The Anxious Physio
Monitoring & Managing Mental Health in Sport: Tips from Me
Following on from my amazing chat with Sports Injury Fix last week, I was asked about advice and strategies I could give that have helped me deal with my Anxiety and Mental Health. Many of these suggestions have arisen and related to working in a sport setting, but most of them can be applied to any work based group or company scenarios. As I expressed in the video I don't have all the answers, I wish I did, but by sharing some of these strategies hopefully, it may spark something in some people. Maybe a suggestion to a boss or clinical lead, maybe looking into implementing monitoring/check up or screening support staff and build a platform for support. There are of course many ideas out there, but the suggestions below are the ones I have found most successful.
1. Buddy System Whether at work or on a camp, its always nice to offload to someone else over a coffee, beer or on a walk. Obviously, I never drank beer away on a sports trip with a squad ;) so imagine any beverage situation you like. The buddy system is normally set up by a clinical lead manager or CMO, who knows his/her team's personalities and can match suitable candidates to one another... for a calming 'zen' experience.
2. Staff Welfare Monitoring I used this when I was away with GB Students at WUGS in Taipei. This trip had obvious high risk factors for physical well being. Being away for 3 weeks, a 24-hour flight, hot climate, earthquake drills and 7000 people all eating and sleeping in the same place, to name a few! However, the emphasis on staff emotional wellbeing was also paramount! It consisted of a simple app with screening questions that every staff member completed each morning. Things like; how did you sleep?, rate your energy on scale 1-10, do you feel unwell?, give 1 word to describe your mood?... etc These scores/answers were then collected into a database which tracked an overall response of our 26+ medical and HQ staff. Peaks, spikes, trends or individual flags would then be shown up with an intervention or 'discussion' put in place if needed.
3. Being Honest and Open Sounds simple, but I learned this the hard way. I used to try and hide how tired I was from bosses or my team as I didn't want to seem weak or unable to do my job. The more honest you are with a boss or clinical lead, the much easier, manageable and enjoyable your work will become without the added pressure. Things will become much more manageable and enjoyable. You are in a role to look after others, so being open and saying "I need some help with this" is a sign of strength and not weakness. There are also many occasions where you will probably find you're not the only one. It's been said a million times by so many people but sometimes it needs capital letters... YOU CAN'T LOOK AFTER OTHERS IF YOU DON'T LOOK AFTER YOURSELF! :)
4. Awareness and Sharing Your Key Stressors This one may be hard but was so important for me on long trips to Gold Coast and Taipei with big teams. Before we left, each team member contacted three family/friends and asked them for three behaviours, gestures, or visible signs that were noticeable when we became stressed. The responses you get back may be surprising, or not in my case, but identifying these with your buddy or team before you go, can highlight behavioural cues for others to help monitor and identify workload and strain whilst you are away.
5. Exercise Time This again might seem obvious but you must not feel guilty for exercising or spending time on your own whilst you are away. Exercise is one of the most common strategies I and colleagues have used to try and relieve stress and sometimes is it hard with a lot lot going on. It makes it vital therefore to talk to your team and explain how important your run, walk or exercise time is. We all know that exercise has HUGE positive effects on mental health, but in the moment in a busy competition, rationale sometimes goes out the window.
6. Alone Time / Self Care - do what's best for you! In a slightly opposite point to the above, on occasion, I found I was forcing myself to exercise when actually what I needed to do was relax, read, sleep, eat, walk or rest in my downtime. I think as Physio's sometimes we perceive ourselves to be invincible, fit, healthy, warriors who never need a rest ;) but in reality, we are actually only human beings and in an active and stressful environment the body may need rest and calm, not further physical exertion. Talking to loved ones at home is also so important as they can provide support and context out of the environment you are in. Everyone is different and there will be many people who use adrenaline and the endorphins from exercise to keep them on an even keel, but for me, it was almost the opposite. As soon as I realised I didn't have to go for the 5.30am run and no one would judge me, I found very calming, restful and peaceful ways to relax in my free time which had a hugely positive effect on my work.
7. When you are given time off, TAKE IT! I used to think I had to be there for every athlete 24/7, I gave my number to everyone, I told them they could call me anytime and at once early stage had an open policy for physio any time of the day! I am laughing now, 13 years down the line at how 1. stupid and 2. impossible that was to maintain! On occasion (at WUGS by Steven Mutch) I have been banished from the Treatment Room and banned from talking to athletes as the signs that I needed a break was clearly visible from the outside, ha!
One of the best pieces of advice I have ever been given was by my now dear friend and mentor Stuart Butler. He told me, having watched me on trips and comps frantically trying to be superwoman, "Don't make yourself too available"... genius! It took me a further 2 years to start putting that into practice, but at least he tried :)
Stopping at point 7 will no doubt annoy a lot of my fellow OCD peeps, but let's do some 'comfort zone expansion' and stop there!
As I have mentioned, these are simple examples of things that have worked for me over the years and there are so many more that a lot of clubs are putting into place well. I guess the key is, start simple and find what works for you. There are many teams now who are adopting very successful monitoring/screening tools for athlete mental health wellbeing with great success. I just hope these strategies are also starting to be applied to support staff monitoring as well.
Many of the ideas I have mentioned have come from work by Mr. Steven Mutch and the assistance of CMO's he has worked with, so I must thank him for his forwarding thinking approach to Team Working and Wellbeing . Stuart Butler my England Athletics Medical Lead has also had a huge impact along with Lucy MacDonald at The Octopus Clinic in London. So many people have helped me along the way, but these three have been instrumental in helping me delve and deal with my mental health and I owe them a lot.
Please have a look at their clinic links below as they are all LEGENDS!
Steven Mutch: Space Clinic - Edinburgh
Stuart Butler: England Athletics / Allen Physiotherapy - Guilford
Lucy Macdonald and Team: The Octopus Clinic - London