1
|
Tranaeus U, Gledhill A, Johnson U, Podlog L, Wadey R, Wiese Bjornstal D, Ivarsson A. 50 Years of Research on the Psychology of Sport Injury: A Consensus Statement. Sports Med 2024:10.1007/s40279-024-02045-w. [PMID: 38862845 DOI: 10.1007/s40279-024-02045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/13/2024]
Abstract
Factors influencing sport injury risk, rehabilitation outcomes, and return to sport processes have been the focus in various research disciplines (sports medicine, psychology and sociology). One discipline, with over 50 years of scholarship, is the psychology of sport injury. Despite the research in this field, there is no evidence-based consensus to inform professional practice. The aim of this original and timely consensus statement is to summarise psychological sport injury research and provide consensus recommendations for sport practitioners seeking to implement psychological principles into clinical practice. A total of seven experts with extensive experience outlined the consensus objectives and identified three psychology of sport injury sub-domains: risk, rehabilitation and return to sport. The researchers, grouped in pairs, prepared initial drafts of assigned sub-domains. The group met in Stockholm, and the three texts were merged into a draft and revised in an iterative process. Stress responses are the strongest psychological risk factor for acute injuries. Intra- and interpersonal factors, as well as sociocultural factors, are demonstrated psychosocial risk factors for overuse injuries. Stress management and mindfulness interventions to prevent injuries have been successfully implemented. The rehabilitation process may influence athlete's cognitive, emotional, and behavioural responses. Social support, mindfulness, acceptance-based practices, and cognitive-behavioural based intervention programs reduce negative reactions. Return to sport includes various stages and different trajectories. Returning athletes typically experience concerns regarding competence, autonomy, and relatedness. It is recommended that athletes focus on the physical, technical, and psychological demands of their sport as they progress to increasingly intense activities. Interdisciplinary collaboration (e.g., sports medicine and psychology) would be beneficial in enhancing clinical practice and improving athlete outcomes.
Collapse
Affiliation(s)
- Ulrika Tranaeus
- Stockholm Sports Trauma Research Centre, FIFA Medical Centre of Excellence, The Swedish School of Sport and Health Sciences, GIH, Box 5626, 114 86, Stockholm, Sweden.
- Department of Physiology, Nutrition, Biomechanics, Sport Performance and Exercise Research and Innovation Centre-Stockholm, SPERIC-S, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
- Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Adam Gledhill
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Urban Johnson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Leslie Podlog
- School of Kinesiology and Physical Activity Sciences, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche, CHU-Saint Justine, Montreal, QC, Canada
| | - Ross Wadey
- St Mary's University, Twickenham, London, UK
| | | | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| |
Collapse
|
2
|
Martin S, Edouard P, Sanchez X, Ivarsson A. Overuse injury and affects in competitive sport: A prospective longitudinal study. Scand J Med Sci Sports 2024; 34:e14644. [PMID: 38760915 DOI: 10.1111/sms.14644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 05/20/2024]
Abstract
Overuse injuries, which have a high prevalence in sport, are suggested to result in different affective responses in comparison to traumatic injuries. Affects may also reciprocally act as risk factors for overuse injury. The aim of this study was to examine the associations between overuse injury and affects within a longitudinal follow-up design. Competitive athletes (N = 149) of various sports and levels of competition completed the Positive and Negative Affect Schedule (PANAS) and the Oslo Sports Trauma Research Centre Overuse injury questionnaire (OSTRC-O) once a week over 10 consecutive weeks. Bivariate unconditional latent curve model analyses with structured residuals were performed to evaluate the associations within and across weeks between OSTRC-O severity score and affects. Results indicated that OSTRC-O severity score and positive affects (PA) had a statistically significant negative within-week relation (r = -24.51, 95% CI = [-33.9, -15.1], p < 0.001). Higher scores of overuse injury were significantly related to lower levels of PA across weeks (ß = -0.02, 95% CI = [-0.04, -0.001], p = 0.044), while the reciprocal effect of PA on overuse injury was not significant (ß = -0.13, 95% CI = [-0.52, 0.26], p = 0.51). No statistically significant association was observed between OSTRC-O severity score and negative affects, neither within nor across weeks. Our findings suggest that overuse injury may have adverse psychological consequences on the long run through lessened PA and address the need for providing sustainable psychological support focusing upon such PA when working with athletes experiencing overuse injury.
Collapse
Affiliation(s)
- Simon Martin
- APERE, UPJV, Amiens, France
- Halmstad University, School of Health and Welfare, Halmstad, Sweden
| | - Pascal Edouard
- Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Xavier Sanchez
- Université d'Orléans, Research Group SAPRéM, Laboratoire CIAMS, Orleans, France
- Université Paris Saclay, Orsay, France
| | - Andreas Ivarsson
- Halmstad University, School of Health and Welfare, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| |
Collapse
|
3
|
Keogh JAJ, Ruder MC, White K, Gavrilov MG, Phillips SM, Heisz JJ, Jordan MJ, Kobsar D. Longitudinal Monitoring of Biomechanical and Psychological State in Collegiate Female Basketball Athletes Using Principal Component Analysis. TRANSLATIONAL SPORTS MEDICINE 2024; 2024:7858835. [PMID: 38654723 PMCID: PMC11023736 DOI: 10.1155/2024/7858835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/07/2024] [Accepted: 03/23/2024] [Indexed: 04/26/2024]
Abstract
Background The growth in participation in collegiate athletics has been accompanied by increased sport-related injuries. The complex and multifactorial nature of sports injuries highlights the importance of monitoring athletes prospectively using a novel and integrated biopsychosocial approach, as opposed to contemporary practices that silo these facets of health. Methods Data collected over two competitive basketball seasons were used in a principal component analysis (PCA) model with the following objectives: (i) investigate whether biomechanical PCs (i.e., on-court and countermovement jump (CMJ) metrics) were correlated with psychological state across a season and (ii) explore whether subject-specific significant fluctuations could be detected using minimum detectable change statistics. Weekly CMJ (force plates) and on-court data (inertial measurement units), as well as psychological state (questionnaire) data, were collected on the female collegiate basketball team for two seasons. Results While some relationships (n = 2) were identified between biomechanical PCs and psychological state metrics, the magnitude of these associations was weak (r = |0.18-0.19|, p < 0.05), and no other overarching associations were identified at the group level. However, post-hoc case study analysis showed subject-specific relationships that highlight the potential utility of red-flagging meaningful fluctuations from normative biomechanical and psychological patterns. Conclusion Overall, this work demonstrates the potential of advanced analytical modeling to characterize components of and detect statistically and clinically relevant fluctuations in student-athlete performance, health, and well-being and the need for more tailored and athlete-centered monitoring practices.
Collapse
Affiliation(s)
- Joshua A. J. Keogh
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew C. Ruder
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Kaylee White
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Momchil G. Gavrilov
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Stuart M. Phillips
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew J. Jordan
- Faculty of Kinesiology, Sport Medicine Centre, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Dylan Kobsar
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| |
Collapse
|
4
|
Naderi A, Alizadeh N, Calmeiro L, Degens H. Predictors of Running-Related Injury Among Recreational Runners: A Prospective Cohort Study of the Role of Perfectionism, Mental Toughness, and Passion in Running. Sports Health 2024:19417381231223475. [PMID: 38311884 DOI: 10.1177/19417381231223475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND The health benefits associated with recreational running are challenged by the occurrence of running-related injuries (RRIs). Effective preventive measures require knowledge of sport injury etiology. Psychological factors such as perfectionism, mental toughness, and passion are believed to predispose to sports injury by influencing training behaviors, motivation to run, and suppression of feelings of fatigue and pain. Yet their association with RRIs are understudied. HYPOTHESIS Perfectionism, mental toughness, and passion predict an increased risk of RRIs in recreational runners. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 3. METHODS A total of 143 recreational runners (age 34.9 ± 13.9 years, 37% women) with a response rate of 76.5% answered an online questionnaire about their characteristics, running behaviors, and psychological variables (perfectionism, mental toughness, and running passion) as well as a sports injury survey. Then, as a primary outcome, RRIs were recorded biweekly for 6 months. The incidence of injuries was expressed as RRI per 1000 hours of running. The association between predictive factors and RRIs was estimated using logistic regression. RESULTS The incidence of RRIs during follow-up was 5.16 per 1000 hours of running. The knee was the location injured most often (26.4%), followed by the foot (18.9%) and lower leg (13.2%). Higher obsessive passion (OP) for running (odds ratio [OR], 1.11; 95% CI, 1.04-1.20) and perfectionistic concerns (OR, 1.22; CI,1.05-1.41) were associated with a greater risk of RRIs, as were previous injury (OR, 2.49; CI,1.10-5.70), weekly running distance (OR,1.10; CI, 1.03-1.16), and both supinated (OR, 4.51; CI, 1.11-18.30) and pronated (OR, 3.55; CI, 1.29-9.80) foot type. Following a running schedule (OR, 0.24; CI, 0.09-0.66) was associated with a lower risk of RRIs. CONCLUSION History of previous RRI, pronated and supinated foot type, weekly running distance, perfectionistic concerns, and OP increased RRI risk in recreational runners. Following a running schedule was a protective factor. CLINICAL RELEVANCE Multiple factors, including runners' psychological characteristics, predict RRIs. These findings can inform the development of injury risk management strategies.
Collapse
Affiliation(s)
- Aynollah Naderi
- School of Sport Sciences, Shahrood University of Technology. Shahrood, Semnan, Iran
| | - Nasrin Alizadeh
- Department of Sport Science, University College of Omran and Tosseeh, Hamadan, Iran
| | - Luis Calmeiro
- School of Social and Health Sciences, Abertay University, Dundee, UK
- Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Portugal
| | - Hans Degens
- Department of Life Sciences, Manchester Metropolitan University, UK
- Institute of Sport Science and Innovations, Lithuanian Sports University, Lithuania
| |
Collapse
|
5
|
Brenner JS, Watson A. Overuse Injuries, Overtraining, and Burnout in Young Athletes. Pediatrics 2024; 153:e2023065129. [PMID: 38247370 DOI: 10.1542/peds.2023-065129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2023] [Indexed: 01/23/2024] Open
Abstract
Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.
Collapse
Affiliation(s)
- Joel S Brenner
- Sports Medicine Program, Children's Hospital of The King's Daughters; Department of Pediatrics, Eastern Virginia Medical School; Division of Sports Medicine, Children's Specialty Group, PLLC, Norfolk, Virginia
| | - Andrew Watson
- Division of Sports Medicine, Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| |
Collapse
|
6
|
Johansson F, Tranaeus U, Asker M, Skillgate E, Johansson F. Athletic Identity and Shoulder Overuse Injury in Competitive Adolescent Tennis Players: The Smash Cohort Study. Front Sports Act Living 2022; 4:940934. [PMID: 35873205 PMCID: PMC9299246 DOI: 10.3389/fspor.2022.940934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives Our primary aim was to determine if athletic identity is prospectively associated with shoulder overuse injuries. Secondly, we aimed to determine if athletic identity is prospectively associated with playing through pain and to describe how athletic identity relates to sex, age, playing level, weekly training load, and match volume. Methods A cohort of 269 adolescent tennis players were followed over a period of 52 weeks. Cox regression was used to estimate the hazard rate ratio (HRR) of first-time shoulder overuse injury associated with every 10-unit increase on the Athletic Identity Measurement Scale (AIMS). Results The adjusted HRR of shoulder overuse injury was 0.89 (95% CI: 0.36–2.20) and the odds ratio of playing through pain was 2.41 (95% CI: 0.74–8.96) for every 10 unit increase on AIMS. The level of athletic identity was higher among players at the national level than among players at the regional level and was weakly correlated to weekly hours of tennis matches, tennis training, and fitness training. Conclusions Our results indicate that higher levels of athletic identity may be associated with a lower incidence of shoulder overuse injuries, and potentially with playing through pain, although these results are inconclusive due to wide confidence intervals.
Collapse
Affiliation(s)
- Fred Johansson
- Department of Health Promotion Science, Musculoskeletal and Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- *Correspondence: Fred Johansson
| | - Ulrika Tranaeus
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- The Swedish School of Sport and Health Sciences, Gymnastikoch Idrottshögskolan (GIH), Stockholm, Sweden
| | - Martin Asker
- Department of Health Promotion Science, Musculoskeletal and Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| | - Eva Skillgate
- Department of Health Promotion Science, Musculoskeletal and Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Johansson
- Department of Health Promotion Science, Musculoskeletal and Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Scandinavian College of Naprapathic Manual Medicine, Stockholm, Sweden
| |
Collapse
|
7
|
Psychosocial Risk Factors for Overuse Injuries in Competitive Athletes: A Mixed-Studies Systematic Review. Sports Med 2021; 52:773-788. [PMID: 34860356 PMCID: PMC8938379 DOI: 10.1007/s40279-021-01597-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 11/24/2022]
Abstract
Background While the psychosocial risk factors for traumatic injuries have been comprehensively investigated, less is known about psychosocial factors predisposing athletes to overuse injuries. Objective The aim of this review was to systematically identify studies and synthesise data that examined psychosocial risk factors for overuse injuries in athletes. Design Systematic review. Data Sources MEDLINE, Web of Science and PsycINFO databases, supplemented by hand searching of journals and reference lists. Eligibility Criteria for Selecting Studies Quantitative and qualitative studies involving competitive athletes, published prior to July 2021, and reporting the relationship between psychosocial variables and overuse injury as an outcome were reviewed. This was limited to academic peer-reviewed journals in Swedish, English, German, Spanish and French. An assessment of the risk of bias was performed using modified versions of the RoBANS and SBU Quality Assessment Scale for Qualitative Studies. Results Nine quantitative and five qualitative studies evaluating 1061 athletes and 27 psychosocial factors were included for review. Intra-personal factors, inter-personal factors and sociocultural factors were found to be related to the risk of overuse injury when synthesised and reported according to a narrative synthesis approach. Importantly, these psychosocial factors, and the potential mechanisms describing how they might contribute to overuse injury development, appeared to be different compared with those already known for traumatic injuries. Conclusions There is preliminary evidence that overuse injuries are likely to partially result from complex interactions between psychosocial factors. Coaches and supporting staff are encouraged to acknowledge the similarities and differences between traumatic and overuse injury aetiology. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01597-5.
Collapse
|