Kelsey suffered multiple ankle injuries and an ACL tear in her pursuit of her professional dance goals. Now, four years after her ACL recovery, she has developed a comprehensive approach to injury recovery that she calls mental skills training. Kelsey has her Masters in sport and exercise psychology and serves as the Performance Enhancement and Rehabilitation Specialist at The Micheli Center for Sports Injury Prevention, an affiliate of Boston Children’s Hospital—Division of Sports Medicine. She joined the team nearly seven years ago and works alongside injury prevention specialists and physicians to support the whole athlete. Kelsey believes that training the mental game is essential in unlocking the athlete’s full potential, both on and off the field. Her work aims to help each athlete navigate the maze of mental challenges associated with sport to better reach self-determined goals and optimal performance.
In this, the second of a two-part episode series, Kelsey and I discussed
- How she trains athletes to develop and maintain a healthy mindset during rehab
- The importance of setting goals
- Kelsey’s advice and strategies for setbacks
- How to get over the fear of re-injury
Ravi Patel: Welcome everyone to the ACL Athlete Podcast! This is the podcast where we talk about everything related to the ACL, whether that’s the injury itself, the rehab process, return to sport, and more. I’m your host, Dr. Ravi Patel, performance physical therapist, and coach. Between myself and fellow guests and experts, you’ll learn through the lens of the patient, the healthcare professional, and the coach. The goal of this podcast is to equip you, the athlete, with the education to make the best-informed decision about your care and your ACL journey. Thanks for joining. Now, let’s dive into today’s episode.
Welcome back ACL athletes. Today, we are covering part two of this two-part interview series with Kelsey Griffith, a mental performance coach. And this is something that we are so excited to dive into. If you have not listened to part one, go and do yourself a favor. Go listen to part one and then that way you can get set up for this part two incredible episode. Now, sit back and enjoy the episode.
We talk about this return to sport or return to activity or whatever goal that an athlete has set like, okay, this is the endpoint. But then what can be tough is that if, as you said, we hit a setback or we have some sort of thing that happens in the ACL process, that it can really derail things and then it almost feels like it’s so far out of reach.
One of the things that we will try to use with our athletes is this A-B-Z framework. And so it’s essentially trying to use these little point-by-point systems. A is essentially where the athlete is, where they currently are. Z is the end goal of what they want to be. We set that as the end and that’s what we’re working towards. But then we have B. The B is the next small step. You need to forget about the Z. It’s your big mountaintop, if you will, or the hill that you want to be on. But you need to forget about that and then have really good tangible goals for whatever that B is. And then once you get to B, you set another B or you set C and start to work towards that Z. And hopefully, you’re taking those small steps towards that and not getting too caught up in this whole big picture thing. Because it can be really challenging in this process because it’s so long
Kelsey Griffith: I love that. And it’s comparable to how I describe it to athletes. I call the end goal the beacon, the lighthouse that you see. And you’re like, I want to get there. But if you get into the ocean in a boat and you don’t have the paddles, that beacon can shine as bright as it wants to. But if you don’t have the steps to get there, you’re reaching for this thing that isn’t attainable at that moment. To keep the beacon there, to keep it shining, but to know very concretely what you need to do, what are actionable items that you can do each and every day to get closer to that beacon. So you got the paddles, you have your GPS, whatever the case may be. Know what those steps are and like commit to them. To say goals -usually when I work on goal setting with athletes, which is a big part of my job, they usually roll their eyes at me.
And I think it’s because like they learn about goal setting sporadically in school. I don’t know that it’s always done as effectively as it can be. If they talk about it and they might do it once, then a lot of times they never come back to the goal. It’s like setting your goal for the number of books you want to read this year and they do. And then at the end of the year comes, and then it’s never revisited. And then, then of course, goals don’t feel, you’re like, why am I going to take the time to do that if like, I’m never going to come back to it? Why? Yeah, it’s a waste of time. To help athletes recognize the difference between those outcome goals, between those performance goals, and process goals.
And I think with ACL in particular, the process is the thing that matters. I want to get back to sport, I’m going to back ’em down and say, okay, what do you need to do that? They’re going to say, well, I need to get stronger, I need to get faster, I need to get more range of motion. And I joke, I’m an annoying English teacher. I’m always going to ask you how or why, and I’m going to make you give me the details. If you need to get faster, how are you going to do that? You need to get stronger. How are you going to do that? Because each of those breakdowns gives you something, you can feel good when you do. Yeah, good. Breeds good. So when an athlete sets a goal and achieves it, they’re like, oh, okay. Like, I did that, that was what I wanted to do. I set out to do it. I had a game plan and I got there. One little piece that they’re like, all right, I’m going to try that again. And each goal gets a little bit bigger because you’re getting closer to the beacon. And then it shines brighter and you’re like, okay, this is working. I’m going to keep these small steps which I love.
Ravi Patel: And one of the things, I think is Herm Edwards, it’s cheesy, but it’s very true. ” A goal without a plan is just a wish.” It’s one of these things where like, we do talk a lot about goal setting, and with any of your athletes, athletes I work with, that’s the number one thing we talk about because we got to set our sights on something. But then it’s like, okay, what is the game plan to get there? And that’s what’s going to be really important. And it’s going to take two parts here. It’s going to be very much on the athlete’s part to be able to talk about this, to actually think about this in detail. And then also with the professional that you’re working with, hopefully, to help create that GPS system to help guide you there.
With the professionals that you’re working with any ACL athletes out there, ask them what is the next step. To be able to like to make this a bit more tangible, whether you’re going through your physical therapy or there’s other pieces with this. So that way it doesn’t feel like, okay, you’re waiting till three months or six months. As we had already talked about, time is a bit arbitrary and it can almost play against you. And I personally do not like time in the ACL rehab process because every person is so different. And it doesn’t account for all of those differences, whether it’s setbacks or just the context of the human being themselves. Being able to set our sights on things that are more tangible, like maybe the range of motion or a certain level of strength or being able to do X, Y, and Z that’s outside of time can be so beneficial. And being able to get that from professionals you’re potentially working with will be helpful as well.
Kelsey Griffith: And I love that, Ravi. I think it’s really important as an athlete. For those of you listening, it’s okay to ask the professionals you’re working with, to help you do those things. Because I can tell you all, many of my friends who are PT, RPTs. I’ve been in PT for probably the last 20 years of my life in some capacity. They’re setting goals all the time because they have to. And my thing is, why shouldn’t you be a part of that process? The more the athlete can feel involved in setting those goals, the more control they can have in something that is very much out of their control. And it sounds probably like, we’ve talked about all of this, you are doing those things and that’s so helpful. Because a lot of times I’ll work with an athlete and I’ll say like, do you know what you’re working towards with PT? They have no idea. They’re like, I’m doing blooper every day, more blooper than I ever thought I do in my whole life. They don’t necessarily know why. And to understand the why is also huge.
As a soccer player, when you’re like, why have I done with bridges for the last 42 weeks of my life? And when a physical therapist can say, this is what X exercise is targeting when you’re in soccer and you do X, Y, or Z. That’s where that strength and foundation and stability is going to help you actually play better. That’s incredibly motivating. Instead of just, I’m broken and so I’m getting better. It’s. All right. Here’s how this can help me become more than I was before I got hurt. There is that benefit when you get hurt; the weaknesses are unveiled. Okay, hamstring strength wasn’t what I needed, X, Y, or Z. Take the opportunity and build back and feel stronger and feel more ready. So that when you do get out there, you’re like, oh, I feel good. I am faster. I don’t have pain in X when I run anymore. I didn’t even realize that was a problem. And being a part of that process in PT, understanding the transferability of skills and strength gains, I think is so crucial.
Ravi Patel: Absolutely, being involved in the process. And one of the things that. It can even be helpful is having feedback loops. These are something where you circle back to things to be able to check and assess. What I will do with some of my athletes is, we’ll have check-ins, where are you on track for your goals? Is there anything you need help with in terms of getting there? Or do we need to reevaluate where you’re at based on how things are going? That’s what’s going to be really important in order to get to that next step and get closer to that beacon that you said or the end goal.
Sometimes the initiative has to be on you to be able to work on those goals and to make sure that those are at the forefront to keep you motivated in this process. One thing I do want to ask you about is what advice or strategies do you have for a setback. Setbacks happen all the time and we’ve talked a little bit about this. The thing that can get really tough with this process is that they go to a good example they go to run and then all of a sudden their knee kind of swells up. That’s a setback. What do we do in that situation, especially from the mental side of things to handle these? Because it’s usually multiple ones during this journey.
Kelsey Griffith: That’s a great question. I think this will speak to a lot of things. The two things I’m going to touch on, one, I think goes back to that idea of comparison to others or even to your past self. It’s not going to go from zero to a hundred for you or for anyone. And comparing to what you could do only takes away from what you can do right then. I talk a lot about like, your best is enough at that moment. We know the challenge as humans is we know what we’re capable of. We know what our ultimate best is. If it’s running without a blown-up me like that’s what I want to be doing right now. But in that right now, It might not be possible. And the more we fight it, the more frustrated we get, the more kind of hyper-focused we are on it, the harder it’s going to be to get there. Similarly, the more we focus on, well, so-and-so started running and they didn’t have a problem. Well, that’s so-and-so’s best. Literally, you can’t control that. And as normal as the comparison is, I always give an example. I step outside and someone walks by me, my brain instantly goes, that person’s taller than me.
Comparison is how we organize our world, but when we compare from a better or worse sort of place, it’s just energy-sucking. Something to keep in mind I think is like, what are you comparing to? Because in essence, you’ve never been in that moment. You’ve never had to try that. And I guess if you’ve had multiple tears, perhaps you have. In actuality, you’ve literally never been in that moment. Even if it’s your second time doing it, it’s still a different moment. Say, okay, this is my best for today. I got 10 seconds in and it didn’t feel good. We’re going to step back a little bit, rebuild, start small and feel good. Probably, I’ve said this 12,000 times, but it’s true. Feel good about the small wins. Ten seconds is better than zero.
The other thing I would encourage athletes to do from the get-go is self-talk. Developing self-talk statements based on your own experience with my ACL athletes, a lot of what I do is we’ll take moments of overcoming adversity in their past; whether it’s another injury, whether it’s sports-specific, it doesn’t matter. What I want to do with athletes is help them develop phrasing that they can believe in. Because in that setback moment when your knee blows up and you can’t run, you have to back it down a little bit, I can… isn’t going to feel super believable. Because the argument is going to be like, well, I actually didn’t. I thought I could. I tried and I didn’t. However, if you have phrasing, I call them like your pocket phrases. Have them ready. If you have something like I can do hard things, that’s believable. Because chances are, if you’re already at the point of running, you’ve overcome a whole lot of stuff along the way. And even if it was hard, you did it. Or something like, I will keep fighting. That kind of acceptance piece of like, this sucks right now, I’m really pissed. Not what I intended for the day, but I can get caught in those feelings and resist them and feel angry about it. And it’s only going to get harder to overcome that. Or I can say, yeah, I’m pissed. Sucks, not what I wanted today. But tomorrow’s a new day and I will keep fighting.
Again, puppies and rainbows, are not what I talk about. I think it’s important to be able to acknowledge both sides of it. To tell an ACL athlete, like, but it’s going to be fine. At that moment, they don’t feel that way. Because at that moment, all they wanted to do was run. I’m going to be the first to say to an athlete when a setback hits, let yourself be upset by it. That’s okay. If you pretend you’re not bothered by it and some may not be. It’s not a one-size-fits-all situation. But if you pretend you’re not bothered by the setback, at some point it’s just going to rear its head and it’s probably going to come at you even harder. Acknowledge it, accept it, and redirect with those self-talk statements, those pocket statements that have meaning to you and weight to you based on your own experience.
Ravi Patel: I love that. Even the idea of finding something where you had overcome adversity. Because at that moment you might just be like, this sucks. And as you had mentioned, that’s okay to do that and have the space to do that. But to be able to reach into your own past experiences of times where you have dealt with adversity and to be able to know that you came out of it better on the other side. It’s sometimes hard to be able to just be like, oh, I can do this. But the self-talk stuff is so important and I’ll never forget watching, who was it? It was one of the USA gymnasts. It passed around. But she was about to go on and, I think it was Simone Bales. It might’ve been someone else. But they went on and you’re like talking about at the elite level. Before she stepped onto the balance beam, she said, I got this. And she crushed it and she got the gold medal for it. And it’s one of these things where you’re just like, if these Olympians who are like literally doing this day in and day out is talking to themselves like this, these are strategies where we can utilize in our daily lives to be able to make sure that we don’t let these things in. Or if they do, they go quickly, and we redirect with positive self-talk. No,
Kelsey Griffith: That’s so great. I actually just recently saw on Instagram, seemingly she’s competing as a gymnast at Auburn. She had written a letter to herself before she competed and it’s awesome because I do that. I do a lot of like text messages with my clients. Before you to PT, what are the reminders you need? Give yourself that pep talk, like that okay. When I saw this letter shoot right now, I was like, this is so awesome. And it was like, you’ve got this, your best is enough today. Your expectations only. All you can do is you can do something along those lines. And I was like, wow. To see, like you said, these athletes who I think, we start to see these elite level performers and assume like, their mental game must be totally in check. And they have to keep it in check. It’s an active choice to say like, I’m going into X situation ready, mentally and physically which is great. Because again, I think with the conversations happening more and more, like normal human athlete folk are like, oh, okay. If they’re doing it like, then it’s totally okay if I do that. Not that we need that permission, but I do think it helps to see that on a larger stage. They have to do it too.
Ravi Patel: Yeah, of course. And I think it’s one of these things where it’s like if we have some of these strategies in place, then it could be one of these situations where we do get into this slump and we go back to these strategies to really help pick us back up. And one of the things, I’ll try to get my athletes whenever they go into surgery or right before to record a video of themselves. They could save it on their phone. But just know that there are going to be setbacks potentially in your process. I want you to record a video of you talking to yourself and talking about what your goals are, what your why is. And being able to kind of like a letter to yourself like she wrote. To be able to be like, okay, why I’m doing this? And so then that way whenever things do get hard, maybe they could reach out and they could watch this video and help turn things around quicker than just letting yourself sit in it.
Kelsey Griffith: Adversity is like, I had a client the other day who had come back from surgery and things were going great, and then got into tryouts, and things kind of crumpled a little bit. The first couple of practices crumpled a little bit. And then he literally was like, no, we’re not doing this again. And he like, split the switch and started crushing it. And I said to him, I was like, I know this is going to sound so weird, but like, I’m really glad you had those bad days. Because it made him realize that he could be in control of that. He could say… the thing is, we’re all going to have bad days. What do you do with that?
Now, on the flip side, I think it’s important for everyone listening to recognize. Sometimes the bad days do stick around and we need then more support. To recognize that line between today’s awful, tomorrow I’m turning it around and like it’s been awful for a really long time and I’m having a hard time dealing with that. Knowing that your resources are there to support you, be it from a mental skills coach or a mental health professional, don’t hesitate to reach out. You shouldn’t have to be in this alone. And I think hearing that, and knowing that it’s normal for this experience to be really hard is really helpful.
Ravi Patel: Absolutely. One of the things that I would like to ask you with your athletes, and especially dealing with an injury, how do you get over the fear of re-injury, especially with something like an ACL. We go to do a movement, especially something new. How do you get over that fear of re-injury?
Kelsey Griffith: It’s a really hard one. And something I still battle with myself. It’s funny. One day, I remember saying to my mom like, I can’t do this again. And she was like, yay, again. And of course, I was advised she was my mom. But she was right. And I think sometimes when we are so fearful of having to go through the process again, that’s the thing that gets in our way. Because you’re like, I can’t do this, but you can, you can. And it doesn’t mean it’s going to be fun or easy, but you can do it. And it’s if you can let go of the, what if, it becomes easier to move through that experience if that makes sense. And I think there’s that acceptance again, to recognize this sucks. I don’t want to have to do this again. If I had to, I could. It just creates space for you, I think, to experience the fear, but not get stuck in the fear.
There’s a great mental skills coach, Justin Soa, who works for the Tampa Bay Rays. And he has the phrase like, “what we resist to persist.” The more you sit there and think, I can’t do this, this is horrible. What if I get hurt again? The bigger that’s just going to be. And what I will say to most of my ACL athletes, day one, we’re probably not going to erase that fear entirely. That’s okay. But what we’re going to do is we’re going to work to turn down the volume on the fear and then turn up the volume on the things that will help you.
Because from a functional movement standpoint, people often ask why I work at an injury prevention facility, I’m currently the only me here. And the rest of our staff are athletic trainers and training conditioning specialists. But I say to clients is like, what happens when you’re stressed? I give the example of like, take your fists and squeeze them as tight as you can. And when I have them do that, after about 5 to 10 seconds, what happened to your breath? They’re like, well, I stopped breathing. Exactly what happened to your shoulders? And they’re like, they were at my ears. We can’t do what we need to do biomechanically in the most efficient way possible when we’re feeling stressed and overwhelmed. When we can learn to quiet the fear, our body is going to do what it knows how to do best.
And at that point, we do need to trust in our readiness. And I think that that readiness piece is such a huge part too. To have an athlete, as they’re going through the process, I’ll give them prompts like, I’m ready. And here’s why before they run. I’m ready and here’s why. I got my range of motion back. My doctor says I can. I’m feeling much stronger and I’m really excited. As you get back to sports, I’m ready, and here’s why. To balance stress management, I think the piece of the fear, turning down the volume, and then also supporting the readiness with evidence, can be super helpful. If people like evidence, they like to see, this isn’t just like, okay, you’re free to fly. It’s like you’re free to fly because you’ve done all of this work. That’s what got you there.
Ravi Patel: That’s such a good point. And that’s where your rehab and the training that you’re doing these things go hand in hand with the mindset piece and the physical training. Especially with athletes I’m working with, we will try to show them, you know what, this is where you’re at and these are the things that you can do. Or, let’s even flip this and say we have an overconfident athlete who’s fearless or whatever. I’m like, okay, well, let’s do this. Obviously nothing to danger them or re-injure them. But I’d be like, okay, well, like let’s do this movement and they can’t do it. Well, then it’s like it allows you to self-assess and be like, I can’t do that yet. And that’s okay. But the other piece too is for the re-injury piece, is knowing like, have you done everything from a physical preparation standpoint to make sure that you do feel the fear of re-injury is more so just like, all right, now I just need to work on the mental side of things because you have checked all the boxes on the physical side.
Kelsey Griffith: I do also think for athletes listening to remember, and I think I alluded to this earlier, it’s not going to go from zero to a hundred. I think a lot of times, athletes hear clearance and I keep using soccer as an example. I currently have quite a few soccer players. I’m going to go to a 90-minute game, and that is overwhelming. I look at him and I’m like, forget the soccer part. Can you run for 90 minutes? And they’re like, oh, you’re right. That is hard. I don’t know that I’m ready for that. And that’s why a place like Micheli, that’s why we exist to really help in that transition piece so that clearance isn’t zero minutes of soccer to a 90-minute game. Clearance is your baby steps. The beacon is now the 90-minute game, you’re back to the sport, you hit that beacon. And now this one is, I wanna play in a whole game like I would normally, and the steps are: okay, in practice, I’m back to drills; in practice, I’m back to scrimmaging, no contact; in practice, I’m back to scrimmaging with contact. And seeing that progression it’s not so overwhelming. Because I think the anticipatory worry can get so huge like, how am I supposed to do that? Well, you’re supposed to take small steps to get there. No one should expect you to go from not playing soccer for a year to playing a game…
Ravi Patel: The thing that makes this really tough, and this is after talking with a lot of different athletes who are going through this process and coming back to the resources that they have and whether it’s the physical therapist or this transitional- essentially the gap. And a lot of this we have things that work against us that I don’t want to go on tangents about, but it’s insurance and healthcare and depending on geography and things like that will play a big role in having these resources available. A lot of the things that a lot of athletes will deal with is the gap that exists to be able to transition to something like that. If the insurance visits run out, what do I do next? And so that’s why there are resources out there, whether it’s remote coaching or being able to find someone local to be able to help be that GPS for you in this process, instead of trying to figure it out yourself.
Kelsey Griffith: The figuring out themselves, I feel like these athletes the expectation is they should be able to, most of them are kids, I mean, adolescents. You’re 16, you can’t get in the car and drive yourself. Why should you be figuring out these next steps? And of course, if you feel confident to do so go to go to town. You’re right, it’s encouraging them that you shouldn’t have to do that on your own. But then the next step is, what resources are available? There are so many logistics that contribute to that. I do think the silver lining of Covid is so many people are now working remotely. Those resources we didn’t have. I wasn’t working virtually before the pandemic and now I’m working probably 90% virtually. I get to see clients from California, which is super, cool.
Ravi Patel: And that’s so awesome. And that’s where resources like this can be available and you don’t have to just feel confined to maybe what is in your city, especially if the resources are a little scarce in that sense. And one of the things that you touched on is this progression. One of the things that we’ll use is, instead of it being like an on-and-off switch. All of a sudden, let’s say you hit six months or whatever it is, and you’re ready to transition back to soccer or to sport, you’re not just going to go and play in a 90-minute match. The way to look at this is like a dimmer switch. And instead of it being something that’s on and off like flip the script, it’s more so of let’s use the dimmer switch and slowly brighten up that light. And that way it’s like a very slow progression and then that way it doesn’t seem very daunting, where you put yourself in a position where you’re like, what am I doing here? And you feel prepared for it.
Kelsey Griffith: Keep it digestible, I like that. The dimmer switch is a great analogy.
Ravi Patel: This leads us toward the end of the podcast. What we will do is we’ll have to have Kelsey on for another episode because there’s still so many things that we love to dive into and we could probably talk all day about this., Kelsey, it was such a pleasure to have you on the show today. Where can people find out more about you online and how can they keep up with you on social media?
Kelsey Griffith: Thank you first of all for having me. This was awesome. Like you said, I could definitely talk about this all day. I think it’s so exciting that there are more resources like this podcast, ACL Club as you mentioned for athletes to know that they’re not alone in this process. To find me on social media, I’m not the most social media savvy, but you can find me on Instagram at. Psychup Sports P-S-Y-C-H-U-P-S-P-O-R-T-S. Also, online for booking. If you’re interested I offer one-on-one sessions. If you’re local to the Boston area in person, if not virtually, and that you can find me at @themichelicenter.com and I will definitely spell that one, T-H-E M as in Mary, I- C- H-E-L-I C-E-N-T-E-R.com. We have all sorts of resources online. You can find me there under our mental skills coaching.
Ravi Patel: Guys, please check this out. Reach out to Kelsey if you’re interested in this. We have talked a lot about this and she’s one of the best out there, and you would be in really good hands. We will put all of Kelsey’s information, The Micheli Center in the show notes below. Kelsey, thank you so much for coming on the show.
Kelsey Griffith: Thank you for having me. It’s been awesome.
Ravi Patel: I love talking to people who have gone through this process, especially about the mindset and the mental aspect as it’s such a huge role in this injury. And I think all the ACL athletes out there will be able to take a lot away from this conversation.
Kelsey Griffith: I hope so. Please feel free to reach out with any questions.
Ravi Patel: I think that wraps things up for this episode, guys. As always, thank you all so much for listening to the ACL Athlete Podcast. This is your host, Ravi Patel, signing off.
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