Wednesday, March 7, 2012

Player Psyche and Injury Risk

Many consider injuries as an accepted part of the game. Despite this, coaches and researchers work together to reduce the risk of players sustaining an injury. Much of the focus has been on external factors such as equipment and playing field as well as internal factors such as fitness. As a result, successful advancements have been made in equipment and training routines. However, psychological issues are sometimes overlooked as a risk factor. Players often cope with events outside of soccer. For some players, these stressors can increase their anxiety level, which can increase injury risk. Two recent studies of Swedish youth and professional players show that these psychological issues are important internal factors in increasing injury risk. The authors of the studies also provide some insight into how coaches may play a role in reducing this risk factor.

The first study focused on high school male and female players in Sweden whereas the second study examined professional players from the Swedish Premier leagues. At the beginning of the study, players completed a series of psychological and personality questionnaires designed to identify characteristics of stress, anxiety, daily hassle and coping. Over the course of the season, injuries were recorded by the team’s medical personnel. The researcher then compared the various psychological traits between those athletes sustained an injury during play and those who did not.

The studies showed that a key predictor of injury risk is a concept called “somatic trait anxiety”. This can be described as long-term stress that results in physical changes. That is, athletes who demonstrate somatic stress anxiety are often chronically anxious and may show physical signs ranging from sweaty palms to muscle tension. Daily hassles were also a factor. For the younger players, trust in the coach played a role in predicting injury. Lastly, poor coping skills also raised the risk of injury in the young players but not the professionals. It is likely that upon reaching the professional level, these highly experienced players have developed effective skills needed to cope with anxiety. Taken together, the researchers found that these factors, especially anxiety, daily hassles and poor coping skills, accounted for about 25% of the injuries sustained.

The source of stress and anxiety for the players may stem from a variety of pressures. For the younger athletes, schoolwork and the pressure to succeed academically as well as social relationships with peers can create anxiety in many athletes. In addition the pressures of playing well can mount. Pressure from parents and coaches along with the desire to be “seen” at college showcase events or to be “identified” by regional or national coaches can be great. These pressures often result in the players dealing with what they perceive as a variety of daily hassles such as interactions with family, friends, coaches and teachers, completing homework assignments, studying for exams and balancing social relationship. The net result of this affects the players focus and concentration on the game. It can also alter the athlete’s physical nature which then affects their play.

The result of stress, anxiety and daily hassles can lead to one of two risky scenarios. The first is a loss of concentration and focus on the game. Losing focus during a match can prevent the player from identifying cues and avoiding risky situations such as a blind-side tackle. The second is more aggressive physical play that creates risky encounters such as an overly aggressive tackle or header. In either case, the player is unable to identify and analyze situations that may put him or her as risk of injury.

The authors of the studies do offer some suggestions to minimize injury risk. First, coaches should consider the athlete as a whole person. In addition to fitness and technical abilities, coaches should pay close attention to their players psyche and look for signs of stress and anxiety. Identify those players who seem to be struggling with life events or daily hassles, those who show physical or emotional signs or stress. Perhaps a day off is needed to restore their focus and balance. Second, help players develop effective coping skills to reduce the level of stress and worry. Creating an open atmosphere where athletes can express their worries, feelings and concerns could be a step in that direction. Third, help athletes learn muscle relaxation techniques to reduce the level of physical anxiety. Muscle tension is a common physical response to stress and anxiety. By controlling muscle tension, injury risk may be reduced. The overall goal is to provide the tools and avenues for each player to reduce or deal with their stress, anxiety and daily hassles in a healthy manner.

The take home message from these two studies is that the psychological profile of an athlete is an important risk factor for injury. Be they a youth player or a professional, anxiety and life stress that leads to daily hassles can cause the player to either respond or lose to focus, both of which can increase the chances of sustaining an injury.


Johnson U, Ivarsson A (2011) Psychological predictors of sport injuries among junior soccer players. Scandinavian Journal of Medicine and Science in Sports, 21: 129-136.

Ivarsson A, Johnson U, Podlog L (2012) Psychological predictors of injury occurrence: A prospective investigation of Swedish soccer players. Journal of Sport Rehabilitation, in press.