Tampa Bay Buccaneers defensive end Jason Pierre-Paul suffered a potentially season-ending fractured neck in a single-car crash last week in South Florida, league sources told ESPN's Adam Schefter on Tuesday.

Pierre-Paul, 30, will likely need surgery, a source told Schefter. He will be visiting with neck specialists at some point this week to get their opinions, with the hope that a portion of this season can be saved.

"As we stated last week following the news of Jason's auto accident, our immediate concern was for both Jason and his passenger," general manager Jason Licht said in a statement Tuesday. "While Jason was treated and released in South Florida the same day of the accident, we wanted to ensure that our medical team had an opportunity to perform a thorough evaluation here in Tampa, and that process is currently ongoing."

The crash occurred early Thursday morning in Broward County. Pierre-Paul sought medical attention at a local hospital and was released. He was not cited for the crash.

Pierre-Paul hasn't attended any of the voluntary workouts that the Buccaneers have held this offseason under new coach Bruce Arians.

The Bucs didn't prioritize defensive line in the draft, partly because they were counting on Pierre-Paul, who had 12.5 sacks last season -- the first time a Tampa Bay player had reached double-digit sacks since Simeon Rice in 2005.

To make matters worse, six-time Pro Bowl defensive tackle Gerald McCoy has not been present for the first month of the offseason program due to team concerns over his $13 million price tag and the fact that the Bucs currently have less than $2 million in salary-cap space. There had been widespread speculation that the Bucs were attempting to trade McCoy -- with the feeling that the relationship may be beyond repair -- but at this point, they may need to make amends for the sake of continuity.

Prior to being traded to the Bucs before last season, Pierre-Paul, a 2010 first-round pick, had an up-and-down run with the New York Giants. He had 16.5 sacks and helped them to a Super Bowl victory during the 2011 season. He made a pair of Pro Bowls and later returned to play at a high level after his career seemed to be in jeopardy following a 2015 Fourth of July fireworks accident that cost him his right index finger and parts of several others.

ESPN's Jenna Laine contributed to this report.

DENVER -- Enes Kanter, a devout Muslim, is fasting from sunrise to sunset each day for the next month in observance of Ramadan. He even sought out an NBA legend for some advice on how to do it while maintaining a high level of play in the playoffs for the Portland Trail Blazers.

"I texted Hakeem [Olajuwon], because I met him like two years ago and I know what he did in I think it was 1995, when he won the MVP in the playoffs. But I texted him and was like, 'Hey, how did you fast through Ramadan and play at a really high level?'" Kanter said Tuesday morning. "And he gave me some tips. He gave me what he was eating, when he would wake up -- like at 4 in the morning -- how much water he was drinking and stuff."

Fasting for Ramadan means throughout the day -- no food, no water and maybe most importantly for Kanter and his injured left shoulder, no medication.

"I took medicine at like 4 in the morning and I will take medicine again right before the game, because I can break my fast before the game," Kanter said. "But I'll be fine."

With Game 5 tipping at 8:30 p.m. in Denver and the city breaking its fast at 8:06 p.m., Kanter, who has been dealing with a separated left shoulder, can eat, drink and take medicine prior to the start.

"I might just have someone get some peanut butter and jelly sandwiches on the bench for me to eat during timeouts," Kanter said.

Kanter fasts each year during the regular season "once or twice a week" to get his body ready for Ramadan and was unconcerned about it affecting his play at all. He said he talked to Blazers coach Terry Stotts about it Monday.

"He was very respectful and respected everything," Kanter said.

Olajuwon was his typical stellar self during Ramadan, even producing better numbers in some seasons while fasting.

"As for fasting, it is a spiritual mindset that gives you the stamina required to play," Olajuwon told The Undefeated's Marc J. Spears in 2017. "Through Allah's mercy, I always felt stronger and more energetic during Ramadan."

Kanter sees it the same way.

"It's just mind over matter, man," he said. "I think it just gives you so much positive vibes that just go out there to say, 'You know what I'm doing this for God, so God [will] help me.'"

Kanter said when he reached out to Olajuwon, the Hall of Famer was "very happy and very proud," and that they talked a little about basketball. But mostly, the focus was on Ramadan, the discipline it requires and how observing it during the most high profile part of the season can serve as inspiration for others.

"It doesn't matter what your status is, what your position is, I just want to set an example for the young generation," Kanter said. "Because it's very important for them to follow their religion.

"It's awesome to get help from a legend," Kanter said, "so I would love to be the new Hakeem for younger generations."

Twenty-three thoughts on the wildest series of a wild second round:

It is easy to dismiss this as the consolation series: Win, and Golden State or Houston tramples you. Yeah, the winner here will be a huge underdog in the Western Conference finals. The Portland Trail Blazers and Denver Nuggets have to be exhausted. Damian Lillard has looked fried for portions of this series, including for the last hour or so (!) of the epic four-overtime Game 3 of this conference semifinal. He spent extended stretches acting as decoy, loitering on the wing as CJ McCollum ran the show.

A willingness to share the stage is part of what makes Lillard a beloved, galvanizing leader. But this looked different. Lillard was passive -- standing instead of cutting or screening. Decoy mode lasted longer than it should have.

The Nuggets are also making Lillard work on defense, often trying to get him switched onto Jamal Murray.

• Denver's resiliency is remarkable. Snagging two borderline must-win Game 4s on the road requires guts and confidence you don't typically find in teams this green. Portland and San Antonio both went 32-9 at home, tied for the league's third-best mark, behind only Milwaukee and the Nuggets themselves. Beating both on the road, down 2-1, is a major accomplishment.

From the last week of March to Sunday, the Nuggets played 20 games in 39 days. Denver is tough.

• On the opposite side of the bracket, Kevin Durant is carrying a Golden State Warriors team that suddenly looks thin and a little wobbly. Durant might not be on that team next season. They have no cap space to replace him and almost no bench. Draymond Green is 29 and had to go on a quick-fix diet -- planned, but still -- to get in playoff shape. Stephen Curry is 31 and dealing with injuries and foul trouble. Those are annual postseason occurrences now.

Curry has another gear in reserve if Durant leaves. Golden State won a championship and then 73 games that way. Curry's alleged postseason struggles are a little overblown. His numbers are very good, and his impact on Golden State's offense always extends beyond those numbers.

But it's hard to watch these Warriors and conclude that the theoretical post-Durant version would be anything like a lock to enter next season as favorites in the West. That is the real backdrop to this Denver-Portland war of attrition, even if it doesn't seem that way.

• The Blazers and Nuggets are almost mirror images of each other. They lean slightly offense-first, and the series has leaned that way too. The combined score after four games is Denver by two. They tied for the league lead in offensive rebounding rate, and they rank first and second in this round. They both take care of the ball and force few turnovers, and this series has been predictably clean. They prefer a slow pace.

They build their offenses around deadly two-man games and run lots of the same actions. The series can feel like an endless series of pick-and-rolls and handoffs on one side of the floor -- with no other players on that same side.

For Portland, the danger is in its guards jacking open 3-pointers behind those picks. For Denver, it is Nikola Jokic -- perhaps the most unpredictable and broadly skilled screen-setter in the league -- taking whatever the defense gives him, and even some things it doesn't realize it is giving.

Both defenses are attacking those pick-and-rolls aggressively, though Denver has its big men -- mostly Jokic -- scampering further to swarm Lillard and McCollum above the 3-point arc:

That starts with McCollum jamming Jokic -- a pet Portland "screen-the-screener" action designed to shove Jokic behind the play:

The Blazers have cleared Lillard's side so that he has an easy passing lane to Kanter, and Kanter a clear view of the floor on the catch. Denver has seen this a million times and knows what to do:

Malik Beasley, a stalwart in these playoffs, slides away from Maurice Harkless under the rim to account for Kanter. Torrey Craig shifts down from Al-Farouq Aminu to block any pass to Harkless but remains in position to dart back to Aminu. This is the past four seasons of Portland basketball: Teams leave Harkless and Aminu open, and the Blazers often win or lose based on how many 3s they hit. They are 4-of-22 against Denver.

• Aminu's flash to the foul line is a smart counter. He can't just chill in the corner. Standing there puts him parallel to Harkless. That is a tricky skip pass for Lillard and McCollum; it's hard to see, and they have to throw it over multiple defenders.

• Jokic has been solid moving his feet, getting the ball out of Lillard's hands and shuffling back into the paint. But there have been a decent number of instances in which he hasn't come out far enough, and Lillard has had space to launch. Lillard has not been able to exploit those openings often enough. He has passed up some 3-pointers and meandered into long 2-pointers.

He can make a lot of those! He's Damian Lillard! But something has felt a little off -- like Lillard is still feeling out the series, wary of Craig pawing at his shot from behind. Lillard is leaving some 3s on the table.

• Something Portland should do even more: have their bigs rescreen in the opposite direction. Jokic has had no shot corralling the Portland guards twice in rapid succession:

(Yes, Lillard missed. The rescreen has worked almost every time.)

• Double screens for Lillard in semi-transition -- especially near midcourt -- have also hurt Denver:

• Another smart tactic Portland has busted out more every game: letting Lillard attack one-on-one, before any pick arrives. Why invite a trap when Lillard can roast Craig in isolation? Lillard slashed inside for a crunch-time layup to bring Portland within two with 2:47 left in Game 4.

• A variation of this that has worked for both Lillard and McCollum: dribbling toward Kanter's pick, then veering away from it -- into open space. Lillard's defender is often leaning toward the pick, girding himself for the chase. Jokic is primed to lunge at Lillard. Going the other way wrong-foots both.

• I suspect the Lillard isolation is why Denver shifted Gary Harris onto him, and Craig onto McCollum, in the second half of Game 4. Harris is quicker and shiftier. He has done good work on Lillard. It hasn't gotten enough attention amid Jokic mania and the Murray roller coaster, but Harris has proved ready for the postseason hothouse. He competes on every possession, and he is not afraid to bulldoze through Lillard and McCollum when he flies into a Jokic handoff with some runway.

• Having Harris on Lillard also means Lillard is often stuck on Harris -- instead of hiding on Craig -- after Portland misses. Anything to make Lillard work.

• We have seen only flashes -- usually in crunch time -- of Jokic hiding on Aminu so that Paul Millsap can take Kanter and muck up the Lillard/Kanter pick-and-roll with his meat-hook hands. Portland has obvious counters -- use Aminu as screener, post Kanter against Millsap -- but I wonder if we might see more of that.

• Slotting McCollum onto the weak side of a Lillard pick-and-roll -- or plopping Lillard there if McCollum has the controls -- puts Denver in a tough position of having to help off an ace shooter instead of the Harkless/Aminu duo:

Denver could adjust by having Millsap abandon Aminu on the strong side -- next to Lillard -- and the Nuggets have tried to do that on a few possessions:

But that reverses typical help responsibilities, and executing it on the fly is hard. (The Warriors are really good at this sort of strongside improvisation.)

• Rodney Hood on the weakside works too, though this is good defense:

The Blazers are plus-9 with Hood, McCollum and Lillard on the floor -- and Hood in place of Harkless. They lose some size that way. Harkless is defending Murray, and that gives Portland the flexibility to switch any Murray-Millsap action.

But Hood has managed the Murray assignment well. He is a more polished post player than Harkless, though less brutish, and the Blazers are trying to scrounge some points by posting Murray. (Murray's defense remains a train wreck.)

I wonder if Terry Stotts might give the Hood/Lillard/McCollum look more run.

• Seth Curry has played only 16 minutes alongside both of Portland's star guards. Portland might be able to risk a few more.

• Meanwhile, here is Denver's version of that side pick-and-roll:

Portland's response is the same: blitz Harris and have a help defender leave one of Denver's blah shooters -- Millsap here -- to meet Jokic on the catch. Easy!

But even when you do it well, Jokic is skilled enough to hurt you:

That is close to what Portland wants: pin Denver on the sideline, and force Jokic into a floater. Problem: Jokic is a floater expert. Jokic sets the pick low enough so that he is almost in layup range. What a scamp.

• The most fun chess match is Portland's defense against the Murray-Jokic high pick-and-roll. Denver is running 37 of those suckers per 100 possessions, up from 24 in the regular season, per Second Spectrum data. In theory, it shouldn't be that hard to contain. Murray is not quite a Lillard-style off-the-bounce gunner; you don't have to blitz him with the same urgency. Jokic is an average 3-point shooter with a slow release.

Plant Kanter around the top of the key -- not too high, not too low -- and he can scramble back in time to either challenge Jokic's jumper or meet him around the foul line:

This feels like an overreaction from McCollum:

Maybe it is. But Jokic can make contested runners over Kanter. If Kanter is a beat late rotating back, Jokic drives into him and draws a foul. Jokic can shoot over Kanter, and he has hit 41 percent from deep in the playoffs. Close out too hard and Jokic can pump-and-drive by you.

He is a threat to do almost anything against a scrambled defense, and you can see Portland panicking in rotation limbo: Should we switch? Should a third defender fly at him? Jokic preys on indecision.

• When Portland sends that third defender at Jokic, Denver has that guy's man cut backdoor -- as Barton does here with Curry waiting to pounce on Jokic:

Denver hasn't gotten much out of that yet -- credit Portland's defense -- but it's something to explore, even if Jokic just fakes a pass there before driving.

• Murray has also been really smart generating switches. If Kanter drops too far back, Murray zooms right into him -- basically forcing Kanter to switch. Murray will bob and weave behind Jokic until he tricks the defense into nearly switching against its will. His feel and IQ are underrated.

• Once that switch happens, Jokic goes to work in the post. He can do that without a switch. Portland has flirted with sliding Aminu onto him -- so Aminu and Harkless can switch the Murray-Jokic action -- but I'm not sure that's tenable. It requires an automatic double-team, and at that point, you're praying Denver misses heaps of open 3s off Jokic kickout passes.

The Nuggets are weirdly prone to missing heaps of open 3s. But Portland's help defense behind double-teams has been kind of a mess. Too many people rush to the same spot, leaving too much space uncovered:

Lillard and Curry (at the foul line here) have a bad habit of turning and watching in no-man's land:

Jokic has to keep posting and trusting his shooters.

• The series might be decided by those fraught moments when the best players are on the bench. Denver is minus-38 in the 30 minutes Jokic has rested. That is, like, impossible. Michael Malone has pivoted to using Millsap as the only starter in lineups that open the second and fourth quarters. Those groups include Will Barton, who came alive in Portland -- Will Barton revenge alert! -- and started half the season.

Malone might need to rejigger the rotation so one of Murray or Harris joins that group. Playing Millsap at center could be a way to do that. He has also experimented with pulling Jokic a bit earlier in the first and third quarters, as well as using him to anchor the second unit.

• Stotts has ditched the bench mob and used McCollum to prop up small-ball reserve groups with Evan Turner at power forward and Zach Collins at center. Collins has been really good on both ends. Turner has three baskets in the playoffs. His ballhandling isn't quite as valuable with McCollum on the floor, though every bit helps. Millsap abused him in the post until Game 4.

These lineups have held up fine. They feel a little rickety. Swapping in Harkless or Aminu might make them sturdier.

Although MLB is starved for quality starters, former Cy Young winner Dallas Keuchel still does not have a job, and he won't take one for less than what he thinks he's worth.

"If you would've asked me on the first day of free agency, I would have said no way I'd be here on May 6," Keuchel told Yahoo Sports on Monday. "This was not the plan at all. I would love to be out there playing ball and helping a team win. Because, to my career at this point, I've done more winning than I have losing and at a much higher clip. So what team wouldn't want me to be out there? Am I the best at this point in time? No. But am I more than or better than some of the offers I've been given? Absolutely.

"That's not me being greedy. That's just my compensation in the market from what the analytical data is telling me. I didn't come up with this. The front offices came up with this. So now they're trying to tell me I'm less than what the analytical data is saying. How is that possible?"

Keuchel, 31, went 12-11 last season with a 3.74 ERA in a league-leading 34 starts for the Houston Astros. The left-hander won 14 games and had a 2.90 ERA during Houston's 2017 World Series-winning season. He won the Cy Young in 2015 with a 20-8 record, 2.48 ERA and American League-leading 232 innings pitched. So how does a workhorse lefty not have a job at this point in the season?

Keuchel's situation is complicated by the fact that he turned down a one-year, $17.9 million qualifying offer. That made him a free agent but also attached draft pick compensation to him. Former Red Sox closer Craig Kimbrel is in the same boat. Any team that signs one of them before the draft has to give up a pick. After the June MLB draft, that goes away.

Keuchel says he has turned down numerous offers presented to him by agent Scott Boras.

"I told him no on numerous deals because it's about principle," Keuchel said. "It's about fair market value. And I wasn't getting that."

Many have argued that draft pick compensation hurts veterans because teams are wary to pay what it costs to land a player with an extensive résumé and lose out on young players in the draft as well. Keuchel didn't start out being a poster boy for the issue, but he's embracing the role now.

"When people tweet at me, saying, 'Hey, quit being the Le'Veon Bell of baseball,' it is a funny line. But he stood up for himself. He stood up for his well-being," Keuchel said to Yahoo, referring to the NFL star who sat out the 2018 season. "And I'm standing up for my well-being as well. It's about principle in both situations. Now, I'm not looking to sit out this whole year. I wasn't looking to sit out at all. But we are in this situation right now. I would love to sign tomorrow."

One of those teams could be the New York Yankees, whose starting ranks have been decimated by injuries. But at this point, the Bronx Bombers appear to be content to wait. In the meantime, Keuchel pitches to junior college players in California.

"My asking price and my due diligence is not just out of left field. It has come to me through my own career path, my own career numbers, and then what my market is valued at this point in time," he told the website. "To this point it hasn't been matched. It's been less than what it should be. And this is out of principle, what's going on right now. I can't speak for other players. It's a principle for me. I'm not asking for the world."

Here's one of the great contradictions in baseball: Modern reliever usage, most of us would agree, has made the game more static, more anonymous, more dawdling -- generally speaking, more boring.

But most of the good stuff also happens once the relievers are in the game. That's when baseball's biological diversity is most apparent, when its strategic adaptation is most in play, when the guys with the weirdest backstories are on screen, and when half the pitchers have You Can't Predict Baseball tattooed on their necks. It's also, generally, when the outcome of the game you're watching is most likely to be determined.

Following the sport requires following the bullpens, so let's survey the first month of the 2019 season in relief work.

The state of the closer

On Valentine's Day three months ago, three rebuilding teams -- the Royals, Orioles and Marlins -- announced they wouldn't necessarily name a closer this season. Not long after that, the Braves said they might use a committee to close games; the Twins were being "coy" about whether they would; and the defending champion Red Sox entered the season without a named closer. In the first two weeks of April, six Mariners relievers, and four Rays relievers, already had saves.

This is an annual spring ritual, and it typically goes nowhere. For various reasons, a handful of teams early in the season don't want to label one guy as better than their other guys; couple it with the longtime feud between statheads and traditional closer roles, and there will be a few teams that look like they might spearhead a movement. But almost inevitably, within a few saves one pitcher is collecting all of them for his team's bullpen, and that's that. You don't see that guy in the seventh inning anymore. You don't see anybody else getting up in the ninth.

Still, there are a lot of front-office executives who want the traditional closer role to go away -- to be absorbed into the larger trends toward nonhierarchical roster flexibility -- so it's never quite safe to assume this won't be the year. Even though it's never the year.

But maybe this is the year! Two years ago, the Ringer's Ben Lindbergh looked at each team's saves leader through April, and found that those 30 leaders accounted for just 79 percent of all saves. That was the lowest share in at least a decade, but there was also plenty of reason to wonder if it was a fluke. For one thing, it was just a small dip -- the average over the previous decade had been 84 percent -- and it came immediately after a 2016 season in which the reverse was true (saves leaders accounted for a higher percentage than any year in a decade). In 2018, the figure through April was 81 percent, still on the historical low end but a tick back up.

This year's 30 team leaders, though, accumulated less than 73 percent of all saves through April, a much lower share than in even the previous lowest year. This year, 83 relievers recorded at least one save by the end of April; the previous high in the 2010s was just 64 (last year), and the average in the decade was 54.

Clearly, teams are distributing their saves to more pitchers, and giving their closers less monopoly on the ninth inning. Some teams, meanwhile, still haven't named "a" closer, almost a quarter of the way through the season.

Three competitive teams -- the Red Sox, Rays and Twins -- have given multiple saves to at least their two best relievers. While the Marlins and Orioles appear to have fallen into predictable ninth innings (with Sergio Romo and Mychal Givens, respectively), the Royals have distributed their five saves to four pitchers. The Mariners haven't had a save opportunity in a while, but their distribution appears to still be undefined.

Of course, it'd be crazy to think the bulk of saves wouldn't end up in the hands of the few dozen best relievers. But in the ideal scenario, by making the closer role less rigid, the very best relievers would be available for a lot of those ninth innings and also other things: four-out saves, six-out saves, seventh-inning jams, eighth innings against the heart of the order, whatever. There's nothing inherently good about a closer by committee, unless it means the best relievers (traditionally, the "closers") can also be used successfully and aggressively elsewhere.

In teams' first 30 games this year, there were 26 saves of four outs or more, not counting three-plus-inning saves. (Those usually come in blowouts, when a mop-up pitcher finishes the final three innings or more with a huge lead.) That's the most at this point in the season this decade -- as many as there were in the first 30 days of 2012, 2013 and 2014 combined. It's only a modest jump from last year, which was only a modest jump from the year before, which was only a modest jump from 2016, but put all of those modest jumps together and it starts to add up. The Brewers' Josh Hader is the pacesetter here -- he has three saves of two or more innings -- but 19 different pitchers on 17 different teams have at least one of these extended saves.

It is definitely too early to overreact. Most teams are still using a traditional closer, and most traditional closers are still pitching in the limited way closers do: Of the closers who've held their jobs all season long, about half have never pitched before the ninth inning this year. Ninety percent of saves have been three outs or fewer. And there is arguably nobody in baseball being used in the extreme (and extremely successful) way Hader was used last year, or Andrew Miller was in 2016 and 2017 -- part closer, part multi-inning fireman available from the fifth inning on. But there are signs that this time, maybe, some of these teams that pledged this spring to try something different in the ninth inning really meant it.

The state of bullpenning and opening

There have been 23 games this year in which the starting pitcher went no more than three innings, threw no more than 50 pitches, and allowed no more than three runs. That's a decent set of filters to identify most bullpen games -- games in which a team started a pitcher with no intention of letting him work past an inning or two. About eight of those 23 games just had starters who got injured. So we have about 15 bullpen games this year.

Fifteen, is that a lot? One answer is, relatively speaking, yes. At this point last year, there had been two. (The Rays didn't debut the opener until mid-May.) In most years before that, there were essentially none. So 15 is a lot more than that.

But it's only 15 games, out of more than 1,000 games started. Nine of the 15 have been by the Rays, and of the other 29 teams only the Angels (with three of these games) have seemed interested in using the strategy regularly for even a single spot in the rotation this year.

An update on 'Relievers Are Bad'

A few weeks into the season, we noted that relievers were collectively pitching worse than starters, an unexpected twist. Since modern relief usage really took off in the late 1980s, there has never been a season in which relievers allowed a higher ERA than starters, and only one in which relievers' ERA wasn't at least 5 percent lower. At the time, relievers' ERA in 2019 was 3 percent higher than starters'.

That was early. It's still early, but less early. Relievers still have a worse ERA than starters, by about 1.6 percent. That's less weird than it used to be, but still weird. A record 381 pitchers made at least one relief appearance in the first 30 games of this season, up from 350 last year.

April's best reliever you'd never heard of

Miami's Nick Anderson is 28, had never pitched in the majors before this year, and was traded by the Twins to the Marlins (for a minor leaguer) in November. He was a 32nd-round pick who spent three years in the independent Frontier League, twice with ERAs over 6.00.

In March and April this year, he faced 51 major league batters and struck out 27 of them. He issued two intentional walks, but no unintentional walks: 27 strikeouts and no unintentional walks, in 13 innings. He had a 2.08 ERA.

He allowed five runs in his first outing in May.

The wildest ongoing reliever storyline

The Blue Jays' Elvis Luciano turned 19 in spring training this year and skipped four levels of the minor leagues to make his big league debut. He's on the team only because of, essentially, a loophole in the Rule 5 draft that made him available to any team that would commit to keeping him in the majors all season.

The Blue Jays are trying to make that happen, and even if it's probably a disaster waiting to happen they haven't completely buried him at the end of the bench: Luciano has appeared 11 times and thrown 15 innings. He has walked 14 batters in those innings. He also has a 4.20 ERA, better than the league-average reliever.

The Blue Jays still have him.

Cognitive behavioural therapist Lauren Povey outlines some techniques you can use to stop negative thoughts affecting your performance

The feelings of anxiety, stress and worry you experience before you compete can be caused and worsened by dysfunctional and ingrained thoughts you can have about yourself or the situation.

The negative thoughts and beliefs you hold such as, “I’m not sure I’m as good as my opponents” or “it’ll be embarrassing when I fall or get hurt”, can have an impact on the choices you make during competition. These thoughts can even have an effect on the future you have as an athlete.

Cognitive behavioural therapy (CBT) is a widely used treatment for anxiety and stress. It can help a person become aware of their unhelpful thought patterns and understand the entrenched beliefs that are causing them to think and feel this way. For athletes, it gives you the opportunity to respond differently to stress triggers, such as upcoming competitions.

How does CBT work?

CBT works to address and interrupt any negative thought patterns you have while giving you the opportunity to learn new ways of thinking.

You spend time monitoring your daily thoughts, feelings and behaviour, taking notice of any particular patterns and pinpointing any that are unhelpful, unrealistic and impacting on how you perform. You then work on changing these thought patterns through different strategies that allow you to replace negative thoughts with positive ones.

Typically, CBT is carried out in one-to-one sessions with a therapist. As a CBT therapist, I treat people with anxiety at Priory Hospital Chelmsford and I’ll now outline some of the different techniques that you can use.

Monitoring and replacing negative thoughts

After training or competition, make a long list of any negative thoughts that you had. Maybe you thought “I’m so slow, I can’t keep up with any of the other athletes.”

Carefully reflect on why this thought is unhelpful and what will happen if you continue to think that way, and jot these unwanted outcomes down. Will you perform at a lower standard or will it cause you to lose faith in yourself and the sport?

Then, challenge the initial thought you had in order to demonstrate to yourself that it’s unrealistic. You know your level of skill and the amount of experience you have. You also know everything is relative – some people will be faster than you and some people will be slower.

Next, in response to your initial negative thoughts, write down a more positive one you could have had instead. If you thought you wouldn’t be able to keep up with the others, you could write down “I’m glad I have the opportunity to hone my skills around such good athletes” or “I will make sure I learn a lot from these athletes”. Rather than impacting on your self-esteem like the negative thought, the reframed thought will give you motivation and spur you on to perform well.

Like anything this technique will take practice. But as you do it more and more, you will notice that it starts to come naturally in moments that have previously caused you to feel stressed or anxious.

Visualising success instead of failure

In the lead-up to a training session or performance visualise the achievement that you want. This will act as a non-verbal instruction, training your body to act confidently in moments when you otherwise would have been nervous.

By spending time visualising success as opposed to failure, you work to build up your experience and confidence, which in turn can put a stop to you worrying about possible things that could go wrong.

Positive self-talk rather than negative inner dialogue

When you’re training or competing and someone performs better than you, do you spur yourself on or shoot yourself down? If your inner dialogue tells you that you can’t do something, that something will go wrong, or that it is too hard, work on swapping this for positive self-talk.

Have a category of phrases you can use in different phases of the performance. If you find yourself indulging in negative self-talk before you perform or compete, work on swapping thoughts such as “this will be too hard” for something positive and importantly believable like “work hard” or “I can do this” to focus and motivate you.

If you slip into negative self-talk during the performance or competition and start thinking, for example, “I can’t push any harder”, practice a simple mantra such as “go, go, go” to inspire yourself as opposed to clouding yourself with self-doubt. Also have instructional self-talk available for moments you are concerned about, such as “focus on your feet” or “light, soft, relax”.

Positive self-talk should also continue after you have finished. Don’t instantly become critical – instead take time to praise yourself for any achievements you made. Even if things didn’t quite go to plan, take the time to review and to remember that any small step you make is progress. Again, over time and with repetition, this can become a habit that sticks, which will help to improve your self-esteem, motivation and energy.

It is important to note that if your feelings of worry, anxiety or stress are persisting, worsening, or are having an impact on
your day-to-day life, you should seek help from a medical professional. They will be able to offer advice on the best course of action and determine if you need any further professional treatment.

British number one Johanna Konta went out of the Madrid Open in the second round, losing to Romanian world number three Simona Halep.

Two-time Madrid champion Halep, 27, wrapped up a 7-5 6-1 win in one hour and 30 minutes.

On Sunday, world number 47 Konta, 27, lost the Morocco Open title to Maria Sakkari in her first final on clay.

Halep, who won the Madrid title in 2016 and 2017, will play Slovakia's Viktoria Kuzmova in the third round.

"I feel like I started playing at a really good level," Konta told BBC Sport.

"I thought I found my footing reasonably quickly. As you would expect playing against someone like Simona, she's going to rally back and what she does incredibly well is compete and really work her way into the points.

"I definitely created chances in that first set - unfortunately I couldn't capitalise. And then I think I just ran out of a little bit of steam there in the second set."

Konta was the first to go up a break, leading 2-1 before easing through two service games to take a 4-2 lead.

She found herself at break point to reach 5-2 but Halep managed to hold serve, going on to break Konta to level the scores.

At 5-5, Halep withstood three break points and when leading 6-5, managed to wrap up the set on her fifth set point.

The French Open champion asserted her dominance in the second set, allowing Konta only two points in the first four games.

Konta broke her opponent's serve to get a game on the board, but Halep broke back immediately before serving out the match.

Former British number one Andy Murray has been offered a wildcard to play at Queen's Club next month and will decide "nearer the time" if he will take it.

The three-time Grand Slam champion, 31, had hip surgery in January.

Murray said in March he was pain-free but rated his chances of playing in the Wimbledon singles at "less than 50%" and has not played competitively since.

The Fever-Tree Championships at Queen's in London will start on Monday, 17 June - two weeks before Wimbledon begins.

Current British top two Kyle Edmund and Cameron Norrie will feature at the tournament, as will last year's beaten Wimbledon and US Open finalists Kevin Anderson and Juan Martin del Potro.

Defending champion Marin Cilic, three-time Grand Slam winner Stan Wawrinka, Australian Nick Kyrgios and former Wimbledon finalist Milos Raonic are also named on the entry list.

A wildcard is being held in reserve for five-time winner Murray, who Queen's say will let tournament director Stephen Farrow know nearer the time of the event if he is fit enough to play.

Murray broke down in tears at the Australian Open in January, saying in his pre-tournament news conference that he planned to retire after this year's Wimbledon because of pain in his hip.

However, he said the first Grand Slam of 2019 could prove to be the last tournament of his career.

After a gutsy first-round five-set defeat by Spain's Roberto Bautista Agut, Murray appeared to soften his stance by telling the Melbourne crowd he hoped to see them again next year.

In his post-match news conference, he said he was considering the resurfacing operation primarily to improve his quality of life.

Murray had the hip resurfacing operation - which keeps more of the damaged bone than a hip replacement, smoothing the ball down and covering it with a metal cap - in London on 28 January.

American doubles player Bob Bryan had the same surgery last year and returned to action, alongside twin brother Mike, five months later. No tennis player has competed in singles after having the operation.

Should Murray compete, it will be the first time since 2006 that Britain has had three direct entrants at Queen's.

BBC Sport will have live coverage from the west London club across television, radio and online.

Referees Nigel Owens and Wayne Barnes have been selected to officiate at their fourth Rugby World Cup.

Welshman Owens, 47, took charge of the 2015 final between New Zealand and Australia at Twickenham.

Barnes, 40, is joined by fellow English referee Luke Pearce, who will be appearing in his first tournament.

Four Frenchmen have been selected among the 12-strong group of referees while the host nation Japan has just one assistant referee, Shuhei Kubo.

England-based Matthew Carley and Karl Dickson have been selected as assistant referees along with Ireland RFU official Andrew Brace.

Owens and Barnes will match the achievement of Welsh referee Derek Bevan to officiate at four World Cups.

"I am very excited and honoured to be doing another World Cup, a tournament which is the pinnacle of everybody associated with rugby," said Owens.

"It is my fourth World Cup and in all probability it will be my last as a referee.

"It is something special as well with it being staged in Japan and it will be the first one in Asia."

Referees: Wayne Barnes (England), Luke Pearce (England), Jérôme Garcès (France), Romain Poite (France), Pascal Gauzere (France), Mathieu Raynal (France), Nigel Owens (Wales), Jaco Peyper (South Africa), Ben O'Keeffe (New Zealand), Paul Williams (New Zealand), Nic Berry (Australia) and Angus Gardner (Australia).

Assistant referees: Matthew Carley (England, reserve referee), Karl Dickson (England), Andrew Brace (Ireland), Brendon Pickerill (New Zealand), Federico Anselmi (Argentina), Shuhei Kubo (Japan) and Alex Ruiz (France).

TMOs: Graham Hughes (England), Rowan Kitt (England), Ben Skeen (New Zealand) and Marius Jonker (South Africa).