Topics: Psychology of Injury
Impacted domains: All athletes and performers
Researchers: Adam Gledhill, Dale Forsdyke, and Eliot Murray
Study type: Systematic review
“Why do they always get injured?”
Your athletes are battling injury.
But you don’t get it.
They’re doing all the rehabilitation work.
The sports medicine team is keeping everyone in great condition, programming all the drills and exercises.
Yet your athletes keep getting injured. Some even have repeated injuries. Again and again their bodies are breaking down.
So what’s going on? Why are well-prepared athletes still getting injured? There’s a piece most people overlook. Psychological.
It sounds farfetched because we are conditioned to believe that injury is only biological.
But that’s only part of the picture.
There’s a large psychological component to injury prevention.
Who are you?
- Team or Individual Coach
- Program Director/Athletic Director
- Mental Performance Professional (Master's or PhD in Sport, Exercise, and Performance Psychology, or equivalent)
- Mental Health Professional (Master's or PhD in Psychology, Counseling, or equivalent)
- Sport Science or other High-Performance Staff
- Athlete
In sport and athletic spaces, we tend to think of injury as bad luck, load mismanagement, or poor conditioning. Sometimes even faulty technique.
But research in sport and performance psychology suggests that there are other factors at play.
Psychosocial factors—such as stress, anxiety, and life events which are improperly handled—can increase the likelihood of injury in athletes. You may be thinking: “What? Why? How?”
Leaning on the Stress-Injury Model (Williams & Andersen), general and competitive stress affects athletes through non-direct mechanisms.
Such as:
Challenges to maintaining attention on task-relevant cues
Attentional narrowing
Slower, poorer decision-making
Muscular tension and decreased coordination
And in high-speed, pressure environments where athletes are moving at full speed and trying to react to game scenarios, that’s all it takes.
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What did the systematic review do?
Gledhill and colleagues set out to answer a simple question: do psychological interventions actually reduce injury risk in real-world scenarios? To do so they reviewed 14 studies that used psychological interventions for injury reduction. These were studies conducted with:
1,380 athletes
Across multiple sports and levels
And here’s what they found:
In 13 out of 14 studies (93%), they reported a reduction in the rate of injury or also a reduction in the time that athletes spent injured.
How does the psychological component reduce injury risk?
As the authors write:
“There are different plausible explanations for the efficacy of psychological interventions. Most contained a stress management component, and stress is associated with injury risk. Periods of high stress influence cortisol and oxytocin release, which may have a relationship to injury risk via immune and pain responses. Stress management interventions can have a beneficial effect on these immune and pain responses.”
Expressed differently, psychological interventions don’t “protect” the body directly. Rather, they help athletes with skills such as cognitive appraisal, stress-management, and relaxation. They influence the mental systems that create a higher risk of injury.
Because... life and competitive stress affects:
Attention-control
Decision-making
Muscular tension
And under excessive stress, athletes are more likely to:
Misread situations
Not pay attention to relevant cues
Mistime movements
Lose “normal” coordination
All of which can increase likelihood of injury.
Takeaway
Injury prevention isn’t just physical. It’s also psychological.
If your athletes are constantly under pressure, looking like they’re constantly stressed out, and struggling to stay focused… then no amount of strength and conditioning will fully solve the problem. Because you’re not addressing one of the variables increasing risk in the first place….
If you’re a coach, director, or performance staff member, it might be worth asking:
Are we doing enough to manage the psychological load on our athletes?
Or are we increasing it by how we manage individuals and our athletes?
Reference
Gledhill, A., Forsdyke, D., & Murray, E. (2018). Psychological interventions used to reduce sports injuries: A systematic review of real-world effectiveness. British Journal of Sports Medicine, 52(15), 967–971. https://doi.org/10.1136/bjsports-2017-097694 
