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How Brain Research That Helps Injured Workers Helped Lindsey Vonn

How does someone with a nearly unprecedented series of injuries and excruciating pain become the most successful female U.S. ski racer in history? Undoubtedly determination, grit, intestinal fortitude and, in the case of Lindsey Vonn, a little help from the brain.

Despite nearly destroying her knee several years ago, Vonn was able to race down an icy mountain at speeds surpassing those allowed on most U.S. highways and win a bronze medal, eight years after picking up a gold. Thanks to the latest research, along with advances in sports medicine, Vonn was able to rewire her brain to her pre-injury state and fulfill yet another dream. Her treatment speaks volumes about what is possible for human beings — especially injured workers with chronic pain.

Rewiring the Brain

One of the most effective treatments for injured workers with chronic pain is cognitive behavioral therapy (CBT); a short-term, goal oriented intervention that helps people change their thinking and behavior. It is always interesting to see how CBT actually effects changes in the brain. Through medical imaging such as MRI, we can see these differences pre- and post-injury.

Pain is an experience that involves much more than physical stimuli. Our thoughts, feelings, and environment play as much or more of a part in our experience of pain, especially when it is chronic. Bodily tissues have healed, but the primal and emotional areas of the brain have literally grown, taking up space from the thinking part of the brain. The result is the brain continues sending pain alerts throughout the body, even though there is no actual ‘injury’ causing it.

Treatments such as CBT help the injured worker by teaching them to refocus their thoughts and behaviors so the thinking part of the brain can become dominant again. It is retraining, or rewiring the brain. The scientific explanation of this is called neuroplasticity; the brain’s ability to change throughout our lives by forming new neural connections.

Researchers studying neuroplasticity at Ohio State University began looking at athletes with anterior cruciate ligament (ACL) injuries of the knee, and their recovery processes. They compared MRIs of healthy adults and those recovering from ACL injuries and found differences in brain activity when extending and flexing the knee.

The lead researcher explained that the brain changes the way it processes information after an ACL injury. He theorized that people recovering from ACL injuries tend to move their knees differently because they don’t completely trust them. Instead of relying on movement or spatial awareness, they depend more on their visual systems in the brain. Rather than moving instinctively, they are somewhat hesitant. For athletes zipping down the slopes this not only decreases their confidence and slows them down, it also presents a risk of reinjuring the knee. In fact, people who have an ACL injury and return to the activity are 30 to 40 times more likely to have a second injury, compared to those who have not had the injury.

To help these athletes requires a way to retrain their brains to the way they were before the ACL injury. They found that visual training technologies could help. Vonn was a prime candidate.

Among the numerous injuries Vonn has sustained throughout her career was when she blew out her knee in a crash during the Super G at the 2013 world championships in Austria. Later that year she was in Colorado training for the Olympics and damaged the same knee. She said her doctors told her the knee was stable, so she continued to race. However, she subsequently fully tore the ACL and was forced to miss the 2014 Olympics.

Vonn is among the athletes who have trained and recovered from injuries at the U.S. Ski and Snowboard Association’s Center of Excellence in Park City, Utah. The Center employs the very latest equipment and treatments, including virtual reality to simulate racing down a specific course.

In the last two years, the Center has also begun using a different type of VR technology. Called strobe glasses, these dark glasses are designed specifically to help retrain the brains of athletes recovering from ACL injuries.

In addition to obscuring the person’s vision, they also emit rapid bursts of light, interfering and distorting what the patient sees. The athlete puts on the glasses during therapy sessions. The visual distractions allow the person’s brain to refocus back to how it was before the injury so the athlete moves her knees based on natural instinct rather than relying on visual cues.

After the Olympics, Vonn said that winning the bronze medal was as or more meaningful than winning the gold. Her injuries have made her have to work harder and appreciate the wins she gets.

Conclusion

Scientific advances in brain research are happening almost daily. Injured workers with chronic pain are benefiting from this through treatments such as CBT. CBT is a method of ‘rewiring’ the pain brain (neuroplasticity). The treatment used for Lindsey Vonn and other high level athletes shows there is no limit to what the body can overcome and accomplish when the latest findings are put into practice.

IMCS – Integrated Medical Case Solutions – is the premier behavioral medicine network for pain and trauma response with evidence-based outcomes and a proven track record for transforming workers’ compensation cases. IMCS makes intervention efficient with a national network of 1,000+ psychologists and psychiatrists in all 50 states.