FEAR OF RELAPSE

Factors that slow down rehabilitation

During the recovery process, the most limiting psychological factor is often the fear of re-injury (kinesiophobia).

This fear may persist even when the biological tissue has completely healed.

The athlete may manifest this fear through avoidance behaviors, unusual pain complaints with no medical basis, sleep disturbances, or erratic compliance with rehabilitation guidelines.

This defensiveness creates a "self-fulfilling prophecy" cycle: fear leads to overprotection of the area, altering natural biomechanics and increasing the risk of further injury in other areas by compensation. Consider an alpine skier recovering from knee surgery.

Although the doctors release him, he continues to ski with his body weight delayed and rigid for fear that the knee will fail in a turn.

This unnatural, fear-driven posture not only reduces his performance, but puts unnecessary mechanical stress on his hips and back, slowing his return to the optimal competitive level.

Strategies for normalizing feelings and reassuring the athlete

To combat the fear of relapse, it is crucial to implement a psychological approach integrated into physical therapy.

Strategies include normalizing the experience of fear, explaining to the athlete that feeling apprehensive is an adaptive protective response and not a sign of weakness.

It is also essential to reassure about the benign nature of certain residual discomfort that does not imply harm.

The psychologist and medical team should work to constantly clarify the actual status of the injury, using objective data to counter subjective perceptions of frailty.

For example, showing a rugby player that his isokinetic strength tests equal those of his healthy leg may give him the cognitive confidence to return to perform tackles with the required intensity, deactivating the unconscious "muscle guard" his brain had established.

Summary

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