The Performance Act

The psychology of injury

Injury turns up in almost every sporting journey at some point, and for a lot of athletes it brings a good deal of mental noise with it: contracts, selection, whether they will ever be the same player again.

So this week we are taking a quick dive into the psychology of injury, and some of the tools coaches and athletes tell us they find useful.

A good place to start is with what happens after an ACL reconstruction. Research has shown that around 85 percent of athletes go on to reach a clinically satisfactory outcome, but only 63 percent get back to the level they were playing at before. Those figures come from the same body of research, and they are answering two very different questions. One asks whether the knee is repaired. The other asks whether the athlete is back.

Plenty sits in the gap between them. Graft quality, access to good rehabilitation, age, code and level of sport all play their part, and so does what is going on in the top two inches.

That gap is what a 2024 consensus statement in Sports Medicine sets out to explore, written by seven researchers with more than 130 years of combined academic experience between them. Three things from it have stayed with me.

The first is what actually stops athletes going back. Pain, stiffness and a knee that will not do what it used to are all common reasons, but fear of the injury happening again was cited more often than any of them.

The second is that a returning athlete is quietly answering three questions at once. Can my body still do this? Do I get a say in when I go back? Am I still a proper member of this team? Support for those three needs shows up consistently right across the literature.

The third is the part I respect most, because the panel is honest about the limits of its own field. When they grade the evidence for strategies built specifically to develop psychological readiness, it comes back low on study design, low on consistency and low on directness. There are few intervention studies, the samples are small, and often there is no control group. Psychology is not the missing key to the whole problem, and nobody can yet tell you which programme reliably moves an athlete from 63 to 85.

None of this replaces good surgery, good rehabilitation or a sensible loading plan. It sits alongside them, and it tends to be the part nobody thinks to ask about. Social support, mindfulness, acceptance based practices and cognitive behavioural programmes have all been found to reduce negative reactions through rehabilitation, so they are worth doing, and worth being careful about what we promise from them.

Open access: Tranaeus et al. (2024), Sports Medicine, 54, 1733 to 1748.

Coaches and clinicians, a genuine question for you. Does psychological readiness get assessed at all in your return to play process, and if so, how?

We've never really done a proper introduction, so here it is.

Three of us, one fairly simple idea. That psychology in sport should be practical, grounded in evidence, and actually useful to the people doing the work. Athletes, coaches, clubs, schools, whānau.

Jason brings 15+ years across performance, wellbeing and human development, and has worked alongside Olympians and world championship athletes.

James is a clinical psychologist who works across therapy rooms and training grounds. Years of playing and coaching shape how he talks with athletes and coaches, and his research looks at what makes those conversations land.

Oliver comes at it from community sport across Canterbury schools, clubs and academies, and keeps the rest of us honest about what genuinely lands on a cold Tuesday night at training.

Different routes in. Same view on the way out. This works best when three things meet. What the research actually shows, what experience has taught us, and what matters to the person in front of us.

Swipe through to meet everyone properly → https://www.performance-act.com/team

Confidence stays stubbornly mysterious for a lot of athletes and coaches.

In our latest piece, James looks at what the research actually says. Three meta-analyses across two decades put the confidence–performance relationship at around r = 0.25 (Lochbaum et al., 2022; Woodman & Hardy, 2003; Craft et al., 2003). Modest. In the newest review that effect was carried almost entirely by male athletes (r = 0.35 vs r = 0.07), and elite athletes were no different from club athletes on it.

One study even knocked expert performers' confidence down on purpose. They performed better (Woodman et al., 2010).

The costly part is not the absence of the feeling. It is waiting for it before you act, when acting is the only thing that reliably produces it (Harris, 2010).

https://www.performance-act.com/post-confidence

At The Performance Act, our core mission is supporting how psychology is applied in sport. We help performers and supporters build the tools they need to grow through their journey. Wherever you are on your path, we are here to walk alongside you.

Our approach is simple. We aren't about silencing the mental noise. We focus on building the psychological flexibility to carry it, so you can keep doing what matters most to you.

→ Athletes → Coaches → Organisations → Whānau

Keen to chat? Book a kōrero at performance-act.com

Some of the most valuable recovery you get all week might have very little to do with your body.

We put so much care into the ice baths, the foam rolling, the recovery swims, and all of that genuinely helps. But the research gently points somewhere quieter too. Feeling truly rested seems to be an active process, and a big part of it is giving your mind a real break from your sport.

Researchers describe this kind of switching off in three parts: easing off physically, getting your head off your sport, and softening the emotions around it. Interestingly, it tends to be that last part, quietly letting go of the frustration or worry, that seems most linked to bouncing back from one day to the next. It has even been associated with more mental energy, and possibly fewer injuries.

The gentle catch is that a rest day spent replaying the game may not feel like much of a rest. When we keep turning things over, our stress response tends to stay switched on. So this weekend, where you can, just be a person. Spend time with people, get absorbed in something that has nothing to do with your event, and give your mind somewhere else to be.

References

Balk, Y. A., de Jonge, J., Oerlemans, W. G. M., & Geurts, S. A. E. (2017). Testing the triple-match principle among Dutch elite athletes: A day-level study on sport demands, detachment and recovery. Psychology of Sport and Exercise, 33, 7–17.

Eccles, D. W., & Kazmier, A. W. (2019). The psychology of rest in athletes: An empirical study and initial model. Psychology of Sport and Exercise, 44, 90–98.

Balk, Y. A., & Englert, C. (2020). Recovery self-regulation in sport: Theory, research, and practice. International Journal of Sports Science & Coaching, 15(2), 273–281.

Our words shape the moment. The moment shapes the meaning. The meaning becomes the mindset.

Last month we spent an evening with Proteus Sport and a great group of coaches, exploring the conversations that sit at the heart of coaching. The chat before training, the quiet word after a tough game, the question you ask instead of the answer you give.

One idea stuck with us long after the whiteboard was wiped: the righting reflex. That very human urge to jump in and fix an athlete's problem before they have finished explaining it. Every coach in the room recognised it. Most of us laughed. A few of us winced.

So James has written about it. Why connecting before correcting matters, what athletes lose when we do their thinking for them, and one small skill you can try in your very next conversation.

Have a read here:

https://www.performance-act.com/post-connect-before-you-correct

Thanks again to everyone who turned up and leaned in. Sessions like this are why we do what we do.

WE'VE BEEN BUSY. 👀

Yes, we're back. Again. (We know, we know... we've said that before.)

The posts stopped. The mahi didn't. Our little team has been quietly chipping away behind the scenes, building new tools, new resources, and a brand new home for it all. The mission is exactly where we left it: helping people grow.

The new Performance Act website is live now. Come have a look around at www.performance-act.com

Whether you're an athlete, coach, or parent/whānau, there's something in there for you.