Originally published in Williamson County Living —

In May, we observe Mental Health Awareness Month, and although the conversation about the importance of mental health continues to evolve, areas remain in which the issue is rarely discussed. With years of experience in the field, Dr. Colin Looney, sports medicine physician and orthopaedic surgeon at Bone and Joint Institute of Tennessee, hopes to bring awareness to the issue in sports medicine. “In the past, one of the biggest weaknesses in the sports medicine field was not understanding the impact of mental health on athletic performance,” said Dr. Looney. “Sports medicine providers are learning to recognize the role they play in athletes’ lives. It is critical to integrate mental health aspects into recovery and treat the whole patient.”

Burnout and injury are the most common causes of mental health issues among athletes. This can be especially problematic for younger athletes. “Studies show that children who specialize in one sport from a very young age are less likely to earn collegiate-level scholarships or continue that sport long-term,” said Dr. Looney.

One of the first signs of burnout can often be “mild anhedonia,” the inability to find joy in something that a person previously loved. If coaches, parents, or teammates begin to notice a change in an athlete’s behavior or feelings of unhappiness, that athlete may be experiencing burnout in that sport. To avoid burnout, Dr. Looney suggests that athletes engage in multiple sports throughout the year. Being a multi-sport athlete can also reduce the risk of overuse injuries which can lead to mental health issues.

Symptoms of anxiety and depression or substance abuse issues are potential consequences of any major athletic injury. “For a devoted athlete, tearing an ACL is not just an injury to a ligament, it is an insult to that person’s self-worth,” said Dr. Looney. About 40% of ACL injury patients experience an element of major depressive disorder, and 50% of athletes with shoulder injuries experience symptoms of depression or anxiety.

Because athletes associate so much of their identity with the sport they play, a career altering injury can have a largely negative effect on their mental health. Not only do depression and anxiety occur more commonly after an injury, but studies also show that athletes who are depressed are more likely to get injured or burnout. “When I have a patient who has experienced a traumatic athletic injury, I make sure to acknowledge their situation, assure them it is normal to be upset, depressed, or angry, and encourage them to confide in others,” said Dr. Looney. “It should be normal to discuss your mental state with your provider so that they can provide the best treatment.”

Being faced with a long road to recovery can be daunting and overwhelming. Dr. Looney offers four helpful tips for athletes to maintain mental health after an injury:

Keep your objectives during recovery small. By setting small, obtainable recovery goals, the end results seem more attainable. Set weekly objectives, create a checklist, or place reminder sticky notes on a bathroom mirror to help track progress.

Know that you are not alone: A team is helping your recovery. Recovery is a team effort. An injured athlete may see an athletic trainer and/or physical therapist multiple times a week. Be sure you are talking with them, as well as with your family, close peers, and coaches.

Remember that your medical providers are ready to help. We are available. Athletes should be aware that providers are available and ready to help them when needed. Sports medicine physicians should establish an open line of communication and encourage athletes to contact them as needed.

Practice good communication. “None of it works if we don’t communicate both ways,” said Dr. Looney. “It’s a two-way street, but the athlete must first acknowledge there’s a problem and be willing to talk with us.”

In some cases, an athlete may also benefit from speaking with a licensed sports psychologist.

“Mental health plays a key role in athletic performance and recovery. As providers, we must continue to communicate with psychologists and psychiatrists so that we have the tools and ability to act quickly when needed,” concluded Dr. Looney.

For more information, visit boneandjointtn.org and follow them on social media at @boneandjointtn.

Williamson Health and Bone and Joint Institute of Tennessee will open clinics in Spring Hill in May 2024. Bone and Joint Institute will offer Orthopaedic Urgent Care, Physical Therapy with Andrea Pierce, PT, and Angel Shipman, PTA, and a Physician Clinic at this location with Matt Anderson, M.D., and Preet Gurusamy, M.D., serving as rotating physicians. Paula Dunn, M.D., and Sanford Kim, M.D., will offer Family and Internal Medicine as well as Laboratory Services at the Williamson Health clinic. To schedule an appointment, call 615-791-2380.