13/06/2025
Thinking traps and recovery from musculoskeletal injuries.
Over the last year, I’ve been slowly working my way through the book Thinking, Fast & Slow by Daniel Kahneman (highly recommended). One of the most important messages in the book is that we are all prone to ways of thinking that are automatic, habitual ways of understanding situations, which can skew our perception towards the negative. These are called cognitive errors and when it comes to recovery from injury or chronic pain, they can slow down or even prevent full recovery.
Psychologists identify these errors as part of our cognitive biases, leading us to view experiences in distorted ways. These cognitive errors or traps of thinking can influence our beliefs, emotions, behaviours, and even physical well-being, often without us realising it.
Here are a couple of examples of cognitive errors:
• All-or-Nothing Thinking: Seeing situations as black or white, with no middle ground. If something isn’t perfect, it’s a total failure.
Example: “My pain hasn’t gone away completely; I must not be getting better.” In reality, very few situations are all-or-nothing, and recognising shades of grey can relieve stress. Most often, recovery from an injury takes time, and will happen gradually rather than all at once.
• Catastrophising: Jumping to the worst possible outcome, often with little evidence.
Example: “This pain is sooo intense or it’s been going on for so long, it must be something terrible like cancer.” In reality, pain intensity doesn’t have to mean you’re dealing with a serious illness (despite what Google will tell you), and it’s best to seek professional help before jumping to a negative conclusion.
By recognising cognitive errors, we can start to question our automatic reactions, which are often unhelpful or unrealistic. When left unexamined, these errors may prolong recovery. People who tend to catastrophise, for instance, may live with constant worry about using that part of their body and they will avoid doing things that load that body part, even when the injury has healed enough to start moving again. When that happens, the guarding and tension around the injury becomes the problem.
Recently, someone mentioned a game that is quite useful at learning different kinds of thinking traps, as well as making it easier to recognise when you’re falling into one. The game is called Stinkin' Thinkin', and it was designed to raise awareness of cognitive distortions by making the process fun and interactive.
Instead of using clinical terms, Stinkin' Thinkin' uses humorous, relatable examples to show how common these errors are. Each round encourages players to recognise and label types of thinking errors, which is the first step towards changing these patterns.
In Stinkin' Thinkin', each game card represents a type of cognitive error. By playing, you begin to recognise similar thought patterns in your own life. The game creates a safe, non-judgemental space for discussing thoughts and behaviour patterns. Playing this game makes it more likely that you’ll notice, for example, when you might be catastrophising about an injury. The goal is to make catching these thoughts feel almost as fun and automatic as playing the game, gradually reshaping thought patterns in daily life.
To wrap up, I encourage you to check out the game by searching for it online.
Also, if you’re interested in a more in-depth dive into this topic, check out this article – https://www.sportsinjurybulletin.com/diagnose–treat/triumphs-over-rehabilitation-thinking-traps.
- André
