Mental health in the injured athlete–why the spikes protocol matters

Athletes are a unique subset of patients that pose unique challenges to the treating physician. The mental health of injured athletes is becoming increasingly recognized as a vital part of adequate care of these patients. Numerous studies link poor mental health function and pre-existing mental health diagnoses to poor outcomes including delayed return to play, inability to return to play, risk of re-injury, and exacerbation of underlying mental health problems. Because this is a topic not often studied by team physicians and this manuscript aims to provide a practical tool to help these physicians communicate with injured athletes. The SPIKES protocol is an effective way to acknowledge and adequately communicate with this unique patient population.