QPR technical director Chris Ramsey has spoken out about the "depression" he faced during his injury-hit playing days.
Speaking to the Guardian, Ramsey said: "I had seven knee operations and three back operations and I was probably depressed for years.
"People don’t realise with long‑term injuries you go into depression – no matter how mild it is.
“The cycle includes denial and anger before you can start recovering. Left to your own devices it can take a long time to accept what is happening. You think about where you are in your contract, where you are in your career, if a new manager might come in who doesn’t know you – will he buy someone to replace you? That’s the worst thing about it. There is so much time to think.”
Dr Misia Gervis, a leading sports psychologist who also works at QPR's academy, said: "We found that the majority had no psychological support at all.
"A tiny percentage might have spoken to someone. Yet we asked if they felt anxiety or isolation, and 99% reported experiencing some kind of psychological disruption.
There is a wealth of evidence around the psychological challenges of long-term injury. If you are an elite athlete where it is your only identity, and suddenly that has been taken away from you, you are sitting there thinking: ‘Who am I now?’ It is a big sense of loss."
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