Athletic injuries, Psychology of Concussions XSC 2060

How is an injury defined in sports psychology?

Trauma to the body that results in at least temporary (but sometimes permanent) physical disability and inhibition of motor function.

What does injury pain cause?

The need for mental during activity, loss of or change in function that directly affect performance capabilities. Not the same as discomfort

What are pre-injury factors that may predispose an athlete to injury?

Physical factors (muscle imbalances, overtraining, physical fatigue), situational factors (sport and exercise situations, environment), and psychological factors.

What are physical pre injury factors?

Muscular imbalances, overtraining, physical fatigue

What are Situational pre injury Factors

sports and exercise situations, environment

What are psychological factors?

Primarly focused on the stress injury relationship

What is the stress and injury model?

A model correlating stress history, personality, coping resources, potentially stressful athletic situations, and the stress response with injury

What personality factors can influence injury risk in the stress injury model?

Trait anxiety, locus of control, athletic identity.

How can stress history ifinclunce the injury risk in the stress injury model

prior injury, life events, daily hassles. Not just absolute stress, but also skills related to management of stress. Those who are better at stress management can protect against some of this risk

What coping resources can influence injury risk in the stress injury model?

Psych skills, self care, social support

What are coping resources and what would be some examples?

Tools individuals have to handle stressful situations. Examples include social support relaxation techniques, imagery, goal setting, cognitive exercise, journaling, stress management etc.

What parts of the stress response can influence injury risk in the stress injury model?

cognitive appraisal --> physiological and/or attentional changes

How does stress influence the risk of injury?

Low resistance to stress or low confidence can lead to slower reaction times, peripheral narrowing, and physiological changes like muscle tightness.

What does cognitive appraisal mean?

What an individual thinks about a particular situation, including whether they see it as threatening or challenging (facilitative vs debilitative) Also can include perceptions of sport, exercise, and injury . Such as if someone already believes in "sacrifice the body" (The sport ethic)

What is the 'sport ethic'?

Society's criteria for what it takes to be identified as an athlete in sport today; 4 types of identified normative behaviors

What are the four types of identified normative behaviors of "the Sport Ethic"

Macke sacrifice for "the game", strive for distinction, accept risk and play with pain, and accept no obstacles in the pursuit of possibilities

What are some examples of normative "sport ethic" behaviors that would relate to injuries?

Faking an injury to get a card in soccer, the brush back pitch to retaliate in baseball, the role of the enforcer in hockey

What are examples of physiological and attentional changes that can predispose to injury?

Concentational/Attentional disruptions and Increased muscle tension

What are the three categories of responses to injury?

1) Injury relevant information processing, 2) Emotional upheaval and reactive behavior, 3) Positive outlook and coping.

What is injury relevant information processing?

Focused on information related to pain, extent of the injury, and how the injury happened, along with potential negative consequences. Individuals ask a lot of questions of health care provides.

What is the emotional upheaval and reactive behavior category in the response to injury?

Agitation, varied emotions, isolation, shock, disbelief, denial, self pity, emotional exhaustion. Individuals can display a range of emotions; more focused on emotion that information.

What is the positive outlook and coping category in the response to injury?

accepts injury and focuses on positive coping efforts, good attitude, optimism, and process. Individuals adhere to rehab programs, work hard, and look forward to return to activity

Cognitive appraisal model -- what are the six categories?

Personal factors, cognitive appraisal, situational factors, behavioral response, emotional response

Cognitive appriasal model -- what are personal factors?

Injury (history, severity, type. Individual differences -- Psychological (personality motivational orientation), Demographic (gender, age, socioeconomic status,) physical (health status

Cognitive appriasal model -- what are cognitive appraisal factors?

Goal adjustment, rate of perceived memory, self perceptions, belief and attributions, sense of loss or relief, cognitive coping

Cognitive appriasal model -- what are situational factors?

sport (ie type, level, time in season), social (ie teammate and coach influences) environmental (ie accessibility to rehab)

Cognitive appriasal model -- what are behavioral response factors?

Adherence to rehab, use of PST strategies, use/disuse of social support, risk taking behaviors, effort and intensity, malingering, behavioral coping

Cognitive appriasal model -- what are emotional response factors?

fear of unknown, tension, anger, depression, frustration, boredom, positive attitude/outlook, grief, emotional coping

What are other reactions to injury?

Identity loss, fear and anxiety, lack of confidence, performance decreasement due to lowered confidence, impact on group process

What psychological responses might an individual experience after an injury?

Responses can range from anger and depression to relief and positive outlook.

What are signs of poor adjustment to athletic injury?

Feelings of anger, obsession about return to play, denial,repeatdle forcing come back too son and rein jury, exaggerated bragging about accomplishments, dwelling on minor physical complaints, guilt about letting team down, and withdrawal from significant others, stating recovering will not occur

What psychological skills can aid in injury recovery?

Goal setting, positive self-talk, thought stopping/cognitive restructuring, relaxation techniques, and imagery. Use of PST needs to be matched to the individual.

What is meant by 'psychological readiness' in injury recovery?

Refers to the mental aspects of return to activity and whether an individual has returned to full mental and psychological levels for activity; focused on confidence and self efficacy, along with mental skills, such as concentration/attentional focus and arousal regulation.

True or false - Determining psychological readiness is often more challenging than physical readiness

True, much harder to quantify. Requires a combination of conversation and observation.

What are some strategies for injury recovery?

Build rapport with the injured individual, Educate the injured individual about the injury and recovery process, Teach specific psychological coping skills, Teach how to cope with setbacks, Foster social support, Ensure injured individuals are psychologically ready to return to participation, Learn from injured individuals

What is a concussion?

A complex pathophysiological process affecting the brain, induced by biomechanical forces. It is not a structural injury, and is referred to as "energy crises" as trauma of the concussions influences the brain's maintenance of normal glucose levels for functioning. This makes the cell in the brain vulnerable to damage or cell death

What is second impact syndrome?

Injury in the brain that occurs when additional trauma is

sustained by the brain when a concussion has not

completely resolved. Leads to vascular engorgement--> significant brain

bleeding--> often fatal

Why are concussions considered an 'invisible' injury?

They often do not show visible signs, making them harder to diagnose and manage.

What are common cognitive symptoms of a concussion?

Difficulty thinking and concentrating, feeling slowed down or not rights, difficulty remembering, fogginess

What physical symptoms are associated with concussions?

Headache, blurred vision, nausea, vomiting, dizziness, and sensitivity to light and sound, balance problems, fatigue, unconsciousness

What emotional symptoms can occur after a concussion?

Irritability, sadness, increased anxiety, more emotional, nervous or anxious.

What are sleep disturbance signs of a concussion?

Sleeping more or less than usual, or trouble falling asleep

What are symptoms associated with protracted recovery?

Headache, dizziness, visual disturbances

What was the old method for treating concussions?

started out with putting people in dark rooms and resting until they felt better; realized that wasn't really working well. Identified a number of potential challenges with this method-- Isolation, anxiety, lack of even minimal exercise, and no real benefit to recovery

What is the recommended initial treatment for concussions?

A period of rest while feeling acutely symptomatic, avoiding activities that worsen symptoms. Next, period of light activity when symptoms have mostly subsides, and then a period of moderate activity when symptoms have almost disappeared, and then return to full activity when symptom free at all levels of intensity

Who should monitor recovery and decisions about return to participation after a concussion?

A medical professional, such as a physician or concussion specialist. The key is that the decision to be released to full activity is made by a medical professional, not the

patient or a parent or a coach (or supervisor)

What psychosocial challenges may arise during concussion recovery?

Concerns about athletic identity, fear about loss of fitness/place on team, concern about academics, isolation from others, lack of normal coping mechanisms like screens or exercise. Also may face challenges distiguisng symptoms from emotional response, and feel pressure from others like coaches, teammates, media glorification.

What are the challenges associated with self-reporting concussion symptoms?

Athletes may deliberately underestimate symptoms due to various pressures. Underestimations might come from risks of scholarships, letting the team down, missing playing time

What are the six general clinical trajectories related to concussion symptoms?

Vestibular, Ocular, Cognitive/Fatigue, Post-traumatic migraine, Cervical, and Anxiety/Mood.

How is the trajectory related to mood and emotions

Anxiety, nervousness, mood disturbances, more

emotional than usual, agitation/anger, sadness,

restlessness, irritability

How can you manage a patient who is experience mostly anxiety/mood symptoms

As long as they aren't having symptoms that might make it dangerous, they can begin exercising as soon as possible(may help control some of the symptoms) Sleep can be a challenge; encourage the individual to try to get on a sleep schedule. If symptoms are not resolving, may require a referral to a psychologist or psychiatrist

How can existing mental health conditions affect concussion recovery?

They may exacerbate symptoms and increase the risk of prolonged recovery.

What should be done if concussion symptoms do not resolve?

Referral to a psychologist or psychiatrist may be necessary.