Injury from Athletes' Perspectives

The central core element of this revised model is a bidirectional relationship between the athlete’s cognitive appraisal of the situation and stress responses as evidenced by physiological changes. For example, selfperception of sports-related demands is challenging and realistically may consolidate an athlete’s resources both physically and psychologically. This can help him or her stay focused and creates an injury-free situation. When cognitive appraisal is inaccurate and distorted by irrational thoughts and there is the belief that resources are inadequate to meet the demands, the injury risk is increased due to “bad distress” (see: Williams, 2001 for details of this model). Stress, related to attention deficits in this model, is attributed to increased generalized tension, narrowing of the visual field, increased distractibility, reduced sustained attention and the reduced capability to extract meaningful information from background noise. Not surprisingly, sustained muscle tension in conjunction with reduced central resource mechanisms may result in fatigue. As discussed in the previous chapter, fatigue may be a serious risk factor for injury.

Since controversy and confusion surround the classification/definition of injury, it is difficult to properly assess the clinical value of the “stressinjury” model. In fact, it was suggested that the “stress-injury” model is probably most appropriate for acute injuries. For injuries such as overuse injuries, the causes and the mechanisms are largely unknown (see: Williams, 2001 for details of this model). Unfortunately, multiple predisposing factors are never operating in isolation. The ways and manners in which these multiple factors are interacting and collectively influencing athletes’ responses are unknown for acute injuries as well. Similarly, it is almost impossible to make any reasonable comparisons between studies examining “stress-injury” relationships due to different research methodologies, types of injury under study, differential severity and the number of injuries experienced over time, age and gender.