WEBVTT
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Welcome to the Factor podcast, where we talk about the
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stuff they didn't teach you in school, how to grow
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your practice, refine your clinical skills, and get better results
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for your patients. We're here to help you navigate the
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real world challenges of being a healthcare provider, from delivering
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top notch patient care to running a business that doesn't
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run you into the ground. Whether you're fresh out of
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school or scaling your practice, we're diving into effective, cutting
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edge treatments to get patients better, faster. We'll also talk
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about business strategies and tactics to help you work smarter
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and not harder, and the mindset shifts required to thrive
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as a top performer in your field so you can
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build a career you love without burning out. If you're
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ready to learn what works and what doesn't from leading experts,
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industry innovators, and respective clinicians across a wide range of specialties,
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you're in the right place.
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My friend.
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Let's dive in. Welcome back to the Factor podcast, where
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we bridge the gap between reabilitation performance and real world
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clinical practice. I'm your host, Jessica Riddle, and today we're
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kicking off a new conversation with doctor Carolina Shander, a
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licensed psychologist and certified mental performance consultant who specializes in
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sports and performance psychology. In this episode, we're diving into
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an area that is becoming increasingly important for clinicians, coaches, athletes,
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and really anyone working with high performers. That is the
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connection between physical health, mental health, identity, recovery, and performance.
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Doctor Shander's work focuses on supporting athletes and other high
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achieving individuals to help them understand not only how to
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perform at a high level, but how to stay well
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while doing it. Through her work with athletes, coaches, teams,
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and organizations, including her connection with USA Gymnastics, she brings
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a valuable perspective on what it means to care for
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the whole human, not just the performer. In Part one
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of this two part conversation, we talk about how sports
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psychology fits into the larger health care and performance team,
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why trust is such a critical part of working with athletes,
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and how coaches, health providers, and mental health professionals can
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better collaborate to support performance and well being. We'll also
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explore the pressure many athletes and high achievers feel to
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constantly push harder, do more, and ignore the signals that
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something may be off, and doctor Shander will offer some
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helpful insights into what providers can look for when an
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athlete's pain, injury, or performance challenges may also be connected
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to their identity, worth, stress, or emotional health. Whether you
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work with athletes, active individuals, performers, or simply have patients
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who are trying to return to the activities that matter
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most to them, this conversation is a reminder that the
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body and the mind are not separate systems. They are
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deeply connected and both matter in the recovery and performance process.
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Let's get into part one of my conversation with doctor
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Carolina Shander. We like to have a bit of a
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master series conversation ever so often with different healthcare providers
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that have meaningful insights to share that I think are
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definitely relevant and things that could be helpful to our community.
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So we're excited to have you with us today. If
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you could start out by telling Jimmy just a little
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bit about what it is that you do and specifically
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how you and doctor Redtle got connected through USA Gymnastics.
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Absolutely, thank you for having me.
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I'm really to have this conversation and be able to
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connect on this topic and discuss the idea of sports psychology,
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and so a little bit about me. I'm a counseling
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psychologist with a specialization in sportant performance, and so what
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that meant is I got generalist training in all types
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of clinical mental health difficulties and challenges, and then was
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able to find a program that also allowed me to
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pursue important performance so any kind of high achieving individuals athletics,
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io psychology and be able to learn like what does
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it look like to be a performer and maintaining your
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well being? And so I've been really fortunate to have
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that background. And I met doctor Riddle by being connected
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with USA Gymnastics, primarily trampoline and tumbling, started working with
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them with my coworker here, doctor Zane Dodd, and we
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were invited to just be a mental health support person
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at some of the trainings and competitions, and then was
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able to foster some relationships with the clinical health providers
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and physicians and was invited to be a part of
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the team to deliver some training to parents athletes as
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well as coaches regarding mental health and mental performance and
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to help foster this idea of the whole human needing
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to be well to be excellent, and so I met
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doctor Riddle when we were in Alabama, I think, for
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a training camp and was able to have a lot
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of conversations about what it looks like to I don't know,
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combine the idea of physical and mental health absolutely.
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Now, I think you have kind of a fascinating choice
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that you took when it comes to the specialization within
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your profession. Obviously under the umbrella of mental health, there's
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so many different ways that someone can specialize, especially in
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that clinical setting where they're doing counseling. What made you
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select kind of this niche within IO and with high
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performers and performance psychology in particular.
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Yeah, it's a great question.
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Part of it was mesearch, which is I was a
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collegiate swimmer and a big part of my challenge was competing,
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and so it meets I would really struggle to be
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able to reach my potential, and so I noticed that
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within myself if there was something that was holding me back.
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And also when I was pursuing my degree, I had
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some wonderful mentors that work actually in a couple of
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different departments that have a master's in sport and performance,
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and they shared with me. The way that you function
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and see relationships and see humans and see how they
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work within a system, You're going to probably do really
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well in the University of North Texas department. Working in
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a place where you get experiences working within a collegiate
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athletic department. You're working within a system, and then you
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have that background simultaneously of being able to learn about
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how to support.
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People just from like a clinical view.
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And so the program here at a University of North
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Texas has a five year program specifically in counseling psychology
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focusing on diagnosing assessment, and then a couple of.
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Years regarding the sport and performance.
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And what I loved about the program here was that
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you get embedded within a team immediately kind of once
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you step foot on.
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Campus, and you learn to understand the.
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System as a whole of how they work within the
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athletic department, how each team has a different culture, how
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coaches work, what kind of approaches they have, as well
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as the individual athletes themselves and how they work within
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also the health system of how their physicians work, their
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athletic trainers and where you might fit. And I was
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I had the opportunity to work with a couple of
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different teams within YOU and T and each one was
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so different and it challenged me to figure out how
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I can kind of best serve based on just.
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The information that I've learned throughout my schooling. That's huge.
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So when you say they kind of allowed you to
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integrate into a team, do you mean specifically a sports team,
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And maybe this is an answer, this is both, but
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a sports team or within the sports medicine team where
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you're co managing these athletes along with other providers.
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So it's a little bit of both.
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The setup is you get kind of paired with a
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kind of like a senior consultant, so somebody who's further
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along in the program, who is doing counseling, psychology and
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the support and performance specialization, and you, as like a
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first year, get to learn from them and see what
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they do. You help plan like mental skills sessions, conversations
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with coaches as well as then start relationships with the
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physicians the other parts of the sports met staff, and
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then you're kind of you negotiate and figure out like
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how often you're a practice, how often you are at competitions,
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and be able to determine kind of what your role
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is in the health of the athletes. Certain physicians or
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certain practitioners would want us around more and would want
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to run things by us a little bit more than others.
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And then some we had to negotiate of like, Okay,
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maybe return to play doesn't involve me as much just
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because of kind of some of the protectiveness around the sport.
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But that's also just a difference based on just the
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culture of every team.
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Absolutely, have you, in your experience found that many people
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within the coaching staff, the training staff, worts, med staff
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have a good understanding of how mental health professionals can
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play into that. Have you experienced a good bit of
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maybe resistance at times where people don't really understand how
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you guys fit into that team.
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You ask a wonderful question, and I'm smiling because it's
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been both. I think a lot of it has been
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dependent on trust as well as understanding of how we fit.
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And there have been opportunities or experiences where I've been
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placed with a group or placed.
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With the team and they don't know how to utilize me.
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And there's a lot of fear around having a an
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outsider and b having somebody that is mental health or
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clinical come into a space because they don't want it
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to be disrupted and they don't trust me, right, and
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so a big part of those relationships has been creating
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a strong bond and creating trust by me sharing what
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I could offer while also being able to observe and
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allow people to kind of invite me in at the
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same time, because I think that's a huge barrier for
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us as providers in the mental health or mental performance
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space is sometimes we're not necessarily invited, even though we
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might be wanted and needed at times, but we have
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to work with that relationship first and the trust before we.
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Can even be able to help at least that's my belief.
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In the times where you've had the most success in
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terms of being able to effectively help your athletes but
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then also being able to work well co managing care,
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have you found that it was typically more practitioner led,
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meaning that the other healthcare providers or the coaches really
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kind of bring you in and drive that relationship, telling
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the athletes we have this resource, or have you found
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that sometimes it's more patient led, whereas if your athletes
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request mental help, or if your athletes are the ones
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to kind of I guess initiate that relationship.
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It works better.
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A little bit of both. I think from my experience. Actually,
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top down it's probably the most effective. When the individuals
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at the top, whether that's athletic departments or just leaders
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of a system, find us to be useful and helpful
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and interested in creating just.
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Space for us, then it's probably the most helpful. There
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have been instances where.
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The athletes or the patients involved have pushed because of
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the how much they request, and I think that's how
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currently in private practice, I see a lot of my
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work grows. I work with a couple of individuals, I
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work then with the group, and then the interest and
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kind of affects to that are shown that leaders, coaches, etc.
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Kind of notice the difference and then invite us in.
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But for me, it's been most successful when the kind
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of individuals in power are bought in because then they're
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also kind of using the same language. They also want
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to learn. We're able to intervene across the system, whether
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that's management, whether that's coaches, other practitioners, and so we
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see the most positive effects that way.
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I can see that especially when when it is a
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top down approach, When you have that athletic staff. When
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you have that sports med staff saying this is a
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part of our culture, like this is what it means
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to be a member of this team. I think that's
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huge because I would imagine that much like our muscular
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skeletal providers see with athletes, athletes are always wanting to
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be strong. They're always wanting to show no weakness, and
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I'm sure there's a lot of misconceptions or maybe even
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like just bad stereotypes in their mind about if I
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ask for help that means I'm weak, or if I
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admit that I'm struggling, then I could be cut from
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the team. I could have be benched or whatnot. How
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have you, or I guess, how have you helped some
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of these athletes that are a bit more hesitant or
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have that mindset kind of work around that to realize
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that mental health is just as important as their physical health.
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I think there's a couple different ways, but the primary
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way that I do it is by being a human.
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I traditionally start with high I'm like Carol.
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Or Carolina depending on how people know me, and I
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share with them kind of like my background and what
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got me here, and then I traditionally just start with
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a relationship of like, hey, I'm noticing these things what's
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happening for you and getting to understand them as a
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human before I start kind of thinking or sharing what
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I think might be helpful, but more so.
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Trying to understand what somebody's coming in with. And so
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there's a huge.
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Stigma still despite it being a lot more prevalent in
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pro sport than like baseball has huge push around mental
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health football, but there's still the stigma of like, wow,
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like somebody's going to like know my inner thoughts and
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my inner demons, and quite honestly, I try.
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To get across it.
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It's like a freaking privilege to be a part of
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that journey with somebody, and so being able to get
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them comfortable with me as a provider first is kind
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of the way that I lean and then being able
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to share with them like hey, this is what people
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utilize this for, and also that I don't have to
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be the one that they pick that there are so
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many different kinds of providers that can be a better
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fit for them that might have a different style, might
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have a different way of thinking, you might have a
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different way of how they implement their kind of skills
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and knowledge, and to give them just the option and
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feeling of agency, because honestly, when it comes to really
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anything in our space, the ability to feel like you
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have any agency and choice is what leads to better
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outcomes as well as leads somebody to actually want to
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be in my office and be able to practice what
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I share with them.
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Absolutely, and I would imagine, and I have to say
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I can't speak from experience. I was never an athlete.
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My husband jokingly calls me an athlete, even though I
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stink at math, So I was more of the art
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and the drama kid and whatnot.
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Which is performance too, yes.
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Exactly, And obviously being a CEO, having spent most of
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my career as an executive like, I totally understand that
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that inner drive and that ability to have the determination
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to push through hard things really is something that can
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be incredibly effective not only in your sports career but
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in all aspects of life. But when it comes to sports,
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what I've noticed, at least just kind of getting a
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look behind the scenes through my own children and then
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obviously the athletes that I've had the privilege of working
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with over the years and various different things are been
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friends with, is there's sometimes a stigma or maybe even
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a misconception that so many athletes have that is, I
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have to constantly go, go, go, go go, and I
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have to push harder and push harder and push harder,
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and that inner drive I think is inherent to being
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a great athlete and being a higher obviously. But at
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the same time, I know many of our healthcare providers
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are also trying to emphasize to their patients from a
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physical standpoint, you have to have rest, like you have
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to balance things out. Do you feel like when it
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comes to many of the high achievers, the high performers
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that you've worked with, whether it's from an IO standpoint
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in the corporate world or even those that are high
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performing athletes, do you feel like sometimes that's one of
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the hardest challenges is just kind of educating them about hey, like,
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this is how your mental, emotional, spiritual help fits into
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you as a person and as an athlete. There's so
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much more that goes into your performance on the field
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than just what you're doing in your physical body.
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Yeah, one hundred percent.
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I think the biggest piece of initial work with somebody
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is to grow their kind of awareness of what all
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goes into being someone's best self. Then, I mean you
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mentioned a couple of those components or like spiritual health,
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mental health and rest and sleep and even relationships, right,
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Like they all impact us. Everything kind of impacts us,
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not just the work we do in the gym or
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on the field. That just pushing harder or doing more
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isn't actually sometimes the marker of success, and.
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So it is hard to convince somebody of that.
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I think that's sometimes one of my biggest challenges, And
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I try to take the approach of like, let's just
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try and understand you as a human in the ways
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that when you've achieved your best, what's been going the like, well,
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what's been most effective and then be able to start
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to help them see, oh, wait, like I was really
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I don't know, feeling supported by my people, or I
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was actually like really involved in my church while also
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competing in.
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My sport, or wow, like I was making sure I.
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Was sleeping this much or taking my vitamin and it's like, okay, hey,
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like there are multiple components here that actually make you
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be your best.
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It's not just this one thing of pushing yourself on
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the field.
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And that's another I think one of my challenges with
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the misconceptions in athletics is that you just got to
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do more and be harder and just like be tougher,
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just do more better, and that's just not actually what's
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going to create the best outcome as well as like
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long term effectiveness, because we see a lot of really
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high performing individuals burn out pretty quickly just because their
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resources have been depleted over the years. And you can
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work hard, but eventually that resource runs out.
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Absolutely when you are working with an athlete, and you
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have a coach that very much has that mindset of
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And obviously I'm not calling out the coaches out there,
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but as I've seen firsthand, sometimes it is those coaches
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that have that condition in weight room and practice and practice.
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Like when you have a coach and a culture and
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a team that has that mentality of NonStop, We're going
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to go one hundred miles an hour, nothing's going to
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stop us.
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How do you.
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Kind of convince that coaching staff or convince that from
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the top down approach that it's good to implement some
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of these other aspects. It's good to kind of give
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priority to rest, because I know that has to be
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a challenge, especially if there's a culture where that's been
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something that they did and their coaches really instilled that
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in them, and their coaches instilled that in them. Like,
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how do you break through that?
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Yeah?
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I very different ways, I think, but it's a good question.
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It's something I and a lot in my fellow colleagues
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also struggle with.
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But it depends on the system that you're in.
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If I'm in a athletic department and I have a really
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great relationship with a coach, and we kind of have
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an understanding that they want like my input, then I'm
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probably a lot more likely to just be honest and
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share of like, hey, like, I'm noticing this. I'm noticing
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that there's no emphasis on the other parts of the human,
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not just rest, but like maybe some of these pieces
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of your athletes that aren't getting emphasized, and I'm worrying
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that it's kind of leading.
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To some detrimental outcomes.
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And maybe if there are outcomes that I'm already seeing
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in my office and I have permission to share that
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of like, hey, like, there's about three or four of
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your humans who are really I don't know, they're feeling
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really burned out, or have low motivation or really struggling
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or are scared to talk to you. I might offer that,
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or I might really rely on research to showcase that
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athletes who are able to access different parts of their
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identities are going to actually perform better. Athletes who are
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seeing rest is just as important as their physical preparation
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are going to have long careers as.
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Well as more satisfaction within their careers. And I also
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might offer a.
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Question to the coaches of like, I know this is
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how you did it? I know that you just pushed
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harder and you grinded like, that's true. But what if
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this isn't the most opportune environment for your people, like
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your kids, your athletes on the field. What if they
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don't learn that way?
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What if they.
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Don't achieve their best result that way? And to offer
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kind of different ways of thinking without pushing my agenda
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on them, because that's also not what I want to do.
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It's hard to also get somebody to buy in if
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they're not interested. So I try and understand the coaches too,
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of like what's going to allow them to hear me
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or at least be open to a different idea.
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I love that, and I love the way that you
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worded that. I think that's one of the most impactful
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things that all of us can learn from mental health
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professionals is sometimes how to approach conversations and that your
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word choice is incredibly important. A lot of the providers
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in our network and many people that are listening see
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athletes when they are in pain. They'll see athletes or
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even just the regular every day driven individual when they're
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at a place where they are either dealing with an injury,
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maybe they're struggling with chronic pain or a chronic injury,
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and they're trying to figure out the best path forward.
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If I'm a healthcare provider working with someone and you know,
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maybe we're going through our care plan in terms of
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their physical body, but there's something that just kind of
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seems a little bit like there's something extra there, There's
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something more that's kind of beneath the surface, and I'm
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not Sometimes people just have an intuition when it comes
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to these things. Sometimes people don't what are some things
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that healthcare providers should look for, whether they're working with
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an athlete or anyone really that kind of makes them
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think it might be time to have a conversation to
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see if they're open to going to see a mental
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health professional.
429
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I think that that was one I've always thought about,
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like when I'm sitting in a doctor's office or if
431
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I'm like sitting with another person and in the health
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setting of when is it time for escalated care some
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different kind of support. Big pieces I think would be
434
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to pay attention to how somebody's responding to any kinds
435
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of challenges from the physical standpoint. Are they saying things
436
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like I'm never going to be the same, I can't
437
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do this very kind of more closed.
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Kind of defining statements.
439
00:24:41.200 --> 00:24:45.240
I start to worry a little bit more when somebody
440
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is and then the big kind of picture seeing them
441
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maybe describe big changes in their life. Right, so like oh,
442
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I'm not sleeping, I'm not eating, I maybe pulling away
443
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from people. I'd be paying attention to kind of different
444
00:25:00.119 --> 00:25:00.920
changes in their.
445
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Life outside of just their sport.
446
00:25:02.359 --> 00:25:06.519
But a big thing to pay attention to is and
447
00:25:06.599 --> 00:25:09.519
listen to is how are they viewing themselves?
448
00:25:10.440 --> 00:25:12.799
It has the injury and the chronic.
449
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Pain potentially changed how they view themselves in a way
450
00:25:16.079 --> 00:25:19.359
that they don't maybe have different aspects to how they
451
00:25:19.359 --> 00:25:22.319
see themselves. So for example, right like if I'm I'm
452
00:25:22.519 --> 00:25:24.720
I'm postpartum, I've had two kids, and i have some
453
00:25:24.839 --> 00:25:27.200
kind of like back pain, and I'm sitting on your
454
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table and I'm saying like I don't have anything else.
455
00:25:30.359 --> 00:25:32.960
I am just an athlete, and you know different parts
456
00:25:32.960 --> 00:25:35.119
about me and you're like wait, wait, like you're a mom,
457
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you're a partner.
458
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Okay.
459
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That just taking account of those things or hearing somebody
460
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like myself say I if I don't do this, like
461
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I've got nothing else, Like I don't I don't prove
462
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I can't prove my worth to anybody else if I
463
00:25:48.839 --> 00:25:51.119
don't do this thing, if I don't compete, And so
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if those things tied to identity or worth are really
465
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coming up, that's a really, I think, really impactful place
466
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to be able to say, hey, like it sounds like
467
00:26:01.759 --> 00:26:04.559
you might really want to have somebody else on this
468
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journey to help support you and show you that there
469
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are other really valuable parts to you, or that your
470
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life can still be really fulfilling and important even if
471
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it is including managing this pain or this injury. But
472
00:26:17.960 --> 00:26:23.079
those are the big things. When worth an identity are collapsing,
473
00:26:23.400 --> 00:26:25.920
that is a really great time to be.
474
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Able to incorporate somebody in the mental health space.
475
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That's huge, And I know that in recent years in
476
00:26:34.000 --> 00:26:37.240
the muscular skeletal space, there's been a lot more at
477
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least awareness of the biopsychosocial aspects of pain and more
478
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and more providers. I think, especially post twenty twenty when
479
00:26:47.319 --> 00:26:52.039
COVID hit and people are dealing with our practitioners are
480
00:26:52.079 --> 00:26:55.519
seeing a lot more COVID cases or even that year,
481
00:26:55.880 --> 00:26:59.240
we're really seeing more and more patients that had so
482
00:26:59.359 --> 00:27:02.680
much stress, much anxiety so much going on mentally that
483
00:27:03.200 --> 00:27:05.559
it weighed heavily on their physical bodies as well. At
484
00:27:05.640 --> 00:27:08.119
least there's more of a conversation and an awareness now.
485
00:27:09.039 --> 00:27:13.759
But if I'm a new graduate, I'm starting my practice
486
00:27:13.799 --> 00:27:18.240
for the first time, obviously, I've learned a lot of
487
00:27:18.279 --> 00:27:21.599
ways in that initial new patient visit to ask a
488
00:27:21.599 --> 00:27:25.279
lot of questions about their physical body. Do you have
489
00:27:25.319 --> 00:27:29.319
any recommendations about maybe just like one or two simple
490
00:27:29.440 --> 00:27:33.240
questions that someone should ask in that initial new patient visit,
491
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just to kind of get an idea to gauge where
492
00:27:37.640 --> 00:27:41.400
that person is from a mental health care standpoint so
493
00:27:41.440 --> 00:27:44.400
that it can better inform their care plan moving forward.
494
00:27:45.559 --> 00:27:48.319
Yeah, I think other than the big questions of if
495
00:27:48.359 --> 00:27:51.839
you're hearing somebody struggling with injury or pain and the like,
496
00:27:52.200 --> 00:27:55.079
have you thought about ending your life for hurting yourself?
497
00:27:55.160 --> 00:27:59.400
Other than those, what I would recommend asking is like,
498
00:27:59.440 --> 00:28:02.079
what is this pain mean to you? How does this
499
00:28:02.160 --> 00:28:04.920
pain disrupt your daily life? What does this pain also
500
00:28:05.039 --> 00:28:09.039
mean to your relationships? What is getting this work done
501
00:28:09.279 --> 00:28:12.440
right in the muscular skeletal space, Like how much relief
502
00:28:12.480 --> 00:28:13.200
does it give you?
503
00:28:14.000 --> 00:28:16.200
And how do you know that it's giving you relief,
504
00:28:16.200 --> 00:28:17.480
not just physical.
505
00:28:17.759 --> 00:28:21.400
But how does this work here impact you, because you
506
00:28:21.440 --> 00:28:23.480
may start to hear maybe this is the one moment
507
00:28:23.519 --> 00:28:25.960
where I don't have to be responsible for my pain,
508
00:28:26.400 --> 00:28:28.599
or this is the one moment I'm being taken care of.
509
00:28:28.799 --> 00:28:29.359
It's like okay.
510
00:28:29.440 --> 00:28:31.359
That gives you a little bit more information of the
511
00:28:31.359 --> 00:28:33.920
different kinds of struggles someone on your table might be
512
00:28:33.960 --> 00:28:38.000
having and the meaning of pain too. If somebody sees
513
00:28:38.039 --> 00:28:40.119
pain as just like a threat that they can't handle
514
00:28:40.160 --> 00:28:43.319
and manage, that's another kind of indicator of like, shoot, okay,
515
00:28:43.319 --> 00:28:46.039
they might need some other resources and some more support
516
00:28:46.079 --> 00:28:48.640
in this kind of way to help equip them to
517
00:28:48.759 --> 00:28:51.759
be able to recover better faster or manage this. And
518
00:28:51.799 --> 00:28:55.279
then who else kind of holds their pain? Who else
519
00:28:55.319 --> 00:28:57.799
helps them and holds kind of the challenges that they
520
00:28:57.839 --> 00:28:58.519
are bringing in.
521
00:28:58.839 --> 00:29:00.440
I like to ask it in that way, and sometimes
522
00:29:00.480 --> 00:29:01.839
people giggle and they're like, what do you mean?
523
00:29:03.200 --> 00:29:06.480
And then I'll clarify, like, we'll hold some of your
524
00:29:06.480 --> 00:29:11.200
stress or challenges. And then finally, you guys, I mean,
525
00:29:12.079 --> 00:29:14.640
I've seen my fair share of Pete's and cairos in
526
00:29:14.640 --> 00:29:17.279
the last couple of years, not during my athletic career,
527
00:29:17.359 --> 00:29:20.400
but y'all get to hear a lot of interesting things
528
00:29:20.480 --> 00:29:26.000
and paying attention to also maybe how they experience their sensations,
529
00:29:26.079 --> 00:29:27.880
Like a big part of what I do in my
530
00:29:27.920 --> 00:29:30.960
office is also helping somebody grow an awareness of where
531
00:29:31.000 --> 00:29:33.279
they hold things in their body. And so if you
532
00:29:33.319 --> 00:29:36.200
can hear that like oh yeah after games like I'm
533
00:29:36.240 --> 00:29:39.359
really and it's not just like from a physical youth standpoint,
534
00:29:39.440 --> 00:29:41.559
be like oh I notice like my next really tight
535
00:29:41.799 --> 00:29:45.359
or my back tenses up after this kind of experience.
536
00:29:45.640 --> 00:29:48.880
If somebody's paying attention to that then has more awareness
537
00:29:48.880 --> 00:29:51.240
to that, they're probably going to be a little bit
538
00:29:51.279 --> 00:29:53.680
better off. But if they have no awareness of their pain,
539
00:29:54.000 --> 00:29:57.240
So if you notice you're working on something and they're
540
00:29:57.279 --> 00:30:00.200
like wait, wow, like that hurts, It's like, oh interesting, Okay,
541
00:30:00.400 --> 00:30:02.720
how much do you notice this or do you ever.
542
00:30:02.599 --> 00:30:05.000
Pay attention to that? Or what does this feel like?
543
00:30:06.240 --> 00:30:10.160
If somebody is unable to maybe grasp that like oh wait,
544
00:30:11.039 --> 00:30:13.480
I do feel that or pay attention to those sensations,
545
00:30:13.640 --> 00:30:16.599
that might be another indicator of like they might benefit
546
00:30:16.680 --> 00:30:18.720
from working with somebody like us to be able to
547
00:30:18.799 --> 00:30:20.839
understand and be able to manage some of.
548
00:30:20.759 --> 00:30:33.119
That that wraps up part one of our conversation with
549
00:30:33.200 --> 00:30:37.839
doctor Carolina Shander. In this episode, doctor Shander helped us
550
00:30:37.880 --> 00:30:41.640
better understand the role of sport and performance psychology not
551
00:30:41.720 --> 00:30:47.359
only for elite athletes, but for anyone navigating pressure, identity, injury, recovery,
552
00:30:47.759 --> 00:30:51.720
and high expectations. One of the biggest takeaways from this
553
00:30:51.880 --> 00:30:55.680
first part of the conversation is that performance is never
554
00:30:55.839 --> 00:31:02.559
just physical sleep, stress, relationships, identity support systems, mental health,
555
00:31:02.599 --> 00:31:06.640
emotional regulation, and the meaning someone attaches to pain or
556
00:31:06.680 --> 00:31:12.000
injury can greatly influence how they recover and how they perform.
557
00:31:12.240 --> 00:31:15.319
For health care providers, this is such an important reminder.
558
00:31:16.079 --> 00:31:18.720
We might be treating the body, but we are always
559
00:31:18.799 --> 00:31:23.079
treating a whole person, and sometimes the clues that someone
560
00:31:23.160 --> 00:31:26.440
may need additional support show up in the way they
561
00:31:26.480 --> 00:31:30.160
talk about their injury, their worth, their identity, or their
562
00:31:30.200 --> 00:31:32.839
fear of not being able to return to who they
563
00:31:32.880 --> 00:31:37.480
were before. Doctor Shander also reminds us that integrating mental
564
00:31:37.480 --> 00:31:42.039
health support into performance and sports medicine settings starts first
565
00:31:42.079 --> 00:31:46.240
with trust. It is not about forcing another provider into
566
00:31:46.279 --> 00:31:50.640
the room. It is about building relationships, creating safety, and
567
00:31:50.720 --> 00:31:54.200
helping athletes understand that support is not a sign of weakness.
568
00:31:55.079 --> 00:31:58.559
It's part of helping them become more durable, more self aware,
569
00:31:58.599 --> 00:32:02.920
and better equipped for the demains of performance. In Part two,
570
00:32:03.039 --> 00:32:06.480
we'll continue the conversation and go deeper into the provider's
571
00:32:06.519 --> 00:32:11.039
role in recognizing these patterns by asking better questions and
572
00:32:11.160 --> 00:32:14.160
helping patients access the right type of support when they
573
00:32:14.200 --> 00:32:17.480
need it. As always, thank you for listening to the
574
00:32:17.480 --> 00:32:21.480
Factor podcast. If this episode resonates with you, share it
575
00:32:21.480 --> 00:32:25.039
with a colleague, coach, or another healthcare provider who works
576
00:32:25.039 --> 00:32:29.519
with athletes or high performing individuals. Until next time, keep learning,
577
00:32:29.599 --> 00:32:32.960
keep profining your systems, and keep raising the standard of care.
578
00:32:33.279 --> 00:32:33.880
We'll see then.
579
00:32:37.519 --> 00:32:39.440
Hey guys, if you like what you heard today, I
580
00:32:39.559 --> 00:32:43.079
encourage you to visit our website at Factor hyphenstore dot
581
00:32:43.119 --> 00:32:48.920
com that's spelled fa k tr hyphenstore.
582
00:32:48.279 --> 00:32:51.079
Dot com to find out more information about all that
583
00:32:51.079 --> 00:32:51.839
we have to offer.
584
00:32:52.079 --> 00:32:54.400
We have a variety of online offerings as well as
585
00:32:54.440 --> 00:32:57.799
our hands on Factor Rehab System course scheduled in cities
586
00:32:57.839 --> 00:32:59.880
around the globe. Be sure to also check out our
587
00:33:00.240 --> 00:33:03.799
calendar and bookmark any of these upcoming live webinar dates
588
00:33:03.920 --> 00:33:05.920
coming up in the near future so you can join
589
00:33:06.000 --> 00:33:08.319
us live, and of course the biggest compliment we can
590
00:33:08.359 --> 00:33:10.359
receive is for you to help us spread the word
591
00:33:10.400 --> 00:33:13.480
to your friends, colleagues and classmates. You'll find all the
592
00:33:13.480 --> 00:33:16.079
important links, as well as info about our sponsors in
593
00:33:16.119 --> 00:33:18.160
the show notes, so be sure to check those out,
1
00:00:00.800 --> 00:00:03.600
Welcome to the Factor podcast, where we talk about the
2
00:00:03.640 --> 00:00:06.400
stuff they didn't teach you in school, how to grow
3
00:00:06.440 --> 00:00:09.640
your practice, refine your clinical skills, and get better results
4
00:00:09.679 --> 00:00:12.560
for your patients. We're here to help you navigate the
5
00:00:12.599 --> 00:00:16.199
real world challenges of being a healthcare provider, from delivering
6
00:00:16.280 --> 00:00:19.199
top notch patient care to running a business that doesn't
7
00:00:19.239 --> 00:00:22.000
run you into the ground. Whether you're fresh out of
8
00:00:22.000 --> 00:00:25.600
school or scaling your practice, we're diving into effective, cutting
9
00:00:25.719 --> 00:00:29.600
edge treatments to get patients better, faster. We'll also talk
10
00:00:29.640 --> 00:00:32.560
about business strategies and tactics to help you work smarter
11
00:00:32.679 --> 00:00:36.600
and not harder, and the mindset shifts required to thrive
12
00:00:36.679 --> 00:00:39.119
as a top performer in your field so you can
13
00:00:39.119 --> 00:00:42.399
build a career you love without burning out. If you're
14
00:00:42.439 --> 00:00:45.960
ready to learn what works and what doesn't from leading experts,
15
00:00:46.000 --> 00:00:50.600
industry innovators, and respective clinicians across a wide range of specialties,
16
00:00:50.920 --> 00:00:52.200
you're in the right place.
17
00:00:51.920 --> 00:00:52.359
My friend.
18
00:00:52.920 --> 00:00:58.280
Let's dive in. Welcome back to the Factor podcast, where
19
00:00:58.280 --> 00:01:02.240
we bridge the gap between reabilitation performance and real world
20
00:01:02.280 --> 00:01:06.480
clinical practice. I'm your host, Jessica Riddle, and today we're
21
00:01:06.519 --> 00:01:10.719
kicking off a new conversation with doctor Carolina Shander, a
22
00:01:10.799 --> 00:01:16.000
licensed psychologist and certified mental performance consultant who specializes in
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00:01:16.040 --> 00:01:20.879
sports and performance psychology. In this episode, we're diving into
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00:01:20.959 --> 00:01:26.519
an area that is becoming increasingly important for clinicians, coaches, athletes,
25
00:01:27.040 --> 00:01:31.159
and really anyone working with high performers. That is the
26
00:01:31.200 --> 00:01:37.519
connection between physical health, mental health, identity, recovery, and performance.
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Doctor Shander's work focuses on supporting athletes and other high
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achieving individuals to help them understand not only how to
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perform at a high level, but how to stay well
30
00:01:49.000 --> 00:01:52.840
while doing it. Through her work with athletes, coaches, teams,
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and organizations, including her connection with USA Gymnastics, she brings
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a valuable perspective on what it means to care for
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00:02:00.239 --> 00:02:04.760
the whole human, not just the performer. In Part one
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00:02:04.920 --> 00:02:08.479
of this two part conversation, we talk about how sports
35
00:02:08.479 --> 00:02:13.520
psychology fits into the larger health care and performance team,
36
00:02:13.800 --> 00:02:16.960
why trust is such a critical part of working with athletes,
37
00:02:17.360 --> 00:02:21.719
and how coaches, health providers, and mental health professionals can
38
00:02:21.759 --> 00:02:26.240
better collaborate to support performance and well being. We'll also
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00:02:26.280 --> 00:02:29.439
explore the pressure many athletes and high achievers feel to
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00:02:29.599 --> 00:02:33.479
constantly push harder, do more, and ignore the signals that
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00:02:33.599 --> 00:02:38.000
something may be off, and doctor Shander will offer some
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00:02:38.080 --> 00:02:41.520
helpful insights into what providers can look for when an
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00:02:41.560 --> 00:02:46.759
athlete's pain, injury, or performance challenges may also be connected
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00:02:46.800 --> 00:02:51.919
to their identity, worth, stress, or emotional health. Whether you
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00:02:52.000 --> 00:02:56.599
work with athletes, active individuals, performers, or simply have patients
46
00:02:56.599 --> 00:02:59.199
who are trying to return to the activities that matter
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00:02:59.280 --> 00:03:02.560
most to them, this conversation is a reminder that the
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body and the mind are not separate systems. They are
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deeply connected and both matter in the recovery and performance process.
50
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Let's get into part one of my conversation with doctor
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00:03:14.439 --> 00:03:28.000
Carolina Shander. We like to have a bit of a
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master series conversation ever so often with different healthcare providers
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00:03:32.879 --> 00:03:37.719
that have meaningful insights to share that I think are
54
00:03:37.919 --> 00:03:42.800
definitely relevant and things that could be helpful to our community.
55
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So we're excited to have you with us today. If
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00:03:46.120 --> 00:03:48.159
you could start out by telling Jimmy just a little
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00:03:48.159 --> 00:03:52.199
bit about what it is that you do and specifically
58
00:03:52.840 --> 00:03:57.080
how you and doctor Redtle got connected through USA Gymnastics.
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Absolutely, thank you for having me.
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I'm really to have this conversation and be able to
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connect on this topic and discuss the idea of sports psychology,
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and so a little bit about me. I'm a counseling
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psychologist with a specialization in sportant performance, and so what
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that meant is I got generalist training in all types
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of clinical mental health difficulties and challenges, and then was
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able to find a program that also allowed me to
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pursue important performance so any kind of high achieving individuals athletics,
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00:04:24.839 --> 00:04:27.480
io psychology and be able to learn like what does
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it look like to be a performer and maintaining your
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well being? And so I've been really fortunate to have
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that background. And I met doctor Riddle by being connected
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with USA Gymnastics, primarily trampoline and tumbling, started working with
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them with my coworker here, doctor Zane Dodd, and we
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were invited to just be a mental health support person
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at some of the trainings and competitions, and then was
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able to foster some relationships with the clinical health providers
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and physicians and was invited to be a part of
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the team to deliver some training to parents athletes as
79
00:05:03.079 --> 00:05:06.879
well as coaches regarding mental health and mental performance and
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to help foster this idea of the whole human needing
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to be well to be excellent, and so I met
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doctor Riddle when we were in Alabama, I think, for
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a training camp and was able to have a lot
84
00:05:20.560 --> 00:05:23.879
of conversations about what it looks like to I don't know,
85
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combine the idea of physical and mental health absolutely.
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Now, I think you have kind of a fascinating choice
87
00:05:31.560 --> 00:05:33.839
that you took when it comes to the specialization within
88
00:05:33.920 --> 00:05:37.720
your profession. Obviously under the umbrella of mental health, there's
89
00:05:37.920 --> 00:05:41.560
so many different ways that someone can specialize, especially in
90
00:05:41.600 --> 00:05:45.639
that clinical setting where they're doing counseling. What made you
91
00:05:45.759 --> 00:05:51.480
select kind of this niche within IO and with high
92
00:05:51.560 --> 00:05:54.560
performers and performance psychology in particular.
93
00:05:55.240 --> 00:05:56.279
Yeah, it's a great question.
94
00:05:56.759 --> 00:05:59.040
Part of it was mesearch, which is I was a
95
00:05:59.120 --> 00:06:02.920
collegiate swimmer and a big part of my challenge was competing,
96
00:06:03.040 --> 00:06:05.560
and so it meets I would really struggle to be
97
00:06:05.600 --> 00:06:07.800
able to reach my potential, and so I noticed that
98
00:06:07.800 --> 00:06:10.319
within myself if there was something that was holding me back.
99
00:06:10.360 --> 00:06:13.079
And also when I was pursuing my degree, I had
100
00:06:13.079 --> 00:06:16.560
some wonderful mentors that work actually in a couple of
101
00:06:16.600 --> 00:06:20.040
different departments that have a master's in sport and performance,
102
00:06:20.079 --> 00:06:23.199
and they shared with me. The way that you function
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00:06:23.439 --> 00:06:26.639
and see relationships and see humans and see how they
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00:06:26.839 --> 00:06:30.720
work within a system, You're going to probably do really
105
00:06:30.759 --> 00:06:34.360
well in the University of North Texas department. Working in
106
00:06:34.759 --> 00:06:38.319
a place where you get experiences working within a collegiate
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00:06:38.360 --> 00:06:41.319
athletic department. You're working within a system, and then you
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00:06:41.399 --> 00:06:45.600
have that background simultaneously of being able to learn about
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00:06:45.600 --> 00:06:46.959
how to support.
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People just from like a clinical view.
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00:06:49.360 --> 00:06:52.240
And so the program here at a University of North
112
00:06:52.279 --> 00:06:56.600
Texas has a five year program specifically in counseling psychology
113
00:06:56.639 --> 00:07:01.120
focusing on diagnosing assessment, and then a couple of.
114
00:07:01.079 --> 00:07:03.240
Years regarding the sport and performance.
115
00:07:03.279 --> 00:07:05.959
And what I loved about the program here was that
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you get embedded within a team immediately kind of once
117
00:07:08.959 --> 00:07:09.800
you step foot on.
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00:07:09.680 --> 00:07:13.519
Campus, and you learn to understand the.
119
00:07:13.480 --> 00:07:15.360
System as a whole of how they work within the
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00:07:15.399 --> 00:07:18.759
athletic department, how each team has a different culture, how
121
00:07:18.800 --> 00:07:21.199
coaches work, what kind of approaches they have, as well
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00:07:21.240 --> 00:07:24.439
as the individual athletes themselves and how they work within
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00:07:24.759 --> 00:07:27.600
also the health system of how their physicians work, their
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00:07:27.639 --> 00:07:31.240
athletic trainers and where you might fit. And I was
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I had the opportunity to work with a couple of
126
00:07:33.160 --> 00:07:36.920
different teams within YOU and T and each one was
127
00:07:36.920 --> 00:07:40.319
so different and it challenged me to figure out how
128
00:07:40.360 --> 00:07:44.000
I can kind of best serve based on just.
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00:07:43.920 --> 00:07:47.920
The information that I've learned throughout my schooling. That's huge.
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00:07:48.000 --> 00:07:50.759
So when you say they kind of allowed you to
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integrate into a team, do you mean specifically a sports team,
132
00:07:54.639 --> 00:07:56.680
And maybe this is an answer, this is both, but
133
00:07:56.759 --> 00:07:59.920
a sports team or within the sports medicine team where
134
00:07:59.920 --> 00:08:03.879
you're co managing these athletes along with other providers.
135
00:08:04.279 --> 00:08:05.519
So it's a little bit of both.
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00:08:05.560 --> 00:08:08.160
The setup is you get kind of paired with a
137
00:08:09.040 --> 00:08:11.439
kind of like a senior consultant, so somebody who's further
138
00:08:11.480 --> 00:08:14.839
along in the program, who is doing counseling, psychology and
139
00:08:14.879 --> 00:08:18.199
the support and performance specialization, and you, as like a
140
00:08:18.360 --> 00:08:20.800
first year, get to learn from them and see what
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00:08:20.839 --> 00:08:24.800
they do. You help plan like mental skills sessions, conversations
142
00:08:24.800 --> 00:08:28.040
with coaches as well as then start relationships with the
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physicians the other parts of the sports met staff, and
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then you're kind of you negotiate and figure out like
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how often you're a practice, how often you are at competitions,
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and be able to determine kind of what your role
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is in the health of the athletes. Certain physicians or
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certain practitioners would want us around more and would want
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to run things by us a little bit more than others.
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And then some we had to negotiate of like, Okay,
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maybe return to play doesn't involve me as much just
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because of kind of some of the protectiveness around the sport.
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But that's also just a difference based on just the
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culture of every team.
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Absolutely, have you, in your experience found that many people
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within the coaching staff, the training staff, worts, med staff
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have a good understanding of how mental health professionals can
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play into that. Have you experienced a good bit of
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maybe resistance at times where people don't really understand how
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you guys fit into that team.
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You ask a wonderful question, and I'm smiling because it's
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been both. I think a lot of it has been
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dependent on trust as well as understanding of how we fit.
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And there have been opportunities or experiences where I've been
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placed with a group or placed.
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With the team and they don't know how to utilize me.
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And there's a lot of fear around having a an
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outsider and b having somebody that is mental health or
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clinical come into a space because they don't want it
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to be disrupted and they don't trust me, right, and
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so a big part of those relationships has been creating
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a strong bond and creating trust by me sharing what
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I could offer while also being able to observe and
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allow people to kind of invite me in at the
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same time, because I think that's a huge barrier for
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us as providers in the mental health or mental performance
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space is sometimes we're not necessarily invited, even though we
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might be wanted and needed at times, but we have
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to work with that relationship first and the trust before we.
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Can even be able to help at least that's my belief.
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In the times where you've had the most success in
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terms of being able to effectively help your athletes but
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then also being able to work well co managing care,
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have you found that it was typically more practitioner led,
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meaning that the other healthcare providers or the coaches really
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kind of bring you in and drive that relationship, telling
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the athletes we have this resource, or have you found
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that sometimes it's more patient led, whereas if your athletes
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request mental help, or if your athletes are the ones
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to kind of I guess initiate that relationship.
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It works better.
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A little bit of both. I think from my experience. Actually,
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top down it's probably the most effective. When the individuals
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at the top, whether that's athletic departments or just leaders
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of a system, find us to be useful and helpful
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and interested in creating just.
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Space for us, then it's probably the most helpful. There
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have been instances where.
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The athletes or the patients involved have pushed because of
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the how much they request, and I think that's how
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currently in private practice, I see a lot of my
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work grows. I work with a couple of individuals, I
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work then with the group, and then the interest and
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kind of affects to that are shown that leaders, coaches, etc.
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Kind of notice the difference and then invite us in.
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But for me, it's been most successful when the kind
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of individuals in power are bought in because then they're
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also kind of using the same language. They also want
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to learn. We're able to intervene across the system, whether
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that's management, whether that's coaches, other practitioners, and so we
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see the most positive effects that way.
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I can see that especially when when it is a
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top down approach, When you have that athletic staff. When
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you have that sports med staff saying this is a
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part of our culture, like this is what it means
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to be a member of this team. I think that's
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huge because I would imagine that much like our muscular
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skeletal providers see with athletes, athletes are always wanting to
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be strong. They're always wanting to show no weakness, and
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I'm sure there's a lot of misconceptions or maybe even
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like just bad stereotypes in their mind about if I
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ask for help that means I'm weak, or if I
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admit that I'm struggling, then I could be cut from
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the team. I could have be benched or whatnot. How
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have you, or I guess, how have you helped some
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of these athletes that are a bit more hesitant or
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have that mindset kind of work around that to realize
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that mental health is just as important as their physical health.
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I think there's a couple different ways, but the primary
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way that I do it is by being a human.
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I traditionally start with high I'm like Carol.
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Or Carolina depending on how people know me, and I
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share with them kind of like my background and what
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got me here, and then I traditionally just start with
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a relationship of like, hey, I'm noticing these things what's
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happening for you and getting to understand them as a
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human before I start kind of thinking or sharing what
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I think might be helpful, but more so.
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Trying to understand what somebody's coming in with. And so
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there's a huge.
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Stigma still despite it being a lot more prevalent in
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pro sport than like baseball has huge push around mental
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health football, but there's still the stigma of like, wow,
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like somebody's going to like know my inner thoughts and
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my inner demons, and quite honestly, I try.
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To get across it.
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It's like a freaking privilege to be a part of
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that journey with somebody, and so being able to get
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them comfortable with me as a provider first is kind
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of the way that I lean and then being able
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to share with them like hey, this is what people
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utilize this for, and also that I don't have to
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be the one that they pick that there are so
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many different kinds of providers that can be a better
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fit for them that might have a different style, might
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have a different way of thinking, you might have a
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different way of how they implement their kind of skills
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and knowledge, and to give them just the option and
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feeling of agency, because honestly, when it comes to really
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anything in our space, the ability to feel like you
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have any agency and choice is what leads to better
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outcomes as well as leads somebody to actually want to
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be in my office and be able to practice what
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I share with them.
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Absolutely, and I would imagine, and I have to say
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I can't speak from experience. I was never an athlete.
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My husband jokingly calls me an athlete, even though I
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stink at math, So I was more of the art
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and the drama kid and whatnot.
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Which is performance too, yes.
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Exactly, And obviously being a CEO, having spent most of
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my career as an executive like, I totally understand that
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that inner drive and that ability to have the determination
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to push through hard things really is something that can
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be incredibly effective not only in your sports career but
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in all aspects of life. But when it comes to sports,
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what I've noticed, at least just kind of getting a
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look behind the scenes through my own children and then
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obviously the athletes that I've had the privilege of working
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with over the years and various different things are been
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friends with, is there's sometimes a stigma or maybe even
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a misconception that so many athletes have that is, I
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have to constantly go, go, go, go go, and I
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have to push harder and push harder and push harder,
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and that inner drive I think is inherent to being
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a great athlete and being a higher obviously. But at
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the same time, I know many of our healthcare providers
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are also trying to emphasize to their patients from a
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physical standpoint, you have to have rest, like you have
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to balance things out. Do you feel like when it
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comes to many of the high achievers, the high performers
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that you've worked with, whether it's from an IO standpoint
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in the corporate world or even those that are high
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performing athletes, do you feel like sometimes that's one of
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the hardest challenges is just kind of educating them about hey, like,
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this is how your mental, emotional, spiritual help fits into
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you as a person and as an athlete. There's so
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much more that goes into your performance on the field
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than just what you're doing in your physical body.
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Yeah, one hundred percent.
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I think the biggest piece of initial work with somebody
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is to grow their kind of awareness of what all
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goes into being someone's best self. Then, I mean you
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mentioned a couple of those components or like spiritual health,
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mental health and rest and sleep and even relationships, right,
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Like they all impact us. Everything kind of impacts us,
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not just the work we do in the gym or
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on the field. That just pushing harder or doing more
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isn't actually sometimes the marker of success, and.
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So it is hard to convince somebody of that.
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I think that's sometimes one of my biggest challenges, And
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I try to take the approach of like, let's just
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try and understand you as a human in the ways
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that when you've achieved your best, what's been going the like, well,
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what's been most effective and then be able to start
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to help them see, oh, wait, like I was really
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I don't know, feeling supported by my people, or I
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was actually like really involved in my church while also
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competing in.
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My sport, or wow, like I was making sure I.
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Was sleeping this much or taking my vitamin and it's like, okay, hey,
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like there are multiple components here that actually make you
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be your best.
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It's not just this one thing of pushing yourself on
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the field.
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And that's another I think one of my challenges with
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the misconceptions in athletics is that you just got to
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do more and be harder and just like be tougher,
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just do more better, and that's just not actually what's
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going to create the best outcome as well as like
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long term effectiveness, because we see a lot of really
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high performing individuals burn out pretty quickly just because their
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resources have been depleted over the years. And you can
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work hard, but eventually that resource runs out.
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Absolutely when you are working with an athlete, and you
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have a coach that very much has that mindset of
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And obviously I'm not calling out the coaches out there,
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but as I've seen firsthand, sometimes it is those coaches
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that have that condition in weight room and practice and practice.
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Like when you have a coach and a culture and
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a team that has that mentality of NonStop, We're going
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to go one hundred miles an hour, nothing's going to
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stop us.
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How do you.
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Kind of convince that coaching staff or convince that from
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the top down approach that it's good to implement some
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of these other aspects. It's good to kind of give
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priority to rest, because I know that has to be
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a challenge, especially if there's a culture where that's been
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something that they did and their coaches really instilled that
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in them, and their coaches instilled that in them. Like,
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how do you break through that?
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Yeah?
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I very different ways, I think, but it's a good question.
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It's something I and a lot in my fellow colleagues
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also struggle with.
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But it depends on the system that you're in.
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If I'm in a athletic department and I have a really
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great relationship with a coach, and we kind of have
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an understanding that they want like my input, then I'm
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probably a lot more likely to just be honest and
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share of like, hey, like, I'm noticing this. I'm noticing
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that there's no emphasis on the other parts of the human,
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not just rest, but like maybe some of these pieces
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of your athletes that aren't getting emphasized, and I'm worrying
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that it's kind of leading.
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To some detrimental outcomes.
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And maybe if there are outcomes that I'm already seeing
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in my office and I have permission to share that
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of like, hey, like, there's about three or four of
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your humans who are really I don't know, they're feeling
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really burned out, or have low motivation or really struggling
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or are scared to talk to you. I might offer that,
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or I might really rely on research to showcase that
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athletes who are able to access different parts of their
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identities are going to actually perform better. Athletes who are
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seeing rest is just as important as their physical preparation
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are going to have long careers as.
390
00:22:01.200 --> 00:22:04.839
Well as more satisfaction within their careers. And I also
391
00:22:04.920 --> 00:22:06.000
might offer a.
392
00:22:06.039 --> 00:22:08.880
Question to the coaches of like, I know this is
393
00:22:08.920 --> 00:22:10.799
how you did it? I know that you just pushed
394
00:22:10.839 --> 00:22:13.359
harder and you grinded like, that's true. But what if
395
00:22:13.359 --> 00:22:18.319
this isn't the most opportune environment for your people, like
396
00:22:18.400 --> 00:22:21.160
your kids, your athletes on the field. What if they
397
00:22:21.160 --> 00:22:22.519
don't learn that way?
398
00:22:22.599 --> 00:22:23.039
What if they.
399
00:22:23.000 --> 00:22:27.079
Don't achieve their best result that way? And to offer
400
00:22:27.200 --> 00:22:30.759
kind of different ways of thinking without pushing my agenda
401
00:22:30.839 --> 00:22:33.119
on them, because that's also not what I want to do.
402
00:22:33.599 --> 00:22:35.599
It's hard to also get somebody to buy in if
403
00:22:35.640 --> 00:22:39.279
they're not interested. So I try and understand the coaches too,
404
00:22:39.440 --> 00:22:42.359
of like what's going to allow them to hear me
405
00:22:42.799 --> 00:22:44.759
or at least be open to a different idea.
406
00:22:45.279 --> 00:22:47.119
I love that, and I love the way that you
407
00:22:47.720 --> 00:22:51.000
worded that. I think that's one of the most impactful
408
00:22:51.079 --> 00:22:54.279
things that all of us can learn from mental health
409
00:22:54.279 --> 00:22:58.119
professionals is sometimes how to approach conversations and that your
410
00:22:58.160 --> 00:23:03.240
word choice is incredibly important. A lot of the providers
411
00:23:03.319 --> 00:23:06.920
in our network and many people that are listening see
412
00:23:06.960 --> 00:23:10.759
athletes when they are in pain. They'll see athletes or
413
00:23:10.799 --> 00:23:14.920
even just the regular every day driven individual when they're
414
00:23:14.960 --> 00:23:19.160
at a place where they are either dealing with an injury,
415
00:23:19.640 --> 00:23:22.920
maybe they're struggling with chronic pain or a chronic injury,
416
00:23:23.519 --> 00:23:26.440
and they're trying to figure out the best path forward.
417
00:23:27.720 --> 00:23:32.839
If I'm a healthcare provider working with someone and you know,
418
00:23:32.920 --> 00:23:35.640
maybe we're going through our care plan in terms of
419
00:23:35.640 --> 00:23:40.000
their physical body, but there's something that just kind of
420
00:23:40.079 --> 00:23:43.680
seems a little bit like there's something extra there, There's
421
00:23:43.680 --> 00:23:45.799
something more that's kind of beneath the surface, and I'm
422
00:23:45.839 --> 00:23:48.480
not Sometimes people just have an intuition when it comes
423
00:23:48.480 --> 00:23:50.839
to these things. Sometimes people don't what are some things
424
00:23:50.839 --> 00:23:54.720
that healthcare providers should look for, whether they're working with
425
00:23:54.759 --> 00:23:58.559
an athlete or anyone really that kind of makes them
426
00:23:58.599 --> 00:24:02.240
think it might be time to have a conversation to
427
00:24:02.240 --> 00:24:04.920
see if they're open to going to see a mental
428
00:24:04.920 --> 00:24:05.720
health professional.
429
00:24:06.519 --> 00:24:08.640
I think that that was one I've always thought about,
430
00:24:08.680 --> 00:24:10.640
like when I'm sitting in a doctor's office or if
431
00:24:10.680 --> 00:24:15.079
I'm like sitting with another person and in the health
432
00:24:15.119 --> 00:24:19.400
setting of when is it time for escalated care some
433
00:24:19.440 --> 00:24:23.119
different kind of support. Big pieces I think would be
434
00:24:23.200 --> 00:24:29.240
to pay attention to how somebody's responding to any kinds
435
00:24:29.279 --> 00:24:32.960
of challenges from the physical standpoint. Are they saying things
436
00:24:33.079 --> 00:24:35.960
like I'm never going to be the same, I can't
437
00:24:36.000 --> 00:24:39.480
do this very kind of more closed.
438
00:24:39.240 --> 00:24:40.720
Kind of defining statements.
439
00:24:41.200 --> 00:24:45.240
I start to worry a little bit more when somebody
440
00:24:45.359 --> 00:24:50.200
is and then the big kind of picture seeing them
441
00:24:50.240 --> 00:24:54.440
maybe describe big changes in their life. Right, so like oh,
442
00:24:54.480 --> 00:24:57.160
I'm not sleeping, I'm not eating, I maybe pulling away
443
00:24:57.200 --> 00:24:59.880
from people. I'd be paying attention to kind of different
444
00:25:00.119 --> 00:25:00.920
changes in their.
445
00:25:00.799 --> 00:25:02.240
Life outside of just their sport.
446
00:25:02.359 --> 00:25:06.519
But a big thing to pay attention to is and
447
00:25:06.599 --> 00:25:09.519
listen to is how are they viewing themselves?
448
00:25:10.440 --> 00:25:12.799
It has the injury and the chronic.
449
00:25:12.480 --> 00:25:16.079
Pain potentially changed how they view themselves in a way
450
00:25:16.079 --> 00:25:19.359
that they don't maybe have different aspects to how they
451
00:25:19.359 --> 00:25:22.319
see themselves. So for example, right like if I'm I'm
452
00:25:22.519 --> 00:25:24.720
I'm postpartum, I've had two kids, and i have some
453
00:25:24.839 --> 00:25:27.200
kind of like back pain, and I'm sitting on your
454
00:25:27.200 --> 00:25:30.079
table and I'm saying like I don't have anything else.
455
00:25:30.359 --> 00:25:32.960
I am just an athlete, and you know different parts
456
00:25:32.960 --> 00:25:35.119
about me and you're like wait, wait, like you're a mom,
457
00:25:35.200 --> 00:25:35.799
you're a partner.
458
00:25:36.640 --> 00:25:36.960
Okay.
459
00:25:37.039 --> 00:25:40.720
That just taking account of those things or hearing somebody
460
00:25:40.759 --> 00:25:43.519
like myself say I if I don't do this, like
461
00:25:43.559 --> 00:25:46.160
I've got nothing else, Like I don't I don't prove
462
00:25:46.240 --> 00:25:48.799
I can't prove my worth to anybody else if I
463
00:25:48.839 --> 00:25:51.119
don't do this thing, if I don't compete, And so
464
00:25:51.680 --> 00:25:54.759
if those things tied to identity or worth are really
465
00:25:54.799 --> 00:25:58.960
coming up, that's a really, I think, really impactful place
466
00:25:59.000 --> 00:26:01.680
to be able to say, hey, like it sounds like
467
00:26:01.759 --> 00:26:04.559
you might really want to have somebody else on this
468
00:26:04.640 --> 00:26:07.240
journey to help support you and show you that there
469
00:26:07.279 --> 00:26:10.960
are other really valuable parts to you, or that your
470
00:26:11.000 --> 00:26:14.599
life can still be really fulfilling and important even if
471
00:26:14.599 --> 00:26:17.880
it is including managing this pain or this injury. But
472
00:26:17.960 --> 00:26:23.079
those are the big things. When worth an identity are collapsing,
473
00:26:23.400 --> 00:26:25.920
that is a really great time to be.
474
00:26:25.880 --> 00:26:28.880
Able to incorporate somebody in the mental health space.
475
00:26:29.680 --> 00:26:33.920
That's huge, And I know that in recent years in
476
00:26:34.000 --> 00:26:37.240
the muscular skeletal space, there's been a lot more at
477
00:26:37.359 --> 00:26:42.680
least awareness of the biopsychosocial aspects of pain and more
478
00:26:42.720 --> 00:26:47.319
and more providers. I think, especially post twenty twenty when
479
00:26:47.319 --> 00:26:52.039
COVID hit and people are dealing with our practitioners are
480
00:26:52.079 --> 00:26:55.519
seeing a lot more COVID cases or even that year,
481
00:26:55.880 --> 00:26:59.240
we're really seeing more and more patients that had so
482
00:26:59.359 --> 00:27:02.680
much stress, much anxiety so much going on mentally that
483
00:27:03.200 --> 00:27:05.559
it weighed heavily on their physical bodies as well. At
484
00:27:05.640 --> 00:27:08.119
least there's more of a conversation and an awareness now.
485
00:27:09.039 --> 00:27:13.759
But if I'm a new graduate, I'm starting my practice
486
00:27:13.799 --> 00:27:18.240
for the first time, obviously, I've learned a lot of
487
00:27:18.279 --> 00:27:21.599
ways in that initial new patient visit to ask a
488
00:27:21.599 --> 00:27:25.279
lot of questions about their physical body. Do you have
489
00:27:25.319 --> 00:27:29.319
any recommendations about maybe just like one or two simple
490
00:27:29.440 --> 00:27:33.240
questions that someone should ask in that initial new patient visit,
491
00:27:34.000 --> 00:27:37.640
just to kind of get an idea to gauge where
492
00:27:37.640 --> 00:27:41.400
that person is from a mental health care standpoint so
493
00:27:41.440 --> 00:27:44.400
that it can better inform their care plan moving forward.
494
00:27:45.559 --> 00:27:48.319
Yeah, I think other than the big questions of if
495
00:27:48.359 --> 00:27:51.839
you're hearing somebody struggling with injury or pain and the like,
496
00:27:52.200 --> 00:27:55.079
have you thought about ending your life for hurting yourself?
497
00:27:55.160 --> 00:27:59.400
Other than those, what I would recommend asking is like,
498
00:27:59.440 --> 00:28:02.079
what is this pain mean to you? How does this
499
00:28:02.160 --> 00:28:04.920
pain disrupt your daily life? What does this pain also
500
00:28:05.039 --> 00:28:09.039
mean to your relationships? What is getting this work done
501
00:28:09.279 --> 00:28:12.440
right in the muscular skeletal space, Like how much relief
502
00:28:12.480 --> 00:28:13.200
does it give you?
503
00:28:14.000 --> 00:28:16.200
And how do you know that it's giving you relief,
504
00:28:16.200 --> 00:28:17.480
not just physical.
505
00:28:17.759 --> 00:28:21.400
But how does this work here impact you, because you
506
00:28:21.440 --> 00:28:23.480
may start to hear maybe this is the one moment
507
00:28:23.519 --> 00:28:25.960
where I don't have to be responsible for my pain,
508
00:28:26.400 --> 00:28:28.599
or this is the one moment I'm being taken care of.
509
00:28:28.799 --> 00:28:29.359
It's like okay.
510
00:28:29.440 --> 00:28:31.359
That gives you a little bit more information of the
511
00:28:31.359 --> 00:28:33.920
different kinds of struggles someone on your table might be
512
00:28:33.960 --> 00:28:38.000
having and the meaning of pain too. If somebody sees
513
00:28:38.039 --> 00:28:40.119
pain as just like a threat that they can't handle
514
00:28:40.160 --> 00:28:43.319
and manage, that's another kind of indicator of like, shoot, okay,
515
00:28:43.319 --> 00:28:46.039
they might need some other resources and some more support
516
00:28:46.079 --> 00:28:48.640
in this kind of way to help equip them to
517
00:28:48.759 --> 00:28:51.759
be able to recover better faster or manage this. And
518
00:28:51.799 --> 00:28:55.279
then who else kind of holds their pain? Who else
519
00:28:55.319 --> 00:28:57.799
helps them and holds kind of the challenges that they
520
00:28:57.839 --> 00:28:58.519
are bringing in.
521
00:28:58.839 --> 00:29:00.440
I like to ask it in that way, and sometimes
522
00:29:00.480 --> 00:29:01.839
people giggle and they're like, what do you mean?
523
00:29:03.200 --> 00:29:06.480
And then I'll clarify, like, we'll hold some of your
524
00:29:06.480 --> 00:29:11.200
stress or challenges. And then finally, you guys, I mean,
525
00:29:12.079 --> 00:29:14.640
I've seen my fair share of Pete's and cairos in
526
00:29:14.640 --> 00:29:17.279
the last couple of years, not during my athletic career,
527
00:29:17.359 --> 00:29:20.400
but y'all get to hear a lot of interesting things
528
00:29:20.480 --> 00:29:26.000
and paying attention to also maybe how they experience their sensations,
529
00:29:26.079 --> 00:29:27.880
Like a big part of what I do in my
530
00:29:27.920 --> 00:29:30.960
office is also helping somebody grow an awareness of where
531
00:29:31.000 --> 00:29:33.279
they hold things in their body. And so if you
532
00:29:33.319 --> 00:29:36.200
can hear that like oh yeah after games like I'm
533
00:29:36.240 --> 00:29:39.359
really and it's not just like from a physical youth standpoint,
534
00:29:39.440 --> 00:29:41.559
be like oh I notice like my next really tight
535
00:29:41.799 --> 00:29:45.359
or my back tenses up after this kind of experience.
536
00:29:45.640 --> 00:29:48.880
If somebody's paying attention to that then has more awareness
537
00:29:48.880 --> 00:29:51.240
to that, they're probably going to be a little bit
538
00:29:51.279 --> 00:29:53.680
better off. But if they have no awareness of their pain,
539
00:29:54.000 --> 00:29:57.240
So if you notice you're working on something and they're
540
00:29:57.279 --> 00:30:00.200
like wait, wow, like that hurts, It's like, oh interesting, Okay,
541
00:30:00.400 --> 00:30:02.720
how much do you notice this or do you ever.
542
00:30:02.599 --> 00:30:05.000
Pay attention to that? Or what does this feel like?
543
00:30:06.240 --> 00:30:10.160
If somebody is unable to maybe grasp that like oh wait,
544
00:30:11.039 --> 00:30:13.480
I do feel that or pay attention to those sensations,
545
00:30:13.640 --> 00:30:16.599
that might be another indicator of like they might benefit
546
00:30:16.680 --> 00:30:18.720
from working with somebody like us to be able to
547
00:30:18.799 --> 00:30:20.839
understand and be able to manage some of.
548
00:30:20.759 --> 00:30:33.119
That that wraps up part one of our conversation with
549
00:30:33.200 --> 00:30:37.839
doctor Carolina Shander. In this episode, doctor Shander helped us
550
00:30:37.880 --> 00:30:41.640
better understand the role of sport and performance psychology not
551
00:30:41.720 --> 00:30:47.359
only for elite athletes, but for anyone navigating pressure, identity, injury, recovery,
552
00:30:47.759 --> 00:30:51.720
and high expectations. One of the biggest takeaways from this
553
00:30:51.880 --> 00:30:55.680
first part of the conversation is that performance is never
554
00:30:55.839 --> 00:31:02.559
just physical sleep, stress, relationships, identity support systems, mental health,
555
00:31:02.599 --> 00:31:06.640
emotional regulation, and the meaning someone attaches to pain or
556
00:31:06.680 --> 00:31:12.000
injury can greatly influence how they recover and how they perform.
557
00:31:12.240 --> 00:31:15.319
For health care providers, this is such an important reminder.
558
00:31:16.079 --> 00:31:18.720
We might be treating the body, but we are always
559
00:31:18.799 --> 00:31:23.079
treating a whole person, and sometimes the clues that someone
560
00:31:23.160 --> 00:31:26.440
may need additional support show up in the way they
561
00:31:26.480 --> 00:31:30.160
talk about their injury, their worth, their identity, or their
562
00:31:30.200 --> 00:31:32.839
fear of not being able to return to who they
563
00:31:32.880 --> 00:31:37.480
were before. Doctor Shander also reminds us that integrating mental
564
00:31:37.480 --> 00:31:42.039
health support into performance and sports medicine settings starts first
565
00:31:42.079 --> 00:31:46.240
with trust. It is not about forcing another provider into
566
00:31:46.279 --> 00:31:50.640
the room. It is about building relationships, creating safety, and
567
00:31:50.720 --> 00:31:54.200
helping athletes understand that support is not a sign of weakness.
568
00:31:55.079 --> 00:31:58.559
It's part of helping them become more durable, more self aware,
569
00:31:58.599 --> 00:32:02.920
and better equipped for the demains of performance. In Part two,
570
00:32:03.039 --> 00:32:06.480
we'll continue the conversation and go deeper into the provider's
571
00:32:06.519 --> 00:32:11.039
role in recognizing these patterns by asking better questions and
572
00:32:11.160 --> 00:32:14.160
helping patients access the right type of support when they
573
00:32:14.200 --> 00:32:17.480
need it. As always, thank you for listening to the
574
00:32:17.480 --> 00:32:21.480
Factor podcast. If this episode resonates with you, share it
575
00:32:21.480 --> 00:32:25.039
with a colleague, coach, or another healthcare provider who works
576
00:32:25.039 --> 00:32:29.519
with athletes or high performing individuals. Until next time, keep learning,
577
00:32:29.599 --> 00:32:32.960
keep profining your systems, and keep raising the standard of care.
578
00:32:33.279 --> 00:32:33.880
We'll see then.
579
00:32:37.519 --> 00:32:39.440
Hey guys, if you like what you heard today, I
580
00:32:39.559 --> 00:32:43.079
encourage you to visit our website at Factor hyphenstore dot
581
00:32:43.119 --> 00:32:48.920
com that's spelled fa k tr hyphenstore.
582
00:32:48.279 --> 00:32:51.079
Dot com to find out more information about all that
583
00:32:51.079 --> 00:32:51.839
we have to offer.
584
00:32:52.079 --> 00:32:54.400
We have a variety of online offerings as well as
585
00:32:54.440 --> 00:32:57.799
our hands on Factor Rehab System course scheduled in cities
586
00:32:57.839 --> 00:32:59.880
around the globe. Be sure to also check out our
587
00:33:00.240 --> 00:33:03.799
calendar and bookmark any of these upcoming live webinar dates
588
00:33:03.920 --> 00:33:05.920
coming up in the near future so you can join
589
00:33:06.000 --> 00:33:08.319
us live, and of course the biggest compliment we can
590
00:33:08.359 --> 00:33:10.359
receive is for you to help us spread the word
591
00:33:10.400 --> 00:33:13.480
to your friends, colleagues and classmates. You'll find all the
592
00:33:13.480 --> 00:33:16.079
important links, as well as info about our sponsors in
593
00:33:16.119 --> 00:33:18.160
the show notes, so be sure to check those out,
