Sport And Exercise Psychology: A Critical Introduction

trainers in the US recognised that injured athletes tend to suffer significant psychological
distress as result of their physical trauma (Larson, Starkey and Zaichkowsky, 1996). In a
similar vein, Francis, Andersen and Maley (2000) asked a sample of physiotherapists
about the psychological characteristics which facilitated recovery in injured athletes.
Among the most important perceived prerequisites of successful rehabilitation were such
factors as a willingness to listen to physiotherapists’ advice and effective interpersonal
communication skills. More recently, Hemmings and Povey (2002) investigated the way
in which English chartered physiotherapists perceived psychological aspects of their
professional work. Results showed that the physiotherapists reported using a variety of
psychological techniques (e.g., creating variety in rehabilitation exercises, setting short-
term goals and encouraging positive self-talk) with injured athletes. However, a rather
surprising finding was the discovery that few of the physiotherapists in the study had ever
referred a patient to an accredited sport psychologist. Clearly, much work remains to be
done in promoting the value and image of sport psychology in the medical community.
The third boost for a psychological approach to injury management came from recent
research in sport science. Specifically, over the past decade there has been a profusion of
studies on mental aspects of athletic injuries (e.g., see the special issue of the Journal of
Applied Sport Psychology on this topic; Brewer, 1998). This body of literature has
generated some interesting findings on the interaction between motivation, fatigue and
injury in athletes. For example, Rahnama et al. (2002) proposed that the increased risk of
injury experienced by soccer players near the beginning (first fifteen minutes) or end (last
fifteen minutes) of football matches may be due to the effects of initial intensity of
tackling combined with subsequent fatigue later in the game. Also, the fusion of athletic
accomplishments and personal identity is apparent from evidence that injured runners had
significantly lower levels of self-esteem than did fully fit athletes in control groups (Chan
and Grossman, 1988). To summarise, several factors have converged to highlight the
importance of psychological factors in the causes and treatment of injury in athletes.

Nature, prevalence and causes of injuries in sport

So far, I have introduced the mental side of physical trauma in athletes without actually
explaining what the term “sports injury” means. This problem will be rectified below.
But as we shall see, there are no universally agreed criteria available to define such
injuries. Therefore, any analysis of sports injuries raises certain conceptual and
methodological issues that need to be addressed.

What is a sports injury? Nature, types and severity

In sports science, an injury may be defined as any physical or medical condition that
prevents a player from participating in a match or training session (Orchard and Seward,
2002). More generally, it may be regarded as any “involuntary, physically disruptive
experience” (Cashmore, 2002, p. 141) encountered by an athlete. Unfortunately, despite
their apparent clarity, these definitions gloss over several important conceptual issues.
For example, as Udry and Andersen (2002) observed, athletes often incur injuries which
originate outside sporting contexts. For example, what if an athlete suffers a car-crash

Helping athletes to cope with injury: from theory to practice 245