Sports Medicine Research: In the Lab & In the Field: Athletes Rely on Athletic Trainers for Social Support Following Injury (Sports Med Res)
Monday, December 8, 2014

Athletes Rely on Athletic Trainers for Social Support Following Injury

Social support from the athletic trainer and symptoms of depression and anxiety at return to play

Yang J., Schaefer JT., Zhang N., Covassin T., Ding K., Heiden E. J Athl Train. 2014;49(3)00-00.

Take Home Message: More than 80% of injured college athletes reported social support from their athletic trainers during their recovery, and athletes reporting higher levels of satisfaction with the social support from their athletic trainers were less likely to report depression or anxiety at return to play.

Social support following an injury is important for an athlete’s health because it can help the athlete cope with an injury and improve motivation during rehabilitation. Many universities provide psychological services; however, they are not always specifically trained to satisfy the need of injured athletes. Athletic trainers who are active in the day-to-day rehabilitation tasks are an important source of emotional social support for the athlete, but there are few studies that examined if athletic trainers are effective in providing social support to the athletes. Therefore, the authors examined the effect of social support received from athletic trainers during injury recovery on reported symptoms of depression and anxiety at return to play among a cohort of collegiate athletes. Three hundred and eighty-seven athletes from 2 colleges (397 injuries by 256 males, 197 injuries by 131 females) completed surveys prior to injury and then after the injury at 1 week, 1 month, 3 months, 6 months, and 12 months. Additionally, a follow-up survey occurred 1 week after the injured athletes’ return to play regardless of the time lost. The authors used the 6-item Social Support Questionnaire to collect information about social support from family, friend, coach, athletic trainer, physician, counselor, or others. The authors assessed depression using the 20-item Center for Epidemiological Studies Depression Scale. To measure levels of anxiety the authors used the 20-item State Trait Anxiety Inventory. Overall, during 84% of injuries the athletes reported receiving social support from the athletic trainer during recovery, and 79% reported that their athletic trainer was the person they can really count on to be dependable when they needed social support during their recovery. During 48% of injuries, the athlete’s reported that the athletic trainer made them feel better when they were down, and 45% reported that their athletic trainer consoled them when he/she was upset. Over half of the athletes said they were very satisfied with the social support they received from their athletic trainer, and only 7% reported being dissatisfied with the social support from their athletic trainer. Upon returning to play 22% of the injuries resulted in depression and 28% injuries resulted in anxiety. Athletes who were very satisfied or satisfied with the social support from their athletic trainer were 70 to 88% less likely to report symptoms of depression or anxiety compared with athletes who were dissatisfied with the social support received from their athletic trainer.

This study illustrates that athletic trainers have an important role in providing social support to athletes with injuries. This study also suggests that social support may positively influence recovery outcomes among injured collegiate athletes. More than 80% of the injured athletes received social support from their athletic trainer, and most reported that they were very satisfied or satisfied with the received social support. Additionally, those that were very satisfied or satisfied with the social support received were less likely to report anxiety or depression during their recovery process. However, only about half of the injured athletes indicated that the athletic trainer was able to help them when they were feeling down or consoled them when they were upset. Future studies should focus on when the social support is most helpful as well as when and if depression and anxiety symptoms arise due to the injury and not other outside factors (e.g., family, school). Medical professionals should be cognizant of the social support they provide to athletes and need to recognize situations where the athlete may need emotional support.

Questions for Discussion: How do you provide social support to your athletes? Do you feel you possess the psychosocial competency to provide a strong social support for your athletes?

Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban

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Yang, J., Schaefer, J., Zhang, N., Covassin, T., Ding, K., & Heiden, E. (2014). Social Support from the Athletic Trainer and Symptoms of Depression and Anxiety at Return to Play Journal of Athletic Training DOI: 10.4085/1062-6050-49.3.65

4 comments:

Danielle D. said...

This study really demonstrates the importance of going beyond the clinical knowledge and treating your athlete more holistically. Unfortunately, I am not very confident in my skills of social support. Are there any suggestions you have for providing support? I was surprised by the anxiety and depression experienced by athletes experienced by athletes dissatisfied with the social support received compared with those satisfied or very satisfied. Personally, this raises the question: Can athletic trainers prolong return to play with poor social support by raising anxiety and depression? I’d be interested to see any studies on this.

Thanks for sharing!

Jane McDevitt said...

Danielle,
I do not think you are alone with not believing in your social support skills. I believe that the best way to help an athlete is communication. Ask them how they are feeling, do they beleive they are progressing as they should, and get them involved in the treatment plan and setting short term and long term goals. If they are active in the plan of treatment they know how long it will take to complete each stage and they will know what each exercise is for. Your second point brings up a great research question. There may be a difference in RTP and faster recoveries when an athletic trainer provides strong social support. We will have to stay tuned!

Jennifer Joseph said...

I agree with this study suggesting athletic trainers have an important role in providing social support to athletes with injuries. Ill admit there are times where I feel as much of a psychologist as an athletic trainer. Seeing an athlete day after day week after week month after month, they begin to trust the athletic trainer more and more and feel comfortable enough opening up to them about other issues that may be present. As clinicians its important to remember to treat the whole patient, in spirit, mind, and body and if we aren’t there for emotional and psychological help, we aren’t fully completing our duties. I think its important for undergraduate athletic training programs to incorporate psychological courses for athletic trainers to take to be able to better support those athletes in times of need.

Jane McDevitt said...

Jennifer,
I agree that we need to be fully aware of how the patient is responding psychologically/emotionally. I think implementing patient reported outcome measures are helpful. Did you take any courses that would be helpful for others to implement this practice? Did you take extra courses/workshops at a convention?

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