La Blessure : un corps qui communique

Informer > Articles > Psychologie du sport
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blessures-musclesDans les cultures sportives, le culte de la performance s’accompagne de coups de théâtre,
de rebondissements. Si la blessure fait partie de ces coups de théâtre, elle s’inscrit également comme un événement incontournable dans la vie de tout sportif.

En effet, si une blessure empêche momentanément un sujet d’être performant, elle témoigne néanmoins de son investissement dans une logique de l’extrême et du risque. Elle révèle également un paradoxe en ce sens où elle symbolise l’excellence corporelle mais aussi la faillite de ce corps.

Comment les blessures surviennent-elles ?

Les facteurs physiques comme le surentraînement, la fatigue sont les causes principales des blessures sportives.
Cependant les facteurs psychologiques sont aussi des éléments prépondérants dans la survenue des blessures mais également dans l’accélération de la récupération de ces facultés physiques.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Lien entre traits de personnalité et blessure

Il est communément admis que certains traits de personnalité seraient corrélés avec la survenue de certaines blessures. Cependant aucune étude n’est venue valider cette conception.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] En revanche, le niveau de stress a été identifié comme un antécédent important des blessures sportives.

Anderson et Williams, 1988, mettent en évidence une corrélation étroite entre le stress de la vie courante et les blessures sportives. Plus précisément, il semble qu’un athlète court un risque accru de blessure s’il subit des changements importants dans sa vie sans jouir d’un soutien social adéquat et sans avoir la capacité de réagir efficacement au stress.
Par conséquent, les sources de stress dans la vie de l’athlète constituent des indicateurs et, lorsque ceux-ci sont élevés, le régime d’entraînement doit être adapté et un soutien psychologique fournit.

Deux théories expliquent la relation entre le stress et les blessures : la rupture de l’attention et une tension musculaire accrue.
Concernant la rupture de l’attention, le stress perturbe l’attention de l’athlète en réduisant son attention périphérique (Williams et Anderson, 1991).
Un niveau élevé de stress s’accompagne parfois d’une tension musculaire considérable qui nuit à la coordination et augmente la probabilité des blessures (Nideffer, 1983)

blessure-musculaire-ba2
D’autres facteurs psychologiques vont également interférés dans la survenue des blessures

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Les exigences et les contraintes exigées parfois par l’entourage du sportif renforcent ce genre d’effort. Des injonctions comme « soit dur et donne toujours 110% », « « tu es un killer» ou encore « donne tout ce que tu as ou reste chez toi » favorisent les comportements à risque.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] La culture du corps sain et robuste, et l’injonction « soit fort ».

La sacralisation du corps, l’excellence corporelle, l’avènement d’un corps sain et robuste, développent une attitude de mépris vis-à-vis de toute faille, de toute rupture de ce corps. Il n’est pas rare que des entraineurs encouragent les sportifs à pratiquer en dépit de blessure avec des injonctions comme « il faut souffrir pour vaincre ». C’est une attitude de déni vis-à-vis de la souffrance. Seule la victoire est belle, peut importante la façon.

Attitude de l’élite ? Pas seulement.

Que dire de l’éducateur sportif qui sollicite l’enfant blessé parce qu’il est en manque d’effectif ou simplement par ce que celui-ci est un élément important de l’équipe ?

Les réactions psychologiques aux blessures sportives

Les réactions psychologiques aux blessures sportives

Fournier, D’Arripe-Longueville, Fleurance et Soulard, 2001, ont décris cinq stades successifs.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Le choc, le refus et l’anxiété. C’est pour le sportif un coup de tonnerre, un choc. En état de choc, il ne peut croire en sa blessure et a tendance à réduire la gravité de la blessure et sa signification. C’est pour certain le moment du nomadisme médical, la recherche de la solution miracle, du diagnostic le plus favorable, de la récupération la plus rapide. Peu importe la pertinence d’une telle démarche thérapeutique, seul le retour à une pratique sportive rapide et prépondérante.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Puis survient la colère : l’athlète culpabilise, mais exprime également une colère vis-à-vis des autres.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Puis survient le temps de la négociation : l’athlète blessé tente de rationaliser afin d’éviter la réalité. « Si je peux de nouveau m’entrainer, je suivrai une autre hygiène de vie ». Les exemples en ce sens foisonnent.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] La phase de dépression accompagne la reconnaissance de la gravité de la blessure et de ses conséquences. L’athlète réalise qu’il ne pourra peut-être plus continuer à s’investir aussi pleinement dans son activité sportive mais réalise aussi la précarité de sa pratique et l’incertitude quant à son avenir.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Enfin, l’acceptation et l’espoir permettent de à l’athlète de se focaliser sur la phase de récupération.

D’autres auteurs comme Petitpas et Danish en 1995 énumèrent d’autres réactions psychologiques.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Ils mettent particulièrement l’accent sur la perte d’identité, au regard d’un corps qui échappe à la maîtrise de son propriétaire. Le corps est un objet de reconnaissance sociale, d’identité sociale.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Après une blessure, l’athlète peut ressentir un niveau élevé d’anxiété en lien avec une incertitude sur son future mais aussi en lien avec sa place au sein du groupe, au sein de l’équipe.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Ces auteurs relatent également une baisse de la confiance en soi, de l’assertivité qui peut générer une baisse de motivation, une performance de moindre qualité ou une autre blessure.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Enfin, nous observons une diminution des performances, une baisse de rendement en raison d’une diminution du niveau de confiance en soi et de la perte de temps d’entraînement. Nombreux sont les athlètes qui n’acceptent pas cette baisse de performance et de rendement.

Rôle de la psychologie sportive dans la réadaptation

blessuresDe nouvelles techniques en psychologie facilitent aussi le processus de récupération. Au vu des données actuelles, il semble prépondérant d’adopter une vision holistique du sportif, d’appréhender le sportif dans son entité et dans son ipséité.
Selon Duda, Smart et Tappe en 1989, la capacité de réaction et de récupération à la blessure va dépendre de trois facteurs principaux : le rendement avant la blessure, la nature de la blessure (localisation de la lésion, le degré de la douleur suspension) et l’importance de la blessure pour le sportif.
Levleva et Orlick en 1991 révèlent dans une étude que les athlètes qui guérissent les plus vite sont ceux qui font le plus appel à la fixation d’objectifs, aux stratégies du discours interne, et à un degré moindre à l’imagerie. D’autres études semblent valider ces résultats.
Parallèlement, d’autres études ont conclu que le refus d’assumer la responsabilité de sa propre réadaptation, le refus des blessures, et le non-respect des consignes liées à la réadaptation sont des signes d’une réaction inadéquate à la blessure.

Approche du psychologue sportif

Une approche multiaxiale du psychologue sportif semble favorable à la récupération.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Le psychologue sportif doit faire preuve d’une empathie et d’un intérêt particulier pour le sportif blessé. Offrir au sportif un lieu de parole, d’écoute pour qu’il puisse exprimer ses craintes, son désarroi, ses peurs, ses déceptions, est un atout indéniable dans le processus de récupération. Cet intérêt doit se poursuivre tout au long de la guérison.

Ceci est d’autant plus prégnant pour le sportif, qu’il observe fréquemment une diminution des interactions avec l’environnement sportif, une fois la nouveauté de la blessure estompée. Il est important de renseigner l’individu sur sa blessure et son processus de récupération, surtout s’il s’agit d’une première blessure. Le processus de récupération doit être évoqué avec une grande précision, aussi bien sur le contenu que sur la durée et la fréquence.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Le discours interne positif. L’enjeu est ici de pouvoir mettre en exergue les aspects positifs de la situation. C’est un moment de prise de distance avec l’environnement sportif mais aussi de remise en cause, d’une prise de conscience de la signification psychologique et sociale du sport dans sa vie (Eldrige, 1983).

C’est à ce moment que l’individu se sent prêt à s’investir de nouveau dans un réseau social élargi. Il s’investit également fortement dans ses différents centres d’intérêt.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] La visualisation est un outil pertinent et efficace en réadaptation. Elle permet pour le sportif de rester dans l’environnement sportif, de mémoriser les séquences techniques et tactiques développées lors de l’entraînement mais aussi de favoriser l’apprentissage de gestes techniques.

Visualiser la guérison permet à l’athlète de s’inscrire dans un processus de retour à l’activité et de se remémorer les sensations vécues dans son sport. L’athlète peut ainsi visualiser sans douleur ni difficulté des mouvements spécifiques au sport, imaginer les habiletés individuelles requises pour une meilleure performance, revivre les sentiments et les émotions qui caractérisent ses meilleures performances, se visualiser revenant à la compétition au mieux de ses capacités, visualiser le processus de guérison à l’intérieur de la partie blessée.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] L’entraînement à la relaxation est parfois utile pour soulager la douleur et le stress qui accompagne habituellement les blessures graves et la récupération.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Lui faire part des déconvenues inhérentes à toute guérison. Chaque sportif récupère à son rythme, avec de possible régression, de possibles douleurs.

[sws_ui_icon ui_theme= »ui-smoothness » icon= »ui-icon-play »] [/sws_ui_icon] Enfin, le soutien social est prépondérant tout au long de son parcours de guérison. Il agit comme une ressource psychologique dont les vertus sont notamment explorées dans des maladies comme le cancer. Des recherches ont montrées une corrélation élevée entre le soutien social et le taux de morbidité : plus la personne atteinte d’un cancer dispose d’un soutien social important, plus son espoir de guérison est élevé.

Les significations d’une blessure ne sont pas à appréhender comme un simple processus psychopathologique qui stigmatise le sportif, mais plutôt comme un processus dynamique où la blessure, loin d’être une catastrophe, peut aussi être une chance pour un individu d’exprimer ses projets de vie. La blessure est une expression du corps, un message qu’il convient d’écouter et de comprendre.

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