Injury Risk Is Increased By Changes in Perceived Recovery of Team Sports Players
van der Does HT, Brinke MS, Ardi Otter RT, Visscher C. Clin J Sport Med. 2016: ahead of print
Take Home Message: A reduced perception of recovery during a season may increase the risk of acute and overuse injury.
Psychological factors such as personality characteristics and history of stressors may be factors that influence injury occurrence. However, there is little research focusing on the role of psychological factors in injury. Therefore, the authors investigated whether changes in perceived stress and recovery over the course of a season are risk factors for acute and overuse injuries among 86 (58 males, 28 females) athletes participating in a team sport (26 basketball, 38 volleyball, 22 korfball). The authors used the RESTQ-Sport survey, which is a 77-item survey that measures the perception of stress and recovery of an athlete over time. The RESTQ-Sport survey responses can be used to calculate 4 different scores: general stress, sports stress, general recovery, and sport recovery. Participants completed the RESTQ survey at the beginning of the season and then every 3 weeks for 41 weeks. When an injury occurred the authors examined the RESTQ score at 3 or 6 weeks prior to the injury and the RESTQ scores from earlier in the season. The team’s physical therapist reported an injury if an athlete had a physical complaint that resulted from a match or training session, irrespective of time loss from sport activities. Participants suffered from 128 injuries, 66 (52%) were acute and 62 (48%) were overuse injuries. A decrease in perceived sport recovery was more likely to occur during the 3 weeks prior to an overuse injury. Furthermore, a decrease in perceived general recovery and sport stress was more likely to occur during the 6 weeks prior to an acute injury.
The authors determined that perceived recovery is lower prior to an injury than other earlier periods in the season. We may infer from this that individuals who report decreased recovery may be at greater risk for both acute and overuse injuries. Specifically, perceived general recovery scores decreased in the 6-week period before an acute injury compared with earlier healthy periods. Furthermore, an athlete’s risk of overuse injuries may be increased when perceived sport recovery scores decrease in the 3-week period before an injury compared with an earlier period in the season. Participants scoring lower on the general recovery scale are scoring poor in subscales such as social recovery and general well being, which suggests they may not be having pleasurable contacts, relaxed, or in good moods. Athletes scoring lower on sport recovery are specifically scoring lower on personal accomplishment, which refers to the participant’s perception of feeling less integrated with the team and less able to accomplish worthwhile sports tasks, which can lead to inadequate recovery resulting in overuse injury. The results of this study indicate that medical professionals could use surveys like the RESTQ to monitor psychological factors during the season to enhance coping mechanisms and reduce injury risk. However, future studies are necessary to confirm that reduced perceived recovery is related to and predictive of a new injury. Furthermore, future studies need to clarify how the RESTQ should be implemented and what cut-off scores would best to identify high-risk athletes. Collecting this data before an injury may also help clinicians detect lower perceived stress and recovery scores during rehabilitation after an injury, which could help identify athletes who are not coping or unready to return to play.
Questions for Discussion: Do you notice any psychological factors that could contribute to acute or overuse injury risk? Do you think it is possible to monitor perceived recovery over the course of a season?
Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban