The Athlete Behind the Injury

By: Briana Galeazzi

Caring For The Whole Athlete

It is very important for me to care for the whole person rather than just the athlete or their physical injury. Student-athletes are humans first who play sports so we must care for them as such. One tactic I try to use is to simply check in with them first before directing our conversation to their injury or sport. It may seem plain, but just saying “Hey, what’s up?” or “How are you?” before you say “How’s the knee feeling?” is an easy way of showing you care about them as an individual and not just an athlete.

What I’ve Witnessed

In my experience as an athletic trainer, especially while working in the Division 1 setting, I witnessed a lot of athletes struggling with “high-functioning anxiety”. Division 1 Athletics can cause high stress environments due to the constant demands and that does not always mix well with competitive student-athletes who generally excel in their sport. Further – you add on school workloads, volunteering hours, study hall hours, and some social experiences – it can be hard to manage, causing a sense of being overwhelmed and anxious.

In most mental health education, it is taught that an individual may have a change in appearance, change in weight, trouble sleeping, isolating from peers and many other signs. Athletes sometimes don’t exactly fit these molds because some of these are requirements of their sport (so they don’t alter as rapidly). For example, gymnasts are very focused on maintaining their weight and appearance for such a visual sport. I think coaches and athletic trainers and other support staff look for changes in mood and other trends that may alter.

When an athlete’s identity becomes closely tied to their sport, their self-confidence and (perception of) their self-worth become associated with the wins and losses that occur in their sport. Mood should not be dependent on sport outcomes.

I have seen how important the presence of an athletic trainer can be to an individual. In two different Division 1 settings, I had individuals approach me stating they were either self-harming or were having suicidal thoughts. To be honest, I was not particularly close with either student-athlete but I think they understood that I could help them bridge the gap to seek mental health support when they were struggling.

Why Athletic Trainers Matter

Athletic trainers are frontline healthcare workers. Athletic trainers have a unique role in athletics as they spend countless hours around teams – recognizing individuals’ personalities and behaviors. With that, athletic trainers can see when a shift might occur in an individual’s routine, character, etc. Athletic trainers may be one of the first to see the red flags rising and assist the athlete in seeking mental health care.

The athletic trainer-athlete relationship is extremely unique compared to an athlete’s relationship with other health care professionals they interact with because of the timespan of their relationship. In the high school and collegiate setting, an athletic trainer can see them for four years (or more) and be quite possibly the healthcare provider they see most (compared to weekly therapy, yearly physical appointments, etc.).

A simple step that may be helpful is signage in and around the athletic training room. Having visual clues helps communicate that the athletic trainer is willing and ready to have a conversation when the student-athlete is ready. This lays a foundation that the athletic training room is an environment that a student-athlete can come to and seek assistance.

Athletic trainers have been described as “quarterbacks” of health care for athletes because they understand and help distribute responsibilities – referring to nutritionists, orthopedic surgeons, physical therapists and so forth. I believe that athletic trainers understand when mental health concerns have outweighed the scope of their practice and are more than willing to help assist athletes in seeking care from specific professionals (mental health included).

Breaking The Stigma

I think a mental-health misconception that is finally changing is that you can excel on the court, on the field, and in the classroom but also be struggling with your mental health. A major example of this was when Lauren Betts - while playing and winning a national championship at UCLA during her senior year – shared that she stepped away from the women’s basketball team during her sophomore season to focus on her mental health.

Asking for help is not a sign of weakness. In so many other facets of life, we seek guidance from others who know more or have more experience in certain fields. For example, student-athletes go to office hours to understand a subject more, they go to a nutritionist when they want to improve or change their diet and they see doctors and get imaging when instructed. Athletes and all others should see “asking for help” as a way to improve their overall wellbeing.

Why I Advocate

My sister was a two-sport Division III student-athlete who died by suicide in March 2022 after her battle with mental health challenges. Professionally, working so closely with individuals, I wanted to make sure I was always “going to bat” for student-athletes, advocating for them no matter what – whether that be their mental health or physical health.

Meaningful mental-health support in athletics means hiring licensed staff to support the needs of student-athletes, especially in the collegiate settings. Data has proven the need for these licensed professionals to be at institutions.