Psychological Factors and Sport Injuries: What Can a Sport and Performance Professional Do? Part 1
Psychological Factors and Sport Injuries: What Can a Sport and Performance Professional Do? Part 1
This blog post introduces an example of a female-identifying athlete with an anterior cruciate ligament (ACL) injury to help demonstrate the nuance required of a sport and performance professional (SPP) to help an injured athlete. Yes, there is a lot required! Together we will discuss the psychosocial factors influencing injury, the role of an SPP in prevention, and use an example athlete to discuss assessment. Let’s dive into Part 1. Part 2 will take us through the example after some time to absorb what is shared in this post.
Psychosocial Factors of Injury and Prevention
When looking at the topic of injuries and injury prevention and rehabilitation, much must be attended to to provide the best care to an athlete. Sport injury risk is multifactorial, and any prevention program must account for this nature (Gledhill et al., 2018). Furthermore, from the perspective of sports medicine and injury prevention, contemporary views offer that sports injuries are complex (Bolling et al., 2018). No matter the field, sport injury is not simple. Instead, several factors must be accounted for when delving into prevention and rehabilitation. While this post cannot address every potential factor, it is vital to acknowledge that there are several factors and that interplay and context must be included in the thought process.
Focusing specifically on the psychosocial aspects, there are a few factors to consider and a model that may help guide a prevention program or interventions. Psychosocial factors may include attention disturbance, arousal levels, anxiety, stress, daily hassles, and negative life events, which have all been demonstrated as predictive of sports injuries; however, psychological interventions have been shown to lessen the impact (Gledhill et al., 2018). The context must be remembered, which is where models become helpful. Williams and Andersen (1988) introduced a model that divides the risk factors for injury into three main categories: personality factors, history of stressors, and coping resources. These risk factors intersect with the stress response, which can be divided into cognitive appraisals (aka the mental thoughts) and physiological/attentional changes (aka how the body responds) in the model, which is where interventions may be targeted.
For an SPP to help an athlete prevent injury, interventions need to be targeted and explicitly focused on that athlete based on their unique personality, coping resources, and with knowledge of their history around stress. To begin to help with injury prevention, an SPP may find it helpful to obtain an injury history, learn more about current and past stressors, and assess coping skills. Then based on the assessments, an SPP can weave in appropriate strategies like anxiety management skills or stress reduction activities like yoga, and progressive muscle relaxation, if the athlete desires. Other options include goal setting, visualization, or self-confidence work. Many of these concepts and factors can be woven to address more than one injury prevention, such as performance, so as other potential issues are being addressed, injury prevention can be part of the plan from day one. One additional consideration is, that depending on the athlete and their past stressors, a mental health professional may be necessary if there is unresolved trauma.
A Band Aid on a person’s arm with their other hand holding the arm below the Band Aid.
take action today moment:
Whether you are an athlete or an SPP yourself, how do you understand the level of complexity around the psychological factors of sport injury? Do you agree or not agree? What factors might you as an athlete be dealing with if you are injured? What skills do you already have that have helped you thus and what skills would you like to have? If you are an SPP, how do you know when it is time to refer to a mental health professional? For anybody reading this post, how could some of these psychological factors be made more culturally relevant? All of these models come from a Western perspective. Take a few moments to journal and see what comes to you.
Learn More About psychological factors and sport injury:
50 Years of Research on the Psychology of Sport Injury: A Consensus Statement (Yes, another research article, but can just read the key points)
Not just a physical thing: The psychology of sports injuries and recovery
References
Andersen, M. B., & Williams, J. M. (1988). A model of stress and athletic injury: Prediction and prevention. Journal of Sport and Exercise Psychology, 10(3), 294-306. https://doi.org/10.1123/jsep.10.3.294
Bolling, C., Van Mechelen, W., Pasman, H. R., & Verhagen, E. (2018). Context matters: Revisiting the first step of the ‘sequence of prevention’of sports injuries. Sports Medicine, 48(10), 2227-2234.
Evans, L., Wadey, R., Hanton, S., & Mitchell, I. (2012). Stressors experienced by injured athletes. Journal of Sports Sciences, 30(9), 917-927. https://doi.org/10.1080/02640414.2012.682078
Gennarelli, S. M., Brown, S. M., & Mulcahey, M. K. (2020). Psychosocial interventions help facilitate recovery following musculoskeletal sports injuries: A systematic review. The Physician and Sportsmedicine, 48(4), 370-377. https://doi.org/10.1080/00913847.2020.1744486
Gledhill, A., Forsdyke, D., & Murray, E. (2018). Psychological interventions used to reduce sports injuries: A systematic review of real-world effectiveness. British Journal of Sports Medicine, 52(15), 967-971.
Goddard, K., Roberts, C. M., Byron-Daniel, J., & Woodford, L. (2021). Psychological factors involved in adherence to sport injury rehabilitation: A systematic review. International Review of Sport and Exercise Psychology, 14(1), 51-73. https://doi.org/10.1080/1750984X.2020.1744179
Hooi, L. B., & Wah, T. E. (2018). Injured athletes and a new invention of relaxation techniques. International Research Journal of Pharmacy and Medical Sciences, 1(4), 78-81.
Petushek, E. J., Sugimoto, D., Stoolmiller, M., Smith, G., & Myer, G. D. (2019). Evidence-based best-practice guidelines for preventing anterior cruciate ligament injuries in young female athletes: A systematic review and meta-analysis. The American Journal of Sports Medicine, 47(7), 1744-1753. https://doi.org/10.1177/0363546518782460
Wolfelt, A. (2006). Companioning the bereaved: A soulful guide for caregivers. Companion Press.