Sports Psychology in Physiotherapy

The links between psychology and medicine are so close that for psychologists working in this field, medical knowledge is absolutely necessary. At the same time, physiotherapists are becoming more and more aware of the need for psychological knowledge for successful medical work. The relevance of sports psychology is determined by the basic position of medicine that clinicians should not treat a disease, but a patient. In recent years, psychological problems in medicine have increased significantly. Further, alongside the treatment of a sick person, the issue of prevention, rehabilitation, and psychotherapy is being raised. Psychologists are becoming more involved in medicine.

The Connection Between Mental Health and Physiology

We are born with basic emotions that we cannot get rid of:

• Sadness
• Joy
• Fear
• Anger
• Shame
• Disgust
• Interest.

They help us to react to stress and understand what is happening. In parallel with how we experience these emotions, something happens in our physical body. Very often people who turn to a psychologist about anxiety or fear complain of unbearable bodily sensations, which they, in turn, begin to assess as very dangerous.

Modern approaches to psychotherapy and physical therapy focus on three points: thoughts, emotions and bodily sensations. Imagine a triangle that has three support points. If we forget about one of these points in working with a psychological issue, there is a chance that we will not really work out the problem.

It can be easier to cope with external stressors, for example, some event, the words and actions of other people, the weather. The internal stressor is more difficult: self-esteem, self-flagellation, goal-setting, certain thoughts, physical sensations.

The process of coping with a stress reaction does not mean removing the stressor or eliminating the irritating factor. Of course, at the first stage of work clinicians remove the source of stress, but this is not enough. We need to send a signal to the body (this is all at the level of physiology) that we are safe again, that the threat has passed, that we can get back to the usual pace and rhythm of life. And such a signal is not a mental activity. This is the same physical activity where the pulse increases minimally, where there is contact with the body, where you notice that the sensations have changed. When we perform these actions, we are giving a signal to the body that we are safe again.

This chain of processes shows that psychological factors play a critical role in achieving high athletic performance in order to maximize moral and volitional potential. The same applies to different phases of the training process, the actual competition itself, as well as the optimal performance of physiotherapy treatment.

The medical field has recognized the importance of physical therapy in regard to injury recovery for many years. Specific exercise programs are carefully designed to strengthen the muscles weakened by injury so that the patient may return to normal functioning.

Although these methods are highly beneficial, they only address one aspect of the human body. Patients’ overall mental well-being plays a vital role in injury recovery but is often ignored or overlooked. It is imperative to identify the psychological effects of injury to ensure that the patient receives the most comprehensive care.

Causes of Overtraining, Overwork, and Burnout

The states of overtraining, overwork, and burnout that arise as a result of grueling workouts inevitably lead to a decrease in athletic performance and mental overstrain.

Overtraining is an excessive lengthening of the training process.

Overtraining causes mental irritation, pain, and a higher risk of injury for athletes. Often the cause of overtraining may have nothing to do with sports activities.

However, the main reason for overtraining is excessive intensity of training. This leads to overwork, the main psychological characteristic of which is depression, leading to complete burnout of the athlete.

Burnout is a complex psychophysiological reaction characterized by exhaustion. It manifests itself in such forms as:

• Indifference to the activity being carried out
• Dissatisfaction with it
• Depersonalization
• Deterioration in the overall quality of life
• Development of neurotic disorders and psychosomatic diseases.

Burnout includes psychological, emotional, and sometimes physical withdrawal from activity in response to excessive stress or dissatisfaction.

Can it be applied to physiotherapy practice?

Overtraining and overwork contribute to the emergence of emotional burnout, that’s a fact. But regular physiotherapy appointments can be a real test for ordinary people, not only for elite athletes. In this regard, providers should choose the right combination of procedures and bearable loads for each patient.

The flow of treatment should be discussed with a patient to ensure that he does not feel tired, physically exhausted, or experience sleep disturbances afterwards. Mental performance during therapy, mood changes, overestimation of values, and even anxiety levels should be monitored. Lack of desire to continue therapy due to a health issue or uncertainty should be addressed as quickly as possible.

The efficient result of combining physical practices and psychiatry work is a diagnosis, recommendations for additional examinations of the patient and a plan for the use of physiotherapy courses of treatment. The data of the treatment process is easily stored, analyzed and transmitted with the help of practice management software.

One of the tasks facing a physiotherapist who helps patients with mental disorders is to change pain sensitivity. Physiotherapy may activate one positive symptom while weakening the severity of another mental disorder, as well as reducing the appearance of negative symptoms.

Psychological Attitudes of Patients and Pain Experience

According to the Association for Applied Sport Psychology, if we talk about traumatology, we see that physical injuries also entail psychological problems. For example, phantom pains are pains that are felt by a person with an amputated limb. They can accompany a person all his life.

Currently, psychotherapeutic techniques have been developed and are being applied in practice by sports psychologists. These techniques show that these pains are psychological in nature, and they can be removed purely psychologically.

Knowledge of the personal characteristics of a sick person is necessary for a clinician to determine the prognosis of the disease. Additionally, you will be able to choose the right therapeutic and psychotherapeutic tactics. As a result, you can timely inform the patient of the diagnosis and much more.

Moreover, in some cases, the revealed physical pathology does not correlate with the intensity of pain or the degree of disability.

What determines the severity of pain and the different responses of patients to identical treatment?

Numerous studies show that psychological and mental skills (the level of anxiety, depression, satisfaction with family relationships, gender, professional and financial viability, negative thoughts etc.) have a significant impact on the perception, maintenance and intensification of pain. One of the factors on which the success of treatment depends is the psychological attitudes of patients.

Attitudes towards events and people can be positive (a patient who willingly and accurately follows all the instructions of a specialist adheres to the attitude resulting from a positive attitude to medicine in general) and negative, assuming the nature of prejudice.

Pain Attitudes

Working with patients suffering from chronic pain you might notice that many of them lack mental toughness. What does it mean?

They experience mood changes, problems taking medications, decreased activity, difficulties getting a job, and family conflicts. Furthermore, such patients frequently do not follow the prescribed treatment and diagnosis.

For example, they expect and even demand the repetition of invasive diagnostic and therapeutic measures. Both of these have already been done and have proven to be uninformative or ineffective. Recommendations to increase physical activity, use fewer medications, and practice relaxation techniques did not suit patients. Many of them believe that their case is special, and an exercise psychologist simply underestimates the severity of the situation.

In the treatment of patients with chronic pain, you can obtain the most valuable information assessing the direct relationship of a person to pain. It can be the key to diagnosis and finding a way to control pain.

A patient’s attitude, including his belief in the need to continue diagnostic studies and interventions, has a significant impact on the effectiveness of physical therapy.

Keep in mind that a patient’s attitude to pain and his reactions are to be stated in physical therapy progress notes.

Treatment of Psychosomatic Disorders with Physiotherapy

Patients with psychosomatic disorders can visit doctors of any specialty. In some cases, diseases can manifest because of unmotivated shortness of breath and palpitations, in others by nausea, vomiting and diarrhea, and in some by pain syndromes.

If the examination does not reveal any signs of organic disease, then this fact should suggest the need for psychiatric help.

The basis of diagnosis is a conversation with the patient. It is only on the basis of how the patient presents complaints that one can think about the presence of psychosomatic disorders. If the clinician has enough time to clarify the circumstances associated with the onset or exacerbation of the disease, if he finds accurate words to clarify traumatic situations, then the picture of the disease will begin to emerge.

Neurotic states often develop against the background of existing somatic diseases, intoxication, traumatic injuries, vascular diseases of the brain.

The main treatment of patients is a combination of psychotherapy, pharmacotherapy and physiotherapy: physical therapy, massage, acupuncture, electrotherapy, magnetotherapy, light therapy, water and heat therapy.

Color light therapy is exposure to violet light on the back of the head for 10 minutes. Purple color has a calming effect on the nervous system, relieves headaches, lowers blood pressure, reduces muscle tension, reduces hunger, helps with low self-esteem, and has an antibacterial effect.

Performance Psychology for Amateur Athletes

If you go the gym or play any sport a few times a week, you are an amateur athlete. And like any other sports person, you can experience stress. But as a healthcare professional, you can suggest your patients the easiest and most productive ways to improve their self-confidence and reach high performance.

It is necessary to start with introspection, goal setting, mental training and training in sports techniques even before basic training.

This applies not only to professional sports! At the heart of mental training is the habit of positive thinking. In addition, a person who expects a high result needs all his psychological resources:

• Strong internal motivation, no need for external motivation
• A winning attitude
• The ability to draw a parallel between the result and athletic form;
• Willingness to learn from mistakes and ability to withstand criticism
• Positive but realistic thinking, the ability not to give up under any circumstances
• Control of feelings and emotions
• Concentration of attention
• Stable state of vigor
• Self-confidence during competition
• Self-talk as a soothing practice
• Awareness of his potential and the ability to show it in every performance.

As a specialist, your job is to constantly remind patients that even with the most qualified physical therapist and psychologist in the world with the most detailed plan, no one will be able to accomplish their goals.

Before setting a goal, they should consider whether their desire to run marathons is true or if it is an idea imposed by fashion, and therefore unneeded for them? If the goal is based on their personal dreams, preferences and interests, it will be much easier to keep motivated.

The path to success will be free of serious psychological failures. The same applies to sports teams and recovering patients.

A sports organization doctor, or a physical therapist in a medical institution must understand that overloads have psychological consequences. He must:

• Participate in solving psychological problems related to load, overload and recovery
• Monitor the patient’s load and his reaction to this load
• Be able to adjust the load when adverse symptoms appear.

To carry out this mission, he must work closely with coaches and other team members. The physical and mental health of the athlete also depends on them.

Psychology helps motivate your patients to train and do not miss physical therapy sessions consider the environmental impact of their goals. It allows them to keep up to wellness program.

Wrapping it up, everything will work out with the proper balance of physical and psychological preparation.