The Psychology of Sports Injury

From Risk to Retirement

Adam Gledhill, Dale Forsdyke, Adam Gledhill, Dale Forsdyke

• Publisher: Routledge
• Year: 2021
• ISBN:
  9780429671586
• Edition: 1
• Topic: Medicine
• Subtopic: Physiotherapy, Physical Medicine & Rehabilitation

The Psychology of Sports Injury: From Risk to Retirement provides a critical overview of the psychology of sports injury, covering the 5Rs of sports injury: risk, response, rehabilitation, return to sport and retirement.

Drawing on a range of expert international perspectives from the fields of sport psychology and sport and exercise medicine, The Psychology of Sports Injury covers the psychological considerations associated with sports injuries, prior to the onset of injury through to supporting athletes with post-injury retirement. In addition to this injury lifespan perspective, the book features special interest topics including anterior cruciate ligament injury, sport-related concussion, spinal cord injury and the role of coaches in achieving athlete and team medical outcomes. Additionally, case studies provide the opportunity to apply learning from each chapter.

By covering the sports injury journey from risk factors to retirement and including athlete mental health during sports injury, The Psychology of Sports Injury is an essential text for students, instructors, and practitioners in sports psychology, sport and exercise medicine and other related fields.

Part I THE ROLE OF PSYCHOLOGY IN SPORTS INJURY RISK AND INJURY RISK REDUCTION

As the old adage goes: ‘An ounce of prevention is worth a pound of cure’. This really provides the essence of this first section of the book.

Sports injury, particularly severe or recurrent sports injury, can have serious and long-term health effects for athletes (Putukian, 2016) and are the leading cause of retirement for top level athletes (Ristolainen et al., 2012). Increased occurrence of injury is associated with less successful performance on the pitch, with fewer competitions won by team who have more injuries (Hägglund, et al., 2013). Injuries also have significant impact off the pitch, with injuries estimated to cost of £45 million per season in the English Premier League (Eliakim et al., 2020). Consequently, injury practitioners and sports organization more broadly have a duty of care to their athletes, their profession and their employers to be doing everything possible to reduce the burden of injury (Gledhill & Forsdyke, 2018).

Given the awareness of psychological risk factors for sports injury (e.g. Ivarsson et al., 2017), as well as the increasingly accepted role of psychologically informed interventions in reducing sports injury risk (e.g. Ivarsson et al., 2017), it would be remiss of us to have started this book with anything other than chapters devoted to the role of psychology within injury risk and risk reduction.

Throughout this section, Urban Johnson and Andreas Ivarsson will guide you through the established and emerging areas of research within this body of knowledge. Urban’s chapter will provide a theoretical and applied overview of the major psychological risk factors within sports injury. It considers the most established model of sports injury risk, the model of stress and athletic injury (Williams & Andersen, 1998), as well as examining more contemporary approaches such as the biopsychosocial model of athletic injury and health (Appaneal & Perna, 2014). As an important contribution, Urban’s chapter will consider various psychobiological, psychosocial and neurocognitive explanations behind sports injury risk.

Following Urban’s introduction, Andreas Ivarsson will walk you through the body of research into the role of psychological intervention within sports injury prevention. Andreas argues throughout the chapter that injury prevention is indeed better than injury rehabilitation, wherever possible. Let’s be frank here: even the leading authorities on sports injury prevention argue that preventing injury in sport is nigh impossible; however we do have a responsibility to reduce injury risk using clinically meaningful methods (Ivarsson et al., 2017). Given that sport psychology as an injury prevention tool is relatively under-utilized in professional sport and the reasons behind this often relate to sports medicine practitioners’ uncertainty over the efficacy or effectiveness of the different approaches (Gledhill et al., 2018), Andreas’ practical evidence-informed approach to the chapter will support an increased awareness in this area.

References

• Appaneal, R. & Perna, F. (2014). Biopsychosocial model of injury. In R. Eklund & G. Tenenbaum (Eds.), Encyclopedia of sport and exercise psychology (pp. 74–76). Thousand Oaks: SAGE Publications.
• Eliakim, E., Morgulev, E., Lidor, R., & Meckel, Y. (2020). Estimation of injury costs: Financial damage of English Premier League teams’ underachievement due to injuries. BMJ Open Sport & Exercise Medicine. DOI: 10.1136/bmjsem-2019-000675.
• Gledhill, A., & Forsdyke, D. (2018). An ounce of prevention is better than a pound of cure: Shouldn’t we be doing EVERYTHING to reduce sports injury incidence and burden? British Journal of Sports Medicine, 52, 1292–1293.
• 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, 967–971.
• Hägglund, M., Waldén, M., Magnusson, H., Kristenson, K., Bengtsson, H., & Ekstrand, J. (2013). Injuries affect team performance negatively in professional football: An 11-year follow-up of the UEFA Champions League injury study British Journal of Sports Medicine, 47, 738–742.
• Ivarsson, A., Johnson, U., Andersen, M. B., Tranaeus, U., Stenling, A., & Lindwall, M. (2017). Psychosocial factors and sports injuries: Meta-analyses for prediction and prevention. Sports Medicine, 47, 353–365.
• Putukian, M. (2016). The psychological response to injury in student athletes: A narrative review with a focus on mental health. British Journal of Sports Medicine, 50, 145–148.
• Ristolainen, L., Ketunen, J. K., Kujala, U. M., & Heinonen, A. (2012). Sports injuries as the main cause of sports career termination among Finnish top-level athletes. European Journal of Sport Science, 12, 274–282.
• Williams, J., & Andersen, M. (1998) Psychosocial antecedents of sport injury: Review and critique of the stress and injury model. Journal of Applied Sport Psychology, 10(1), 5–25.

1THE INJURY-PRONE ATHLETE

PSYCHOSOCIAL RISK FACTORS IN SPORTS INJURY

Professor Urban Johnson

INTRODUCTION

Participation in competitive sports is associated with high physiological, biomechanical and psychological demands. Difficulties in coping with these types of demand are related to increased risks of becoming injured (see e.g. Soligard et al., 2016). Sport injuries are ubiquitous and represent substantial economic, health, personal and community costs. In Europe approximately 4.5 million athletes are annually treated for sport injuries (Kisser & Bauer, 2010). Severe sport injuries are related to negative emotional responses, such as sadness, anger and depression (Wiese-Bjornstal, 2010), and decreased psychological and physiological well-being (Putukian, 2016). Moreover, recent research has conceptualized some sport injuries as career-changing events that can have substantial impact on athletes’ careers and trajectories (e.g. Ivarsson et al., 2016). With the high rates of injury within sport, together with the negative consequences that may follow, it seems warranted as a first step, to identify psychosocial risk factors that might increase the risk of becoming injured, but also to suggest applied strategies to decrease injury risk in sport.

At the start of this chapter, I initially present some models focusing on psychological risk factors in sports injury, with a special attention on the model of stress and athletic injury (Williams & Andersen, 1998), but also more contemporary models. A literature review of some of the more characteristic psychosocial risk factors in sport follows after the presentation of the models, with a focus on traditional risk factors such as personality, history of stressors and coping resources. Attention will also be paid to less researched areas including psychological risk factors and overuse injuries, risk factors among younger athletes but also psychological perspectives of the injury-prone athlete. Suggestions for applied recommendations as well as future research directions are provided. In addition, a case study, built on the core of the literature review, will be presented followed by questions derived from the chapter.

THE MODEL OF STRESS AND ATHLETIC INJURY

The model of stress and athletic injury is probably the most cited model in the area of psychology and injury prediction/injury prevention (Johnson & Ivarsson, 2017). According to the model, injury risk may be influenced by the athlete’s stress responses that are suggested to have a bidirectional relationship with the athlete’s appraisal of a potential stressful situation (e.g. game, competition) (see Figure 1.1). Both the magnitude of the stress reaction and the athlete’s appraisal of the situation are suggested to be influenced by the interplay between various psychosocial factors, which are divided into three categories: personality factors, history of stressors and coping resources. In the early version of the model, Andersen and Williams (1988) suggested that only the history-of-stressors variable directly influenced the stress response, whereas both personality and coping variables had an indirect effect on stress responses through history of stressors. Ten years later, however, they argued that an athlete’s history of stressors could influence the development of both an athlete’s traits and coping mechanisms and, therefore, placed bidirectional arrows between the three psychosocial categories (Williams & Andersen, 1998). Also,...