Adversarial Growth Following a CrossFit Injury: A Guide for CrossFit Athletes

Injuries in competitive sports can hugely affect an athlete not only physically, but also psychologically.

CrossFit was first introduced to the fitness industry as a strength and conditioning program used to improve “fitness” as a whole by optimising the 10 general physical skills (i.e. cardiovascular and respiratory endurance, stamina, strength, flexibility, power, speed, coordination, agility, balance and accuracy), and has received great attention ever since.

Around 2007, though, since the start of the CrossFit Games, CrossFit has become something more than just a training system and it can almost be considered a sport. In order to become the “Fittest on Earth” it is not enough to be in a good shape and have good technique, but you also need to show great commitment, determination, courage, motivation and respect to the other people involved [1].

Because of the high intensity WODs, the rapid repetitive movements and high loads of weight, CrossFit has repetitively received a bad reputation regarding the potential injuries, especially in the shoulder, knees and lower back areas [17] it’s said to cause.

Others argue that CrossFit has lower injury risks compared to other sports, as the movements are more controlled compared to basketball, football or tennis, for example. However, epidemiological studies have shown that the injury rates of CrossFit athletes are very similar to related sports such as weightlifting, powerlifting and gymnastics [9], with competitive athletes having a higher injury incidence, probably due to the higher exposure to training.

Source: Stevie D Photography

Wherever we fall on this debate, we cannot question the impact that an injury has on a CrossFit competitor, both physical and psychological. Following a serious injury, athletes may need to rest and stop practising for a while, or keep practising but at a lower intensity. Others might need to have a surgery or even retire. How can this affect them?

 “I am mad, I am sad, I am disappointed… however this too shall pass.”

-Carleen Mathews after withdrawing from the CrossFit Games in 2017 due to an injury in her left arm [8]

“This is a tough decision and a tough post to make. The competitor in me can’t help but to feel like a quitter, although I know it is the furthest thing from it.”

-Kristin Reffett after retiring from competitive CrossFit due to some health issues [11]

“My self-esteem crashed a little bit after having to withdraw from the Games cause of my rib.”

-Sara Sigmunsdottir after withdrawing from the CrossFit Games in 2018 because of a broken rib (Morning Chalk Up interview, 2019)

Numerous studies suggest that a physical injury can result in negative changes in the athletes’ mood, lower self-esteem, intrusive thoughts and confusion about their (athletic) identity among others [3], [5], [6].

HOW CAN AN INJURY AFFECT CROSSFIT ATHLETES INITIALLY?

As mentioned above, injuries can have various consequences that can be divided into cognitive (thoughts), emotional and physical.

COGNITIVE CONSEQUENCES OF INJURY

When an athlete gets injured, they tend to think about and thoroughly process the event of the injury in terms of what happened, why it happened, the impact it had on themselves and their identity, and the possible future scenarios (e.g. “Am I going to train/compete again? Am I going to perform as well as before?” etc) [7], [16].

Looking back at this stressful experience can easily lead athletes to intrusive thoughts, ruminations and catastrophising [18].

Others might also respond with denial, which can be used as a cognitive strategy to cope with the distress and negative feelings caused by the injury. Usually linked with avoidance of feeling bad, denial is a form of “self-deception” and it can help the athlete to adaptively cope with a stressful situation and to protect their self-esteem.

In other words, the athlete avoids people, places and events that remind them of the injury, suppresses the negative emotional consequences of the injury and tries to console themselves by focusing on the perceived positive outcomes [6], [13].

That’s why it is very common for athletes to keep a distance from people close to them (especially from people related to their sport) and to avoid talking about the injury and their emotions about it [5], [7], [13].

EMOTIONAL CONSEQUENCES OF INJURY

A very important issue that most athletes face after an injury is a feeling of confusion about their (athletic) identity, as the new situation does not fit with their identity prior to the injury. For example, their capabilities might not be the same as before, their goals for the following months, season or year might need to change as they might be unable to compete or prepare for a competition, athletes might need to retire and stop competing.

Especially for athletes who are forced to retire due to an injury the confusion is more significant, as their retirement was not expected or planned. In response to that, athletes might either try to find ways to maintain and protect their identity, known as assimilation process, or form a new identity including a new role and goals, known as accommodation process [2], [10].

The above thoughts affect the athletes’ emotions. It is quite common for them to experience depression, anxiety (i.e. fear of the unknown) and negative emotions, such as rage, fury, shock, frustration, regret and self-pity, as well as loss of confidence [7], [12].

It has been shown that athletes feel that the injury increases stressors and demands, and that it has an impact not only on their athletic career and/or performance but also on their everyday functioning and on others’ lives, such as their coach, teammates, family.

Of course, the intensity of their emotional responses varies according to the injury’s severity [12].

PHYSICAL CONSEQUENCES OF INJURY

Finally, athletes face physical difficulties after an injury, as in most cases they perceive that they are not at the same fitness level as before the injury, or they feel that they are unable or struggle to complete tasks that they used to complete with relative ease [7].

It is obvious that the first reactions to sports injuries are not usually positive and it is highly understandable.

Is it possible, then, for a CrossFit athlete who puts a lot of effort in their conditioning and training, nutrition, sleep and mindset to mentally and psychologically recover from such a setback in their career and/or performance?

The answer is yes. It has been shown that an obstacle or a difficulty during an athlete’s career might in fact be beneficial, as it could lead to adversarial growth and resilience.

WHAT IS ADVERSARIAL GROWTH?

Adversarial growth can be described as positive changes that benefit an individual’s level of functioning through the process of struggling with a traumatic, stressful and/or demanding event [6], [12].

According to a growing body of research, “people can grow following adversity to the extent that they report development beyond their pretrauma functioning” [6].

Specifically, most of the world’s best athletes experience some kind of sport or non-sport related adversity (e.g. an injury, a serious illness, mental health issues, bullying, bereavement or financial issues), which can work as a “developmental catalyst” in the athlete’s career and optimal performance.

Athletes who have endured a serious difficulty during their sports career have reported various beneficial changes in their attitudes, relationships and performance, such as a development of a greater appreciation of life, improved personal strength, enhanced relationships, but also improved performance and better engagement in their sport [6], [14].

Is growth always constructive?

Although growth is possible, it is not an easy and quick process, and some qualitative studies have proven that it might be “illusory” and not “constructive” growth [5], [6], [7].

An athlete’s growth is illusory when the perceived positive changes are not reflecting true changes from within the athlete but are based on self-deception and denial. Illusory growth is usually associated with avoidance, denial and self-deception, and are often associated with:

1. Seeking meaning: an athlete might experience intrusive thoughts and rumination that cause distress. In order to resolve this distress, they might try to understand and make sense of their experience by looking back at the onset of the injury. Through illusory growth the athlete just comprehends their experience, which is not enough to reach constructive growth. The athlete just focuses on why the injury happened (e.g. “I did not focus on my technique”), and does not seek to understand and reflect on all the factors that impacted them (e.g. possible overtraining or other stressors that might affect concentration), their thoughts (e.g. “I am useless”) and emotions (e.g. “I feel depressed”) [6], [7].
2. Cognitive manipulation and denial: an athlete might use cognitive techniques in order to reduce and avoid negative feelings, such as disappointment and distress, and to protect some parts of their identity. These techniques are also called “self-enhancement cognitions” and include (unrealistically) optimistic language and downwards social comparison [6]. Another example of avoidance of the negative emotions resulting from an injury is not disclosing information about their experience [12].
   

   “Also, having everyone ask me how I was feeling was tough, because I really didn’t want to tell them that I feel like shit.”

   -Annie Thorisdottir talking about her recovery period after a herniated-disk during an interview with BoxLife magazine.

3. Derogation of the injury experience: commonly, athletes will try to lower the significance of their experience in order to reduce negative feelings. For instance, they might compare themselves with other athletes who are in worse situations to feel better [2] or compare their current situation with a worse one they have experienced before.
4. Assimilation: when an athlete experiences a traumatic experience, such as a serious injury, their identity can be shattered. In order to maintain and protect their identity, some athletes tend to use distorted positive perceptions that fit their already formed identity prior to the injury (e.g. “I am the same athlete as before, I have the same goals and aspirations, I am as capable as before” etc), rather than form a new identity using the new information after the injury [5], [6]. A common example happens during the rehabilitation period, when athletes might not be ready to go back to training, but instead keep training or even compete in order to protect their (pre-injury) identity and avoid negative emotions.

Although illusory growth can seem quite negative, some aspects can be considered as beneficial at the beginning of the process of growth. Specifically, denial can be used as a “short-term palliative coping strategy” when the athlete is unable to cope with the amount of shock and distress caused after the injury.

When denial is also accompanied by an effort to cope with the traumatic injury, it can work as a function to support them psychologically and to help them develop their performance later [5].

HOW CAN YOU CONSTRUCTIVELY GROW AND DEVELOP FOLLOWING AN INJURY?

Research has shown that there are personal and external factors that can facilitate constructive growth.

What you can do:

1. Reflection: making sense of and reflecting on your experience, your thoughts and feelings after the injury, and understanding what and why you are thinking and feeling the way you are. This way, you can find any maladaptive thoughts that affect your emotions and keep you from growing and start focusing on your sporting goals and aspirations. In turn, this will help you rationalize your thoughts, and finally regulate your negative emotions [7], [16].
2. Injury = challenge: seeing your injury as a challenge and not as a threat. It is your opportunity to take control, develop and become better based on what went wrong [12].
   

   “It’s crazy how our biggest challenges can become our greatest gifts”

   -Julie Foucher referring to her retirement and injury [4]

3. Acceptance: accepting your injury, what has happened and all its consequences, as well as the challenge to develop [7].
4. Perceived social support: having and/or creating a safe and reliant social network. Apart from the actual social support, the perception of having social support is very important as it provides you with reassurance and a sense of security that if you need support, you will have it [12].
5. Accommodation: a reformation of your identity, your role, your priorities and goals based on the new situation, all of which are very important in athletes forced to retire [2], [5], [7]. For example, an injured athlete who retires from competitive CrossFit might become a coach (new role) and set “supporting and training other athletes” as their new goal.
6. Personality: Mental toughness/resilience, confidence, creativity, openness to experience, optimism and emotional intelligence are some of the personality traits that are found to facilitate the process of growth [7], [12].
7. Prior experience: having already experienced (a more stressful) adversity (e.g. other injury, bereavement, illness etc) in the past, athletes might compare them and realise that their injury is not worth the distress [5], [7].

What you can use:

1. Physical and educational resources: reading, watching and/or hearing (e.g. autobiographies, documentaries, films, sport events) about other people’s recoveries, information on your type of injury, how you can heal, cope and recover can help and facilitate the process of growth [5], [7], [16].
2. Social support: emotional but also practical support from family, friends, coach and/or sport psychologist can be extremely helpful; you can be benefited by encouragement, talking about your emotions, and feeling that someone understands you [5], [7], [12].
3. Time: having an injury equals more free time which can be positive [12], [16]. Many injured athletes have mentioned that during their free time they were focusing on things that they didn’t focus on before, such as technique.

“I worked a lot on technique. I was doing Snatches and Clean & Jerks at 30kg (60lbs) for a month and a half. My technique has probably benefited a lot from that. Now that I’m able to able to add more load, my lifts feel the same or better. I also got to practice gymnastics movements that I otherwise wouldn’t have. The experience was good that way.”

-Annie Thorisdottir talking about her recovery period (interview with BoxLife magazine).

Other athletes might also focus on things irrelevant to their sport that they couldn’t before because of lack of time. For instance, Julie Foucher who retired after rapturing her Achilles tendon, focused on finishing med school.

IN WHAT WAYS CAN YOU GROW AFTER A CROSSFIT INJURY?

When an athlete experiences constructive growth, they can develop in various ways.

Particularly, some of the perceived improvements of previously injured athletes of different levels, from club to national level, are the following:

Intrapersonal development

1. Emotional regulation: increased ability to understand, express and regulate one’s emotions [7]
2. Increased sport confidence, motivation and focus [15], [16]
3. Improved resilience and personal strength [7], [13], [16]
4. Better coping strategies when faced with other problems [15]
5. Change in beliefs, values and attitudes [15]
6. Spiritual change [7]
7. Change of priorities and perspective: looking at the bigger picture [5], [7], [15], [16]

 Interpersonal development

1. Strengthened social network and enhanced relationships [15], [16]
2. Greater appreciation of friends and family [7]
3. Better relationship with coach [15], [16]
4. Increased levels of empathy and prosocial behaviour [7], [16]
5. Improved ability to speak to others and ask for help [7], [15]

Physical development

1. Improved physical outcomes [7]
2. Improved technique, strength, conditioning, flexibility [15], [16]
3. Lower risk of injury: there is an increased knowledge of anatomy and risk factors of injury [15], [16]

It is evident that a CrossFit competitor can grow and develop as an athlete and as a person, even after a serious injury that can affect their career. In fact, it is this adversity that gives them the opportunity to progress.

However, it should not be assumed that an injury or any adversity is desired or needed for someone to develop, nor that it is enough to thrive, as there are other aspects and processes that determine an athlete’s success.

It is also important to note that the psychological impacts an injury can have on an athlete should not be neglected or undermined, as these can be stressful, devastating and traumatizing. What is suggested is that despite the negative consequences, an athlete can benefit through an injury in many ways.

Internal or External Motivation – What Drives You to Train?

Athina Papailiou is an MSc Sport & Exercise Psychology student at Loughborough University, you can find more of her work here.

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