Injury rehabilitation is often associated with repairing the body, bones, muscles, joints. But sometimes, the most significant hurdles aren’t physical at all.
That was the case for Anna (name changed for privacy), who was referred to Exercise Physiology services two months after a traumatic pedestrian vs. vehicle accident. Her injuries were significant: multiple skull and facial fractures, a fractured nasal bone, damage to her sphenoid and anterior skull base and a deep supraorbital laceration. But it was the emotional impact of the incident, the sudden trauma and its aftermath, that left the biggest mark.
The Unseen Impacts of Injury
When Anna was first referred, she wasn’t just recovering from physical trauma. She was also managing an acute stress reaction. The psychological effects of the accident had manifested as ongoing fatigue, poor sleep, low motivation and difficulty sticking to any routine, all of which made returning to her pre-injury life feel out of reach.
She hadn’t yet returned to her full time job at the office, though she was certified for 24 hours per week. Even simple household tasks felt overwhelming. Initial assessments reflected this. On the RAND-36, she scored just 15% for energy levels, 28% for emotional well-being, and 33% for emotional role limitations. Her self-reported functional ability was also reduced, with her PSFS (Patient-Specific Functional Scale) sitting at 23/30.
It was clear that this wasn’t just a musculoskeletal case. The real barrier to returning to life and work was her confidence, motivation, capacity and internal state.
A Tailored, Holistic Approach
We started with two sessions per week to offer optimal support, tapering over time as Anna built capacity and independence. Our goals were clear: support her return to full-time work, rebuild her ability to manage daily tasks and most importantly, restore her belief that she could do hard things again.
From the outset, education was woven through the program. We didn’t just focus on strength, but on postural tolerances, sleep habits, pacing and ways to support her energy throughout the day. Full-body resistance training helped combat the deconditioning that had occurred since her accident, while regular check-ins gave her space to reflect, adjust, and stay accountable.
One of the most important shifts wasn’t in the gym, but in how Anna began to take ownership of her own routine. What started as guided sessions evolved into consistent self-led training, a reflection of growing confidence, motivation, and belief in her own capability.
Over 12 Weeks, the Changes were Remarkable.
Anna went from not working at all to full-time work – not only that, she even received a promotion! Her confidence skyrocketed. She joined a gym and began attending three times a week, independently. She went from lifting 30kg floor to waist to 50kg, and improved her sit-to-stand test from 14 to 17 reps in 30 seconds. Sleep increased to seven to eight hours per night, a huge improvement from the five hours she managed at the beginning of the program.
Her PSFS improved to a perfect 30/30, reflecting her ability to manage both work and home life once more. But perhaps most importantly, she reported feeling motivated again. The fog of fatigue and fear that had clouded her recovery had started to lift.
Rehabilitation Isn’t Just Physical
What Anna’s story highlights is something we see often, yet isn’t talked about enough: the psychological aftermath of injury matters just as much as the physical recovery. For many people, especially those recovering from traumatic events, the road back is less about muscles and more about mindset.
As Exercise Physiologists, we don’t just prescribe sets and reps. We walk alongside clients as they reclaim their routines, rebuild their confidence, and re-learn how to trust their body.
Author: Tessa Nielsen
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