Stress Affects Athletic Injuries, Recovery: Physicians Not Immune to 'Culture of Risk,' Which Encourages Athletes to Keep Playing despite Pain

Article excerpt

Difficult life events and other types of stress, as well as psychological interventions, can have a marked impact on the occurrence of athletic injuries among children and adolescents, according to the authors of a review on the topic.

These issues also can affect the way in which children and adolescents recover and subsequently perform in sports, the authors wrote.

Awareness of psychosocial stressors "unique to young athletes that may contribute to injury occurrence and influence rehabilitation may help counter the negative effects and unhealthy behavioral responses that sometimes occur post injury," said Angela H. Nippert, Ph.D., and Aynsley M. Smith, Ph.D., in the May issue of Physical Medicine and Rehabilitation Clinics of North America.

Dr. Nippert is with the department of kinesiology and health sciences, Concordia University, St. Paul, Minn.; Dr. Smith is with the Mayo Clinic Sports Medicine Center and the department of orthopedic surgery and physical medicine and rehabilitation at Mayo Medical School, Rochester, Minn.

Dr. Nippert and Dr. Smith also recommend that medical professionals be aware that even though they might be considered the least likely person involved with an injured athlete to pressure the athlete to return to participation before a full recovery, they may not be immune to the "culture of risk," in which playing a sport despite continuing pain and injury is acceptable.

To help maintain objectivity, it is important to be aware of the influence this culture of risk might have on decisions about injured athletes, the authors wrote. Other factors, such as whether an athlete is a starter, the time in the season, and their own experiences with competing and training also can influence their decisions, the authors added (Phys. Med. Rehabil. Clin. N. Am. 2008; 19:399-418).

Psychosocial factors that can affect child and adolescent athletes before and after an injury include athletic identity, body image, and life stressors, such as a parent's divorce. A stressful situation can increase the risk of sustaining an injury when, for example, it interferes with attention.

The authors cite several studies of different types of young athletes that have found an association between stressful life events and increased risk of sustaining injuries. Stress and coping resources, in addition to the stress of an injury, also can affect athletes after an injury.

As an example, the authors described a 14-year-old basketball player who sustained a severe ankle sprain after the divorce of his parents and missed out on a full season. He became alienated from the team, which had provided support during the divorce. …