The Psychology of Sport Injury and Rehabilitation

Monna Arvinen-Barrow, Monna Arvinen-Barrow, Natalie Walker

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135906207
• Edition: 1
• Topic: Medicine
• Subtopic: Sports Medicine

Athletes routinely use psychological skills and interventions for performance enhancement but, perhaps surprisingly, not always to assist in recovery from injury. This book demonstrates the ways in which athletes and practitioners can transfer psychological skills to an injury and rehabilitation setting, to enhance recovery and the well-being of the athlete.

Drawing on the very latest research in sport and exercise psychology, this book explores key psychological concepts relating to injury, explaining typical psychological responses to injury and psychological aspects of rehabilitation. Using case studies in every chapter to highlight the day-to-day reality of working with injured athletes, it introduces a series of practical interventions, skills and techniques, underpinned by an evidence-base, with a full explanation of how each might affect an athlete's recovery from injury.

The Psychology of Sport Injury and Rehabilitation emphasises the importance of an holistic, multi-disciplinary approach to sports injury and rehabilitation. No other book examines the psychological aspects of both sports injury and the rehabilitation process, and therefore this is an essential resource for students, scholars and practitioners working in sport psychology, sports therapy, sports medicine or coaching.

Part 1 Introduction to the psychology of sport injuries: theoretical frameworks

DOI: 10.4324/9780203552407-1

1 Introduction To The Psychology Of Sport Injuries

Monna Arvinen-Barrow and Natalie Walker

DOI: 10.4324/9780203552407-2

In society today, sport can form an important part of the ways in which an individual identifies themselves, how they interact with one another and reflect on their position amongst those around them. According to the Council of Europe (2001), the term sport refers to ‘all forms of physical activity which, through casual or organised participation, aim at expressing or improving physical fitness and mental well-being, forming social relationships or obtaining results in competition at all levels’. At its best, sport can provide opportunities for physical, psychological and economic growth, and be a vehicle for providing exciting, challenging, rewarding and memorable experiences for all those involved. Despite such positive benefits, unfortunately some experiences gained through sport are in fact the opposite (Brown, 2005). Involvement in sport frequently places the participants under immense physical and psychological pressure and stress, which in turn amplifies the likelihood of negative outcomes, such as injuries. Although injuries are an experience that athletes are trying to avoid (Pargman, 1999), virtually all athletes will experience an injury that can temporarily (or permanently) impede any subsequent sport participation (Taylor and Taylor, 1997). In fact, Brown (2005) argues that ‘serious athletes come in two varieties: those who have been injured, and those who have not been injured yet’.

Such a claim is supported in the literature. For example, in Australia, it has been estimated that 20 per cent of all child/adolescent and 18 per cent of adult hospital accident and emergency room consultations were sport injury related (Finch,Valuri and Ozanne-Smith, 1998). In 2002, approximately 20.3 million Americans suffered a sport injury, of which half required medical attention (Conn, Annest and Gilchrist, 2003). In the UK, it has been estimated that nearly 30 million sportrelated injuries occur every year (Nicholl, Coleman and Williams, 1995), accounting for nearly 33 per cent of all injuries nationwide (Uitenbroek, 1996). More recently, in Finland, it was found that amongst adolescent male and female athletes involved in association football, ice hockey, basketball, cross-country skiing, figure skating, gymnastics and athletics, 50.4 per cent of all that responded reported having suffered sport-related injuries in the past 12 months (Konttinen, Mononen, Pihlaja, Sipari, Arvinen-Barrow and Selänne, 2011).

With the aid of advanced medical knowledge and technology, most injured athletes have the potential for full recovery to their pre-injury (or in some cases higher) level of fitness and performance. However, numerous athletes fail to recover back to their pre-injury level of play (Taylor and Taylor, 1997) and often this failure is attributable to psychological factors. It has been highlighted that psychological factors can influence injury onset and can also determine the extent to which an athlete is able to cope successfully with injury and its subsequent rehabilitation (see, for example, Arvinen-Barrow, Hemmings, Weigand, Becker andBooth, 2007; Clement, Granquist and Arvinen-Barrow, 2013; Heaney, 2006; Hemmings and Povey, 2002; Larson, Starkey and Zaichkowsky, 1996). Furthermore, research has also found links between sport injuries and reduced levels of self-esteem, loss of personal identity, anxiety (for example, pre-injury anxiety; Walker, 2006), depression and, on occasions, feelings of isolation (Leddy, Lambert and Ogles, 1994; Petitpas and Danish, 1995).

Drawing from existing sport injury literature, it is apparent that both physical and psychological factors can have a significant impact on sport injury susceptibility, injury occurrence, cognitive appraisals of injury, emotional and behavioural responses to the injury, the overall injury recovery outcomes and the return to sport (see, for example, Ievleva and Orlick, 1991; McDonald and Hardy, 1990; Wiese-Bjornstal, Smith, Shaffer and Morrey, 1998). It has also been suggested that the use of psychological interventions can be beneficial in the context of sport injuries as they have the potential to: (a) reduce athletes injury susceptibility (Williams and Andersen, 1998), (b) facilitate injury recovery (Ievleva and Orlick, 1991), (c) provide a sense of control over the rehabilitation process subsequently enhancing motivation and rehabilitation adherence (Flint, 1998), and (d) increase communication between the athlete and the medical professional working with the athlete (Ray and Wiese-Bjornstal, 1999). These can facilitate injured athletes‘ greater understanding of the injury, the injury process and possible recovery outcomes (Heaney, 2006; Hemmings and Povey, 2002). A greater understanding of the injury can also affect treatment compliance, which is also believed to have an effect on athletes’ coping skills and injury recovery (see, for example, Arvinen-Barrow et al., 2007; Hemmings and Povey, 2002). Moreover, athletes who engage in psychological interventions which enable them to perceive themselves as active agents in their recovery are more likely to have better physical recovery outcomes (Durso-Cupal, 1996).

The most popular and prominent psychological interventions used in sport today are goal setting, imagery, relaxation training and positive self-talk (Brown, 2005; Vealey, 1988). Encouraging and employing the use of social support has also been identified as important and beneficial for injured athletes (Brown, 2005; Heil, 1993). However, despite the widely accepted view that all of the above psychological interventions are extremely useful in assisting athletes to achieve performance gains, they are often underused in sport injury prevention and rehabilitation by both the injured athlete and the medical professionals alike (see, for example, Arvinen-Barrow, Penny, Hemmings and Corr, 2010).

Such underuse could be attributable to number of reasons. Firstly, it has been proposed that both athletes and sport medicine professionals working with injured athletes may be unable to transfer existing skills from performance enhancement settings to the injury rehabilitation context. Secondly, those working with injured athletes may possess limited knowledge on how to use psychological interventions during injury rehabilitation, as it appears that only a few professionals have been extensively trained to use such skills during sport injury rehabilitation. For example, in the UK, physiotherapy educators profess to deliver their psychology content through an integrated approach, with a view that this approach would lead to a more applied understanding of the topic. However, there is often a disparity between knowledge of the subject and the ability to apply this knowledge to benefit individuals (Heaney, Green, Rostron and Walker, 2012).Thirdly, it may be that psychological interventions are underused simply because of lack of adequate understanding of how psychological interventions can be integrated seamlessly into physical rehabilitation. As such, the principle aim of this book is to demonstrate ways in which psychology plays a role in the sport injury process and how psychological interventions can be used in sport injury rehabilitation. After all, by attending to the psychological needs of the athlete, the practitioners working with injured athletes are treating the whole person, and not just the injury, and thus offering a more holistic approach to recovery.

References

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