Fear Avoidance After Injury and Readiness to Return to Sport in Collegiate Male and Female Gaelic Games Players

Abstract

Background: Injuries are common in collegiate Gaelic games, and negative psychological responses to injury, such as fear avoidance and a lack of psychological readiness to return to sport, can affect players during their rehabilitation and their subsequent return to sport. Thus, identifying these responses in players can allow clinicians to address these issues during rehabilitation. This study aimed to examine fear avoidance and psychological readiness to return to sport in collegiate Gaelic games players. Hypothesis: Collegiate Gaelic games players will experience similar levels of fear avoidance and psychological readiness to return to sport as other adult athletes. Study Design: Cohort study. Level of Evidence: Level 3. Methods: Male (n = 150) and female (n = 76) players from 1 Irish collegiate institution were recruited. Players that were injured over 1 collegiate season completed the Athlete Fear Avoidance Questionnaire (AFAQ) immediately after the injury and the Injury-Psychological Readiness to Return to Sport (I-PRRS) Scale once cleared to return to sport. An injury report form was also completed. The overall AFAQ (sum of 10 items) and I-PRRS (sum of 6 items/10) scores were calculated. Results: Seventy-three injuries (n = 73) occurred, and injured players had a mean overall AFAQ and I-PRRS score of 22.6 ± 5.3 and 46.4 ± 8.8, respectively. Just less than half (47.9%) of players were deemed psychologically unready to return to sport when cleared physically. After severe injuries, significantly higher overall AFAQ scores than mild injuries ( P = 0.01) and lower overall I-PRRS than moderate injuries ( P < 0.0001) was noted. For the overall scores, no gender differences were observed. Conclusion: Fear avoidance and lowered confidence levels before return to sport occurs in collegiate Gaelic games players similar to other student-athletes. Clinical Relevance: Identification of fear avoidance or low readiness to return to sport, particularly after serious injury, is important to implement psychosocial support during their rehabilitation.

Cross-cultural adaptation and validation of the Athlete Fear Avoidance Questionnaire in Italian university athletes with musculoskeletal injuries

“…Psychometric testing demonstrated good internal consistency and acceptable concurrent validity, as assessed through established measures of fear-avoidance and catastrophizing [15]. Despite clinical use of this tool in different countries [9,13,16,17], to our knowledge, no psychometric validation of the AFAQ in a language other than English has been indexed in PubMed. Considering the importance of collecting athletes' experience in this clinical area, we aimed to develop a culturally adapted and validated Italian version of the AFAQ for assessing fear-avoidance beliefs in Italian athletes with musculoskeletal injuries engaged in both team and individual sports.…”

Clinical outcomes of Gaelic Athletic Association athletes after surgical stabilization in the setting of anterior shoulder instability

“…Moreover, a recent study by O’Connor et al found that approximately half of all GAA players consider themselves not to be psychologically ready to RTP, despite being cleared clinically. 24 With all factors considered, the authors believe that perhaps consensus to inform on criteria for RTP in GAA games after surgical stabilization would be of benefit to both orthopedic surgeons in future.…”

“… 17 Previous literature has reported that the incidence of injury for GAA athletes may be as high as 61 injuries per 1000 match hours, with lower limb injuries representing the most common injuries seen in GAA players. 21 , 23 , 24 However, similar to other collision sports, shoulder injuries commonly occur during GAA games particularly while tackling or reaching for the ball overhead, as the shoulder is commonly forced into abduction and external rotation, representing a harbinger for potential anterior shoulder instability. 3 The high incidence of injuries among GAA athletes is not without morbidity.…”

Psychological prevention and treatment and rehabilitation for sports injuries

“…During rehabilitation or even after being completely healed, athletes may develop a fear of re-injury thus the need for addressing it during rehabilitation. During rehabilitation, an injured athlete may experience fear avoidance, which, in turn, may cause behaviors that adversely impacts their recovery [12]. Nonetheless, if fear is noted early, it can be addressed promptly to avoid a negative effect on recovery.…”

“…Nonetheless, if fear is noted early, it can be addressed promptly to avoid a negative effect on recovery. Consequently, a player may not be psychologically ready to return to the sport after complete healings fear avoidance and low confidence issues emerge [12]. The fear of re-injury, in turn, brings about adverse outcomes.…”