Injury Risk Is Increased By Changes in Perceived Recovery of
Team Sports Players

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.

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.

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?

Jane McDevitt, PhD
by: Jeff Driban


van der Does HT, Brink MS, Otter RT, Visscher C, & Lemmink KA (2016). Injury Risk Is Increased by Changes in Perceived Recovery of Team Sport Players. Clinical Journal of Sport Medicine PMID: 26945309