Psychosocial Aspects of Athletic Injuries as Perceived by Athletic Trainers

Abstract

Context: Despite the Psychosocial Strategies and Referral content area, athletic trainers (ATs) generally lack confidence in their ability to use this information. Objective: The current study's primary purpose was to determine (a) perceived psychological responses and coping behaviors athletes may present to ATs, (b) psychosocial strategies ATs currently use with their athletes, (c) psychosocial strategies ATs deem important to learn more about, and (d) ATs' current practices in referring athletes to counseling or sport psychology services. Design: Mixed-methods study. Setting: Online survey containing both quantitative and qualitative items. Patients or Other Participants: A total of 215 ATs (86 male, 129 female), representing a response rate of 22.50%. Main Outcome Measure(s): The Athletic Training and Sport Psychology Questionnaire. Results: Stress/anxiety (4.24 ± 0.82), anger (3.70 ± 0.96), and treatment adherence problems (3.62 ± 0.94) were rated as the primary psychological responses athletes may present upon injury. Adherence and having a positive attitude were identified as key determinants in defining athletes' successful coping with their injuries. The top 3 selected psychosocial strategies were keeping the athlete involved with the team (4.57 ± 0.73), using short-term goals (4.45 ± 0.67), and creating variety in rehabilitation exercises (4.32 ± 0.75). The top 3 rated psychosocial strategies ATs deem important to learn more about were understanding motivation (4.29 ± 0.89), using effective communication (4.24 ± 0.91), and setting realistic goals (4.22 ± 0.97). Of the sample, only 59 (27.44%) ATs reported referring an athlete for counseling services, and 37 (84.09%) of those who had access to a sport psychologist (n = 44) reported referring for sport psychology services. Conclusions: These results not only highlight ATs' current use of psychosocial strategies but also their desires to increase their current knowledge and understanding of these strategies while caring for injured athletes.

Role of Sport Medicine Professionals in Addressing Psychosocial Aspects of Sport-Injury Rehabilitation: Professional Athletes' Views

“…Thus, SMPs should consider an approach in which they are actively engaged in dialogues regarding the physical processes of injury, while being attuned to the possible psychosocial processes of injuries, such as cognitive and emotional reactions and barriers that may undermine the rehabilitation process. 8,17,50 Based on our results, we feel there are several points of note. First, the athletes reported their SMPs set targets for them throughout their rehabilitation and that they found this practice beneficial.…”

“…16 Other investigations of SMPs' views yielded similar findings. For example, 99.7% of sport medicine physiotherapists surveyed in the United Kingdom 8 and 74.4% of the US athletic trainers 17 surveyed believed that, to some extent, all athletes are psychosocially affected by their injuries. 8 In both studies, the key strategies used with athletes were creating variety in rehabilitation exercises and short-term goal setting.…”

“…Athlete self-regulation-the ability of the athlete to manage his or her thoughts, feelings, and behaviors and to delay gratification to achieve a longer-term objective 29,30 -may be affected by a physical injury. In particular, researchers 8,9,16,17,31 have demonstrated that athletic injuries elicit stress, fatigue, and negative emotions, all of which can undermine an individual's ability to self-regulate future behavior. 32,33 Although self-regulation strategies, such as planning and monitoring goals and ongoing evaluation, are beneficial to sport performance, [34][35][36] SMPs must understand how those strategies might be implemented within a sportinjury rehabilitation program.…”

“…In addition, SMPs are reported 2,[18][19][20][21][22] to have central roles in dealing with injured athletes' typical psychosocial responses to injuries and in influencing their overall recovery. Ideally, an athlete will have access to a range of allied health professionals during rehabilitation, including a sport psychologist 23 ; however, very rarely do athletes outside of professional sport have access to such services, 8,17,24 thereby highlighting the need for the SMP to develop competencies in the psychosocial aspects of injury rehabilitation.…”

Psychosocial Responses During Different Phases of Sport-Injury Rehabilitation: A Qualitative Study

“…Indeed, evidence collected from ATs indicates that they appear to recognize the prevalence of psychosocial responses to athletic injuries, but their lack of education on how to appropriately deal with these responses limits their ability to properly incorporate athletes' reactions into their treatment plans and thereby provide holistic care. 2 Recently Kamphoff et al 3 suggested a variation of the phase-like approach to rehabilitation by integrating psychosocial components with physical characteristics of the healing process: reaction to injury, reaction to rehabilitation, and reaction to return to sport. 3 The development of these phases, guided by the physical healing process, has the potential to increase ATs' ability to provide holistic care to injured athletes.…”