Psychological Aspects of Sport Injury

In an effort to promote healthy life styles and as an effort to stem the epidemic proportions of obesity in our society, participation in sporting events is encouraged. Sport injuries are an unfortunate aspect of attempting to stay healthy. In a study of sports and recreation related injuries in the U.S. between 1997 and 1999, Conn, Annest, and Gilchrist (2003) found that, "annually, seven million Americans receive medical attention for sport related injuries (25.9 injury episodes per 1000 population)". They go on to state the highest sports injury rates were for children between 5-14 years of age (59.3 per 1000 persons) and 15-24 years of age (56.4 per 1000 persons). Males were injured more than twice as often as females; whites 1.5 times as often as blacks. Basketball injuries were the most frequent.

In a study of sport related injuries in Western Australia, Stevenson, Hamer, Finch, Elliot, and Kresnow (2000) found that 51% of participants (n = 1391) who participated in a survey had sustained one or more sports related injuries. Most injuries were moderate (58%) or minor (40%) with 3% requiring treatment in an emergency department or hospitalization. Football (soccer) was the sport incurring the most injuries (20.3 injuries per 1000 hours played). Field hockey incurred 15.2% and basketball 15.1% injuries per 1000 hours played. Most injuries occurred in the first four weeks of the season and in participants who were between 26 and 30 years of age compared to those less than 18 years of age. Injured individuals, coaches, trainers, and health care professionals are most concerned about the injured athlete's physical health. Often little regard is given to the psychological aspects of sport (?) related injury. This is the focus of this brief article.

Pargman (1993) cites a number of behavioral factors that some studies have found to be correlated with sport injuries. First, personality has been implicated as a factor in sport(s?) injuries but the relationship is tenuous and needs more research. Second, compliance or adherence with rehabilitation, after injury, is an area where a great deal of psychological research and clinical practice points to success in many individuals returning to sport related activities. Third, self-concept or sense of mastery with athleticism, are additional areas that are important to the self-esteem of an athlete. However, while adequate self-esteem is necessary to perform well in athletic competition, inflated self-esteem, combined with other factors such as impulsivity and thrill-seeking behavior, may actually do more harm than good and lead to greater risk of injury. Fourth, social factors, such as interactions with others in a negative or positive fashion, can influence attitude, mood, and behavior, thus influencing the risk of injury. A study completed by Bramwell, Minoru, Wagner, and Holmes (1975) examined social and athletic readjustment to various life events in 82 college football players. The researchers found that the football players with low life event scores had the lowest injury rate (35%), those with medium scores had injury rates of 44%, and those with the highest life event scores had an exceptionally high injury rate of 72%. One can look at the recent unfortunate events of Cleveland Browns tight end, Kellon Winslow, and find personality, non-adherence to rehabilitation, thrill-seeking behavior, and social factors influencing his off-the-field injuries that have on-the-field and career implications.

When an athlete is injured and the physical damage is surgically repaired or the injured body part is immobilized and is healing, rehabilitation becomes the next, and longest, part of treatment. This is the time psychological interventions are employed. Grove and Gordon (1991) expanded upon a model of rehabilitation from sport injury first described by Anderson and Williams (1988). The model is described in this diagram.

As one can see, rehabilitation of sport injuries (from a psychological perspective) is multifactorial and can be complicated. If you, a family member, or colleague is struggling with the aftermath of a sport injury and need the assistance of a sport psychologist in the rehabilitation process, please ask our staff.

References

• Anderson, MB & Williams, JM (1988). A model of stress and athletic injury: Prediction and prevention. Journal of Sport and Exercise Psychology, 10, 294-306.
• Bramwell, ST., Minoru, M., Wagner, NN., & Holmes, TH. (1975). Psychosocial factors in athletic injuries. Journal of Human Stress, 1 (2), 6-20.
• Conn, JM., Annest, JL., & Gilchrist, J. (2003). Sports and recreation related injury episodes in the U.S. population, 1997-99. Injury Prevention Online, 9, 117-123. http://ip.bmjjournals.com/cgi/content/abstract/9/2/117
• Grove, JR & Gordon, S. (1991). The psychological aspects of injury in sport. In J. Bloomfield, P.A. Fricker, & K.D. Fitch (Eds.), Textbook of science and medicine in sport (pp. 176-186). London: Blackwell.
• Pargman, D. (1993). Psychological Basis of Sport Injuries. Fitness Information Technology, Inc. Morgantown, WV.
• Stevenson, MR., Hamer, P., Finch, CF., Elliot, B., & Kresnow, MJ. (2000). Sport, age, and sex specific incidence of sorts injuries in Western Australia. British Journal of Sport Medicine Online, 34, 188-194. http://bjsm.bmjjournals.com/cgi/content/full/34/3/188

Gerald J. Strauss, Ph.D.
Clinical Health Psychologist