Psychological Interventions Can Reduce Injury Risk in Athletes: A Critically Appraised Topic

in Journal of Sport Rehabilitation

Click name to view affiliation

Shauna Ericksen
Search for other papers by Shauna Ericksen in
Current site
Google Scholar
PubMed
Close
,
Geoff Dover
Search for other papers by Geoff Dover in
Current site
Google Scholar
PubMed
Close
, and
Richard DeMont
Search for other papers by Richard DeMont in
Current site
Google Scholar
PubMed
Close
Restricted access

Clinical Scenario: Injury prevention programs are becoming standard practice for reducing sports-related injuries, but most programs focus on musculoskeletal elements. Psychological factors can be strong predictors of sports-related injuries and there is recent evidence that suggests psychological interventions can be effective at reducing injury risk. It is unclear if injury prevention programs that focus on psychological factors are an important inclusion for athletic trainers/therapists. Athletes can be exposed to different psychological factors based on sport type including team or individual sports, which can increase their risk of injury. While psychological interventions can reduce injuries by addressing psychological symptoms, it is unclear if the interventions are effective for at-risk athletes in addition to athletes who are not suffering from any psychological factors. Currently, there are no guidelines or recommendations for athletic trainers/therapists to address psychological factors with the purpose of injury prevention. Clinical Question: Are psychological intervention programs effective in reducing sports-related injury risk and are they clinically relevant to athletic trainers/therapists for implementation in all settings? Summary of Findings: The authors searched the literature for studies investigating the use of psychological intervention programs to reduce sports-related injuries in an athletic population. The search returned 6 possible papers (2 systematic reviews without meta-analysis, 1 systematic review with a meta-analysis, 2 meta-analyses, and 1 randomized control trial not included in the systematic reviews). The authors narrowed our appraisal to one systematic review and one randomized controlled trial. The review contained all the studies from the previous review papers including 3 studies which performed screening procedures. The collection of evidence demonstrates positive effects associated with implementing psychological intervention techniques to reduce sports injury rates in all athletes; at-risk athletes, not at-risk athletes, and individual and team-sport athletes. Bottom Line: There is sufficient evidence supporting the use of a psychological-based intervention by athletic trainers/therapists to effectively reduce the number of injury occurrences in the athletic population. Direct comparisons of effectiveness between team and individual sports was not conducted in the research, but a substantial representation of both sport types existed. The current evidence includes a variety of athletic populations, at-risk and not at-risk, different sport types, and competition levels. Athletic trainers/therapists should consider the integration of psychological disciplines in current injury prevention practices to address the psychological concerns which put athletes at additional risk for injury. Strength of Recommendation: Grade B evidence exists to support the use of psychological intervention strategies in a well-developed injury prevention plan. Sports medicine practitioners can help athletes reduce stress, increase mindfulness, and be more aware of mental health practices which helps reduce injury risk.

Ericksen is a PhD student with the Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QC, Canada. Dover and DeMont are with the Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QC, Canada.

Ericksen (shaunaericksen@gmail.com) is corresponding author.
  • Collapse
  • Expand
  • 1.

    Padua DA, Distefano LJ, Hewett HE, et al. National athletic trainers’ association position statement: prevention of anterior cruciate ligament injury. J Athl Train. 2018;53:519. PubMed ID: 29314903 doi:10.4085/1062-6050-99-16

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Ivarsson A, Johnson U, Andersen MB, et al. Psychosocial factors and sport injuries: meta-analyses for prediction and prevention. Sports Med. 2017;47(2):353365. PubMed ID: 27406221 doi:10.1007/s40279-016-0578-x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Tranaeus U, Ivarsson A, Johnson U. Evaluation of the effects of psychological prevention interventions on sport injuries: a meta-analysis. Sci Sports. 2015;30(6):305313. doi:10.1016/j.scispo.2015.04.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Maddison R, Prapavessis H. A psychological approach to the prediction and prevention of athletic injury. J Sport Exerc Psychol. 2005;27(3):289310. doi:10.1123/jsep.27.3.289

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Pluhar E, McCracken C, Griffith KL, Christino MA, Sugimoto D, Meehan WP III. Team sport athletes may be less likely to suffer anxiety or depression than individual sport athletes. J Sci Med Sport. 2019;18:490496.

    • Search Google Scholar
    • Export Citation
  • 6.

    Nixdorf I, Frank R, Beckmann J. Comparison of athletes’ proneness to depressive symptoms in individual and team sports: research on psychological mediators in junior elite athletes. Front Psychol. 2016;7:893. PubMed ID: 27378988 doi:10.3389/fpsyg.2016.00893

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Gledhill A, Forsdyke D, Murray E. Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness. Br J Sports Med. 2018;52(15):967971. PubMed ID: 29463497 doi:10.1136/bjsports-2017-097694

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Noh YE, Morris T, Andersen MB. Psychological intervention programs for reduction of injury in ballet dancers. Res Sports Med. 2007;15(1):1332. PubMed ID: 17365949 doi:10.1080/15438620600987064

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Clement D, Granquist MD, Arvinen-Barrow MM. Psychosocial aspects of athletic injuries as perceived by athletic trainers. J Athl Train. 2013;48(4):512521. PubMed ID: 23724772 doi:10.4085/1062-6050-48.3.21

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Smyth EA, Newman P, Waddington G, et al. Injury prevention strategies specific to pre-elite athletes competing in Olympic and professional sports—a systematic review. J Sci Med Sport. 2019;22(8):887901. PubMed ID: 30930142 doi:10.1016/j.jsams.2019.03.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Slimani M, Bragazzi NL, Znazen H, et al. Psychosocial predictors and psychological prevention of soccer injuries: a systematic review and meta-analysis of the literature. Phys Ther Sport. 2018;32:293300. PubMed ID: 29776844 doi:10.1016/j.ptsp.2018.05.006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Zadeh MM, Ajilchi B, Salman Z, et al. Effect of a mindfulness programme training to prevent the sport injury and improve the performance of semi-professional soccer players. Australas Psychiatry. 2019;27(6):589595. PubMed ID: 31282193 doi:10.1177/1039856219859288

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Shea BJ, Reeves BC/given-names>, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. doi:https://doi.org/10.1136/bmj.j4008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. J Am Board Fam Med. 2004;17(1):5967. doi:10.3122/jabfm.17.1.59

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Barends E, Rousseau DM, Briner RB, eds. CEBMa Guideline for Critically Appraised Topics in Management and Organizations. Amsterdam, The Netherlands: CEBMa; 2017. https://www.cebma.org/wp-content/uploads/CEBMa-CAT-Guidelines.pdf.

    • Search Google Scholar
    • Export Citation
  • 16.

    Sadigh G, Parker R, Kelly AM, et al. How to write a critically appraised topic (CAT). Acad Radiol. 2012;19(7):872888. PubMed ID: 22480959 doi:10.1016/j.acra.2012.02.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Appaneal RN, Perna FM. Biopsychosocial model of injury. In: R.C. Eklund & G. Tenenbaum (eds.) Encyclopedia of Sport and Exercise Psychology. Thousand Oaks: SAGE Publications, Inc;2014:7477. doi:10.4135/9781483332222.n30

    • Search Google Scholar
    • Export Citation
  • 18.

    Hänsel A, Hong S, Cámara RJA, et al. Inflammation as a psychophysiological biomarker in chronic psychosocial stress. Neurosci Biobehave Rev. 2010;35(1):115121. doi:10.1016/j.neubiorev.2009.12.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Petterson H, Olson BL. Effects of mindfulness-based interventions in high school and college athletes for reducing stress and injury and improving quality of life. J Sport Rehabil. 2017;26(6):578587. PubMed ID: 27632857 doi:10.1123/jsr.2016-0047

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 4999 3677 88
Full Text Views 163 98 1
PDF Downloads 237 142 1