inducing situations, and I took an active effort to pay attention to any unhealthy thinking and deliberately put myself into positions of risk.
After weeks of wearing a neck brace, feeling vulnerable and being treated like I was vulnerable, it was my number one priority to return to doing every activity I enjoyed with pre-injury confidence.
Despite the fear in the back of my mind that I would hurt my neck again, I continued to play basketball or let my kids ride on my shoulders. When coaching football, I initially avoided doing header drills, but I recognised the fear avoidance and went ahead with them.
Each time you push through fear avoidance, the less the hold this unhealthy psychological habit has on you. You demonstrate to yourself that you are still capable and that, just because something bad happened once, doesn’t mean it’s going to happen again.
It’s not a trivial process: it requires you to physically push through experiences that your mind is trying to pull you away from, but each time you overcome your fear it gets a little easier.
My own process culminated last week when I went skiing for the first time since my neck injury.
My fear was at its peak when I was standing at the top of a steep slope. I took a deep breathe, started my descent and it wasn’t long until I had a crash.
After lying in the snow for a moment, I got back to my feet and laughed to myself. I had put myself in the exact situation which fractured my neck last February and I felt great.
I had overcome my last psychological hurdle, and enjoyed the rest of the trip. A year on and – aside from some occasional stiffness in my neck – life is back to normal.
Clinical Director and Prescriber
B.PHYSIOTHERAPY PG CERT INDEPENDENT PRESCRIBING, MCSP, MHCPC