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Overcoming Fear and Getting Back in the Game

Overcoming Fear Avoidance: A Physical Therapist’s Guide to Getting Back in the Game


athlete in fear

As a physical therapist, I often see clients struggling with fear after an injury. Fear avoidance is when someone avoids activities they think might hurt them again, which can really slow down their recovery. If you've seen me in the clinic, you know I ask a ton of questions on how your ecosystem is and how your stress levels are. They are super important in understanding the hurdles that come with rehab. Fear is, by far, the biggest and hardest hurdle to overcome. Let’s break down what fear avoidance is and how we can help athletes move past it and get back to doing what they love.


What Is Fear Avoidance?


Fear avoidance comes from our brain trying to protect us. After getting hurt, it’s normal to be cautious. But sometimes, that caution turns into fear that stops athletes from getting better. They might skip exercises or movements that remind them of the injury, which can make things worse in the long run.


Why Does Fear Avoidance Happen?


1. Imagining the Worst: Athletes might worry excessively about getting hurt again.

2. Pain Misunderstanding: Thinking all pain means more damage, when sometimes it’s just part of healing.

3. Trauma Memories: Bad memories of the injury making them afraid to get back into action.


How Physical Therapists Help


As a physical therapist, my job is to help athletes not just physically, but mentally too. Here’s how I tackle fear avoidance:


1. Educating Athletes


I start by explaining the injury and the recovery process. When athletes understand that some pain is normal and doesn’t mean they’re getting worse, it helps reduce their fear.


2. Gradual Progress


I design a step-by-step plan that starts easy and gradually gets harder. This helps athletes build confidence without overwhelming them. Starting with small, manageable exercises can make a big difference.


3. Focus on Technique


Good technique is key to preventing re-injury and boosting confidence. I work closely with athletes/clients to make sure they’re doing exercises correctly, which helps them feel more secure.


4. Mind Over Matter


Using mental strategies like visualization and positive thinking can really help. I often teach clients to picture themselves succeeding and staying focused on their progress, not their fears. This is by far the hardest thing to teach.


5. Set Small Goals


Setting small, achievable goals gives athletes something to celebrate along the way. These little wins can boost their confidence and keep them motivated.


6. Build a Support Network


Having a supportive environment is crucial. I usually involve coaches, family members, and other healthcare professionals to create a team that encourages and supports the athlete’s journey. We all need people in our corner!


Success Stories


Hearing about other athletes who’ve overcome fear avoidance can be super inspiring. Sharing these success stories shows that it’s possible to get back in the game, even after a tough injury.


Getting over fear avoidance is about more than just physical recovery; it’s about building mental strength too. As physical therapist, I use a mix of education, gradual exposure, proper technique, mental strategies, goal setting, and support to help athletes face their fears and return to their sport. Each step forward is a win, and with the right approach, athletes can reclaim their passion and confidence.


I am beyond blessed to experience so many success stories over my 20 year career as a physical therapist. It really brings me so much joy to hear all the people that I've been able to help along the way. From the professional athlete to the weekend warrior, every athlete who tells me of their success makes this the greatest profession in the world. Of course, I'm biased 😉


Since my work right now consists of mainly endurance athletes, I've had a ton of questions on how to make a game plan on getting back onto the bike pain free. With years of experience here, I've been able to develop a very structured graded exposure plan for cyclists to get back on the road. If you're interested in trying to overcome that fear of getting back on the bike, check out the "return to cycling" training plan to get you back on the road again!



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