Rebuilding Safety After Outdoor Sports Trauma
Many athletes love and enjoy their time outside engaging in the sport of their choice, whether it be cycling, running, football/soccer, field hockey, swimming, basketball, etc. It can happen where an athlete becomes injured or has an outdoor sports accident that leaves a lasting impact. When we are talking about outdoor accidents this may include being hit by a car while cycling, having a near drowning experience, or getting injured while running on the trail and not having help nearby. The lasting impact may not just be physical. It could be mental or a combination of both physical and mental. In this case, we are talking about the mental impact after a doctor has cleared the athlete and the gear is ready to go, but as soon as the athlete sees the trail, the mountain, or the water, their body completely freezes up. In this case it isn’t a lack of grit, mental fortitude, devotion, determination, or lack of passion. Rather, it is a highly intelligent, automatic survival mechanism where the brain, particularly the amygdala, is doing its job by sending a signal of danger in effort to keep the athlete alive. So, then how do we work with experience to get back out there? Enter the bottom-up approach. And, as we dive in please remember that this blog post is not intended to be mental health advice, treatment, or a plan. Rather it is meant to bring hope and know that trauma is not the end of enjoying a sport.
Top-Down or Bottom-Up: Which One?
Before we can answer that question, we need to explore and understand the difference between performance anxiety and a trauma response.
When we think about performance anxiety, it is more of intense worry or fear about the potential for underperformance in competition causing mental blocks and physical symptoms like muscle tension, for example (Ford et al., 2017). Now let’s contrast this with trauma. Trauma is a human response that can be emotional and/or physical to a distressing, life-threatening, or overwhelming event that shatters a person’s sense of safety (Bany-Mohammed et al., 2025). These are two very different experiences. Traditional sport psychology tends to use techniques and strategies that focus on top-down cognitive reframing (addressing the thoughts to then change the feelings), which can be beneficial. No question! However, when it comes to trauma, trauma is stored in the nervous system and body as well. Think about this for a moment. What happens to a cyclist who approaches the corner where they crashed? Their sympathetic nervous system is activated and adrenaline is released before the conscious mind can even process a positive thought. This is where the bottom-up approach (body-to-mind) becomes effective because we are acknowledging the impacts of the trauma.
Micro-Dosing the Environment Aka: Titration
Titration is a word often heard in the field of chemistry. It is a technique used to determine the exact concentration of an unknown solution. The process involves slowly adding a testing agent of known concentration to the unknown solution until the chemical reaction is fully done to reveal the answer. While this blog post is not about chemistry, it serves as a useful analogy and a fun excuse to talk about chemistry. When we apply titration in this scenario we are talking about from a somatic perspective, where the return to the sport where the trauma occurred into more manageable pieces/steps/experiences that keeps an athlete within their “widow of tolerance.” What is the window of tolerance? It is a psychological concept introduced by Dr. Dan Siegel that provides a description of where a person is in the optimal zone of emotional arousal (Corrigan et al., 2011). This is where learning and change happen because people can still effectively function, process emotions, think clearly, and handle everyday stressors without going into a space of hyper- or hypoarousal (overwhelm or shut down).
What does this process look like? Let’s explore a couple examples. Please remember these are just examples and not meant to be mental health advice, treatment, or a plan.
For a Trail Runner/Climber after a bad fall: A runner may not start running on the exact same technical trail. They may start by sitting at the trailhead in their gear, listening to the sounds, and tracking their breath. Then once they can stay regulated they may consider transitions to walking flat sections, then gradually reintroducing technical terrain over weeks, not days.
For a Cyclist after a crash: A cyclist may begin by spending the first week simply spinning on a stationary trainer to rebuild the somatic rhythm of pedaling without the visual threat of moving asphalt.
Finding Physical Anchors
One of the many benefits to being outside is that there are so many different objects to look at or feel including an object if we are engaging in a sport that includes an object like a bike or a ball. There is even research to support the benefits of just looking at nature on our mental health (Jo et al., 2019; Soga & Gaston, 2025). Bonus! Back to the point after a short digression. Athletes can find physical anchors or dual-awareness. This happens when an athlete is taught to split their focus when they feel an anxiety spike. Part of their awareness (about 50%) acknowledges the challenges ahead while the rest of the awareness (about 50%) is pinned to an unshakeable point of safety like the secure feeling of their feet in their running shoes or the solid grip of their hands on handlebars. Again, this is not meant to be mental health advice, treatment, or a plan.
Visualization and Repair
Visualization is a common sport psychology technique (Pelz, 2025; Stephen et al., 2022). Often, it is used for performance anxiety. However, in this case the focus shifts to more of coping imagery done with the support of a trained mental health professional. This process asks the athlete to visualize the scenario that frightens them while in a safe, warm space. Then they are asked to explicitly visualize themselves feeling that wave of fear, pausing in their mind, executing a grounding technique, seeing their nervous system settle, and then continuing forward with calm control. This teaches the brain that fear is a manageable sensation, not a sign of an impending crash. Again, this is not meant to be mental health advice, treatment, or a plan.
Rebuilding after a trauma requires honoring the body’s timeline, not the race calendar. When we listen to the nervous system and rebuild safety from the ground up, we don't just return to our sport—we return with a deeper, more resilient, and more abundant mind-body connection than we had before.
A black and white image of cyclists. There are two in a row wearing helmets and the image is blurred giving the idea that they are moving quickly
take action today moment:
It will not be a surprise that this take action moment is not about trying any of the interventions discussed above, as they are meant as discussion points, not to be treatment, advice, or a plan. A mental health professional needs to be consulted when working with trauma. Rather, the take action moment is about remembering that there is hope and help. Trauma does not have to be the end of participating in a sport. Finding the necessary support will allow athletes to once again thrive and enjoy the great outdoors while playing their sport.
Learn More About Trauma:
How to Help Your Clients Understand Their Window of Tolerance [Infographic]
American Psychological Association - Trauma
References
Bany-Mohammed, M., Asim, S., Elalami, M., & Agrawal, D. K. (2025). Trauma, stress, and mental health outcomes. Journal of Psychiatry and Psychiatric Disorders, 9(5), 276–288. https://doi.org/10.26502/jppd.2572-519X0260
Corrigan, F. M., Fisher, J. J., & Nutt, D. J. (2011). Autonomic dysregulation and the window of tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology, 25(1), 17-25. doi: 10.1177/0269881109354930
Ford, J. L., Ildefonso, K., Jones, M. L., & Arvinen-Barrow, M. (2017). Sport-related anxiety: Current insights. Open Access Journal of Sports Medicine, 205-212. https://doi.org/10.2147/OAJSM.S125845
Jo, H., Song, C., & Miyazaki, Y. (2019). Physiological benefits of viewing nature: A systematic review of indoor experiments. International Journal of Environmental Research and Public Health, 16(23), 4739. https://doi.org/10.3390/ijerph16234739
Pelz, B. (2025). Translating visualization techniques from performance psychology to clinical psychology: Efficacy, adaptation, and applications. Journal of Psychology and Neuroscience, 7(3), 1-23. https://doi.org/10.47485/2693-2490.1123
Stephen, F. A., Ermalyn, L. P., Mangorsi, B. Y., Louise, L. J., & Juvenmile, T. B. (2022). A voyage into the visualization of athletic performances: A review. American Journal of Multidisciplinary Research and Innovation, 1(3), 105-109. https://doi.org/10.54536/ajmri.v1i3.479
Soga, M., & Gaston, K. J. (2025). Health benefits of viewing nature through windows: A meta-analysis. Bioscience, 75(8), 628–636. https://doi.org/10.1093/biosci/biaf089