Fear of Injury, Kinesiophobia & Perceived Risk

It is a well-documented fact that decreases in athletic performance after injury can be attributed to both psychological and physical factors (Dunn, 1999). The sports professionals have become aware of the integral role that psychological factors play in the injury occurrence and recovery processes. For this reason, such constructs like “perceiving fear” and “confidence in avoiding injury”, “fear of pain” and “fear of injury” have become important factors to consider when dealing with injured athletes. The previous information paints an intricate picture of an athlete’s psychological response to injury, but lacking information regarding emotional factors it is difficult to reliably predict athletes at high risk for injury. Although sports psychologists have contributed invaluable information to this concern, the emotional aspects of injury have not yet been fully addressed. The emotion of fear has not been excluded from research on general orthopedic injuries, but it has not been highly considered among athletes. Athletes are generally perceived as warrior type individuals who do not harbor emotions such as fear. This may be a major misperception considering that athletes face possible physical harm every time they step onto the field. When a nonathletic individual suffers an injury, he or she is faced with the difficulty of completing normal daily tasks due to pain and a loss of mobility. Once the person returns to pre-injury level, he or she is still only faced with the challenge of completing normal daily tasks. An athlete on the other hand, is not only faced with the challenges of daily functioning, but also faced with the challenge of returning to the field. Though he or she has overcome the injury, the athlete must deal with possibility of re-injury due to the high demands of sport activity. Therefore, the challenges for an injured athlete are quite complex because the act of returning to play forces an athlete to participate in the exact activity that caused the injury initially. Being faced with memories of pain and discomfort is likely to cause some level of fear. Given the complexity of the athlete’s experience of injury, it seems erroneous to ignore fear as a possible component of re-injury.


Anterior Cruciate Ligament Sport Participation Ankle Sprain Mild Traumatic Brain Injury Ballet Dancer 


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  1. Dunn, G.H. (1999). A theoretical framework for structuring the content of competitive worry in ice hockey. Journal of Sport & Exercise Psychology, 21, 259-279.Google Scholar
  2. Crossman (1985). Psychosocial factors and athletic injuries. Journal of Sport Medicine and Physical Fitness, 25, 151-154.PubMedGoogle Scholar
  3. Flint, F.A. (1998). Integrating sport psychology and sport medicine in research: The dilemmas. Journal of Applied Sport Psychology, 10, 83-102.CrossRefGoogle Scholar
  4. Macchi, R., & Crossman, J. (1995). After the fall: Reflections of injured classical ballet dancers. Journal of Sport Behavior, 19, 221-234.Google Scholar
  5. Magyar, M.T., & Chase, M.A. (1996). Psychological strategies used by competitive gymnasts to overcome the fear of injury. Technique, 16, Retrieved February 14, 2001.Google Scholar
  6. Kontos, A. P., Feltz, D. L., & Malina, R. M. (2000). The perception of risk of injury in sports scale: Confirming adolescent athletes’ concerns about injury. Journal of Sport & Exercise Psychology, 22, S12.Google Scholar
  7. Vlaeyen, J.W., de Jong, J., Geilen, M., Heuts, PH., van Breukelen, G. (2002). The treatment of fear of movement/(re)injury in chronic low back pain: further evidence on the effectiveness of exposure in vivo. Clinical Journal of Pain, 18, 251-61.CrossRefPubMedGoogle Scholar
  8. Severeijns, R., Vlaeyen, J.W., van den Hout, M.A., Weber, W.E. (2001). Pain catastrophizing predicts pain intensity, disability, and psychological distress independent of the level of physical impairment. Clinical Journal of Pain, 17, 165-72.CrossRefPubMedGoogle Scholar
  9. van den Hout, J.H., Vlaeyen, J.W., Houben, R.M., Soeters, A.P., Peters, M.L. (2001). The effects of failure feedback and pain-related fear on pain report, pain tolerance, and pain avoidance in chronic low back pain patients. Pain, 92, 247-57.CrossRefPubMedGoogle Scholar
  10. Crombez, G., Eccleston, C., Vlaeyen, J.W., Vansteenwegen, D., Lysens, R., Eelen, P. (2002). Exposure to physical movements in low back pain patients: restricted effects of generalization. Health Psychology, 21, 573-8.CrossRefPubMedGoogle Scholar
  11. Boersma, K., Linton, S., Overmeer, T., Jansson, M., Vlaeyen, J., de Jong, J. (2004). Lowering fear-avoidance and enhancing function through exposure in vivo. A multiple baseline study across six patients with back pain. Pain, 108, 8-16.CrossRefPubMedGoogle Scholar
  12. Roelofs, J., Goubert, L., Peters, M.L., Vlaeyen, J.W., Crombez, G. (2004). The Tampa scale for kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia. European Journal of Pain, 8, 495-502.CrossRefPubMedGoogle Scholar
  13. Peters, M.L., Vlaeyen, J.W., Weber, W.E. (2005). The joint contribution of physical pathology, pain-related fear and catastrophizing to chronic back pain disability. Pain, 113, 45-50.CrossRefPubMedGoogle Scholar
  14. Miller, R.P., Kori, S.H., Todd, D.D. (1991). The Tampa Scale of Kinesiophobia. Ref Type: Unpublished work.Google Scholar
  15. Swinkels-Meewisse, I.E., Swinkels, R.A., verbeek, A. et al. (2003). Psychometric properties of the Tampa Scale for Kinesiophobia and fear avoidance beliefs questionnaire in acute low back pain. Manual Therapy, 8(1), 29-36.CrossRefPubMedGoogle Scholar
  16. Moss, R., Slobounov, S. (2006). Neural, behavioral and psychological effects of injury in athletes. In. S Slobounov & W. Sebastianelli (Eds.), Foundations of sport-related brain injuries, (pp.407-430). Springer.Google Scholar
  17. Gravetter, F.J., Larry, B., Wallnau, B. (2000). Statistics for the behavioral sciences: a first course for students of psychology and education. 2nd ed. West Pub. Co. St. Paul. MN.Google Scholar
  18. Martin, S.B. (2005). High school and college athletes attitude toward sport psychology consulting. Journal of Applied Sport Psychology, 17(2), 127-140.CrossRefGoogle Scholar
  19. Messner, M.A. Power at play: Sports and the problem of masculinity. Boston: Beacon Press, 1992.Google Scholar
  20. Nixon, H.L. (1996). Explaining pain and injury attitudes and experiences in sport in terms of gender, race, and sports status factor. Jounrnal of Sport and Social Science, 20, 33-44.Google Scholar
  21. Addis, M.E., & Mihalic, J.R. (2003). Man, masculinity, and the contexts of help seeking. American Psychologist, 58(1), 5-14.CrossRefPubMedGoogle Scholar
  22. Keefe, F.J., Bradley, L.A., Crisson, J.E. (1990). Behavioral assessment of low back pain: identification of pain behavior subgroups. Pain, 40(2), 153-160.CrossRefPubMedGoogle Scholar
  23. De Mondaigne, M. The Complete works: Essays, Travel Journal, Letters. Alfred A. Knopf New York: Everyman’s library, 2003.Google Scholar
  24. Phares, J. Clinical Psychology: Concepts, Methods & Prodession. 3rd edition. The Dorsey Press, 1988.Google Scholar

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