Andre Myhrer of Sweden skis at the Audis FIS Alpine Ski World Cup in February 2016 in Stockholm. (Hans Christiansson/Shutterstock)

Mental focus can aid in recovery from injury

Picture an elite skier in the starting gate: Their eyes closed, face serious, rocking their body and weaving their hands around the pole.

They are visualizing the course they are about to ski. Those few seconds are crucial; they are willing their performance. All of the best athletes are able to conjure up images in their mind of what their body is supposed to do. Their minds are able to control their bodies, even before their bodies have time to react.

Conversely, injuries occur most frequently because of mental errors arising from lack of mental control. The athlete’s mind just wasn’t in the game for that moment or their judgment failed them. So many of our skier patients tell me that they tried to recover from a technique error and, as they did so, they felt their knee pop. The decision a skier makes to keep from falling or to try to go for it, when, in reality, they are already gone (out of the race course), leads to that knee giving way.

The mind can work in our favor in health and recovery, too. Visualizing how you would like to feel, how strong you want to be, what muscles you want to build, what body shape you want to have, what weight you want to be is the first step in actualizing those changes.

In surgical practice, we note that people who are really good at visualization recover from surgery faster. They feel less pain and achieve their goals earlier. Why is this? How can we encourage and nurture this skill in everyone?

What we’ve come to understand is that if somebody has been injured in the past, the negative experience of that injury has likely been cemented into their brain.

When a patient comes to see us with an injury, he or she has that negative image in their mind. It’s full of the stress that the injury has produced: Will I get back my full function? How will I manage work? How will I deal with the pain?

This disordered thinking, and often the repetitive fixation on the same details, leaves little time for marshalling the internal resources necessary to heal the injury. Our job is to open the patient’s mind to other possibilities. When we suffer an injury, we have externally disrupted the fluid activities of our daily living and thinking. The disruption gives us a chance to either fall into the despair and turbulence of the injury induced disability or rewire the connections to produce a new reality — a new image of themselves as somebody who can quickly recover.

Our patients who can rapidly prioritize their concerns, especially those who after surgical or nonsurgical repair can see themselves as athletes in training and not patients in rehabilitation, are able to use their injury as an opportunity to become fitter, faster and stronger than they were before they were injured. These patients do far better than the despondent patient or the patient without new goals to visualize.

Our role as physicians, surgeons and physical therapists is to encourage a new imagery, to implant exciting, new and empowering goals and accomplishments for the injured person to strive for. The recruitment of the endorphins, pheromones, adrenaline and testosterone that those desires cause stimulate healing and well-being. Thus, the faster and better recovery.

The moment we first see the patient, we focus on exactly what they are saying. We listen well and incorporate their understanding of what happened and what is wrong. The patient is almost always right about his or her problem. Our ability to expand their understanding with the science of medicine and diagnostic tools available to us determines whether they trust us to then solve their problem. Once an accurate diagnosis is made and confirmed by the experience of the physician, the rehabilitation team and the latest in diagnostic technology (usually an MRI in orthopaedics), the conversation between the physician and patient goes like this:

“Here’s the diagnosis. These are the treatment options to get to the optimal outcome. Here’s the team that can bond with you to help you achieve that outcome. This is what you need to do to get not just the optimal outcome, but to become fitter, faster and stronger than you have been in years. Can you visualize that? If we agree, let’s start that journey together.”

Dr. Kevin R. Stone is an orthopedic surgeon at The Stone Clinic and chairman of the Stone Research Foundation in San Francisco.

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