Brainspotting for Athletes: When Your Knee Is Ready but Your Mind Isn't

Brainspotting for athletes may help with the part of injury recovery that rehab does not reach: the fear that stays after the body heals. Your doctor clears you. Your physical therapist says your knee is strong. The scans look good. But the first time you cut, jump or take contact, something in you hesitates. Your body tightens up before your mind even decides to.

If that sounds familiar, you are not weak and you are not making it up. This is one of the most common reasons athletes struggle to get back to their old level. In this article, I will explain why it happens, how fear can show up in your muscles without you noticing, and how Brainspotting, a body-based therapy I use with athletes, may help you feel calm and safe in your body again, both after an injury and during stressful stretches of training and competition.

Why the Knee Heals Before the Mind Does

For many athletes, the biggest barrier to returning after an injury is not physical. It is fear. A large review of athletes who had ACL surgery looked at why some never made it back to their sport. Of the athletes who did not return to play, about 65% gave a psychological reason. The most common one by far was fear of getting hurt again (Nwachukwu et al., 2019).

That number tells me something important. Rehab is very good at rebuilding strength, range of motion and balance. It is not designed to rebuild trust. An injury is often a scary moment: the pop, the pain, the ride to the doctor, the season on the bench. Your brain remembers all of that. Long after the tissue heals, part of you may still be bracing for it to happen again.

This is why "just trust it" rarely works. You cannot talk yourself out of a fear your body is still holding.

Muscle Guarding: When Your Body Protects You Without Asking

Muscle guarding is when your body tightens and braces around an injured area to protect it, and it often happens without you noticing. Right after an injury, guarding is helpful. It keeps you from moving in ways that could cause more damage. The problem is that the body does not always get the message when the danger has passed.

In my work with athletes, I often see guarding hang around long after the injury has healed. An athlete may land a little stiffer on one leg, shift weight to the "good" side, or hold back on a cut without ever deciding to. When I point it out, many are surprised. They did not know they were doing it. That is what makes guarding so hard to fix with willpower alone: it lives below conscious thought.

Research backs up the link between fear and how muscles work. In one study of men who had ACL surgery, those with more fear of reinjury walked less evenly. They also used their thigh muscles differently on the injured side than on the healthy side (Tajdini et al., 2021). In other words, fear does not just stay in your head. It can show up in how your body moves.

Guarding and fear can feed each other. You feel tight, so the movement feels unsafe. It feels unsafe, so you tighten more. Breaking that loop is a big part of getting back to playing freely.

What Is Brainspotting for Athletes?

Brainspotting is a therapy that uses where you look to help your brain and body process stress that talking alone may not reach. It was developed in 2003 and grew out of EMDR, another eye-based therapy. The idea is simple: where you point your eyes can connect to how you feel inside. Certain eye positions, called "brainspots," seem to bring up stronger feelings or body sensations tied to a stressful memory.

Here is what a session usually looks like:

1. We pick a focus. This might be the moment you got hurt, the fear of your first full-speed practice, or the tightness you feel before a big game.

2. You notice your body. I ask where you feel it and how strong it is on a scale of 0 to 10.

3. We find the spot. I slowly move a pointer across your field of vision. We watch for a spot where the feeling gets stronger or your body reacts, like a blink, a swallow or a shift.

4. You stay with it. You keep your eyes on that spot and simply notice what comes up. There is no pressure to talk or relive every detail.

5. We check in. Over time, many athletes notice the feeling lower in intensity, or their body start to relax.

Many athletes like that Brainspotting does not require them to tell the injury story over and over. Some of the work happens quietly, with you in charge of the pace.

What the Research Says (and What It Does Not)

Early research suggests Brainspotting may help lower distress tied to hard memories, but it has not yet been studied in athletes. I want to be honest with you about where the science stands, so you can make a clear choice.

These are encouraging results. They also have real limits:

• The studies are small. Larger, stronger trials are still needed.

• None studied athletes or sports injuries. What we know comes from adults working on trauma or upsetting memories.

• One study was co-written by Brainspotting's creator, which is worth keeping in mind.

So here is how I think about it. We have strong evidence that fear holds injured athletes back. We have early, promising evidence that Brainspotting may help the brain process stressful experiences. Putting those together is a reasonable next step, not a proven fix.

Finding Calm Under Pressure in Training and Competition

The same tools that help with injury fear may also help athletes stay calm during stressful stretches of the season. Big games, tryouts, slumps and hard coaching all put the nervous system on high alert. Your heart races, your breathing gets shallow, and your muscles tense up before you even step on the field.

The good news is that sport anxiety responds well to mental training. A 2025 review of 24 controlled studies with more than 850 athletes found that psychological approaches, like cognitive-behavioral therapy, mindfulness and mental skills training, lowered athletes' pre-competition anxiety by a large amount (Li et al., 2025). Brainspotting was not one of the approaches tested, but the message is clear: anxiety is trainable, not a fixed trait.

In my sessions, Brainspotting fits alongside these skills. It may help athletes:

• Notice where pressure lives in their body before it takes over

• Process a past mistake, loss or bad game that keeps replaying

• Find a "resource spot," an eye position linked to feeling grounded, that they can return to before a big moment

The goal is not to make you feel nothing. It is to help your body learn that pressure is not danger, so you can play loose and focused.

Brainspotting for Athletes in Sacramento, CA: Safety First

Brainspotting works best as one part of a full recovery team, never as a replacement for medical care. Your doctor and physical therapist decide when your body is ready. My job is to help your mind and nervous system catch up. For athletes in the Sacramento area, I work closely with care partners, including a physical therapist, so the physical and mental sides of recovery move together.

A few things to keep in mind:

• Strong feelings can come up. That is normal and part of the process. A trained therapist helps you go at a pace that feels safe.

• It is not the right first step for everyone. If you are in a crisis, having thoughts of harming yourself, or dealing with a medical condition that affects your eyes or nervous system, talk with your doctor and therapist about what fits best.

• Rest still matters. Sleep and recovery routines support everything you do in therapy. Read more: The Ultimate Guide to Sleep and Athletic Recovery for Teen Athletes

Conclusion

When your knee is ready but your mind is not, the answer is not to push harder. It is to help your body feel safe again. Fear of reinjury and muscle guarding are normal, common and often hidden. They are also workable. Brainspotting is a gentle, body-based approach that may help you process what happened, quiet the bracing and find calm when the pressure is on.

Disclosure: I am certified in Brainspotting and offer it to clients at iMan Therapy Inc., both in my office and through telehealth.

If you are an athlete who feels stuck after an injury, or tense and on edge during competition, let's talk. Please email me at [email protected] and/or call 408-345-5293 to schedule a personalized consultation. I work with athletes and families across the Sacramento area.

Frequently Asked Questions

Is it normal to be scared to play again after an injury? Yes. Fear of getting hurt again is one of the most common things injured athletes face, even after doctors clear them. It does not mean you are weak or not tough enough. It means your brain is trying to protect you, and it may need help learning that you are safe now.

What is muscle guarding, and how do I know if I am doing it? Muscle guarding is when your body tightens or braces around an old injury to protect it. Signs include landing stiffer on one side, favoring your healthy leg, or holding back on certain moves without meaning to. A coach, trainer or therapist can often spot it before you do.

How many Brainspotting sessions does it take? It depends on the athlete and what we are working on. Some people notice a shift in a few sessions, while others benefit from working together over a longer stretch. We check in along the way and adjust based on how you feel.

Can Brainspotting help with nerves before big games, even without an injury? It may. Many athletes use Brainspotting to work through pressure, past mistakes or tension that shows up before competition. It works best alongside other mental skills, like breathing and focus routines.

About the Author

Kamal Ahmed, LMFT, is a licensed therapist in the Sacramento area specializing in mental health and performance for student athletes and teens.

Cover photo by [Photographer] on Unsplash (added in Step 2)

References

D'Antoni, F., Matiz, A., Fabbro, F., & Crescentini, C. (2022). Psychotherapeutic techniques for distressing memories: A comparative study between EMDR, brainspotting, and body scan meditation. International Journal of Environmental Research and Public Health, 19(3), 1142. https://doi.org/10.3390/ijerph19031142

Hildebrand, A., Grand, D., & Stemmler, M. (2017). Brainspotting – the efficacy of a new therapy approach for the treatment of posttraumatic stress disorder in comparison to eye movement desensitization and reprocessing. Mediterranean Journal of Clinical Psychology, 5(1). https://doi.org/10.6092/2282-1619/2017.5.1376

Li, H., Yang, Q., & Wang, B. (2025). Effects of psychological interventions on anxiety in athletes: A meta-analysis based on controlled trials. Frontiers in Psychology, 16, 1621635. https://doi.org/10.3389/fpsyg.2025.1621635

Nwachukwu, B. U., Adjei, J., Rauck, R. C., Chahla, J., Okoroha, K. R., Verma, N. N., Allen, A. A., & Williams, R. J., III. (2019). How much do psychological factors affect lack of return to play after anterior cruciate ligament reconstruction? A systematic review. Orthopaedic Journal of Sports Medicine, 7(5), 2325967119845313. https://doi.org/10.1177/2325967119845313

Tajdini, H., Letafatkar, A., Brewer, B. W., & Hosseinzadeh, M. (2021). Association between kinesiophobia and gait asymmetry after ACL reconstruction: Implications for prevention of reinjury. International Journal of Environmental Research and Public Health, 18(6), 3264. https://doi.org/10.3390/ijerph18063264