Effects of a Mindfulness-Based Program on the Incidence of Injuries in Young Male Soccer Players
Naderi A, Shaabani F, Gharayagh Zandi H, Calmeiro L, Brewer BW. J Sport Exerc Psychol. 2020 Mar 9:1-11. doi: 10.1123/jsep.2019-0003 [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/32150722
Take-Home Message
A mindfulness training program reduced the number of injuries, days out of play, and improved attention, perceived stress, and anxiety levels among male soccer players.
Summary
While many injury prevention programs affect physical risk factors for injury (e.g., neuromuscular control), few programs address the psychological risk factors. Personality traits, history of stressors, and an athlete’s coping strategies may influence someone’s stress response and subsequent risk of injury. Mindfulness interventions improve executive function, awareness, and decrease stress and anxiety; but, their ability to prevent injury is unclear. Therefore, the authors conducted a randomized trial to determine if a 7-session mindfulness-acceptance-commitment approach (81 athletes) could decrease the number of acute sports injuries in soccer athletes (~17 years of age, 8 different clubs) compared to a 7-session educational program on the psychology of injury (79 athletes). They also assessed if the mindfulness intervention influenced psychological changes (anxiety, stress, attention) that can influence the rate of acute sports injuries. All mindfulness sessions were 45 minutes and performed in small groups (~15 participants per group). The mindfulness sessions started with shared feelings, followed by a presentation on a specific mindfulness topic. At the end of the sessions, the athlete was given a mindfulness exercise specific to that session’s topic. The athletes logged how long they practiced the technique daily (~30 minutes a day). The control group also met for 45 minutes once/week and was delivered content from a book on the psychology of sports injury. The coaches sent the authors data on the athlete’s athlete exposure. Two study staff members recorded any injury and interviewed the coach or athlete for additional details. The authors defined an injury as any physical complaint sustained during a competition or practice that was directly related to soccer, which resulted in 4 or more days of absence from practice throughout one season. They focused solely on acute injuries. The athletes completed several patient-reported outcome measures before the intervention and then monthly for 5 months: Comprehensive Inventory of Mindfulness Experiences, Toronto Mindfulness Scale, Sport Anxiety Scale-2, Kessler Psychological Distress Scale, D2 Attention Endurance Test. Coaches and athletes also completed a survey regarding how satisfied they were with the program. Overall, the mindfulness program reduced the number of injuries (3.67 vs. 6.12 per 1,000 athlete exposures), days lost to injury (~10 days vs. ~14 days), anxiety, and stress compared to the control group. Additionally, the mindfulness group reported greater attention and state mindfulness compared to the control group. Lastly, both coaches and athletes reported high satisfaction rates with the mindfulness program.
Viewpoints
The authors of the study demonstrated that mindfulness-based training might be an effective strategy to reduce the incidence of acute sport injures in soccer athletes in one season. The mindfulness intervention reduced the number of injures, mean time lost to injury and reduced anxiety and stress levels as well as improved mindfulness and attention during 1 season. The authors suggested that mindfulness training may improve attentional processes (quicker reaction time, more accurate movements) that could decrease the susceptibility to injury. Additionally, athletes in the mindfulness group reported decreased perceived anxiety and stress levels, which may also decrease the risk of acute injury. Furthermore, mindfulness practice may reduce the influence of emotional factors by helping an athlete focus more attention on the current training or competition. It is also important to note that both coaches and athletes were satisfied with the mindfulness program, which suggests that this strategy can gain buy-in and have good compliance. Medical professionals should encourage and implement mindfulness strategies to help prevent injuries.
Questions for Discussion
Do you practice any mindfulness exercise techniques? Would you consider implementing mindfulness practice strategies into your prevention program?
Written by: Jane McDevitt
Reviewed by: Jeffrey Driban
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I really enjoyed reading this. I wish that I had known about it when I was playing sports. There was always that constant fear of what if I get injured again.
I would implement mindfulness strategies into a prevention plan. It allows the athlete to express any anxieties or fears about becoming injured and not being able to participate in the sport that they love. Even having the patient express the anxiety, fears and stresses they have when they have to rehabilitate an injury. This is something that I will keep in mind for the future.
This post was very interesting to read. It seems as though implementing mindfulness training is beneficial not only mentally, by reducing stress and anxiety, but physically as well, by preventing injury. I also think that it is very important that both the coaches and the athletes were satisfied with the program. I will consider implementing mindfulness practices into my programs in the future.
I personally do not practice mindfulness techniques but I do think utilizing mindfulness techniques could be beneficial to many in reducing anxiety and stress. In regards to injury, implementing mindfulness strategies may help alter negative attitudes when recovering from injury and allow the athlete to have a positive outlook on their recovery. For injury prevention, athletes who engage in mindfulness techniques may become more aware of their body which decreases their risk for injury.
Thank you for your comments. I would like to know more about the exercises they do to practice mindfulness strategies to decrease anxiety. Considering the buy from everyone this could be beneficial to many different athletes instead of doing one specific prevention protocol per sport. This could be really helpful in those settings where ATs have a lot of different sports and athletes (e.g., high school setting).
This article was very interesting to read as mindfulness seems to be gaining a large leap in its implementation with athletics. I found it very promising that the coaches that were involved in this study did not find the mindfulness training to interfere with their training plan and reported that they were willing to promote mindfulness training within their own program. As an athlete, I believe a lot of a player’s stress and anxiety can come from a lack of understanding or communication with their own coach and what their relationship is on and off the playing field. Some athletes may be intimidated or very hesitant to reveal how they are truly feeling to their coaches, as their performance can be affected by these feelings.
I have recently been trying to add more mindfulness exercise techniques into my daily life (such as yoga or meditation). I personally have noticed a different when mindfully doing yoga, as ones body and breath connect they become more grounded. I strongly agree with this study and would love to implement mindfulness practice strategies into my prevention program. After reading this article and realizing that the mindfulness intervention reduced the number of injures, mean time lost to injury, reduced anxiety and stress levels and improved mindfulness and attention, I don’t see why anyone wouldn’t want to add this to their prevention program. I feel as though treating our athletes holistically is important, since if an athlete is not healthy mentally, they will not be able to perform to their top potential physically. We must treat athletes as people and not just an injury.
I believe that mindfulness plays such an important role in everyone’s life especially athletes. I feel like there is so much excessive emphasis put on athletes and there ability’s on and off the field that they are overwhelmed. I definitely think that this pressure to perform can effect an athletes reaction to an injury. I feel like i have seen this a lot with some star athletes that i have had the pleasure of working with. They feel so intensely that the way the team performs is based on how quickly they can recover from injury. I have seen this pressure cause them to try and hasten themselves through rehab and end up in a worse condition than the initial injury. I really think that mindfulness can help all athletes by alleviating the pressure put on them by coaches, and peers to perform. I hope that this gets to be a more mainstream idea.
Thank you for your comments. Sometimes I feel as though people do not implement something new like mindfulness techniques because 1. Change is hard and 2. they are not familiar enough with the new technique. Like Brandon said they may just be intimidated in sharing their feelings
For those of you who use these techniques already, do you have any tips on how to educate coaches, athletes on mindfulness techniques and make these more digestible outside of research like this?