This month we examine the painful topic of athletic injuries (ouch!) ... and offer some tips for successful coping.

Injuries were recently described as the greatest source of stress, and single most important issue in sports. They may lead to emotional problems such as anxiety and depression, and unhealthy behaviors such as increased drug and alcohol abuse. These negative moods and behaviors place the athlete at risk for prolonged rehabilitation and further behavioral problems.

There are an estimated seventeen million annual sport injuries in the United States alone, but surprisingly little research has examined the consequence of sport injury or psychological factors which may promote healing. For example, why do some athletes adjust to injuries with increased optimism and effort, while others with even less severe physical damage plunge into the depths of depression or fail to comply with treatment recommendations? These types of questions prompted me to pursue this topic for my dissertation at the University of Florida.

Although more severe injuries obviously occur in contact sports such as football and boxing, injured tennis players may also endure great distress from any number of losses including lost playing time, forfeited scholarships, decreased self-esteem, or simply the lack of a pleasurable outlet.

Sport psychologists are becoming fully integrated members of the world's best sports medicine teams, involved in all aspects of athlete care including injury prevention, assessment and rehabilitation. Whether you have access to a sport psychologist or not, the following are some tips to help you, or those close to you, in coping with a difficult sport injury. Keep in mind that these tips are never a substitute for qualified professional care:

1. Maintain a positive, yet realistic, attitude about injury diagnosis and treatment options.

2. Make sincere efforts to understand how the athlete interprets the meaning of the injury, avoiding careless assumptions. This knowledge defines the scope of the loss, and sincere empathy goes a long way toward recovery.

3. Social support protects against many negative effects of stress. The athlete should stay in touch with friends, family, and teammates on a regular basis.

4. Successful performance imagery should be used to keep skills and strategies sharp, even when real practice is impossible. Regular imagery can also be targeted to help defeat the fear of re-injury.

5. Difficult yet attainable short- and long-term goals should be set to monitor progress and speed recovery.

6. Seek professional therapy when severe psychological distress is suspected (e.g., depression or severe anxiety).