Using Visualization After an ACL Injury: Rebuilding Confidence and Returning Stronger

It isn’t just about rehabing the body, you need to rehab the mind.

An ACL tear is mor than a physical injury that ends a season. It disrupts identity, momentum, and confidence. The rehabilitation process can feel slow, frustrating, and uncertain while creating feelings of distrust in one’s own body to be able to perform normally ever again.

Many athletes report feelings of:

• Being disconnected from their sport

• Having fear of re-injury

• Frustration with the speed of progress they are experiencing

• Uncertainty if they ever will return to the same level

Research has consistently shown that physical readiness doesn’t equal mental readiness. A return to sport needs to be a fully prepared athlete, both mind and body. That is where visualization comes in, a powerful mental performance and enhancement tool that can be used to rebuild confidence and prepare for a return to sport.

Why Visualization Works.

Visualization is often confused or used interchangeably with “imagery” but they have different roles. Visualization is watching a scene from the first or third-person view and is often used with sports skills, or observing a situation. Imagery is developing a single place and time to help cause a specific response such as imagining a beautiful scene with a lake and animals, crystal blue skies, and then using that image to calm the body down.

While both are extremely useful, visualization actives the same parts of the brain that are used during actual movement and it is an excellent way to get additional reps in when learning new skills or when hoping to develop a sport specific mindset. When an athlete visualizes movement, neural pathways are developed and strengthened and micromovements have been observed within muscles connected to the movements.

Studies have shown that visualization can be used to:

• Reduce anxiety during rehabilitation

• Increase confidence and intrinsic motivation

• Improve motor learning and neuromuscular control

• Improve strength gains when paired with physical therapy

To summarize, visualization keeps the mind in the game while the body heals.

When to Use Visualization.

During Rehabilitation

When you can’t yet perform movements physically, you can rehearse them mentally. This keeps your brain focused on correct movement patters and builds confidence before you even step back on the field. If your team is learning new plays, you can rehearse them over and over again allowing you to catch back up to speed quicker, after returning to sport.

The best times to use visualization during rehabilitation are:

• Before physical therapy sessions: Go over the exercises that are ahead, visualize your muscles getting stronger and your body healing.

• During moments of fear or frustration: Look ahead to returning to your sport with a strong, healed, leg.

• At night before bed: Reinforce your progress, review the exercises performed and visualize your leg healing from your hard work.

During Return to Sport (Post-Rehabilitation)

The #1 barrier athletes face when cleared to return is the FEAR of re-injury. How do you apply visualization to overcoming this fear?

• Visualization can help to replace fear with confidence. You can review all the progress you made during rehab. Visualize the conversation with your physical therapist where they stated you are ready to return to sport. Visualize your leg performing with strength during a game.

• Mentally practice stressful movements: If you have a drill that concerns you, take time to visualize yourself completing it successfully. Focus on a strong leg, visualize it from the 3rd person as you perform it with excellent form, and then visualize it from the first person.

• Visualize yourself competing without restriction. Take time to play through a game in your mind, visualize yourself accomplishing all the tasks and requirements of your sport without restriction. Remind yourself that you have put in the work, you have put in the effort, and you are ready.

Work with a Script.

When utilizing visualization, sometimes it is beneficial to use a script until you find what works for you. Here are two examples of visualization scripts, one for during rehabilitation, and one for your return to sport. Find what works for you but two major keys need to be taken away from these scripts, being in a comfortable position/place, using breathwork to control your arousal/anxiety levels relating to the sport. You are in a comfortable and safe place, you have total control of your mind and body, use breathwork as the throttle and brake to be where you need to be in your visualizations.

Visualization Script #1: During Rehabilitation
(Focus: Mental repetitions and confidence building)

Instructions:

1) Get into a comfortable position (sitting or lying down).

2) Close your eyes and take a moment, starting at your toes to examine your body slowly from the tip of your toes to the top of your head. Check for tension or built up stress. If you feel any, take a moment focusing on that part of your body, tighten those muscles, hold for 5 seconds and then release them as you feel the tension releasing from your body.

3) Slow your breathing for 1-minute:
Inhale through your nose for a 4 second count: Breathe 1…2…3…4…
Hold for 2 seconds: Hold 1…2…
Exhale slowly through your mouth for 6 seconds: Exhale 1…2…3…4…5…6…
Repeat for 1 minute or until you feel your body calming down

Visualization Script:

Picture yourself in a calm place where you feel safe, confident, and grounded.
See yourself walking confidently with smooth, controlled, and strong steps.
Visualize each repetition during rehabilitation, strong, stable, and balanced.
Watch your muscles engaging, supporting your movements.
Feel the strength returning to your body.
Each repetition brings progress.
Every day, you are getting stronger, more stable, and better.
Repeat silently to yourself:
”I am healing. I am capable. I am stronger every day.”

After 5-10 minutes of this visualization engage in the breathing exercise again for 1-minute before opening your eyes as you bring yourself back to the present with the progress you visualized.

Visualization Script #2: Return to Sport
(Focus: Overcoming fear of re-injury)

Instructions: Do this right before a practice or game as part of your routine.

1) Get into a comfortable position (sitting or lying down).

2) Close your eyes and take a moment to become present.

3) Slow your breathing for 1-minute:
Inhale through your nose for a 4 second count: Inhale confidence 1…2…3…4…
Hold for 2 seconds: Hold with strength 1…2…
Exhale slowly through your mouth for 6 seconds: Exhale fear and tension 1…2…3…4…5…6…
Repeat for 1 minute or until you feel your body calming down

Visualization Script:

Picture the field, court, or rink, where you play.
See the colors, the lines, the lights, the smells.
Hear the sounds, your teammates, coaches, and the environment.
Visualize yourself moving confidently:
Cutting. Sprinting. Jumping. Landing.
Your knee is stable.
You trust your body.
You are in total control.
You are FREE to compete.
Repeat silently to yourself:
”I trust my body. I trust my training. I am READY.”

After 5-10 minutes of this visualization bring yourself back to the present. Count back from 5 to 1 reminding yourself that your body is strong and you have total control after each count.

5… I am strong
4… I have control
3… I put in the work
2… I am ready
1… I am ready
0… Let’s go

The Mind is Part of the Rehabilitation Process.

Returning from an ACL injury is not just about muscles and ligaments, it is about confidence. When the mind believes, the body follows, and you are free to compete.

Strong Body + Strong Mind = A Strong Return

If you, your team, or your coaches would like a customized visualization script or structured mental performance coaching during injury rehabilitation, I woudl love to help. Schedule a free 30-minute consultation at www.PeregrineRisingMPC.com

~ Dr. Ty