Injury Isn’t Just Physical: How Therapy Helps Athletes Navigate Setbacks

When athletes get injured, everyone talks about rehab timelines.

Few people talk about the identity hit.
The loss of control.
The quiet fear that whispers, What if I don’t come back the same?

Injury doesn’t just disrupt training.
It disrupts meaning.

For many endurance and mountain athletes, sport isn’t a hobby. It’s structure. It’s community. It’s self-trust. It’s how you regulate stress and feel competent in the world.

When that’s gone — even temporarily — it can feel destabilizing.

Here are six ways therapy helps athletes navigate injury and setbacks in a way that builds long-term resilience, not just a short-term comeback.

Rebuilding Identity Beyond Performance

Many athletes don’t realize how fused their identity is with performance until they can’t perform.

“I’m a runner.”
“I’m a climber.”
“I’m the fit one.”

When training stops, the question becomes: Who am I now?

Therapy helps separate:

  • Who you are (values, character, qualities)

  • From what you do (training, racing, competing)

This isn’t about lowering standards.
It’s about widening identity.

You can’t train right now.
But you can still embody discipline.
Curiosity.
Leadership.
Integrity.

When identity expands, injury stops feeling like an existential threat.

Making Space for Grief

Injury is a loss.

Loss of:

  • Routine

  • Fitness

  • A season you planned for

  • Social connection

  • A version of yourself you were building toward

Many athletes skip grief and jump straight to productivity.
They push positivity.
They minimize.

But unprocessed grief leaks out as irritability, anxiety, or quiet depression.

Therapy normalizes grief as a healthy nervous system response to loss.
You don’t need to dramatize it.
But you don’t need to suppress it either.

Making space for disappointment often reduces its intensity

Unhooking From Catastrophic Thinking

Injury amplifies mental noise:

  • “I’ll never get back to where I was.”

  • “Everyone is passing me.”

  • “This ruined everything.”

These thoughts feel convincing — especially when you’re sidelined.

Using approaches like Acceptance and Commitment Therapy (ACT), therapists teach skills like:

  • Cognitive defusion (seeing thoughts as mental events, not facts)

  • Present-moment grounding

  • Expanding perspective under stress

The goal isn’t toxic positivity.
It’s flexibility.

You can’t always control the thoughts that show up.
But you can change your relationship to them.

Rebuilding a Sense of Control

Injury often creates helplessness.

Training gives athletes a clear formula: effort → adaptation → progress.

Injury disrupts that formula.

Therapy helps shift the focus from:
“Why did this happen?”
to
“What is still within my control?”

That might look like:

  • Consistent rehab adherence

  • Sleep hygiene

  • Fueling intentionally

  • Staying connected socially

  • Training upper body when lower body is injured

  • Following your PT’s instructions

  • Showing up well at work or school

Agency restores confidence.

When athletes regain small areas of influence, anxiety decreases.

Addressing Fear of Re-Injury

Even after physical clearance, the nervous system may still be on high alert.

Athletes often notice:

  • Hesitation on descents

  • Guarding movements

  • Hypervigilance around pain signals

  • Panic during intensity spikes

This isn’t weakness.
It’s protective wiring.

Therapy can include:

  • Gradual exposure to feared movements

  • Nervous system regulation skills

  • Rebuilding trust in the body through mastery experiences

  • Imagery and confidence rehearsal

Courage isn’t the absence of fear.
It’s increasing your willingness to move with it.

Developing Psychological Flexibility

The athletes who navigate setbacks most sustainably aren’t necessarily the toughest.

They’re the most adaptable.

Research on posttraumatic growth — including work by Richard Tedeschi — suggests that adversity can deepen resilience, meaning, and perspective when it’s processed intentionally.

Injury can become a pivot point:

  • Shifting from ego-driven goals to values-driven effort

  • Learning self-compassion instead of self-criticism

  • Expanding identity beyond sport

  • Developing emotional regulation skills that transfer to competition

Injury doesn’t have to be “a gift.”
But it can become growth.

Mental Health and Performance Aren’t Separate Lanes

There’s a myth that focusing on mental health makes you soft.

In reality, psychological flexibility is a performance skill.

When athletes learn to:

  • Hold discomfort without panic

  • Adapt when plans change

  • Separate identity from outcomes

  • Stay values-driven under uncertainty

They don’t just recover.

They become more durable.

If you’re navigating injury right now, you’re not behind.
You’re in a different phase of training.

And sometimes the most important gains happen when you can’t log the miles.

If you’re here in Colorado and need help navigating an injury or setback this is the work I do. Reach out to me to set up an introductory call.

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Minding the Gap: Confidence in the Face of the Abyss