By Alyssa Muir
Kinesiologist John Coumbe-Lilley spent years observing the care, or lack thereof, that athletes who had experienced severe sports injuries were receiving during their rehabilitation process.
Surprised by the results he saw, Coumbe-Lilley decided to conduct an official research study to “see if he could prove (himself) wrong.” His research since 2018 confirms his worst concerns.
Coumbe-Lilley is a clinical professor in kinesiology and nutrition in the applied health sciences department at the University of Illinois at Chicago, his alma mater. He received his Ph.D. in education psychology at the university in 2007.
Why was the emotional response of athletes following severe sports injury an area you wanted to study?
John Coumbe-Lilley: I noticed through work I had done with different teams at the national level and college athletes that there was a difference in the way that care was provided. I also observed that athletes that were recovering from severe sports injuries, which were going to keep them out for six months or later, seemed to be treated differently and treated less (vigilantly) than athletes who were going to be returning quite soon to their sport. So, I wanted to know if my judgment was accurate and if what I was experiencing was true. That led me to begin the research in 2018.
What can you share about your research subjects?
I’ve got 45 cases — 13 are men and the rest are women. They range from Division I, national teams, college and varsity high school. The injuries range from traumatic brain injury, pelvic fractures, ACLs and ulnar collateral ligament injuries. It’s been many sports as well: soccer, baseball, volleyball, rugby, track and field, and American football.
What findings have you discovered so far?
Of the 45 cases, we’ve only got three that we can point to and say that they’ve had positive emotional outcomes as a response to their rehabilitation. We’ve just done a piece where a third of those cases can tie their emotional (suffering) to the mistreatment that they’ve received from coaches and medical professionals. We have several cases of emotional abuse, dehumanization, body shaming, restriction of medical treatment. It’s a (bleep)show.
Did you find differing treatments or outcomes for male versus female athletes?
We haven’t dug deep into this, but one of things that comes out is that the majority of failed surgeries are done by men on women’s bodies. Maybe it’s because there are more male surgeons. But we have a case of a successful recovery where that athlete interviewed surgeons before they operated on her, and she chose a female surgeon because she felt that female surgeons understood a women’s point of view for surgical recovery. I’ve got a case where an athlete was operated on by a man who then admitted to her that he wasn’t best qualified to do it and that she should’ve seen someone else. And that was a professional soccer player. She had five hip surgeries on both hips by the end of her career.
What have you seen in terms of mental health support for these athletes through their rehabilitation process?
In the sample that we have, we have 100% of athletes who did not receive a mental health referral of any kind in the beginning. Imagine hearing you’re going to be out six months minimum before you’re cleared to return to play. You would think common sense would say that’s going to be a hard recovery. But all 45 athletes never received any information or any kind of mental health referral just to talk to someone about what’s in front of them. There’s an absence of mental health support for these individuals that will experience several peaks and troughs as they go through the rehab experience.
Were some of the athletes referred, either by you or others around them, and were they able to receive the necessary mental health treatment?
We offered referrals to two participants. Five sought out their (own) therapists. One was directed to a sports psychiatrist later in their rehab process.
Are you consulting with sports teams to push for increased mental health support?
We regularly communicate with athletes and college sports representatives about our work. However, we need to improve our outreach to sports teams. We have connected with practitioners across North America and Europe who asked for materials and program outlines we developed and employed based on this work, so that they could start their own interventions and efforts to address similar issues in their context.
Where are you hoping to take this research in the future?
Our goal is to put it to work to develop programming for athletes and sports medicine providers and develop approaches we can test and validate for enhancing rehab outcomes.
Alyssa Muir is a sports reporter at Medill from Tampa, Florida. You can follow Alyssa on Twitter at @alyssa_muir21.