When Injured Athletes Do More Than Rehab Requires, It Could Be a Warning Sign

An injured athlete is told to run one mile as part of rehabilitation. They run three.

At first glance, that might look like exactly what coaches and sports medicine professionals want to see: an athlete who's motivated to get back.

But new research from West Virginia University suggests that behavior may sometimes deserve a closer look.

“A lot of times, we look at these behaviors and see a sign of a great athlete,” said Dana Voelker, director of WVU's School of Sport Sciences. “But if someone asked to run one mile runs a lot more than that, it’s a red flag.”

Injury Recovery Can Affect More Than the Injury

Researchers studied 158 current and former athletes who had experienced an injury that affected their attitudes or behaviors involving their bodies, food or exercise.

Participants reported that body pressures, body-image concerns, eating pathology and dysfunctional exercise became more frequent and intense during injury recovery compared with before their injuries. Athletes participating in sports emphasizing low body weight or aesthetics reported the greatest body pressures.

The study doesn't mean these problems occur following every athletic injury. But it identifies behaviors Athletic Trainers and others involved in an athlete's recovery may want to recognize.

Those can include exercising beyond rehabilitation requirements, increasingly negative comments about weight or appearance, anxiety about how a uniform fits, restrictive eating and compulsively checking one's appearance or weight.

The challenge is that some of those behaviors may initially resemble the dedication athletes are often praised for.

Why Athletic Trainers May Be in a Unique Position to Notice

One of the study's most useful takeaways for Athletic Trainers may be the importance of noticing when an athlete simply isn't behaving like themselves.

“When an athlete’s behaviors diverge from their normal, there’s reason to explore further,” Voelker said.

That's also where collaboration matters. An Athletic Trainer, coach, nutritionist, strength coach and mental-performance professional may each see a different part of an athlete's recovery. Sharing those observations can provide a more complete picture than any one person has alone.

For Athletic Trainers, it's another reminder that rehabilitation isn't only about whether a knee, shoulder or ankle is ready.

As Voelker put it, “Athletes are whole human beings who participate in sports, not just bodies that exist to perform.”