Part 2 of the series on how stress can physically hurt us and prevent healing, and how relaxing and believing we can get better have been shown to heal injury and disease.
In Part 1 I looked at the science behind how stress hurts us and relaxation heals us. This post discusses how to implement the science to help us get and stay healthy on the court.
In her book, Mind Over Medicine, Lissa Rankin tells us how belief that a treatment will work, the nurturing care of a practitioner and anything that makes us feel relaxed can turn off our stress response and put us in “rest and digest” mode – our maintenance mode where our bodies repair and strengthen themselves.
While I’d already thought a lot about the stress response and how it affects our tennis, I’d done so mostly from the perspective of how it prevents us from performing our best. I investigated this in my post on the neuroscience of fear in tennis.
But Rankin’s book got me thinking that if stress hurts us and relaxation heals us, tennis players should be using this knowledge to help keep us injury-free. That’s the purpose of this post.
How Tennis Players Can Use the Power of their Minds to Stay Injury-Free
1. Spend more time in rest and digest mode.
Even if you’re not struggling with any current injuries, rest and digest is your “maintenance mode” where your body will be able to heal itself from the micro-damage you’re inducing on court.
If you want to maximize the time you can spend playing tennis and training, you need to maximize your recovery off-court. We typically think of recovery as including things like sleep, nutrition, and cooling down muscles, but doing things that relax you and limit stress might be just as important.
And stress doesn’t need to be tennis-related to impact your health on the court. If you have a stressful life event or job, you might be spending a lot of your time in sympathetic mode. Learn how to relax yourself quickly so that even in the midst of stressful situations you can find some peace and enter rest and digest mode as much as possible.
So how do we get into rest and digest mode?
The great thing about this is it’s actually easy and enjoyable. You don’t need to jump into a tub full of ice water or join an expensive gym to spend more time resting and digesting.
Here are a few suggestions:
- Spend 15 minutes a day meditating
- Do yoga
- Read novels
- Hike in nature
- Go for coffee with a friend
- Listen to music you love
- Or just pick any activity that relaxes you and do more of it
The following exercise can help you quickly activate your parasympathetic system:While this exercise is simple, it’s still important to practice. Why? Because if you don’t, you won’t remember to do it when your stress response turns on. The more you calm yourself down with your breath, the easier it becomes to do and the more automatically you’ll do it whenever you sense that you’re getting stressed.
2. Rethink your injury protocol
The goal here is still pretty much the same as item one – to spend more time in rest and digest mode. But this becomes even more important, and can be harder to do, when you’re actually experiencing injury.
For tennis players, getting injured sucks. Anything from a blister to a torn ligament typically means time spent away from the sport we love. So it’s hard not to freak out when we start feeling aching pain or if we fall and twist something. But freaking out doesn’t help, and can activate our stress response which just makes things worse. We need to find ways that we can relax even when facing the setback of an injury.
Searching for Cures – Focus on Solutions
While searching for online articles and forum discussions can certainly be helpful in diagnosing your injury and finding treatment options, try to limit this if you find it makes you feel negative about your injury, or at least change how you go about doing it.
While learning that someone healed their shin splints by wearing compression socks can give you hope that you can also heal your shin splints by wearing compression socks, you’ll undoubtedly come across other comments that shin splints derailed someone’s tennis career or how even after years of rehab someone is still suffering from shin splints.
Do your best to skim over the negative comments and look for ones that have helpful advice. In other words, focus on the solution instead of on the problem. And if you feel stressed or down about your injury after your search, this is a great time to do one of your relaxing activities or a few extended exhale breaths to stop the negative thoughts and activate your relaxation response.
The Placebo Effect – Take Advantage of it
Many of us think that the placebo effect is “all in our heads.” That is, we believe we just think we feel better when given a placebo. But in Mind Over Medicine, Rankin presents evidence that actual physiological changes occur when people are given fake treatments. She says:
When given placebos, bald men grow hair, blood pressure drops, warts disappear, ulcers heal, stomach acid levels decrease, colon inflammation decreases, cholesterol levels drop, jaw muscles relax and swelling goes down after dental procedures…Placebos don’t just change how you feel, they change your biochemistry.
Take advantage of the placebo effect when you’re injured. Find a practioner (doctor, physio, etc) that you trust and make an appointment. Instead of thinking negatively about your injury, think about how you’ll be getting treatment. Trust that it will work. During treatment, relax and imagine your body healing itself.
Positive emotions associated with nurturing care and belief that treatment will work are associated with the placebo effect. So even if the treatment in and of itself doesn’t do anything for your injury, you can get some benefit from the placebo effect.
And if the treatment itself is effective for your injury, doesn’t it stand to reason that believing it will work will only help? Kind of like two treatments in one!
Remember that this isn’t just blind positive thinking. Doing things that you truly believe will make you better, like getting surgery from a trusted surgeon, taking certain supplements that you’ve read will help your body heal, or doing exercises prescribed by a well-respected physiotherapist can all have positive impacts on your injury, even if you’re not actually getting the benefit the way you think you are.
For example, in a famous study published in The New England Journal of Medicine, it was shown that patients with knee pain that received a fake surgery by renowned orthopaedic surgeon Dr. Bruce Moseley experienced the same results as those receiving the real surgery!
THE NOCEBO EFFECT – AVOID IT
We also need to be aware of the “nocebo” effect, which is the opposite of the placebo effect. This occurs when patients expect to get worse and then do, based on their treatment experience (i.e. they’re told they might experience negative side effects, are given a placebo, and then do experience the negative side effects).
If you see a practitioner that you don’t have a good feeling about – who doesn’t make you feel emotionally cared for and supported – find another one.
While doctors don’t always understand the mechanisms behind the placebo effect (and the nocebo effect), turning off the stress response and shifting to rest and digest is believed to play a role. This article is a great one for a full explanation of the placebo effect.
Use time-off wisely: Focus on what you can do rather than what you can’t.
When you’re injured, you might be able to do some neglected off-court training or study that you haven’t had enough time for in the past. Watch coaching videos. Develop action plans. Take a trip to watch live tennis. And consider that a break from tennis altogether will be good for your body and mind if you’ve been overdoing it. Look at these things as positive rather than negative.
And remember that you can actively heal yourself by spending as much time as possible in rest and digest. Set aside time for what you can think of as “healing sessions.” Begin a relaxing activity with 2:1 breathing, and then simply relax into whatever you’re doing (watching a movie, enjoying dinner with friends, etc), occasionally reminding yourself that your body is healing itself and feel good about that.
3. Assess your Limiting Beliefs and Change Them
A theme I’m coming across again and again in my research of late is that we have habitual thought patterns wired into our brains. I discussed this a bit in my post on the neuroscience of fear in tennis.
Basically scientists now understand that neurons that fire together wire together, so the more often we think a thought, a specific group of neurons fire, and thus it becomes easier and easier to have that same thought. Eventually the thought becomes unconscious or automatic. The thought becomes a belief.
You might have a belief that you get injured easily. Or that you’re slow to heal. Or that you’re unhappy when you’re injured. So as soon as you fall on court your mind immediately starts thinking about how you undoubtedly injured yourself in the fall, you’re going to need to take time off, you’re going to miss the tournament next month, you’re going to miserable about it. This thinking can activate the stress response, and prevent your body from healing any damage you did.
These limiting beliefs can also make it hard for you to believe that treatments will work for you, and this robs you of the beneficial placebo effect. It makes having a positive attitude that your body can heal very difficult.
But don’t despair – you can change your beliefs! I’ll be writing more about this in upcoming posts, but you can use the principle of neurons that fire together wire together to change your thought patterns.
- The first step is becoming aware of your habitual thinking. For me, I’ve found that mindfulness meditation has allowed me to recognize negative thoughts as they happen.
- And the next step is to consciously change your thinking. When a negative thought appears, recognize it, and change it. When you find yourself thinking, “I always get injured,” tell yourself instead “My body can heal itself.”
This can be hard at first, since you have to develop a new set of neural pathways (similar to the difficulty in changing your forehand technique), but over time it gets easier.
You can also choose a set of beliefs you’d like to create and develop a “mantra” (something like “my body is strong and healthy”) that you repeat over and over, perhaps when you’re meditating, hiking, jogging or even playing tennis. The more you think these positive thoughts, the more automatic they will become and they’ll begin to crowd out the negative ones.
4. Read Empowering Stories
I recommend reading Mind Over Medicine. The stories in the book, which are largely taken from scientific journal articles, show numerous examples of people who experienced healing that was at least aided by their beliefs, their support systems, nurturing care, placebos, or essentially anything that made them feel hopeful and relaxed. It’s hard not to feel uplifted and empowered after reading this book.
In another book I’m reading – Evolve Your Brain – Author Joe Dispenza writes about how he elected not to have the standard surgery when he broke his spine in a cycling accident. Four different surgeons told him he’d likely become paralyzed if he didn’t have the surgery that would have metal rods implanted into his spine. He instead chose to meditate for hours each day, visualizing his cells rebuilding his bones, and he was walking within 10 weeks.
This is an extreme example, and not meant to convince you not to get surgery if you want or need it, but rather to show you what’s possible, if you only open yourself up to the possibility.
I’m also not suggesting you put your head in the sand, avoiding the reality of your situation. But rather that you focus on solutions instead of problems. Reading empowering stories of others who have healed injuries and disease and returned to their activities stronger than ever can give you hope, and hope can heal.
My Story: Wrist Pain
I wrote a series of posts awhile ago about the factors that I believed led to me finally being able to play tennis pain-free after severe wrist pain – which was finally diagnosed by MRI as ECU tendinosis – plagued me for years. Last winter, I had been considering taking a full year off of tennis since I was so frustrated by the cycle I was in of resting, feeling better, and then having the pain return as soon as I played tennis again.
And then I started doing Bikram yoga last spring, and my pain virtually vanished. I went from playing tennis, painfully, about once a week, to playing pain-free 6 days a week all season long. I was so interested in figuring out how I was able to seemingly heal myself so that maybe others could benefit from my experience.
I didn’t believe that yoga alone explained the elimination of my pain. I wrote a 3-part series on this so I won’t go into details, but basically I credited a combination of factors and one of them was the physical postures of Bikram yoga gently stretching my forearms and performing a type of traction on my wrist.
But now that I understand this concept of rest and digest and how this state can help injuries heal, or even just how it can reduce the perception of pain, I’m wondering if a major factor was actually that I started spending big chunks of time (about 90 minutes, 4 days a week) in the perfect state for my body to heal.
And all the yoga and meditation I’m doing at Bikram no doubt helps me manage my stress levels outside of the studio as well, thus helping me stay in parasympathetic mode more of the time.
To summarize Parts 1 and 2 of this series:
- Our bodies are designed to heal from injury.
- When we’re in the stressed state, our ability to heal injuries is turned off, and when we’re relaxed it’s turned on.
- We might need outside help (i.e. surgery, medication, treatments) to heal and prevent injuries, but we can greatly help these interventions work by relaxing, trusting practitioners, believing in the effectiveness of treatments, and believing our bodies can heal.
- Our limiting beliefs (automatic negative thinking) can reduce our abilities to heal. We can change our beliefs by learning to recognize our negative thoughts and work on consciously changing them to be more positive.
- The more time we spend in rest and digest, the better. This can be accomplished by doing anything that relaxes us. Meditation, yoga, hiking, listening to music and reading novels are a few suggestions.
- We can quickly enter the parasympathetic mode by extending our exhales. Practicing this technique is important so that it becomes habitual.
For serious tennis players, I believe that our state of mind should be tended to just as much as our technique, fitness and strategy. Up until recently, I understood this only from the perspective that without the ability to control your mind, you can’t perform your best.
But after reading Mind Over Medicine and some related resources I’m now seeing that our minds impact our health as well as our performance. This reinforces the importance of developing mindfulness so that we can see when we’re needlessly activating our stress responses and learn to make the switch to rest and digest.
So serious tennis player or not, if you want to be able to play tennis injury-free, or get back onto the court as quickly as possible after an injury, consider that you have an innate ability to heal yourself if you just tap into it.
And all you need to do is relax.
I’d love to hear your thoughts on this. Have you experienced “spontaneous healing” of a tennis injury? And of course please let me know if you think I’m misinterpreting any of the science, I’m writing about these topics in the hopes of learning more.