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I'm Kelsey Royston, a licensed professional counselor, and I work at a physical therapy office providing psychotherapy. The reason that I got into this in the first place is because when I was playing volleyball in college, there weren't any mental health resources for people at that time, so I wanted to be able to do that. At my current workplace right now, we have return-to-play programs, but most of the clients that we see are adults who used to have some type of sport background. They used to run around, play soccer, and do things with their kids but now they've had some life-altering injury and don't know how to get back out there into exercising. So they still identify themselves as that athlete, but they're unable to do those things that they use to as an athlete. I work in a private practice as well, and that's where I see most of my athletes. It's usually students who get to come in after school when we have discounted prices, so that they are able to come in.

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Can you give an estimate of how many injured athletes you see per season?

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It depends on the day. Most of my clients are adults, but my specialty at my private practice is treating athletes. I see about a handful of athletes.

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What's the most common reaction you see from these seriously injured athletes immediately following the injury?

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When an athlete gets injured, they're immediately like, "I'm fine. Everything's fine. Nothing's wrong, everything's gonna be the same." Then they go get their MRI or they start to feel the pain setting and adrenaline's gone. It's either one of two things: they completely ignore it and they try to play immediately, or partake in risk-taking behaviors like alcohol and drug consumption and they stop going to class and seeing friends, etc. They think that they may not be able to play anymore that's when the risk taking behavior goes up and fill in the void with other things such as drugs now.

 

Are you the one responsible for steering them away from that risk-taking behavior?

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So I wouldn't be responsible for getting them out of that behavior, I would just make them aware of what's going on. When someone comes in, a lot of times they come in just because they're upset they can't play anymore. They don't even realize that they're filling it with drugs or alcohol or sex or other things to mask and take over that adrenaline rush. So how I do it is gradually point out these behaviors to them and let them know "Okay, you're feeling this way and now you're acting this way, so how do we change one of those things?" Changing one of those things will give them a better perspective of what's going on.

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What is the biggest mental roadblock you see these athletes recover from their injury?

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As athletes, living that athlete lifestyle is all we ever did. You didn't have spare time. You went to school then you went to practice then you went home and you're going to tournaments on weekends. Now that's completely taken away. So you want something to fill that time because you can't do what you used to do, so you don't know what to do with yourself. It's like your first time to actually have free time. So now you want to go do everything under the sun, even if it's harmful, you just don't even think about it.

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What aspect of the journey to injury recovery makes your patients the most sad or depressed?

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It's literally everything. So maybe it's the fact that they no longer have confidence in their body. They were this strong person, seen as an athlete, identified as an athlete and now they're not. They can't lift and sometimes can't even walk. They have to relearn how to do these things that they learned as a kid and it doesn't come back that easy. It's really hard work. Definitely the saddest thing is seeing someone struggle with identity, realizing "I'm no longer this person who I thought I was and life shouldn't be this way, but it is now." 

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What type of advice do you give to  those people specifically struggling with their identity?

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So that's what I work with the most, is people who struggle with an identity through any life changes such as not playing a sport, a bad relationship, a failed class, whatever happened. I help them work towards acceptance.

So how you do that, is going through the grieving cycle. You're going to be angry, you're gonna deny that it happened and you're going to do anything to make it back to the way it was. Then you're going to be able to accept it. So, allow yourself to go through that process and be okay with it. Once you're finally closer towards that acceptance, then make sure you're hanging out with friends and make sure you are still a part of that team. Still be a part of practice, still go to games if you can, even if coaches don't let hurt people travel, go anyway if you have the means to do that. Still do the things that you used to do before. It just might look different and I think a lot of people don't want it to look different, so they just choose to do completely the opposite. But just like you have muscle memory, you have emotional memory. So doing those things that used to make you happy is going to make you happy again also.

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What advice did you give to athletes trying to cope with their injuries and how effective was it?

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The thing that resonated with the patients that I've had, is the quote, "Perception is reality". So if you perceive that you are just an injured person, you're going to act like an injured person. You have so much power in how you feel and how much you can contradict pain even with just thought and action. So, if you look for the positivity you surround yourself with, seeing your environment positively, you can literally change how you feel about your pain and your life circumstance.

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Can you give insight regarding the stigma of student-athletes wanting to be perceived as tough?

 

So for athletes -both men and women, you're taught "You're not hurt. Rub some dirt in it. It's more important to win.Why are you crying?" Even if you are bleeding, they're like "It's fine. Don't get blood on your jersey, go back out there, we need your right now". Then you start to put together, "I'm needed only when I'm producing for someone." Now you can no longer be that productive person, again you have been trying to fill in other ways, but you feel weak. You feel

less strong and instead of people building you up and saying "It's gonna be okay, we're gonna work through this", they're like "Well it's not that bad. Who cares. You get to not have to practice. You don't have to go to weights at 6 A.M You're so lucky. In reality, you would do anything to just be in that weight room struggling with alongside your teammates.

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How do you think we can get rid of that stigma?

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I think with the students who are in college right now, are doing an amazing job at letting people know that they struggle with anxiety or struggle with depression and it's becoming more okay as more generations move through college. But, I think it's going to take the uppers in the school system to really make a big impact. You see that there's a need for mental health system and NCAA is just now coming around to it, and there's so much that goes on we don't see. I think if athletic directors and coaches had more training and understanding warning signs and symptoms, and just not treating their athletes like "Okay now that you're broken, we don't want you anymore". I think the students are doing the job, but the coaches and the administration can do a lot better.

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What words of encouragement would you give to someone who is too scared or hesitant to go to therapy?

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The main thing is try not to close yourself off. It's a big life change. You have to talk to someone. No one can read your mind. I wish I'd known that sooner when I was injured myself, otherwise I would've recovered a lot faster if I had taken that step to talk to someone. So if you want to get back on the field or the court faster, talk to someone to speed up your recovery. What I say to all the people I have for the first time in therapy anyway is: Time is gonna pass no matter what. You can either choose to show up and just have a conversation or not. You're just talking to someone who's actually listening to you and wants to help you. I find out so much more about people when I just be quiet and listen. People want to talk. Just like anyone reading this, they maybe want to go out and talk to someone. It's just a conversation. It's not scary. Once you get past that initial fear of judgement, you're going to realize that you're sitting across from someone who gets it. 

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What do you think is the difference between venting to a friend rather than venting to a stranger (like a counselor)?

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So when you're talking to your friends, you still want your friends to like you. You don't want to come across as complaining or whining and then they may not want to be around you anymore. You go to a complete stranger therapists, and they're just there for you to talk. There is no judgment. There's this open space and you get to fill it with whatever you want to talk about. You don't want to talk about what's actually going on? Then start talking about something else, and

it'll all come out. As counselors, our entire profession revolves around listening and understanding people. Your friends are not doing that as a job, even if they really care about you. That's why the client-therapist relationship is so important. There's boundaries set up so that you can come to this objective person, and you can spill your guts and they legally can't tell anybody about it. Your friends, on the other hand, can tell everybody.

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Top 3 Recovery Tips

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1. Get Involved in Something

You're going to have a lot more free time. You could fill that with friends or family or school or getting better at something. As an athlete, you're used to working hard and seeing progress, so it's going to be the same thing; it's just working hard in a different area.

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2. Allow Yourself to Go Through the Grieving Process

Get angry, get upset. It's okay. It's a complete life change. It's not going to be something that's simple, so just lean into that process and allow it to happen because only you have control over how long that part of your injury lasts.

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3. Set Small Achievable Daily Goals for Yourself

If your goal is "I'm going to get out of bed today", let that be your goal. If your goal is "I'm gonna try to walk today", let that be your goal and let that be enough. Don't beat yourself up if you can't complete the goal that day, literally setting a goal and trying to go do it is what's going to make you feel better.

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