How Can We Decrease The Increasing Injury Risk which Accompanies Stressors?

Competitive sport demands athletes to display not only a large amount of physical but also psychological skills to handle the stressful situations they face[1]. So how can we decrease an athlete’s risk of injury and ensure they are psychologically prepared for stressful situations?

Until recent years research on improving our skills to predict sports injury has mainly focused on physiological and training factors[2], however in recent years more studies have focused on studying the psychological factors that impact injury susceptibility[3].

Injury to an athlete can occur when stressors not related to the task at hand interrupt their focus, this is due to the athlete missing important play cues or not being aware of what’s happening in their peripheral[4]. Disruption to focus can also be joined by increased muscle tension, which can interfere with normal coordination, increasing the risk for injury[5].

Williams and Andersen’s (1998) “stress injury model” is the most widely referenced stress injury model and it states that injury risk may be increased by various psychosocial factors that may cross over. Their model suggests that these factors may potentially influence the athlete’s ability to manage a stressful situation such as a game or competition and they have divided them into three categories;

  • Personality factors
  • History of stressors
  • Coping resources[6]

They argue that an athlete that is/has experiencing/experienced a greater amount of life stressors will hold personality traits that increase susceptibility to stress and manifest for example as anxiety. Also suggested is that an athlete with poorly developed coping resources will view more situations as threatening which in turn will increase muscle tension, impair peripheral view and hence increase risk of injury.

Encouraging players to take part in ‘lifestyle interventions’ such as Mindfulness based stress reduction (MSBR) could be an extremely useful tool for coaches to implement[7]. MSBR is a highly structured 8-week program, which involves 1 class per week and daily 45 minutes personal meditation. At the end of the sixth week there is also a full retreat day of silent meditation. MSBR has been used with elite athletes to improve concentration, performance and recovery, which could decrease an athlete’s injury risk[8]. Athletes could undertake this program during the off-season or directly after a seasons end to aid in psychological health and self-knowledge.

This type of lifestyle intervention could provide education for athletes as to how to ‘tweak’ their psychological state and in turn reduce injury risk, however, ensuring athletes complete each task of the full 8 week program could be hard to manage and motivating professional footballers to get in touch with their inner vulnerabilities could be a hard task.

Coaches and sporting organisations could also put in place offers of support to players in the way of team psychologists to assist with educating the players on coping strategies to combat the ill effects of stressful situations that may arise in their life.[9] Having a sports psychologist on hand for players to discuss their issues, although an extremely expensive addition to coaching staff, could really help players to attack an issue before it becomes an injury risk, however players may be faced with stressful life situations (divorces, issues with teammates, drug abuse, reoccurring pain of previous injury) that they may not want to bring to the attention of coaching staff and may shy away from this option in fear of losing their place on the team or the comradery of teammates.

Developing individual training programs for players based on regular meetings with coaching and medical staff in which they asses the players psychological state, would be a very efficient way to ensure players injury risk due to psychological factors is low. Completion of questionnaires such as;

  • Scales of personality[10]
  • Daily hassles scale[11] and
  • Brief cope[12]

Could be implemented in these interviews and programs created with the results of these in mind. Although this strategy to plan and decrease of injury would be greatly individualised and in turn beneficial to the players and team, it is unlikely that coaches and medical staff possess the time or resources to focus on the implementation of this. It would be extremely time consuming and individualised programs would split team trainings and may in turn have a detrimental effect on team morale – e.g. why is Tony doing one on ones daily and we are all training together?

Team psychologists are vastly becoming a vital part sporting organisations. Although the cost is a factor to lower earning clubs, Including a team psychologist could help implement questionnaires or possible MSBR at appropriate times of the season, leading to coaches having a greater understanding of how athletes are coping, what changes may need to be made to training programs, as well as decrease the costs created by the loss/treatment of injured players.

By Annie Gallacher

[1] Maddison, R. and Prapavessis, H. (2007) Preventing sport injuries: A case for psychology intervention. In: Psychological bases of sport injuries. Ed: Pargman, D. Morgantown, WV: Fitness Information Technology, 25-38.

[2]Bahr, R., & Krosshaug, T. (2005). Understanding injury mechanisms: a key component of preventing injuries in sport. British Journal of Sports Medicine, 39(6), 324-329.

[3] Wiese-Bjornstal, D.M. (2010). “Psychology and socioculture affect injury risk, response, and recovery in high-intensity athletes: a consensus statement”.

[4] Williams, J.M., et al. 1991. The effects of stressors and coping resources on anxiety and peripheral narrowing. In R.S. Weinberg & D. Gould, Foundations of Sport and Exercise Psychology (3rd ed., p. 405). Champaign, IL: Human Kinetics.

[5] Nideffer, R.M. 1983. The injured athlete: Psychological factors in treatment. In R.S. Weinberg & D. Gould, Foundations of Sport and Exercise Psychology (3rd ed., p. 401). Champaign, IL: Human Kinetics.

[6] Williams, J.M., & Andersen, M.B. 1998. Psychosocial antecedents of sports injury: Review and critique of the stress and injury model. Journal of Sport and Exercise Psychology, 10, 5-25.

[7] Johnson, U., & Ivarsson, A. (2011). Psychological predictors of sport injuries among junior soccer players. Scandinavian journal of medicine & science in sports, 21(1), 129-136.

[8] Goldin, P. R., & Gross, J. J. (2010). Effects of mindfulness-based stress reduction (MBSR) on emotion regulation in social anxiety disorder. Emotion, 10(1), 83.

[9] Johnson, U. (2007) Psychosocial antecedents of sport injury, prevention, and intervention: An overview of theoretical approaches and empirical findings. International Journal of Sport and Exercise Psychology 55, 352-369.

[10] Gustavsson, J. P., Bergman, H., Edman, G., Ekselius, L., Von Knorring, L., & Linder, J. (2000). Swedish universities Scales of Personality (SSP): construction, internal consistency and normative data. Acta Psychiatrica Scandinavica, 102(3), 217-225.

[11] DeLongis, A., Coyne, J. C., Dakof, G., Folkman, S., & Lazarus, R. S. (1982). Relationship of daily hassles, uplifts, and major life events to health status. Health psychology, 1(2), 119.

[12] Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the brief cope. International journal of behavioural medicine, 4(1), 92-100.


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