Achieving peak performance in competitive athletics requires a balance of skill, physical conditioning, practice, precision, grit and passion. However, sometimes self-doubt, pressure, anxiety and stress can interfere with an athlete's performance or desire to play.
The delayed 2020 Tokyo Olympics stood as an opportunity for athletes to come together on the world stage and celebrate amid a backdrop of social, epidemiological and medical challenges. However, the games also shed light on challenges that athletes have faced prior to this pandemic. Athletes such as Simone Biles, Naomi Osaka and Michael Phelps shared their struggles with mental health. Their stories highlight the importance of caring for the whole athlete—mind and body.
"The emotional and mental aspect of athletes' lives, whether competing at an elite level or for a summer T-ball recreation league, are crucial and cannot be overlooked," says Bianca Edison, M.D., attending physician at Children's Hospital Los Angeles Orthopaedic Center. "For a long time, athletes have been conditioned to push through physical pain, exhaustion and pressure in a ‘whatever it takes' fashion because they have been brought up in an arena that celebrates winning more than well-being. But winning at all costs overshadows common sense, puts one at extreme risk, and robs athletes of the very joy of their sport."
Athletes, no matter the age or skill level, often encounter pressure from coaches, parents and teammates. In the past, many in the sports world ignored mental and emotional health because they were not tangible injuries like a sprained ankle or a broken arm. Now there is a greater awareness of these issues, and better mental health resources are available.
"We can't forget to care for all of our athletes wholly, ones who are carrying our burden of social healing in the aftermath of psychological trauma experienced during these challenging times," says Edison.
Knowing that a team approach to supporting the athlete is essential for optimal care and performance, the sports medicine specialists at Children's Hospital Los Angeles work with local sports psychologists to help promote self-care and well-being at its fullest.
"We focus on treating the athlete as a whole—the physical and the mental," says Ryan Kelln, DO, FAAP. "Sports should be fun. We want to see athletes get out there and give it their all, but we also want to see athletes happy, feeling good and excited about what they are doing. If an athlete is in pain from a physical injury, or if they are distracted or not in the right headspace to play, they are putting their bodies at risk."
"While an athlete like Simone Biles is exciting to watch as a fan, we also need to realize the risk she's taking to put her body through it. If she's not in a good space overall physically and mentally, she's putting herself at an even greater risk for injury."
What's more, Edison says, an athlete who isn't in a good mindset is more inclined to pull out of sports altogether.
"We are facing a crisis of young athlete burnout," she says. "The Aspen Institute found that the average child today spends less than three years playing a sport and has a high risk of quitting by the age of 11—mostly because the athlete doesn't view the sport as fun anymore."
Athletes need to recognize that supporting their own mental health can be as much of a reason to pull back and focus on recovery as physical exhaustion, a muscle strain or injury. And athletes like Biles have brought that into the international conversation. While an athlete may be physically ready to compete, psychologically, they may not. "When an athlete starts to place a collective social responsibility of performance and perfection ahead of their responsibility to themselves, both physically and mentally, that athlete reaches a zero-sum game of achievement," says Edison. "We cannot put so much emphasis on results as opposed to an athlete's well-being."
"Looking out for one's best interests as a human being and saying ‘Hey, I'm not feeling up to this today,' or ‘this isn't fun for me' is not a sign of weakness. It's a sign of strong self-awareness," Kelln says. "Remember, athletes are not robots. When we can support them overall—their physical and their mental health—that will allow them longevity and that will allow them to be in a good space to compete."