MMA Psychology: The Psychological Impact of Injury

It should have come as no surprise when Anderson Silva recently opened up to Fantastico about working with a psychologist to banish the “ghosts” of the horrific tibia-fibula fracture he suffered against Chris Weidman at UFC 168.

Then again, it has long been easy to trivialise the importance of mental health. Intuitively, we seem to have a dualistic conception of mind and brain, and this erroneous view has had a deleterious effect on the general perception of mental health.

The prevailing attitude seems to be that physical ailments require medical intervention, while mental ailments can be overcome by sheer force of will.

The truth is that there is no meaningful distinction between physical and psychological health. Telling someone with clinical depression that they have no reason to be depressed is as wrongheaded as telling a dementia sufferer that there’s no reason for them to have dementia.

Psychological issues can be every bit as debilitating as physical ones. Mental scars often linger long after a physical injury has healed.

Imagine, if you will, snapping your leg after throwing an inside leg kick. How long would it take for you to be comfortable committing to that technique again? Would you ever fully trust that limb in subsequent fights? Would those doubts become pervasive?

There are many mental hurdles that can arise after a serious injury. Of course, how individuals respond to injury varies. Some may take it in their stride, while others slide into crippling depression.

“There are many varied types of responses to injury,” points out Dr. Michael Gervais, director of High Performance Psychology at DISC Sports and Spine Center. “Some athletes meet it head-on with a focused intent: ‘OK, let’s get the brightest minds together to help provide a smart game plan. I’ll put in the work once I know what direction to take.’

“Some athletes get stuck in the information-gathering process, feeding overthinking and anxiety: ‘OK, I have four professional opinions, I’ve talked to everyone I know about what I should do. I’m not exactly sure what course of action to take, I’m a bit overwhelmed by this, maybe I’ll talk to a few more folks about a game plan.’ And some athletes become completely overwhelmed with the idea that all of their goals and dreams are going to slip right through their fingertips, finding themselves feeling hopeless: ‘My life is upside down, and I can’t see how this is going to work out. I’ve wasted so much of my life training and now this.’”

There are many variables that play into how a fighter will respond to physical adversity. Along with the quality of the athlete’s social support network, the extent to which personal identity is tied to athletic achievement is arguably the most salient factor in determining the response.

The more successful the athlete, the more likely athletic achievement is going to be a disproportionately large component of personal identity. The loss of such a significant part of one’s sense of self can be traumatic even for athletes who go out on their own terms.

This is perhaps one reason why making a graceful exit from the fight game is such a rare occurrence—retirements often either come too late or simply don’t last. When not afforded the luxury of exiting on one’s own terms, the psychological trauma of injury can be particularly acute.

“When an athlete has foreclosed on his or her identity, only seeing himself as ‘an athlete,’ he tends to have a more difficult time moving through the injury process,” argues Dr. Gervais. “When this person is no longer able to do what defines him, he runs straight into a crisis—could be small, could be big. When the person has a more rounded approach in life, seeing himself as multi-dimensional, with a high emphasis and attention to detail in training the athletic side of himself, he often has an easier time moving through the phases of injury.”

As anyone who has endured physical hardship doubtless knows, recovery is not always a smooth process. One need only look at the case of former UFC bantamweight champion Dominick Cruz to remind oneself of how psychologically challenging rehabilitation can be.

There is a huge role for luck in life, and few experiences reinforce this fact more painfully than physical rehabilitation. Setbacks occur, goals are not met and continuing with the process can seem futile to the point of masochism.

In the case of Cruz, it took him almost three years to return to action after suffering an initial ACL tear, followed by numerous setbacks. How does one cope with such a calamitous run of bad luck?

“During any setback or obstacle, the person is challenged to find a new path toward his goal, as the intended route is no longer as smooth as planned,” suggests Dr. Gervais. “This new route tests one’s ability to be resilient (adjusting to new information). Resiliency is only developed by going through challenges and accepting and adjusting, in a resourceful way, to the new set of conditions. 

“Having clear goals, and knowing that you’ll adjust if the goals are not met on time, is a powerful strategy to stay on course. Effective goals help people articulate a plan that puts them in control of a process that is controllable (i.e. effort, intensity, attitude, diligence, attention to detail). During the injury process, it’s unfortunate if this is the first time the athlete has been exposed to effective goal setting.”

When one has been as successful as Anderson Silva and Dominick Cruz, a common fear is that some part of what created that success is irretrievably lost after a serious injury. Such fears are rational and not altogether empty.

It would be disingenuous to say that all injuries are surmountable or that it is always possible to return from injury unscathed. As Cruz discussed with MMAJunkie Radio after his sensational return against Takeya Mizugaki, assuaging those doubts can take time and doesn’t necessarily immediately come hand in hand with successful physical rehabilitation:

Once you get to a fight, you’re like, I’m used to feeling this. Well, it had been so long since I’d been at the show, I didn’t know what it was going to do to me when I walked through. All I could do is speculate and hope

What brings fear is the unknown. I was still questioning what my nerves were going to do to me, but when I got into the room with those fighters, I felt more comfortable than I’ve ever been in my career.

That being said, it’s debatable whether getting back one’s former self should be the goal when dealing with a serious injury. Indeed, in many circumstances the rehabilitation process can be viewed as an opportunity for—and I hesitate to use such a tarnished word—growth.

As previously mentioned, this may not always be possible. But when an athlete is faced with months or even years on the sidelines, stasis can begin to feel like a deficit. If nothing else, time is lost, and time is not the professional athlete’s ally.

Athletic careers are short, and one’s prime is even shorter. Therefore, using that brief time to improve is vital, even when coping with serious injury and circumstances appear antithetical to growth.

“It’s not possible for the athlete to be the same. It’s not possible for any of us to be the same as we once were,” states Dr. Gervais. “The goal is not to ‘get it back,’ but rather to ‘upgrade a new version.’ Hopefully the athlete will have met the mental challenges, if any, head-on during the rehab and strength training process and will have developed deeper resiliency, becoming mentally stronger, with higher resolve. How exciting is that?”

James MacDonald is a freelance writer and featured columnist for Bleacher Report. All quotes obtained first hand unless otherwise noted. Follow James on Twitter.