January 5, 2026

Vision is More than 20/20

By Lylah Ruparel

So What's the Big Deal with Eyecare?

For most of my athletic life, I thought vision was simple. You either had good eyesight or you didn’t. You passed the exam, or you needed glasses. End of story. But the more time I’ve spent talking with doctors, coaches, and specialists through HERcovery, and the more I’ve paid attention to my own body, the more I’ve realized how incomplete that idea is.

Because vision isn’t just about seeing clearly. It’s about how your brain processes movement, depth, speed, balance, and threat, especially when you’re moving fast, flipping, landing, or reacting in milliseconds. And for girls in high-impact sports, that difference matters. Seeing clearly doesn’t mean seeing safely. One of the most surprising things I learned is that you can have “perfect” eyesight and still be at higher risk for injury.

That’s because vision isn’t just acuity; it’s coordination. As Dr Jung, optometrist and orthokeratologists told me during our interview, “Clear vision doesn’t actually tell us know well the eyes are working together or how safely an athlete is moving.” He explained that many athletes adapt so well to subtle visual issues that they don’t realize anything is off until their body compensates in ways that increase injury risk.

Your eyes don’t work alone. They work with your vestibular system (balance), your nervous system, and your muscles. Together, they tell your body where you are in space, how fast you’re moving, and what’s coming next. If that system is overloaded by fatigue, stress, growth, hormones, or injury, your body can hesitate. Or misjudge distance. Or react just a fraction of a second too late. In sports, a fraction of a second matters.

I’ve felt it myself. That moment when something feels off even though nothing looks wrong. When you hesitate before a skill you’ve done a hundred times. When the beam suddenly feels narrower. When the floor feels farther away than it should.

Trust is Critical but So is Visual-Motor Integration

Girls are taught to push past these signals. We’re praised for pushing through. For being tough. For not making a big deal out of discomfort, especially when it isn’t visible. Vision strain, dizziness, spatial disorientation, or anxiety don’t always look like injuries. So they’re often ignored by athletes, coaches, and even medical systems that weren’t designed with female bodies in mind. But research shows that visual-motor integration and balance deficits are associated with higher injury risk, especially for ACL injuries in female athletes (Herman et al., 2015; Wilkerson et al., 2012). In other words: when your eyes and brain aren’t working smoothly together, your body pays the price. 

Confident isn't Only Mental; It's Also Neurological

Something else clicked for me during these conversations: confidence isn’t only about mindset. It’s about trust. When your visual and balance systems are regulated, your brain trusts your body. Movements feel automatic. Decisions feel clear. Fear doesn’t take over. When those systems are stressed, confidence drops, not because you’ve suddenly become less capable, but because your brain is trying to protect you.

Neuroperformance coach Ms Sugiura described it this way: “When the brain senses uncertaintly, it increases tension and hesitation, not to hold you back but to keep you safe.” She emphasized that fear and stiffness often aren’t mindset problems at all, but signals that the nervous system is overloaded.

Girls are especially vulnerable during adolescence, when growth spurts and hormonal changes can temporarily disrupt balance and spatial awareness. Studies suggest that these changes may affect neuromuscular control and injury risk during puberty (Quatman-Yates et al., 2013).

But sometimes the solutions are simple. Things like:

• Checking in with how your eyes feel when you’re tired or stressed

• Giving your vision breaks from constant near-focus (screens, homework)

• Practicing basic tracking or balance drills

• Paying attention to hesitation instead of ignoring it

Ms Scott, high school varsity girls soccer coach told me during our interview that she started noticing that athletes who felt dizzy, anxious, or “off” before practice often pushed themselves harder, which made things worse. When those same athletes were encouraged to slow down and stay engaged without forcing performance, they came back stronger and more confident.

That’s not quitting. That’s regulation.

So How Does this Impact Athletes, Coaches and Parents?

If we want girls to stay in sports longer, and stay safer, we need to expand what we consider “training.” Strength matters. Skill matters. But so does the nervous system. So does vision. So does giving girls permission to notice what their bodies are telling them.

Because seeing isn’t just about clarity. It’s about confidence. It’s about safety. It’s about trust. And girls deserve to understand their bodies well enough to protect them, not override them. That’s part of what HERcovery is about.

Sources & Further Reading

• Herman, D. C., et al. (2015). Visual-motor control deficits and ACL injury risk. Journal of Athletic Training.

• Wilkerson, G. B., et al. (2012). Neuromuscular and balance deficits associated with ACL injury risk. American Journal of Sports Medicine.

• Quatman-Yates, C. C., et al. (2013). The maturation of neuromuscular control and injury risk in adolescent athletes. Sports Health.

• Grooms, D. R., et al. (2017). Neurocognitive and sensory contributions to ACL injury. British Journal of Sports Medicine.

• HERcovery Project — In Converstation... Series (2026)