Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.
Returning to Sports after Injury: How to Overcome Your Fear
Getting back to a sport or activity after an injury involves mental effort just as much as physical.
Advice to improve your movement, fitness, and overall health from the world's #1 in orthopedics.
If you’ve ever been injured during a sport, you’re probably familiar with the mental hurdles involved in getting back on the field, court or slopes once you’ve healed. “Injuries can take a toll on our thoughts and emotions, sometimes even more than the physical injury to our body,” says Julia Kim, PhD, a psychologist at HSS who helps athletes cope with a fear of reinjury. “Physical stress from an injury can lead to fear and anxiety. Fear can cause the body to tense and our thoughts to become stuck in a negative loop. This can result in a slowed and difficult recovery.”
To put this in context, Dr. Kim explains what happens when a person experiences a traumatic event, like an injury. “Let’s say you twist your foot and fall playing soccer. When you stand, you experience severe pain and can’t walk. When you try to put pressure on your foot, the pain takes your breath away and you become fearful of putting weight on your foot. The brain has a pathway to process this sensory information (the stimulus, which is the injury and anything associated to it) to tell us what is happening, how to feel and how to act.”
First, the sensory information of the event (what you see, hear, smell, touch, say, etc.) is processed and your brain works out what happened. That information is stored in your memory along with an emotional association with the event. Then, the combination of these details tells us how to respond and activates our response to fight (do something to help ourselves), freeze, or flight (avoid).
“All the sensory information from the event is strongly linked to the emotional response,” says Dr. Kim. “This means that any aspect of the event—no matter how small—can trigger the same emotional response, such as fear. You might be aware of the fear, such as if putting weight on the foot is frightening, or you may not be aware, as if the smell of grass as on the soccer field suddenly makes you afraid.” When that emotion is triggered, it could lead you to avoid putting weight on your foot or freezing altogether.
Changing the Brain
So how can you use your brain to get you back to your sport?
Fortunately, says Dr. Kim, “our brain can change and adapt throughout life by reorganizing its neural connections and pathways. This is known as neuroplasticity.
This adaptability allows the brain to learn new skills, recover from injuries, and compensate for deficits. We have the ability to apply this when fear of reinjury is preventing us from returning to a sport or activity that we enjoy.”
When you return to your activity and feel that rush of fear, your brain isn’t processing what is happening in the moment—it is reacting as if you were experiencing the injury again. In other words, the emotional response happens first, bypassing the processing of the present stimuli.
"We can achieve this by focusing on facts about the current situation,” says Dr. Kim. “Facts are truths, not emotional interpretations. For example, when your physical therapist asks you to put weight on your foot, facts could include that your doctor and physical therapist believe you are ready to put weight on your foot, that you need to start using your foot to recover, that you trust your physical therapist, or that though you may be scared, you are in a safe environment. If you’re able to resume your sport, your facts might be that you worked through your rehab and are stronger than before the injury. While it may indeed be a fact that you are scared, that fear can be contained by the other facts, so you can take control of your emotions.
“By actively processing facts in the present, you can work through fear of injury and reach your goal,” she adds. “For further guidance, working with a psychologist can help you understand your specific situation, fears and provide you with what you need to succeed.”
Dr. Kim shares more information about how the mind, body and emotions work together to control what we feel.
Mind
Have you ever wondered if a pain or feeling you have is “all in your head?” Technically, it is. The brain is a complex network of cells called neurons that receives information from inside and outside your body. It is estimated that the human brain has close to 100 billion neurons. These cells generate electrical impulses used to send and receive electrical messages to other neurons by releasing chemicals called neurotransmitters. These electrical signals spread out like waves in the body, enabling us to think, feel and act. So, yes, what you are feeling is all in your head!
Body
The autonomic nervous system includes two parts: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS is linked to the “fight or flight” response, which prepares us for stressful situations like injuries or surgical recovery. When the SNS is activated for too long, it can stress the body. The (PNS) has an opposite and complementary role. It is responsible for the “rest and digest” response and acts as a reset button to help us feel calm and safe.
Emotions
The limbic system is a group of structures in the brain. It controls emotions, behavior, motivation and memory. These parts work with other areas of the brain to process memories, thoughts and motivations, and then tell the body how to respond emotionally. While small in size, the limbic system has a big job: to help you interact with the world around you.
Published 5/14/2025
