The role of imagery in the rehabilitation setting

Imagery is the ability to use all the senses to create or recreate an experience in the mind. Thus, imagery is a sensory experience that occurs in the mind without environmental props. Imagery research in sport dates back to 1930 when the technique was used to enhance physical practice and to prepare an athlete mentally for competition. Due to the increasing physical demands of sport, the risk of injury has heightened. As Mainwaring (1993) found athletes in the rehabilitation process, still focus on the physical aspects of recovery such as exercise. This has led a wide examination of psychological techniques in preventing and treating injuries, Bewer et al (1994). So only recently have researchers extended the role of imagery to the rehabilitation process.

When applying this concept of imagery to an athletic population, Weiss and Troxel (1986) suggested that athletes be taught to think constructively and not destructively when dealing with injury management. They advocated visualizing successful rehabilitation as a useful strategy for injury recovery. Since athletes already engage in imagery to improve their physical skills, the transition of using imagery to cope with injuries might be beneficial in addressing varied psychological factors related to injuries.

There is a growing body of medical literature suggesting that a mind-body connection facilitates the healing process. Researchers’ have reported an improved facilitation of the immune system response when activated by imagery ,  helpful in managing stress, anxiety, and depression for people with cancer and been used a pain management tool for people with chronic back pain.

After explaining briefly what imagery is and its ‘mind-body’ association, we also need to understand importantly the psychological feeling and thoughts of athletes during their injury process. After an injury a athlete naturally undergoes a stage of psychological sequences similar to those of a individual who encounters a personal loss (Kubler-Ross 1969). Athletes would often respond to an injury by denying they are injured, when in time when a reality sets in, feelings of depression and anger take over.  Often athletes may not understand the nature of the injury and its long term effects on their career and skill level. Therefore it is key as a coach, doctor or physio to explain the injury in lay terms which will help facilitate an image of the injury during the rehabilitation process

Now that you have a greater understanding of what imagery is and why it is an important tool in the rehabilitation process, based on research here are four key steps when establishing an imagery orientated rehabilitation program.

Step 1: Introduce Imagery to the Athlete

•  Imagery works best when the athlete believes it will assist the healing process, Therefore it is important to define imagery and explain how it works and the possible benefits it may aid in the rehab process.  Additionally the athlete should understand that imagery will not guarantee a full recovery, but that it has been successful when used adjunctively in the recovery process.

Step 2: Evaluate the Athlete’s Imaging Ability

• You must informally assess the athlete’s ability to image and you must recognize that there are differences among athletes. To be successful when using imagery, the athlete needs to have some background training on how to increase his/her ability to image. The athlete needs to be able to see, control, and vividly construct a mind-image. Injured athletes who attend practices and competitions might visualize running through the drills and workouts just as though they were physically performing them.

Step 3: Assist the Athlete in Developing Basic Imagery Skills

• Imagery is a skill; therefore, each athlete needs to go through the three phases of vividness, controllability, and self-perception in the basic training (twice a day for 15 minutes) in order to be successful in this program. After the athlete has a basic understanding of imagery techniques, it becomes important to link these skills to the rehabilitation process.

Step 4: Provide Tips on Adjunctive Use of Imagery in Rehabilitation Programs

• When implementing the program for an athlete, keep the information concise and simple; focus on the injury.

From reading this article, you should have gained knowledge around imagery, understand the importance of the mind and body association and how imagery can be a productive tool in the rehabilitation process with injured athletes. Just remember imagery is only productive when used and practiced throughout the healing process.