Lecture 12: Injury Flashcards
what are examples of physical factors that can cause injury and how can this be prevented
muscle imbalances, high-speed collisions, overtraining, and physical fatigue
–> importance of physical preparation and fitness
what is an example of social factors that can cause injury
- view that playing with injury/pain is valued; athletes may feel like it is expected of them to continue
visualize and explain the model that shows the effect of psychological factors (stress) on athletic injury
factors that have an influence (from the top):
- personality factors
- history of stressors
- coping resources
factor that has an influence (from the left):
-_potentially stressful situation
factor that has an influence (from the bottom):
- _psychological skill interventions
they influence:
- perception of threat
- stress response and increased state anxiety
- attention/idstractions and muscle tension
outcome variable:
- injury
what are 4 examples of personality factors related to injury
- optimism (low; pessimistic)
- self-esteem (low)
- hardiness (low)
- trait anxiety (high)
explain the relationship between stress and injury briefly
- athletes with higher levels of life stress have more injuries than do those with lower levels of life stress
- teaching stress management techniques may help athletes and exercisers perform more effectively and may reduce their risk of injury and illness
what are the main stress sources for athletes
- physiological reactions (e.g., fear of reinjury, feeling that hopes and dreams were shattered, watching others get to perform)
- social concerns (e.g., lack of attention, isolation, negative relationships)
what 2 factors have the biggest influence on whether stress may lead to injury
- few coping skills
- little social support
what are 2 theories to explain the relationship between stress and injury and explain them
- Attentional disruption; stress disrupts an athlete’s attention by reducing peripheral attention –> there is less attention for situations that could potentially cause injuries
- Increased muscle tension; high stress can be accompanied by considerable muscle tension that interferes with normal coordination and increases the chance of injury; increased stress may also lead to generalized fatigue, muscle inefficiency, reduced flexibility, and motor coordination problems
what are 2 attitudes held by players that may increase the chance of injury
- Act tough and always give 110%”
- “If you’re injured, you’re worthless”
explain chronic traumatic encephalopathy
= neurodegenerative disease characterized by cognitive (e.g., memory impairment), mood (e.g., depression), and behavioral (e.g., impulse control) problems thought to be caused, in part, by repetitive brain trauma associated with contact sports like football, rugby, and boxing
provide and explain the 5-stage grief response that is apparent in athletes as an emotional response to injury
- denial,
- anger,
- bargaining,
- depression, and
- acceptance and reorganization
what are the 3 general categories of emotional responses to injury
- Injury-relevant information processing: the injured athlete focuses on information related to the pain of the injury, awareness of the extent of injury, and questions about how the injury happened, and the individual recognizes the negative consequences or inconvenience
- Emotional upheaval and reactive behavior: once the athlete realizes that she is injured, she may become emotionally agitated; have vacillating emotions; feel emotionally depleted; feel isolated and disconnected; and feel shock, disbelief, denial, or self-pity
- Positive outlook and coping: the athlete accepts the injury and deals with it, initiates positive coping efforts, exhibits a good attitude and is optimistic, and is relieved to sense progress
what are 5 examples of other kinds of reactions to injury
- Identity loss: Some athletes who can no longer participate because of an injury have a loss of personal identity. Coaches providing a supportive environment during the rehabilitation process helped athletes maintain their self-identity as athletes
- Fear and anxiety: Worry about whether they will recover, whether reinjury will occur, and whether someone will replace them permanently in the lineup. Much time for this is freed up by the lack of practice.
- Lack of confidence: Given the inability to practice and compete and their deteriorated physical status, athletes may lose confidence after an injury. This can result in decreased motivation, inferior performance, or even additional injury if the athlete overcompensates.
- Performance decrements: Because of lowered confidence and missed practice time, athletes may have postinjury declines in performance. Many athletes have difficulty lowering their expectations after an injury and may expect to return to a preinjury level of performance.
- Group processes: Injury to an athlete can affect group processes in a team either negatively or positively. Eg, might disrupt the flow of the team, but may also bring them together to make up for the loss.
what are some signs of poor adjustment to injury
- Feelings of anger and confusion
- Obsession with the question of when one can return to play
- Denial (e.g., “The injury is no big deal”)
- Repeatedly coming back too soon and becoming reinjured
- Exaggerated bragging about accomplishments
- Dwelling on minor physical complaints
- Guilt about letting the team down
- Withdrawal from significant others
- Rapid mood swings
- Statements indicating that recovery will not occur no matter what is done
explain the role that sport psychology has in injury
- mostly important in recovery
- psychological interventions can have an effect on how fast/slow someone recovers
what are 3 things that fast-healing athletes did compared to slow-healing athletes (psychological interventions)
- more goal-setting
- more positive self-talk strategies
- (to a lesser degree) more healing imagery
what are 5 challenges involved in the return to sport
- anxiety over reinjury
- heightened performance anxiety
- uncertainty about meeting the expectations of others
- diminished physical self-efficacy
- concerns about performing at preinjury levels
how does type of motivation influence return to play
- athletes who exhibited higher levels of intrinsic motivation to return to play displayed a greater appreciation of the sport, enhanced mental toughness, and heightened motivation for success
- athletes with extrinsic motivation displayed diminished confidence, unsatisfying performances, and heightened competitive anxiety
what are 4 predictors of adherence to injury rehabilitation
- Personal attributes: Pain tolerance, tough-mindedness, self-motivation, identity
- Environmental characteristics: Social support, practitioner expectations of adherence, comfortable clinical settings, convenient scheduling of appointments
- Effective adherence interventions: Reinforcement, goal setting, education, multimodal interventions
- Predictors of adherence: Rehabilitation self-efficacy, personal control over injury recovery, perceptions of injury severity, emotional distress, treatment efficacy
what are the 3 phases of injury recovery
- Injury or lllness Phase: Help the athlete deal with the emotional upheaval that accompanies the onset of injury.
- Rehabilitation and Recovery Phase: Help the athlete sustain motivation and adherence to rehabilitation protocols.
- Return to Full Activity Phase: Full recovery is not complete until the athlete can return to normal functioning within his or her sport.
what are ways to support injured athletes
- build rapport with the injured person; athletes often feel frustration, anger, confusion, etc, which makes it hard to connect –> try to understand their feelings/show empathy, provide emotional support, be realistic but positive and optimistic
- educate the injured person about the injury and recovery. process; explain what to expect, make sure they understand the practicalities and outline the recovery process
- teach specific psychological coping skills
- teach how to cope with setbacks; inform them that they are likely to occur but that its important to maintain a positive attitude
- foster social suport; emotional support from friends and loved ones; informational support from a coach
- ensure athletes are psychologically ready to return to play
what are the 4 most important psychological coping skills to teach athletes recovering from injury
- goal setting; eg. when you want to return to play, performance goals, what you will do when, etc
- positive self-talk; help counteract lowered confidence
- imagery or visualization; visualize yourself in game conditions to maintain playing skills and facilitate return to competition, or quicken recovery by visualizing the removal of injured tissue and the growth of new healthy tissue and muscle
- relaxation training; useful for relieving pain and stress, which usually accompany severe injury and the injury recovery process.; athletes can also use relaxation techniques to facilitate sleep and reduce general levels of tension
how can one identify athletes that are at risk of sustaining injuries (5)
These athletes have been characterized by combinations of:
- high trait anxiety
- high life stress
- low psychological and coping skills
- low social support
- high avoidance coping
what are 7 recommendations for coaches for coping with injuries and facilitating rehabilitation
- Foster coach-athlete contact and involvement.
- Demonstrate positive empathy and support.
- Understand individual variations in injuries and injury emotions.
- Motivate by optimally pushing.
- Engineer the training environment for high-quality, individualized training.
- Have patience and realistic expectations.
- Don’t repeatedly mention injury in training.
what are 7 recommendations for sports medicine personnel for coping with injuries and facilitating rehabilitation
- Educate and inform the athlete about the injury and rehabilitation.
- Use appropriate motivation and optimally push.
- Demonstrate empathy and support.
- Have a supportive personality (e.g., be warm, open, and not overly confident).
- Foster positive interaction and customize training.
- Demonstrate competence and confidence.
- Encourage the athlete’s confidence.
what are 5 risk factors for acute injuries
- potentially stressful events which leads to a stress response; may be because the strong stress responses are likely to reduce athletes’ decision making capacities, leaving them vulnerable to errors, collisions and compromised motor control, thereby increasing injury risk
- personality traits
- history of stress response; may be because of an increased magnitude of the stress response
- adequate coping resources
- general well-being factors (eg. sleep, health conditions, psychological mechanisms)
what are 6 risk factors for overuse injuries
- personality traits (eg. perfectionism, obsessive passion)
- previous injuries
- neglecting bodily warning signals
- poor coach-athlete relationships
- lack of social support
- pain normalisation
what are 4 recommendations for practice in injury risk reduction
- Form strong relationships with your athletes and colleagues; goal consensus/collaboration, empathy, working alliance and positive regard
- Screen athletes frequently and consistently for psycho- social stress indices, sleep quality, and perceived recovery
- Consider stakeholder education around psychosocial injury risk factors for coaches, sports medical staff and athletes; organisational culture, psychological safety, psychosocial stressors and relational issues
- Adopt mindfulness and acceptance-based practice and stress management approaches to reduce acute injury risk
what are 9 individual factors influencing sport injury rehabilitation
- hardiness
- resilience
- self-efficacy
- pain catastrophizing
- motivation
- perfectionism
- coping skills
- under/over-adherence to rehabilitation processes
- exercise dependence
what are 3 interpersonal factors influencing sport injury rehabilitation
- perceptions of social support; social support seeking/use
- physiotherapists’ influence; limit number of behavior-change techniques and focus on psychological interventions
- sociocultural forces that influence thoughts, behaviors and feelings
what are 3 recommendations for sport injury rehabilitation
- Incorporate elements of mindfulness and acceptance- based practices and cognitive-behavioural-based programs to improve coping and well-being; These elements focus on improving awareness and acceptance of one’s current thoughts and feelings as a basis for psychological flexibility and positive action towards recovery.
- Provide time and space to contribute as much social support as possible
- Cultivate elements of a positive psychology mindset, such as optimism, gratitude, and self-compassion, to benefit mood and promote sport injury-related growth; aids athletes in focusing on seeing meaning and possibilities beyond their present circumstances and beyond themselves
how do you increase motivation during rehab
-
autonomy; Athlete’s input in rehab journey, reduce pressure to return, provide choices in involvement
(no obligation to attend) -
relatedness; Informational and emotional support, inclusion in team
activities, 1-on-1 meetings, giving relevant tasks -
competence; Goal setting, positive self-talk, imagery, reflective practice
& talks, modifying activities, providing alternative activities
what are 2 types of injuries and what are 2 other dimensions that we can judge injuries on
- acute = eg. you get tackled during a game and break your ankle
- overuse = develops over time, slowly
two dimensions:
- recurrent vs new
- severity; duration and impact (on performance)
Summarize the key findings concerning head injuries compared to other types of injuries
there are almost 38 head injuries per 1000 player hours, compared to (ranging from) 2-12 other injuries per 1000 player hours
what are 3 implications of the (relatively high) prevalence rates of sport/exercise injuries
- Sports & active recreation injuries are common, BUT non-active people also get injured!
- Injuries may impact activities of daily living & limit future sport performance/participation
- Risk reduction efforts could be targeted towards (eg. particular age/sub groups, particular sport types & levels)
what are 8 psychological risk factors that might make you more susceptible to injury
- Anxiety/worry
- Hypervigilance
- Poor body image / low self esteem
- Perfectionism
- Limited coping resources
- Life event stress
- Risk taking behaviours
- Low mood state
what are 7 socialcultural risk factors that might make you more susceptible to injury
- Limited social resources
- Lifetime history of abuse
- Social pressures
- Organisational stress
- Stress due to negative self-
appraisal of performance - Coaching quality
- Culture of sport and teams
explain the study that investigated the stress & injury model and its predictive factors in dance
- Student characteristics (age, sex, BMI, educational program, and history of injury) and psychological constructs (coping, perfectionism, and self-regulation) were assessed
- coping skills, age, and BMI were identified as significant risk factors
- stress levels increased from the injury-free to the injury period, which means that stress levels were already increasing before they got injured
- the model explained 24% of the variance (= injuries that happened), which means that there were many injuries that it could not account for
–> this model only incorporated the mental aspect of injuries, maybe if a model would incorporate both the mental and the physical aspects, more variance (injuries) could be explained
Name the components of biopsychosocial model and explain the relations between the components
components:
- characteristics of the injury
- sociodemographic factors
- biological factors
- psychological factors
- social/contextual factors
- intermediate biopsychological outcomes
- sport injury rehabilitation outcomes
what are 7 positive factors affecting rehab outcomes
- Hardiness, resilience and
flourishing - High self-efficacy
- Optimism, gratitude, self-
compassion - Motivation
- Coping
- Social support
- Locus of control
what are 7 negative factors affecting rehab outcomes
- Severe pain catastrophizing
- Strong ahletic identity
- Perfectionism
- Negative affectivity
- Self-presentational concerns
- Negative attitude to help-
seeking - accessibility issues
what are 5 positive responses to injury
▪ Provide infrastructure to enable injured athletes
to disclose their emotions
▪ Reinforce self-disclosure = Strength, not sign
of weakness!
▪ Challenge injured athletes to see their injury
from an alternative perspective
▪ Emphasize importance of & facilitate
emotional/social support
▪ Be aware of impact culture
what are 7 strategies to build confidence
- Goal setting
- Self-talk
- Imagery
- Emotional support
- Informational support
- Reflective practice
- Simulation
