Activity Cycles: Barriers to Recovery
Activity Cycles are common barriers to a successful recovery.
Following a basketball injury, it is common to have a fear or worry about re-injury. Other players may be concerned about losing fitness. Whilst some may be concerned they will lose their place in the team or have blown their opportunity for selection.
We all have different past experiences, beliefs and values. Therefore, when we experience an injury, we can respond in different ways. The injury can have an impact on your thought processes, your emotions and your mindset. Ultimately, this can cause you to adopt one of the activity cycles, changing your behaviours, the way you move and the way you rest.
Commonly, we identify 3 types of response to an injury or ongoing pain:
1) Avoidance
2) Perseverance
3) Boom and Bust
Whilst many individuals will fit into one of the activity cycles for most activities. It is important to note, that one individual can do all 3 different responses for different activities.
All 3 responses are potential barriers to recovery. If you recognise one or more of the cycles when you are recovering from an injury, it is important to address them. By not addressing the cycle, your rehab is likely to go round in circles and take longer to recover. If you are unsure how to break the cycle, speak to your therapist or drop us a message. The most important step is that you have recognised you are in the cycle.
Avoidance
Avoiding a painful movement or activity sounds like the right thing to do and sometimes it is. However, some individuals will completely stop particular movements, activity or exercises. Sometimes, this is driven by fear of re-injury and you may start to guard or become overprotective.
An individual that avoids the activity that provokes the pain, will often find their level of function reduces. This can lead to a loss of fitness, stiffening of joints, weakening of muscles and surrounding tissues. Consequently, when you next come to do something, you are less able to cope and your pain comes on sooner.
This can make you feel your injury is getting worse or that it is more significant than first thought. In turn, frustration and worry can increase, when in fact; it is just that you are losing fitness. Finally, avoidance can have a big impact on mood, especially if you are missing basketball.
Perseverance
This is a common activity cycle amongst ballers. Perseverance is often driven by the competitiveness of most basketballers. These individuals push through the pain, which often makes the nervous system more sensitive, thus increasing their symptoms i.e. turning up the volume of pain. This is a bit like constantly scratching your hand…it is going to become irritable and sore.
For many people who persevere, the biggest challenge is the fact that activity needs to be modified. For a competitive and ambitious baller, taking a backwards step often feels counterproductive. However, those who trust in the process will often return to play quicker. Modifying activity will help with increasing their activity levels in the long term, without always increasing their symptoms.
Changing this mindset and starting at a lower level is difficult. It is also hard to explain to your teammates, coach, family, friends and colleagues. Many players report that they feel doing less will impact their chances within the team or have feelings of guilt they can’t be relied on as much. However, discussing the situation with them will really help. Explain to them that reducing activity is needed to get you back to full speed quicker.
Boom and Bust
This is a combination of the two previous cycles. For someone who has decreased activity or been avoidant, the boom and bust cycle can begin with a good day. Because they are feeling good, they then ramp up the activity too quickly and increase their symptoms again. Now they need to avoid or rest again.
The individual who has persevered through pain for too long will eventually reach the tipping point. They reach their limit and cause a flare-up of their symptoms. Forcing them to avoid activity for some time. During this downtime, deconditioning can occur as in the avoidance cycle. They will often then repeat this cycle when feeling better again.
This group will often report increased levels of frustration as they are reacting to the pain levels rather than controlling them. Over time, due to the consequences of the previous cycles, individuals become less able on a good day and recovery from activity takes longer; resulting in more bad days than good.
All of these behaviours lead to:
- The feeling of getting worse
- Inability to make plans or commitments
- Pain controlling what you do – your symptoms are in charge when you should be
- Feelings of frustration and failure
- Time away from training and games
You may find it helpful to write down whether you tend to avoid certain activities, overdo an activity or do a mixture. Be honest and think of some of the reasons that make you act in this way; you could write down these reasons too.
The box below shows some common reasons we hear from people:
Once you have highlighted which cycle may be stopping you from recovering, you can come up with the plan to overcome and return to play. If you are unsure, ask for support in building your rehab programme.