Understanding injuries in sports: Self-reported injury and perceived risk of injury among adolescents

IntroductionAlthough exposure and perceived risk of injury in sports among adolescents is a well-known phenomenon today, their understanding remains poorly explored.ObjectiveThis study examines the relationships between demographics, sport motives, and sport-related characteristics in a sample of French adolescents involved in sports.MethodsThe sample included 394 adolescents involved in sports, between 13 and 19 years old. The adolescents filled out a questionnaire requesting information about their age, sex, sport motives, sport-related characteristics, the number of injuries, and perceived risk of injury in their preferred sport.ResultsThe findings showed that the number of injuries was related to age, sex, type of sport and the participant's motives. The will to play to the limit increased with the exposure to injury. Participation in risky sports and the will to play to the limit were predictors of the adolescents’ risk of exposure to sports injuries. Time devoted to sports appears to be a confounding factor. Moreover, boys exhibited higher number of injuries than girls, and they perceived their preferred sport as riskier.ConclusionExposure to the risk of injury in sports and the exacerbated perception of that risk may provide a means of enhancing one's self-image, procuring an emotional experience, and constructing one's masculinity.     

Studying the transgenerational aftereffects of the holocaust in israel

Abstract

A study of 31 patients (20 males and 11 females) at a sports medicine clinic who attributed their injuries to overtraining or overuse was conducted to examine the relationship between causal attribution dimensions and psychological adjustment to sport injury. Participants completed a battery of questionnaires that included the Profile of Mood States (POMS) and an attribution measure in which participants were asked to identify the main cause of their injuries and to rate the perceived cause of injury in terms of internality, stability, and globality dimensions. The attribu-tional dimensions accounted for 55% of the variance (p < .0005) in POMS total mood disturbance (TMD) scores. Internality (ft =– .38, p < .01) and stability (ft = –.58, p < .0005) were inversely related to TMD. These findings were essentially the same when statistically controlling for injury duration, injury severity, and injury status. The findings suggest that attributing overuse injuries to internal and stable factors may have adaptive value.     

Systematic review of stress-related injury vulnerability in athletic and occupational contexts

Injury is a pervasive, expensive and, to some extent, preventable problem. Stress is a psychological risk factor for injury but little is known about how stress processes compare in athletic and occupational contexts. This paper reviews research on stress-related injury vulnerability in athletic and occupational contexts to characterize and compare samples, methods, and conclusions from the perspective of an integrated model of stress-related injury vulnerability. A comprehensive search of four major databases identified research in both athletic (n = 34) and occupational contexts (n = 22). Studies were coded to extract characteristics of the samples, research designs, measures, and conclusions about stress-injury relations. Studies used more prospective than cross-sectional or case control research designs. Injury was most frequently defined as missing one subsequent day of training or work (35.7%). Approximately 75% of the identified studies in each context indicated a positive association between stress and injury occurrence. The consistency of findings suggested a robust stress-related injury vulnerability for both exposures and responses, however, caution is warranted due to the diversity of measures and surveillance periods and the lack of experimental designs. New hypotheses are identified to refine models of stress-related injury vulnerability in athletic and occupational contexts.     

Causation, Liability and Toxic Risk Exposure

ABSTRACT Persons injured as a result of exposure to toxic or carcinogenic substances are seldom able to recover damages from those who are responsible for the exposure. Tort law requires proof of causation, and causation is often unprovable because of long latency periods, because of the relative infrequency of the injuries and because many of the injuries among the exposed population are the result of other factors. A number of proposals for modifying the legal causation requirement to allow those who create hazardous risks to be held liable for the injuries that materialise are considered and found inadequate. A proposal to treat risk exposure itself as an injury for which compensation under private law is possible is also considered and ultimately found incoherent. The paper concludes by arguing for a public law solution, modelled on criminal law, but providing compensation for victims.     

The psychosocial aspects of a return to sport following serious injury: A review of the literature from a self-determination perspective

ObjectivesThe objective of this paper is to review the literature relevant to the psychosocial aspects of a return to sport following injury using a self-determination theoretical (SDT) framework.MethodsThe literature was reviewed qualitatively. SDT was used to interpret and bring coherence to the diverse array of findings.ResultsThe review is divided into four main sections. In section one, two conceptual models—the biopsychosocial model and the stages of return to sport model—that have been used to describe the return to sport following injury are examined and critiqued. In light of the limitations of these two models, SDT is presented as a potentially useful framework for synthesising the extant literature and making suggestions for future research on return to sport after injury phenomena (Section 2). Analysis of the psychosocial sport injury literature within a self-determination framework (Section 3) reveals the ways in which issues of competence, autonomy and relatedness may be salient during the return transition. In the fourth and final section, the implications of the findings are discussed and suggestions for future research are provided in line with self-determination theoretical contentions.ConclusionsSDT has potential for understanding findings in this area and for guiding future research. From an applied perspective, ensuring athletes’ needs for competence, autonomy and relatedness are met, may yield beneficial return-to-sport outcomes.     

Conjunctive moderator variables in vulnerability and resiliency research: life stress, social support and coping skills, and adolescent sport injuries

In life event research relating to vulnerability and resilience factors, single moderator variables have typically been the focus of study. Little is known about the ways in which moderator variables may interact with one another to increase vulnerability or resilience. We propose a distinction between conjunctive moderation, in which multiple moderators must co-occur in a specific combination or pattern to maximize a relation between a predictor and an outcome variable, and disjunctive moderation, in which any one of a number of moderators maximizes the predictor-criterion relation. Our results indicate that social support and psychological coping skills are statistically independent psychosocial resources and that they operate in a conjunctive manner to influence the relation between life stress and subsequent athletic injury in adolescents. Only athletes low in both coping skills and social support exhibited a significant stress-injury relation, and in that vulnerable subgroup, negative major life events accounted for up to 30% of the injury variance. Methodological considerations in the assessment of conjunctive moderator effects are discussed.     

Adherence to sport injury rehabilitation programs

Abstract

Adherence to sport injury rehabilitation prognms has emerged as a prime area of interest in the psychology of sport injury. In this article, behaviors typically involved in sport injury rehabilitation adherence are described. research findings on sport injury rehabilitation adherence are reviewed. and theoretical, methodological. and practical issues associated with sport injury rehabilitation research are identified and discussed. Primary recommendations resulting from the literature reviewed include use of conceptual models to guide research efforts, use of prospective resexch designs and standardized, psychometrically-sound measures of key constructs. and resolution of the question of whether enhancing adherence actually improves rehabilitation outcomes before interventions targeted at adherence behavior are developed, implemented, and evaluated.     

Examining the Prevalence and Predictors of Injury From Adolescent Dating Violence

Medical needs of youth who experience dating violence are not well understood because of limited past research examining the prevalence and predictors of injuries and medical help seeking. To address these gaps, the current study described the prevalence and predictors of injuries from dating violence from grades 8 through 12 in a large sample of youth. Results indicate that one third to one half of youth who experienced any physical and/or sexual dating violence also sustained an injury. Prevalence of injury was highest in the 8th grade and was significantly higher for females than for males across grades 8 through 11. Youth who experienced greater amounts of violent victimization in their relationships (physical, sexual, and psychological) were at the highest risk for injury. Results also suggest that victims at highest risk for injury are girls, White youth, those experiencing multiple types of violence, and those who also engage in perpetration. Given the high prevalence of injury among youth who report dating violence, healthcare professionals may be in a unique position to screen and counsel youth about dating violence. Because the highest prevalence of injury occurred before high school, prevention programs should start early and selected prevention may be used for youth at highest risk for injury.     

Disability,inclusive adventurous training and adapted sport: Two soldiers' stories of involvement

ObjectivesTo generate insights into the personal meaning and value of an inclusive adventurous training and adapted sport course for military personnel who have experienced physical disability as a result of injuries sustained during active service.DesignNarrative storytelling approach based on collaboratively written creative nonfictions.MethodFirst-person stories were constructed with two male soldiers on the basis of informal interviews and conversations across five days of a residential adventure training and sport course.ResultsThe stories portray the personal benefits, meaning, and value of adventurous training and sport by illuminating each individual's experiences since injury/trauma, his experiences while on the course, and how these interact to shape psychological wellbeing and future life horizons. They reveal a complex interplay between physical, psychological, and social disability among some military personnel.ConclusionsThe story as analysis expands current understanding of the psychological effects of physical activity for injured military personnel through: (i) providing an alternative analytical approach; (ii) revealing subjectivities, personal meaning, and biographical connections to generate a holistic understanding of the individual; (iii) preserving the complexity and ambiguity that characterize lived experience to support plural understandings; (iv) sharing an embodied representation as an ethical act of witnessing another's life. We suggest these kinds of understandings are necessary for physical activity practitioners who wish to support military personnel who have sustained a disability.     

The Predictive Validity of Injury Proxies: Predicting Early Adolescent Injuries with Assessments of Minor Injuries

This study offers an initial step in establishing the predictive validity of injury proxies. Proxies are utilized frequently by injury researchers to overcome various methodological and ethical issues inherent in injury research, although psychometric data on proxies are limited. Using data from the NICHD Study of Early Child Care and Youth Development we found that minor injuries predicted adolescent injuries longitudinally, even in the context of well-established predictors of injury risk. This study is the first to demonstrate the predictive validity of minor injuries, a common proxy of pediatric injury risk. Findings are discussed with respect to implications for conceptual understanding of injury risk, future research, and prevention efforts.     

Post-traumatic stress disorder symptom severity in service members returning from Iraq and Afghanistan with different types of injuries

IntroductionRisk for post-traumatic stress disorder (PTSD) varies in part due to the nature of the traumatic event involved. Both injury and return from combat pose high risk of PTSD symptoms. How different injuries may predispose towards PTSD is less well understood. METHODS: A retrospective record review was conducted from 1402 service members who had returned to Naval Medical Center San Diego from Iraq or Afghanistan and who had completed the PTSD Checklist as part of their post-deployment screening. Rates of PTSD were examined in relation to mechanism of injury. RESULTS: Of those without injury, 8% met Diagnostic and Statistical Manual criteria for PTSD. Thirteen percent of those with a penetrating injury, 29% with blunt trauma, and 33% with combination injuries met criteria for PTSD. PTSD severity scores varied significantly according to type of injury.DiscussionThe World War I concept of "shell shock" implied that blast-related injuries were more likely to result in psychological symptoms than were other injuries. These data may support that idea. Circumstance of injury, population differences, and reporting bias could also have influenced the results.ConclusionThese results suggest that service members with blunt or combination injuries merit particular attention when screening for PTSD.     

Does delayed onset muscle soreness affect the biomechanical variables of the drop vertical jump that have been associated with increased ACL injury risk? A randomised control trial

IntroductionDelayed onset muscle soreness (DOMS) and Anterior Cruciate Ligament (ACL) injuries are both prevalent in sport. It is currently unknown whether DOMS increases ACL injury risk.AimThis study aimed to provide preliminary insight on whether DOMS affects ACL injury risk by investigating whether DOMS affects the biomechanical variables of the DVJ that have been identified as risk factors for future ACL injury.MethodsThis was a randomised control trial involving 32 active individuals aged 18–35 years, with no history of ACL injury. Participants underwent two sessions of force-plate testing and 3D motion analysis of the drop vertical jump (DVJ). The DVJ was chosen as it has been investigated prospectively for association with future ACL injury. Initial testing was followed by randomisation to DOMS or control group. The DOMS group underwent a DOMS-inducing exercise protocol, the control group did not. Both groups were re-tested 48 h after initial testing. Five variables of the DVJ that have been associated with future ACL injury were chosen for analysis - peak knee flexion angle, peak vertical ground reaction force, ground contact time, peak knee abduction angle & peak knee abduction moment. Between-group differences were compared using a two-way mixed analysis of variance; alpha level set to 0.05.ResultsDOMS was successfully induced in all participants of the DOMS group however no statistically significant group x time interactions were found for any of the five variables analysed.ConclusionsDOMS did not affect the biomechanical variables of the DVJ that have been associated with future ACL injury. By extension, this may suggest that DOMS might not affect ACL injury risk. However, it is also possible that certain attributes of the DVJ meant that any effect of DOMS was simply unable to be quantified, even if an effect existed. All considered, our position is that conclusion cannot be drawn from this study alone on whether DOMS affects ACL injury risk. Further research is required.     

High-level athletes' perceptions of success in returning to sport following injury

ObjectiveFor many injured athletes, a safe and successful return to sport following injury is the ultimate aim of injury recovery. Little consensus exists however, regarding the meaning of a “successful” return to sport following injury recovery [Evans, L., Mitchell, I., &; Jones, S. (2006). Psychological responses to sport injury: a review of current research. In S. Hanton, &; S. D. Mellalieu (Eds.), Literature reviews in sport psychology (pp. 289–319). New York, NY: Nova Science Publishers]. The purpose of this investigation was to obtain greater insight into this issue by examining high-level athletes' perceptions of a successful return to play following injury.MethodUsing a longitudinal design, 12 elite athletes from Australia and Canada were interviewed on a total of 40 occasions over a six–eight month period.ResultsPerceptions of success centered on (but were not limited to): a return to pre-injury levels and attaining pre-injury goals, staying on the “right” path, creating realistic expectations of post-injury performance, and remaining uninjured.ConclusionsConsistent with previous research [Podlog, L., &; Eklund, R. C. (2007a). Professional coaches perspectives on the return to sport following serious injury. Journal of Applied Sport Psychology, 1, 44–68], findings from this investigation highlight the importance of self-determination theory (SDT) constructs – namely, competence, autonomy and relatedness – in relation to athlete perceptions of a successful return to sport from injury. Such findings support the value of an SDT perspective in guiding future research and intervention efforts aimed at facilitating successful return from injury.     

Two Kinds of Brain Injury in Sport

Abstract

After years of skepticism and denials regarding the significance of concussions in sport, the issue is now front and center. This is fitting, given that the impact of concussions in sport is profound. Thus, it is with trepidation that one ventures to direct some attention onto brain injuries other than concussions incurred through sport. Given a closer look, however, it may be that considering various kinds of brain injuries, with different causes, will help us better understand the range and seriousness of brain injuries in sport. My focus is on emotional trauma in sport. I argue that severe emotional pathology is evidence of underlying brain injury. Any attempt to minimize the significance of emotional disturbance that results from emotional trauma as ‘merely’ psychological in nature is thus misguided.     

Body-Region-Specific Injuries as Predictors of Psychosocial Outcomes Among Those Injured in Combat: Results From the Wounded Warrior Recovery Project

Associations between body region injured and psychosocial outcomes may have implications for injury prevention and mitigation strategies. The present study investigated the association of body-region—specific injuries and their association with 3 psychosocial outcomes (i.e., quality of life, QOL; posttraumatic stress disorder, PTSD; and depression) among a large sample of U.S. military service members injured in combat. A total of 1,011 individuals wounded in combat enrolled in the Wounded Warrior Recovery Project and provided QOL, depression, and PTSD measures on a Web-based survey. These psychosocial variables were linked with the presence/absence of combat injuries in 9 different body regions (head, face, neck, thorax, spine, abdomen, upper extremity, lower extremity, and external skin/other), as well as overall injury severity and demographic factors. Two-step hierarchical linear regressions revealed that after adjusting for overall injury severity and time since injury, those with combat-related head and spine injuries were particularly at risk for relatively worse psychosocial outcomes. Head and spinal injuries were associated with lower QOL and higher PTSD and depression. Overall, even those with relatively minor injuries may be at risk of lower QOL and adverse psychosocial outcomes. These findings may highlight the need for early interventions to minimize the psychological effects of combat injuries to the head and spine.     

Childhood Abuse,Head Injuries,and Use of Medical Emergency Services in People with Severe Mental Illness

People with severe mental illness (SMI) report high rates of traumatic experiences. This study analyzes data collected from 183 people diagnosed with SMI on reports of childhood trauma, head injuries, and emergency room (ER) services. More than half the cohort (56.7%) reported 3 to 7 cooccurring categories of childhood abuse (CAB). People who reported 6 and 7 categories of CAB had a 5-fold risk of experiencing a head injury. If they have used the ER for reasons other than psychiatric illness they endorse more traumatic experiences in their childhood when compared to those who did not. People with SMI and cooccurring CAB experiences might be predisposed to a higher risk of head injuries and more frequent use of the ER.     

Ethics,Brain Injuries,and Sports: Prohibition,Reform, and Prudence

Abstract

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on (a) the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development of a degenerative brain disease known as chronic traumatic encephalopathy (CTE); and (b) John Stuart Mill’s rejection of consensual domination (ie voluntary enslavement). We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that (i) certain autonomy-based arguments undermine paternalist arguments for reform; (ii) the nature of the goods people pursue in their lives might justify their foregoing (degrees of) future autonomy; (iii) Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; (iv) the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded.     

Suicide Risk Among Wounded U.S. Service Members

The association between suicide and combat injuries sustained during the wars in Iraq and Afghanistan was examined. A retrospective population‐based cohort design was conducted using official military records to identify combat injuries (October 7, 2001, to December 31, 2007). Those who were injured during combat had higher crude suicide rates than those who deployed and were not injured (incidence rate ratio [IRR] = 1.50; confidence interval [CI] = 1.06, 2.12), or never deployed (IRR = 1.46; CI = 1.04, 2.06). After adjusting for demographics, these findings were no longer statistically significant. Although our data did not support an elevated suicide risk among wounded service members, additional research is needed to examine the impact of injury severity.     

Where is Safeguarding in Sport Psychology Research and Practice?

Recent cases of sexual abuse of athletes have drawn significant concern amongst stakeholders in sport and the public at-large. The fact that the perpetrators in many cases of athlete abuse had numerous victims over the span of several years raises questions of who might have known or suspected that athletes were being harmed. Sexual abuse cases should serve as an impetus for all of us in sport psychology to interrogate our roles and responsibilities as consultants and researchers in the protection of athletes. We propose that future research in applied sport psychology and education of consultants address maltreatment and safeguarding.

Lay Summary: In the following article, we propose that more attention in the research and practice of sport psychology should be devoted to understanding maltreatment of athletes and ways to protect athletes from harm.     

Gender biases in children's appraisals of injury risk and other children's risk-taking behaviors

Children ages 6, 8, and 10 years were given tasks designed to assess their beliefs about risk of injury from activities. Children were asked to appraise the risk of injury for boys and girls engaging in various play behaviors and to judge the sex of the character in stories about children engaging in activities that result in injuries. Results revealed gender biases in children's appraisals of injury risk: Both boys and girls rated boys as having a lower likelihood of injury than girls even though the boys and girls were engaging in the exact same activities. Children also showed higher accuracy in identifying the sex of the character in stories of boys' injuries than girls' injuries, and accuracy improved with the participant's age. Overall, the results indicate that by the age of 6 years children already have differential beliefs about injury vulnerability for boys and girls. Although boys routinely experience more injuries than girls, children rate girls as having a greater risk of injury than boys. With increasing age, school-age children develop a greater awareness of the ways in which boys and girls differ in risk-taking activities that lead to injury outcomes.