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Existing theoretical frameworks and empirical research support the applicability and usefulness of integrating mental skills throughout sport injury rehabilitation.


To determine what, if any, mental skills athletes use during injury rehabilitation, and by who these skills were taught. Cross-cultural differences were also examined.


Cross-sectional design.


College athletes from 5 universities in the United States and a mixture of collegiate, professional, and recreational club athletes from the United Kingdom and Finland were recruited for this study.


A total of 1283 athletes from the United States, United Kingdom, and Finland, who participated in diverse sports at varying competitive levels took part in this study.

Main Outcome Measures:

As part of a larger study on athletes’ expectations of injury rehabilitation, participants were asked a series of open-ended and closed-ended questions concerning their use of mental skills during injury rehabilitation.


Over half (64.0%) of the sample reported previous experience with athletic training, while 27.0% indicated that they used mental skills during injury rehabilitation. The top 3 mental skills reported were goal setting, positive self-talk/positive thoughts, and imagery. Of those athletes that used mental skills, 71.6% indicated that they felt mental skills helped them to rehabilitate faster. A greater proportion of athletes from the United States (33.4%) reported that they used mental skills during rehabilitation compared with athletes from the United Kingdom (23.4%) and Finland (20.3%). A small portion (27.6%) of the participants indicated that their sports medicine professional had taught them how to use mental skills; only 3% were taught mental skills by a sport psychologist.


The low number of athletes who reported using mental skills during rehabilitation is discouraging, but not surprising given research findings that mental skills are underutilized by injured athletes in the 3 countries examined. More effort should be focused on educating and training athletes, coaches, and sports medicine professionals on the effectiveness of mental training in the injury rehabilitation context.

Arvinen-Barrow is with the Dept of Kinesiology Integrative Health Care & Performance Unit, University of Wisconsin-Milwaukee, Milwaukee, WI. Clement and Lee are with the Dept of Sport Sciences, West Virginia University, Morgantown, WV. Hamson-Utley is with the University of St Augustine for Health Sciences, St Augustine, FL. Zakrajsek is with the Dept of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN. Kamphoff is with the Dept of Human Performance, Minnesota State University, Mankato, Mankato, MN. Lintunen is with the Dept of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland. Hemmings is with the School of Sport, Health and Applied Science, St Mary’s University, London, UK. Martin is with the College of Education, University of North Texas, Denton, TX.

Address author correspondence to Monna Arvinen-Barrow at arvinenb@uwm.edu.