SP Midterm P6

Injury

Trauma to the body or its parts that causes at least temporary, and sometimes permanent, physical disability and limits motor function. It can involve playing through pain, a loss or change in function, and a decision about whether to keep participating.

Three areas of focus in athletic injury

The psychological and social causes of injury, psychological responses to injury and rehabilitation, and career-ending injuries.

Main cause of athletic injury

Physical factors are the primary cause of injury, but psychological factors can also contribute.

Physical causes of injury

Muscle imbalance, high-speed collisions, overtraining, and physical fatigue.

Social causes of injury

Attitudes and norms in society, such as the belief that playing with pain and injury is admirable and highly valued.

Psychological causes of injury

Personality factors, a history of stress, coping ability, and psychological skills all influence whether an athlete gets injured.

Personality factors linked to injury

Competitive anxiety, Type A behavior, vulnerability to stress, mood disturbances, self-esteem, and passion. Personality affects injury in complex ways, mostly by interacting with stress levels.

Cognitive and behavioral causes of injury

Believing you are at low risk of injury, ignoring health problems, heavy training and competition loads, and not reporting injuries.

Stress-injury relationship

Stress is the most consistent psychological predictor of athletic injury. Athletes with more life stress get injured more often. This includes negative life events and, in some cases, positive life events too.

At-risk athletes (stress and injury)

Life stress is most strongly linked to injury in athletes who have few coping skills and low social support.

Characteristics linked to more injuries

Low self-esteem, pessimism, low hardiness, high trait anxiety, low mental toughness, low family social support, many daily hassles, and few daily uplifts.

Stress management and injury prevention

Teaching stress management techniques to high-risk athletes reduces their injuries and may also help them perform better.

Stress mindset

Viewing stress as something that can help you (facilitative). This mindset may help prevent athletic injuries.

Greatest sources of stress for injured athletes

The psychological parts of injury, such as fear of reinjury and shattered hopes and dreams, rather than the physical parts.

Stress-athletic injury model

A model by Andersen and Williams. In a stressful athletic situation, the athlete appraises it as a threat or a challenge. This appraisal creates a stress response, including anxiety, narrowed attention, and muscle tension, which directly affects the chance of injury. Personality, history of stressors, and coping resources all influence the stress response.

Stress response

The physical and attentional changes that happen when an athlete sees a situation as stressful, such as increased anxiety, a narrowed field of vision, distraction, and muscle tension. In the stress-injury model, it is what directly leads to injury.

Cognitive appraisal (threat vs. challenge)

How an athlete interprets a stressful situation. Athletes who see stressors as threats respond with negative emotions and cope poorly. Athletes who see stressors as challenges respond in a healthier way and are less likely to be injured.

Three groups of factors in the stress-injury model

Personality factors, history of stressors, and coping resources. These all affect how strong an athlete's stress response is.

Personality factors in the stress-injury model

Hardiness, locus of control, sense of coherence, competitive trait anxiety, achievement motivation, athletic identity, and mental toughness. Competitive trait anxiety has the strongest research support.

Hardiness

A personality factor made up of commitment, control, and challenge. Low hardiness is linked to more injuries.

Mental toughness

A personality factor made up of confidence, determination, and emotional control. Athletes with low mental toughness and high stress miss the most days due to injury.

History of stressors

A group of factors in the stress-injury model that includes major life events, daily hassles, and previous injuries.

Life event stress

How many major life events a person has experienced over a period of time, like a year. These can be negative, such as a death in the family or losing a job, or positive, such as getting an athletic scholarship.

Daily hassles

Part of an athlete's history of stressors in the stress-injury model. Having more daily hassles and fewer daily uplifts is linked to more injuries.

Coping resources

The support an athlete has to deal with stress, mainly social support from family, friends, teammates, coaches, athletic trainers, sports medicine staff, and administrators.

Family social support and injury

Family support is an especially important coping resource. Athletes with low family support and high stress miss the most days due to injury. Practitioners should help these athletes improve family support or find other sources of support.

Psychological skill interventions (stress-injury model)

Mental skills training, such as stress management, that can reduce the stress response and lower the risk of injury.

Attentional disruption

One reason stress leads to injury. Stress narrows an athlete's peripheral vision and causes distraction and irrelevant thoughts.

Increased muscle tension

One reason stress leads to injury. Stress causes muscle tension, poor coordination, fatigue, reduced flexibility, and inefficient movement.

Other psychological explanations for injury

Overemphasizing acting tough and 'giving 110%,' not being able to tell normal discomfort from the pain of injury, the attitude that 'if you're injured, you're worthless,' and the sport ethic that leads athletes to deny pain and injury.

Sport ethic

The norms and values of sport, such as 'winners never quit and quitters never win' and a culture of bravery, bravado, and machismo, which lead athletes to deny their pain and injuries.

Three categories of emotional reactions to injury

1) Processing information about the injury, 2) emotional upheaval and reactive behaviors, and 3) developing a positive outlook and coping.

Key points about emotional reactions to injury

Most people go through a typical pattern of reactions, but how quickly and easily they move through the stages varies a lot. The strongest negative emotions happen right after the injury.

What coping with injury affects

Rehab adherence, the recovery process, motivation and commitment to sport, confidence and self-esteem, performance after injury, and overall psychological well-being.

Model of psychological response to injury

Personal factors (injury characteristics and individual differences) and social factors (social support and the sport environment) feed into a cycle of cognitive appraisal, emotional response, and behavioral response. These three keep influencing each other and shape both psychological and physical recovery.

Cognitive appraisal (response to injury)

How the athlete thinks about their injury, including their self-perceptions, beliefs and attributions, a sense of loss or relief, and cognitive coping.

Emotional response (response to injury)

How the athlete feels about their injury, including fear of the unknown, depression, anxiety, tension, a positive outlook, and emotional coping.

Behavioral response (response to injury)

How the athlete acts after their injury, including rehab adherence, effort and commitment, malingering, and behavioral coping.

Identity loss (injury reaction)

When an injured athlete can no longer participate, they may feel they have lost an important part of who they are, which seriously affects their self-concept.

Fear and anxiety (injury reaction)

Injured athletes often worry about whether they will recover, whether they will get reinjured, and whether someone will permanently take their spot. Since they can't practice or compete, they have a lot of time to worry.

Lack of confidence (injury reaction)

Because they can't practice and their bodies get weaker, injured athletes can lose confidence. This can lower motivation, hurt performance, or lead to another injury from overcompensating.

Performance decrements (injury reaction)

Drops in performance after injury caused by lower confidence and missed practice. Many athletes struggle because they expect to return immediately at their pre-injury level.

Group processes (injury reaction)

An athlete's injury can affect how the whole team functions, either negatively or positively.

Athletic identity

Brewer's (1993) term for how much a person's identity depends on their role as an athlete. Athletes with a high athletic identity see injuries as a threat to who they are and to their self-worth.

Athletic identity foreclosure

When an athlete identifies only with being an athlete and their self-concept does not go beyond sport. When injury happens, the psychological effects are often devastating, because they rely on athletic success for approval.

Signs of poor adjustment to injury

Anger and confusion, obsessing over when they can return, denial, repeatedly coming back too soon and getting reinjured, guilt about letting the team down, withdrawal, rapid mood swings, dwelling on minor complaints, pulling away from loved ones, and saying they will never recover.

What to do when an athlete adjusts poorly to injury

Refer them to a sport psychologist or another qualified mental health provider, just as you would with an uninjured athlete who shows clinical problems like depression.

Career-ending injury

An injury that forces an athlete to retire from sport. It is a major life change that usually involves shock, a process of moving forward, filling a void, and eventually developing a new positive outlook.

Losses that come with a career-ending injury

Loss of athletic identity ('Who am I?'), loss of physical strength from permanent damage, and loss of social support from teammates, coaches, athletic trainers, friends, and fans.

Common experiences after a career-ending injury

Physical pain and rehab, emotions like anger, confusion, depression, fear, and guilt, feeling a lack of control over the decision to retire, difficulty being around sport, false hope, and feeling that 'nobody understands,' which can lead to withdrawal and isolation.

What helps athletes transition after a career-ending injury

Family social support, connecting with athletes who have been through similar experiences, and being able to process and transform the injury experience, which is a major factor in a healthy transition. A poor transition is linked to lower long-term life satisfaction.

Control over the retirement decision

Athletes who had some control over retiring worked with others on the decision and agreed the injury warranted it. Athletes who had no control disagreed with having to retire, felt betrayed by coaches, athletic trainers, and doctors, and felt like a 'commodity.'

Psychological consequences of career termination

Changes in identity and self-perception, difficulty adjusting, self-esteem problems, concerns about body attractiveness, and challenges keeping personal relationships.

How practitioners can help after a career-ending injury

Provide support during the transition, connect the athlete with other parts of campus life, offer academic and career support, help build routines and time management skills, help them develop identities and values beyond being an athlete, teach them about injury responses, address unhealthy coping, and help coaches understand how much their response matters.