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Ashley M.B. Suttmiller and Ryan S. McCann

Context: Injury-related fear has recently been recognized to exist in ankle sprain populations. It is unclear, however, if injury-related fear levels differ between those who develop chronic ankle instability (CAI) and those who do not and the best tools for assessing these differences. Objective: The purpose of this study was to conduct a comprehensive systematic review investigating differences in injury-related fear between individuals with and without CAI. Evidence Acquisition: Relevant studies from CINAHL Plus with full text, PubMed, and SPORTDiscus through November 2020 were included. All studies used the Tampa Scale of Kinesiophobia, Fear-Avoidance Beliefs Questionnaire, or Athlete Fear Avoidance Questionnaire as either a descriptor or a main outcome and provided comparison data between a CAI group and ankle sprain copers (COP) or controls (CON). The authors independently assessed methodological quality using the modified Downs and Black Quality Index. Studies were then grouped by between-group comparisons including CAI and CON, CAI and COP, and COP and CON. The authors calculated Hedge g effect sizes and 95% confidence intervals to examine group differences. Evidence Synthesis: A total of 11 studies were included in this review. In total, 8 studies provided data for the CAI and CON comparison, 7 for CAI and COP comparisons, and 4 for COP and CON comparisons. Methodological quality scores ranged from 60.0% to 86.7%, with 2 high-, and 9 moderate-quality studies. Overall, the evidence suggests that physically active individuals with CAI report higher levels of injury-related fear when compared with both COP and CON. Although limited, ankle sprain COP do not seem to differ from CON. Conclusion: Available evidence emphasizes the importance of injury-related fear in individuals who develop chronicity after ankle sprain injury. The Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia are useful for the identification of injury-related fear in individuals after sustaining an ankle sprain and should be used to inform rehabilitation strategies and to monitor efficacy in fear reduction.

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Lauren M. Harte, James J. Czyrny, Sonja Pavlesen, and Michael R. Ferrick

A 13-year-old female cheerleader presented with common peroneal neuropathy secondary to repetitive direct blow contusion injuries to the lateral leg, sustained during her role as a flyer in cheerleading. Symptoms resolved when removed from cheerleading activities. Nerve conduction velocity and needle electromyography electrodiagnostic test studies performed at presentation and during treatment confirmed improvement of the neuropathy. The use of a protective knee brace that provided cushion near the fibular head prevented recurrence after returning to cheerleading. An association between common peroneal neuropathy and cheerleading has not been documented in previous literature. Awareness of this association will help with diagnosis and prevention of injuries.

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Lorin A. Cartwright and Timothy Neal

An area that has not been closely considered in the sporting world is the mental health effects on the competitive athletes who identify as Lesbian, bisexual, gay, transgender, queer/questioning (LBGTQ+) and thus, experience discrimination because of their sexual identity. Considerations include concepts an athletic trainer should keep in mind when caring for patients/athletes who identify as LBGTQ+. This article reviews the mental health impact of sexual minority identity stress on LBGTQ+ individuals, steps to address discrimination for those in athletics who identify as LBGTQ+, legal ramifications in the workplace for the LBGTQ+ individual, and the tragic consequences when LBGTQ+ individuals lack coping skills for stress and pursue suicide as a way to cope. Strategies are provided to improve the outcomes, prevent suicide, and create an environment of inclusivity.

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ZáNean McClain, Erin Snapp, Daniel W. Tindall, and Jill Anderson

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Philip Sullivan and Laura Tennant

Intercollegiate student-athletes appear to be a high-risk population with respect to mental health. Student athletic therapists are one of the groups with whom these athletes may be comfortable disclosing concerns. The current study investigated the relationship between mental health literacy and mental health referral efficacy in a sample of intercollegiate student therapists. One hundred and eleven student athletic therapists (81 female, 29 male, 1 nondiscloure) competed a revised version of the multicomponent mental health literacy measure and a four-item measure of mental health referral efficacy. T tests revealed statistically significant differences in mental health literacy by gender and personal history, and a multiple linear regression revealed a significant model predicting referral efficacy from mental health literacy. There are several implications of these results, particularly when working with a high-risk population of student-athletes.

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Andreas Kuettel, Natalie Durand-Bush, and Carsten H. Larsen

The purpose of this study was (a) to investigate gender differences in mental health among Danish youth soccer players, (b) to discover the mental health profiles of the players, and (c) to explore how career progression and mental health are related. A total of 239 Danish youth elite soccer players (M = 16.85, SD = 1.09) completed an online questionnaire assessing mental well-being, depression, anxiety, along with other background variables. Female players scored significantly lower on mental well-being and had four times higher odds of expressing symptoms of anxiety and depression than males. Athletes’ mental health profiles showed that most athletes experience low depression while having moderate mental well-being. Depression, anxiety, and stress scores generally increased when progressing in age, indicating that the junior–senior transition poses distinct challenges to players’ mental health, especially for female players. Different strategies to foster players’ mental health depending on their mental health profiles are proposed.

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Eleftherios Paraskevopoulos, Georgios Gioftsos, Georgios Georgoudis, and Maria Papandreou

Adherence to exercise rehabilitation has been shown to be an important factor that may influence successful treatment. In professional athletes, a significant reduction in exercise adherence delays recovery. The aim of this study was to explore barriers to and facilitators of exercise rehabilitation adherence in injured volleyball athletes. Eight professional volleyball athletes were recruited, and qualitative data were collected using semistructured interviews. All athletes had completed their rehabilitation program after they had suffered a musculoskeletal injury. All data were analyzed using thematic analysis after the investigators ensured that saturation had been reached. Pain was identified as a significant barrier to exercise adherence by all athletes. The provision of social support, including mental, practical, and task related, also had a significant positive impact. The athletes’ ability to develop the necessary coping strategies and confidence on performing exercises at home was also mentioned as a factor that affected exercise adherence, although less often.

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Benjamin J.I. Schellenberg, Jérémie Verner-Filion, and Patrick Gaudreau

Athletes can respond to positive experiences in sport by engaging in savoring—that is, by attempting to prolong or amplify their positive feelings. In this research, the authors tested if savoring was predicted by levels of harmonious or obsessive passion for sport and if savoring was associated with symptoms of burnout. In Study 1 (n = 499), the authors found that savoring was positively associated with harmonious passion and negatively associated with obsessive passion. In addition, savoring predicted lower levels of burnout and played an indirect role in the relationship between both passion types and burnout. The authors replicated these findings in Study 2 (n = 298), with collegiate-level athletes, prospectively, over the course of a season. Overall, athletes with strong levels of harmonious passion appear to be most likely to engage in savoring, a response that may protect them from experiencing higher levels of burnout.

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Christine E. Pacewicz and Alan L. Smith

Interpersonal exchanges may contribute to athletes’ motivational and well-being experiences through their contribution to athletes’ feelings of loneliness. Loneliness is understudied in sport, yet it is potentially salient in connecting social relationships with motivational processes and well-being of athletes. The purpose of the current research was to examine (a) the association of aspects of teammate relationships with athletes’ perceptions of burnout and engagement and (b) whether loneliness explained these associations. Adolescent athletes (N = 279) completed established measures of teammate relationships, loneliness, burnout, and engagement. The mediational model was invariant between boys and girls. Loneliness mediated the relationship of social support (β = −0.14, 0.10), corumination (β = 0.09, −0.06), and appraisal of peer rejection (β = 0.11, −0.08) with burnout and engagement, respectively. Continued examination of athletes’ loneliness will extend understanding of athletes’ motivational and well-being experiences and inform the promotion of adaptive sport experiences.

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Naser Nawayseh and Saleh AlBaiti

In recent years, whole-body vibration (WBV) training has received an increasing interest in the sports and medical fields. However, there has been inconsistency among several studies regarding the effect of WBV training on the human body, which is partly due to the lack of the existence of guidelines for using WBV training machines. To understand the effect of WBV training on the human body and build the needed regulations, it is essential first to understand the biodynamic responses to vibration which represent how vibration is transmitted to and through the human body. The purpose of this study is to systematically review previous studies that measured biodynamic responses when using WBV training machines to highlight inconsistencies in their results and provide possible reasons for them. An extensive literature search was performed on the SCOPUS database to obtain relevant studies. One hundred and fifty-six potentially relevant studies were obtained but after further screening, 23 papers from 2007 to 2020 met inclusion criteria and were included in the study. The papers were analysed with respect to acceleration, transmissibility, interface force, and apparent mass during different vibration settings, body posture, age, and sex. Results and conflicts among studies were highlighted and possible explanations for the inconsistency were provided.