SCOTTSDALE, Ariz. — Not long after Amy Van Dyken-Rouen had surgery for a life-threatening spine injury, while she still wasn't completely out of danger, her husband placed a cellphone in her hands.
The decorated Olympic swimmer had always enjoyed sharing her life and thoughts on social media, so Tom Rouen figured it might do her some good when she awoke.
It worked more than he could have imagined, providing Amy a therapeutic tool as she makes the transition from elite athlete to possibly spending the rest of her life in a wheelchair.
"She sends stuff out there and gets so much positive energy and positive feedback that I really think it helps her a whole lot," said Rouen, a former punter for the Denver Broncos. "It's also been good to be able to have a distraction with everything that's going on."
Before the advent of social media, information on athletes had to be disseminated: Through agents, teams or hospital representatives, interviews with the media, carefully worded statements by teams of publicists.
Now, athletes provide updates freely and instantaneously with a few keystrokes on their phones or computers.
Being unfiltered doesn't always go so well.
Dallas Mavericks owner Mark Cuban was fined $50,000 by the NBA for criticizing officials on Twitter and numerous athletes were chastised for some of their negative posts at the 2012 London Olympics.
Miami Dolphins safety Don Jones and former Mississippi basketball player Marshall Henderson also took some heat this year for tweets critical of Michael Sam, the first openly gay player drafted in the NFL.
Social media can have a positive impact, however, when athletes use it to express their personalities more fully, give fans a window into their lives and have a personalized interaction with them.
"We do get to see them as real people living their lives," said Kelli Burns, associate professor for the school of mass communications at the University of South Florida. "It may make her fans feel like they're right there with them and seeing a lot of what's happening. People are interested in knowing more about a celebrity than just their professional accomplishments."
Social media have become a conduit of information in an area that was once taboo: Athletes' health.
Teams still try to hide players' injuries like they're guarding state secrets, but now the athletes are freely providing information on their own.
Kobe Bryant, Alex Rodriguez, Bryce Harper and Mark Teixeira are among the athletes who have posted updates on their surgeries or rehabilitation.
Most of the posts are superficial.
Van Dyken-Rouen seems to have taken it to a new, open-book level.
The six-time Olympic gold medalist was involved in an all-terrain vehicle accident on June 6, severing her spine and leaving her with no feeling in her legs.
A day after surgery, Van Dyken-Rouen posted photos on Instagram of her family in the hospital room and a drawing from her niece and nephew.
The next day, she posted a selfie in her hospital bed and later put up a shot of her sitting up for the first time. She even posted images of her X-rays; one showing her dislocated vertebrae, another of the pins and rods holding her spine together after surgery.
Van Dyken-Rouen continued to be active on social media throughout her stay in intensive care and after she moved to a Colorado hospital to continue rehab.
The striking part about Van Dyken-Rouen's posts are they're just as open, positive and sarcastic as before her injury:
— Just thinking out loud..Now I will get really good seats at @dbacks and other favorite sports teams. #awesome #bringMyOwnChair #goodParking2
— Was in MRI until 4:00am today (started at 11:30pm) did whole spine and brain, and so far, so good. Yes, I have a brain! LOL #BabySteps
— Happy Friday! No more surgeries for this girl, so I celebrate with Froot Loops... SHHH, don't tell!.
— Well this is about a week late for me (with a photo of a TV story about national ATV safety week).
"She's doing it in such a positive and upbeat way, it's almost breathtaking how inspiring it is," said William Ward, professor of social media at Newhouse School at Syracuse University.
"I don't know if most people are that upbeat on any given day much less after going through something that traumatic, but here she within days of it is talking and interacting, really doing it in an upbeat way, inspiring people."
It's been a two-way street.
Before social media, well wishes came in the form of notes and cards, maybe signs outside the hospital.
Now, athletes and celebrities not only get instant messages from their family and friends, they can interact with them, adding another layer to their therapy.
"It's blowing me away. It truly is," Van Dyken-Rouen said before boarding a medical flight to Colorado last week. "I've gotten a lot of messages sending me thoughts, prayers, positive vibes. I feel them. It's helping me and I just want to say thank you to everyone."
And she has — on social media of course.