Predictors of Perceived Susceptibility to Sport-Related Injury among Competitive Runners: The Role of Previous Experience, Neuroticism, and Passion for Running

Predictors of Running-Related Injury Among Recreational Runners: A Prospective Cohort Study of the Role of Perfectionism, Mental Toughness, and Passion in Running

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.

Athlete Burnout Is Associated With Perceived Likelihood of Future Injury Among Healthy Adolescent Athletes

We examined perceived risk of future sports injury and athlete burnout among uninjured adolescent athletes. Uninjured high school athlete participants completed the Athlete Burnout Questionnaire (ABQ) and a questionnaire assessing attitudes toward likelihood of sustaining a future sport-related injury. We compared ABQ responses between injury risk perception groups: those who expected injury versus those who did not. Half of the participants reported a somewhat/very high likelihood of future sport-related injury (n = 98; 52% female; age = 15.3 ± 1.9 years), while the other half reported it was unlikely/not possible (n = 98; 45% female; age = 15.3 ± 1.3 years). A significantly greater proportion of those in the expected injury group reported a history of bone/muscle/ligament/tendon injury (56% vs 24%; P < .001). Those in the expected injury group reported higher athlete burnout scores (median = 28 [interquartile range = 25-34] vs 25 [23-30]; P = .002). Adolescent athletes who reported they were likely to experience a future injury in their sport also reported greater levels of burnout.

Young Adults' Knowledge and Perceptions of Permanent Noise-Induced Tinnitus and its Influence on Behavioural Intentions

Objective

Young adults' music-listening behaviours may put them at risk of developing permanent hearing loss and tinnitus. This study aimed to assess knowledge of permanent tinnitus and whether this knowledge may influence listening behaviours to a greater degree than knowledge of hearing loss.

Materials and Methods

A two-group (between subjects), randomised post-test only, single-factor experimental design was used to determine the effects of health message focus (permanent tinnitus vs. permanent hearing loss) on the main outcome measure of protective behavioural intention. The sample included 109 male and 287 female adults, aged 18 to 25 years, living in the United Kingdom. The young adults' existing knowledge of either permanent hearing loss or permanent tinnitus was measured, and after exposure to a health message, their perceptions and resultant behavioural intentions were assessed and compared. The pooled data were used to test a proposed model of factors influencing hearing protective behavioural intention using path analysis.

Results

Whilst 83% knew about the link with hearing loss, only 75% knew that loud music may cause permanent tinnitus. The participants viewed tinnitus as closer temporally than hearing loss, perceived themselves as equally susceptible to both, but perceived hearing loss as more severe. There was no significant difference in behavioural intention between the groups.

Conclusion

Perceived susceptibility and severity have a positive effect on behavioural intentions. In light of these results, recommendations for future noise-damage prevention campaigns are made.

The Two Dimensions of Passion for Sport: A New Look Using a Quadripartite Approach

Research relying on the dualistic model of passion has consistently found that harmonious passion for sport is positively associated with adaptive outcomes and that obsessive passion for sport is positively associated with maladaptive outcomes. In this research, we tested if various sport outcomes were related to within-person combinations of both harmonious and obsessive passion. Three samples of athletes (total N = 1,290) completed online surveys that assessed various sport outcomes (e.g., sport enjoyment, goal attainment), along with harmonious and obsessive passion for their sport. We found that athletes were best served by having either high harmonious passion or low obsessive passion or, in many cases, high harmonious passion that was combined with low obsessive passion. These results add to our understanding of passion by showing that combinations of harmonious and obsessive passion for sport are differentially associated with indicators of a positive sport experience.

Prediction of Health Risk Preventative Behavior of Amateur Marathon Runners: A Cross-Sectional Study

Introduction

Prevention of the health risk of amateur marathon runners is of great significance for the sustainable development of marathon. To reduce the psychological burden of amateur marathon runners and improve the participation experience, the current study used the health belief model to study the relationship among health beliefs, attitude to preventative behavior, self-efficacy, and health values of amateur marathon runners.

Methods

A total of 342 data were collected, and using the PROCESS (analytical procedures developed for mediating and moderating effects tests based on SPSS and SAS). A series of multiple linear regression models were established to study the relationship between variables, and the bootstrap confidence interval was selected to test the mediating and moderating effect.

Results

The results showed that perceived health threat (b = 0.463, p <0.05), health behavior expectations (b = 0.373, p <0.001), self-efficacy (b = 0.322, p <0.001), and behavioral attitudes (b = 0.230, p <0.001) can be regarded as antecedent variables for predicting preventative behaviors. In addition, the results also show that health behavior expectations, self-efficacy, and behavioral attitudes play chain-mediating role between perceived health threat and preventative behaviors. Health values appear to play a moderating role in the direct/indirect effects of perceived health threat on preventive behavior through a number of mediating variables.

Discussion

This study emphasizes that the amateur marathon runners must improve their health concept and take effective preventive measures before participating in the competition. According to this research, it is the responsibility of the event parties, public health officials and relevant departments of the host city to provide rich health information and risk education to amateur marathon runners. More public service advertisements or educational materials are needed to be placed on runners to enhance their awareness of the necessity and importance of taking preventive measures.

Factors Associated With Lower Limb Injuries in Recreational Runners: A Cross-Sectional Survey Including Mental Aspects and Sleep Quality

Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise), sleep quality, perceived health, quality of life, foot arch type, and RRIs over the past six months. Data were analyzed descriptively and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for RRIs were investigated. 54% of runners reported at least one RRI. The knee was the most-affected location (45%), followed by the lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome (17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95% confidence interval (CI):1.18-1.54), motivation to exercise (OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-1.31) were associated with RRIs, as were perceived health (OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58; CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus (OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37; CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate regression analysis showed that mental aspects and sleep quality explain 15% of the variance in RRIs. The association of mental aspects and sleep quality with RRIs adds new insights into the multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be incorporated into the advice on prevention and management of RRIs.

Passion for an activity: a new predictor of sleep quality

STUDY OBJECTIVES

The present research examines the relationship between people's frequent involvement in an activity they like and find important (i.e., a passion) and the quality of their sleep. Research on the dualistic model of passion has widely documented the relationship between individuals' type of passion-harmonious versus obsessive-and the quality of their mental and physical health. However, research has yet to examine the relationship between passion and sleep quality. Building on prior research has shown that obsessive (vs harmonious) passion is related to depressive mood symptoms-an important factor associated with sleep problems-we hypothesized that obsessive passion would be associated with overall worse sleep quality, whereas harmonious passion would predict better sleep quality.

METHODS

A sample of 1,506 Americans filled out an online questionnaire on sleep habits and passion. Sleep quality was measured using the Pittsburgh Sleep Quality Index. Hierarchical linear regressions and mediation analyses were carried out with results confirming our hypotheses.

RESULTS

Obsessive passion for an activity was associated with worse sleep quality, whereas harmonious passion was associated with better sleep quality, adjusting for demographics, the type of passionate activity and its self-reported importance, alcohol and tobacco consumption, BMI, self-reported health, and diagnosed health conditions. The relationship between both types of passion and sleep quality was mediated by depressive mood symptoms.

CONCLUSIONS

Our study presents evidence of a strong relationship between sleep quality and passion, opening the door for future research to create new interventions to improve people's sleep and, consequently, their well-being.

Effects of Psychological Interventions on the Prevention of Sports Injuries: A Meta-analysis

Background:

Studies have shown that preventive psychological interventions can reduce the occurrence of sports injuries.

Purpose:

To systematically evaluate the published literature on the effects of psychological interventions on rates of sports injuries and propose a set of psychological interventions to reduce such injuries.

Study Design:

Systematic review; Level of evidence, 1.

Methods:

A total of 11 randomized controlled trials and intervention control trials involving 1287 participants were included. A random-effects model was used to analyze the data. Pooled results were expressed as effect sizes and 95% CIs. Bias and heterogeneity among the studies were assessed, and sensitivity and subgroup analyses were performed.

Results:

Meta-analysis suggested that preventive psychological interventions effectively prevented the occurrence of sports injuries (effect size = –0.55; P < .001), although the studies showed substantial heterogeneity (I² = 94.2%; P < .001), which could not be attributed to specific variables. Nevertheless, sensitivity analysis suggested that overall results were reliable. No significant risk of publication bias was found.

Conclusion:

Preventive psychological interventions moderately reduced the risk of sports injuries. Risk screening also significantly reduced the risk of sports injuries. These interventions should focus on cognitive behavior and be administered in 1 to 6 sessions over 7 to 12 weeks for 60 minutes per session.

Mental Recovery and Running-Related Injuries in Recreational Runners: The Moderating Role of Passion for Running

This pilot study investigates the moderating role of passion for running in the relation between mental recovery from running and running-related injuries (RRIs). We predict that the relation between recovery and injuries is dependent on the level of passion. A cross-sectional survey study was conducted among 246 Dutch recreational runners. Multivariate logistic regression analyses revealed that the negative association between mental recovery after running and RRIs is moderated (i.e., strengthened) by harmonious passion. Put differently, runners who are able to mentally recover well after running were less likely to report RRIs in the case of harmonious passion. Additionally, findings demonstrated that obsessively passionate runners were more likely to report RRIs. Passionate runners may benefit from education programs to help them integrate running more harmoniously with other aspects of life, and to prevent injuries. In addition, they should be educated about the crucial role of appropriate mental recovery from running. Considering mental aspects in running such as mental recovery from running and passion for running seems to be worthwhile to gain a better understanding of the incidence and/or prevalence of RRIs. Future (quasi-experimental) studies should investigate the issues raised here more profoundly.

'Take a Mental Break!' study: Role of mental aspects in running-related injuries using a randomised controlled trial

Background

Running-related injuries (RRIs) can be considered the primary enemy of runners. Most literature on injury prediction and prevention overlooks the mental aspects of overtraining and under-recovery, despite their potential role in injury prediction and prevention. Consequently, knowledge on the role of mental aspects in RRIs is lacking.

Objective

To investigate mental aspects of overtraining and under-recovery by means of an online injury prevention programme.

Methods and analysis

The ‘Take a Mental Break!’ study is a randomised controlled trial with a 12 month follow-up. After completing a web-based baseline survey, half and full marathon runners were randomly assigned to the intervention group or the control group. Participants of the intervention group obtained access to an online injury prevention programme, consisting of a running-related smartphone application. This app provided the participants of the intervention group with information on how to prevent overtraining and RRIs with special attention to mental aspects. The primary outcome measure is any self-reported RRI over the past 12 months. Secondary outcome measures include vigour, fatigue, sleep and perceived running performance. Regression analysis will be conducted to investigate whether the injury prevention programme has led to a lower prevalence of RRIs, better health and improved perceived running performance.

Ethics and dissemination

The Medical Ethics Committee of the University Medical Center Utrecht, the Netherlands, has exempted the current study from ethical approval (reference number: NL64342.041.17). Results of the study will be communicated through scientific articles in peer-reviewed journals, scientific reports and presentations on scientific conferences.

The Feasibility and Usability of RunningCoach: A Remote Coaching System for Long-Distance Runners

Studies have shown that about half of the injuries sustained during long-distance running involve the knee. Cadence (steps per minute) has been identified as a factor that is strongly associated with these running-related injuries, making it a worthwhile candidate for further study. As such, it is critical for long-distance runners to minimize their risk of injury by running at an appropriate running cadence. In this paper, we present the results of a study on the feasibility and usability of RunningCoach, a mobile health (mHealth) system that remotely monitors running cadence levels of runners in a continuous fashion, among other variables, and provides immediate feedback to runners in an effort to help them optimize their running cadence.

Is motivation for marathon a protective factor or a risk factor of injury?

This research investigated whether and how self-determined motivation predicts perceived susceptibility to injury during competition (marathon). Two correlational studies including 378 (Study 1) and 339 (Study 2) marathon runners were conducted. Participants filled out a questionnaire the day before the race measuring self-determined motivation, perceived susceptibilities to marathon-related injury and to keep running through pain, and control variables. Study 1 showed that self-determined motivation was negatively related to perceived susceptibility to marathon-related injury. Study 2 replicated this finding and showed that this relationship was partially mediated by perceived susceptibility to keep running through pain during the race. Moreover, results indicated that the predictive role of self-determination was mostly driven by controlled forms of motivation, and more particularly external regulation. These results suggest that self-determined motivation for sport is a protective factor of injury.

Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players

OBJECTIVES

Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence.

DESIGN

Pre-post treatment-non treatment group comparison.

PROGRAM ADMINISTRATION

The program was administered by a trained psychologist on a once-a-week, 1-h session basis.

PARTICIPANTS

Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group.

MEASURES

Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview.

RESULTS

Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η²_p = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η²_p = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p < 0.001, η²_p = 0.309).

CONCLUSIONS

A controlled implementation of a psychosocial program was effective in reducing youth soccer sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches.

Board Diving Regulations in Public Swimming Pools and Risk of Injury

Public session access to diving boards is one of the stepping stones for those wishing to develop their skills in the sport of diving. The extent to which certain dive forms are considered risky (forward/backward/rotations) and therefore not permitted is a matter for local pool managers. In Study 1, 20 public pools with diving facilities responded to a U.K. survey concerning their diving regulation policy and related injury incidence in the previous year. More restrictive regulation of dive forms was not associated with a decrease in injuries (rs [42] = -0.20, p = 0.93). In Study 2, diving risk perception and attitudes towards regulation were compared between experienced club divers (N = 22) and nondivers (N = 22). Risk was perceived to be lower for those with experience, and these people favored less regulation. The findings are interpreted in terms of a risk thermostat model, where for complex physical performance activities such as diving, individuals may exercise caution in proportion to their ability and previous experience of success and failure related to the activity. Though intuitively appealing, restrictive regulation of public pool diving may be ineffective in practice because risk is not simplistically associated with dive forms, and divers are able to respond flexibly to risk by exercising caution where appropriate.

Factorial validity and measurement invariance of the Perceived Susceptibility to Sport Injury scale

The Perceived Susceptibility to Sport Injury (PSSI) scale is a measure that has recently surfaced in the sport injury literature. The factor structure of the PSSI scale has not been subjected to a rigorous factor analysis; thus, the factorial validity of the measure in athlete populations is unknown. To establish the validity of the PSSI scale in sports medicine research, the purpose of this study was to examine the factor structure and measurement invariance across gender of the PSSI scale. Male and female intercollegiate athletes (N = 217) completed the PSSI scale during the off-season. The factor structure was analyzed using confirmatory factor analysis (CFA) procedures and maximum likelihood estimation. The measurement invariance analysis was conducted via comparisons of fit indices within a series of hierarchically constrained models. Results of the CFA yielded a very good fit of the measurement model: χ² (2) = 4.535, P = 0.104; RMSEA = 0.076; SRMR = 0.018; CFI = 0.995; NNFI = 0.985. Results of the measurement invariance analysis demonstrated strict invariance across gender, and no significant latent mean differences emerged between men and women. Study results support the factorial validity of the PSSI scale for use in future sports medicine research.

Passion for a Cause: How It Affects Health and Subjective Well-Being

Using the dualistic model of passion (Vallerand et al., 2003), this research investigated how harmonious passion (HP) or obsessive passion (OP) for a cause can affect volunteers' health and subjective well-being. Three studies with volunteers for local (local emergency crises and community help) and international (humanitarian missions) causes assessed physical and psychological health using cross-sectional and longitudinal designs. Study 1 (N = 108) showed that HP was positively related to satisfaction with one's involvement in the cause and unrelated to physical injuries due to cause involvement. OP was unrelated to satisfaction but positively associated with injuries. Findings were replicated in Study 2 (N = 83). Moreover, self-neglect mediated the positive and negative effects of HP and OP, respectively, on injuries. Study 3 (N = 77) revealed that HP predicted an increase in satisfaction and health over a 3-month mission. OP predicted an increase in physical symptoms and a decrease in health. Furthermore, OP before a mission was positively related to self-neglect that was positively associated with physical symptoms after a mission. OP also positively predicted rumination that was conducive to posttraumatic stress disorder. HP was unrelated to these variables. Findings underscore the role of passion for a cause in predicting intrapersonal outcomes of volunteers.

Obsessive passion: a dependency associated with injury-related risky behaviour in dancers

Grounded in self-determination theory, obsessive passion for an activity has been associated with increased risky behaviour and rigid persistence, both symptomatic of dependence. However, it is unknown whether obsessive passion may predict the development of dependence, and furthermore, theoretically important relationships between basic need satisfaction, passion, exercise dependence and subsequent risky behaviour have not been fully explored. A sample of 100 professional dancers (50(fs); 50(ms); Mage = 20.88; SD = 2.69) completed self-ratings of risk-related behaviours (doctor visits; following treatment, and warming up), passion for dance and dance dependence. Findings supported the maladaptive nature of obsessive passion in relation to risky behaviour and as predicted dance dependence mediated this relationship. Interestingly, need satisfaction was positively related to both obsessive passion and harmonious passion. Results are discussed in the light of self-determination theory and dysfunctions of obsessive passion, suggesting that professional dancers are at risk of employing maladaptive behaviours if high in obsessive passion, which may be detectable via symptoms of dance dependence.

Psychological mediators of the sport injury--perceived risk relationship

Drawing upon both heuristic- and threat-based approaches, we sought to examine whether perceived similarity with injury-prone people and perceived control over injury occurrence would directly contribute to perceived risk and whether these variables would mediate the previous injury-perceived risk relationship. Judokas (n = 207) reported the number of injuries experienced in the past year and then completed measures of perceived similarity, perceived control, and injury risk perception. Analyses revealed that perceived similarity and perceived control directly contributed to perceived risk of injury; only perceived similarity acted as a partial mediator of the injury-perceived risk relationship. These findings are discussed in relation to the potential influence of the sport context, which universally involves the acceptance of a high risk of injury.

Psychological Predictors of Injury among Professional Soccer Players

Objectives: Numerous empirical studies suggest that specific psychological factors influence the frequency and severity of sport injuries. The main purpose of the present study is to outline the psychological factors, which predict increased injury vulnerability among professional male soccer players in Denmark. Based on the Stress-Injury Model by Williams & Anderson (1998) it is hypothesized that low coping resources, high competitive trait anxiety, and history of previous injuries would be positively related to an increased risk of injury occurrence and severity. Methods: The soccer players (N = 87) were asked to report history of previous injuries within the last 12 months. Furthermore, 2 questionnaires were used; Competitive Trait Anxiety Test, and Athletic Coping Skills Inventory - 28 (ACSI-28). Injuries were prospectively recorded throughout a period of approximately 3 months by the team's medical staff (doctors and physiotherapists). Results: Study findings clearly suggest that history of previous injury and coping with adversity are the best predictors of injury occurrence. These factors explained between 7 % and 11 % of the total variance of injury occurrence and days lost due to injury respectively. Furthermore, the same variables were found very successful in prediction injury occurrence. Conclusions: The findings support the suggestions that psychological factors can be utilized as a predictive measurement to sport injuries, which should be considered by coaches and medical staff in order to reduce vulnerability to injury.