For Rams players stuck in a dark place after major injury, help came from within

Rams left guard Joe Noteboom closed his eyes, and in his mind, he stepped onto the practice field with his teammates.

First, he went through stretches. Then individual and pass-rush drills. Hello, Aaron Donald, Michael Brockers and Sebastian Joseph-Day. Then, team drills. Like usual, left tackle Andrew Whitworth lined up next to Noteboom, and the two silently communicated plays and checks as they moved through their series. Like usual, Noteboom felt quarterback Jared Goff behind him, and heard his calls and adjustments. He went into the huddle with his teammates and prepared for the next sequence of the practice.

And then Noteboom opened his eyes and came back to the reality of his situation.

He was never physically on the field with the rest of the team. He was instead in a room with Rams sports psychologist Dr. Carrie Hastings. His physical reality was not that of feeling the purpose and satisfaction of being on the field with teammates, but of pain.

Noteboom tore his ACL and MCL in October 2019. After surgery, his physical reality became re-learning how to walk and to run, then how to play football again. And because so much was out of his control in his physical reality, in his mental reality, Noteboom began to sink.

“Just to not be able to, like, even walk around your house is just …” said Noteboom, his voice solemn. “You know, it was, easy to get down on yourself.”

Then Hastings stepped in.

“She talked a lot about, kind of visual stuff because that’s all we could do,” Noteboom said. “Watch film and you could visualize yourself in there, visualize yourself running, doing certain techniques … just to get our mindset back into like we’re playing a game or practicing, just so we don’t lose anything, talking through how not to get down on yourself, and how to bounce back, and how to stay motivated. She was really helpful for sure.”

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Noteboom and teammates Brian Allen and Micah Kiser — all of whom will either be starters or important depth players this season — entered that visualization space periodically with Hastings over the course of their grueling rehabilitation periods during the offseason. She worked with each of them through the mental aspect of their healing process after significant injuries in 2019.

Mental reps and visualization are just two of many techniques used by Hastings, who creates each session to cater to the individuality of the players. And her area of care is massive.

“People forget that professional athletes are human beings and have lives outside of sports,” Hastings told The Athletic this week. “It’s often helping players cope with things like family issues, or environmental issues, current events-type stuff. … And then anxiety, things the individual may already be dealing with and then wanting to better enhance their performance by being able to regulate some of those things.”

Hastings has helped players mentally return from injuries and also address and work through childhood traumas, mental-health disorders like anxiety and depression, and family struggles. This spring, Hastings helped facilitate public and private counseling and conversation sessions as Black players experienced grief and anger over the killing of George Floyd by a Minneapolis police officer and the subsequent social-justice movement that followed. She also has helped players address anxieties — usually related to the safety of their families — during the COVID-19 pandemic.

For the last three seasons in Los Angeles, Hastings has led a progressive group of mental-health, personal well-being and player-development staffers that also includes director of player engagement Jacques McClendon, head athletic trainer Reggie Scott and new strength coach Justin Lovett. The group works together to help players pursue total wellness, inside and out.

Hastings says that, with the Rams, an open-minded attitude toward mental healthcare starts with support from the top — from head coach Sean McVay and general manager Les Snead. Players are the main focus for Hastings, but she also has an open door for coaches and front-office staff.

“Everybody has their own set of circumstances and things that they deal with, whether it be in this building or outside of the building,” McVay said. “And to be able to have somebody that you can share and confide in and have the strength to really be vulnerable to go and spend some time with her, I think, has been a huge part of us encouraging that. Anybody that’s met Dr. Hastings, you can see she’s really special at what she does.”

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A former sprinter and hurdler at the University of Notre Dame, Hastings, 44, found her calling to help others work through mental-health issues after she experienced the Sept. 11 attacks as a New York City resident.

She also knew, from her background in sports, that she wanted to work with athletes. While her specific position with the Rams was not in her plans when she began practicing 14 years ago, Hastings finds in this role not only the opportunity to help athletes on a deeper level, but also to help reduce the stigma associated with mental health in a hyper-masculine environment such as an NFL locker room.

“I think that there is a huge plight,” Hastings said, “right now more than ever, within the NFL and within the individual teams, to reduce the stigma associated with mental health — which I do think has already reduced tremendously — and make it OK for elite male athletes to engage in help-seeking behavior. It can take some time to earn someone’s trust and for them to allow themselves to be vulnerable.”

But in interviews, starting with Kiser last week and continuing with Noteboom and Allen, it seemed natural and comfortable for each player to offer his experience working with Hastings.

“I guess, the easiest thing (after getting hurt) was just to feel sorry for myself. It took a while to get over that, honestly,” said Kiser, who last winter recovered from a torn pectoral muscle suffered in the preseason.

“Going to the games was really tough knowing like, ‘Man I wish I could be out there, and just not really being in the thick of it, not really being in the foxhole … just trying to get over the feeling of feeling down on myself and feeling sorry for myself.”

Hastings met with Kiser every week. Her approach, she says, is first and foremost one of empathy and understanding. She wants to meet players where they are, instead of forcing them to get to her mental space. Then, in the case of injury recovery, Hastings works to deconstruct the deep connection players have between their physical and mental selves, a process she recognizes as similar to recognizing and moving through stages of grief.

“One of the trickiest things is that athletes at this level are used to being the best,” she said. “They have been the best at their sport their whole lives. It’s what they talk about the most. It’s how they have been identified. … They are used to, ‘I work hard. I get better.’ And then, all of a sudden, they’re just slammed with a season-ending injury. And everything has to come to a halt. They’ve lost that control. And it feels not only hopeless, but helpless.

“They’re so used to showing up every day, and then they are not even necessarily with the team every day or for every meeting. That sense of family is impacted. And that sense of really being a contributing member of the team and standing out — and now they’re standing out in a way they don’t want to be.”

That sense of loss — of both ability and the feeling of being a part of something — was a huge barrier for Allen to overcome as he recovered not just from ACL and meniscus tears but also a fractured tibia that left him wondering, at one point, if he would walk again.

“You’re alone a lot,” Allen said. “I lived with guys on the team, so they’re going to practice and I’m sitting at home. My mom came and stayed with me for a couple weeks just to get me on my feet. But when she left, I’m alone all day. I come to rehab, I go home and just sitting on my couch, can’t walk.

“That was a tough time.”

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Hastings said one major point of anxiety for players recovering from injuries can be the waiting. They want the recovery process to go by as fast as possible. She describes it as the concept of “winning the healing” — the idea of recovering on schedule, or quicker, because there is a dearth of a competitive environment without on-field play.

In Allen’s case, it didn’t work out that way. He was thrown even further off schedule when he contracted COVID-19 in March — the first known active NFL player to do so — and his rehab progress hit a setback as he recovered from the illness.

“I was in a pretty critical part of rehab (when I got sick),” he said. “I had just started running and getting my strength back. I couldn’t come in the facility for three weeks. So, I was just at home.”

Enter Hastings.

“Once they decide they are ready to work themselves out of that dark place, we look at the choices,” she said. “They always have the choice to stay there … but they also have the choice to do something about it. And that can be very empowering. Like, ‘I can’t control this physical healing. But recovery is a combination of physical and psychological healing. And the psychological aspects, I can control. I can work on.’

“‘I can use things like imagery to do the workouts as closely as I can mentally. I can still set goals.’ … And looking at it instead of 10 weeks of recovery, (viewing it) like, ‘OK, what am I going to do today?’”

Hastings said that healing can come even in the simpler actions of her job, like letting a player know he is not alone when he feels most isolated.

“I’ll meet a little more often with players if they really are in a dark place. I will check in with them regularly and see how they’re doing,” she said. “Sometimes just doing that, showing them I’m still here (saying), ‘You may be at home and you can’t even stand right now. But you are still supported.’

“‘I got your back. And we are going to get through this. It may not always be pretty, but you will get through this.’”

(Top photo of Joe Noteboom: Jayne Kamin-Oncea / Getty Images)