Psychological Effects of Injury on University Athletes and Their Return to Sport

Psychological Effects of Injury on University Athletes and Their Return to Sport
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Literature Review
The Popularity of Organized Sports
Researchers have demonstrated that sports involvement is a beneficial extracurricular activity, particularly among adolescents (Zaff, Moore, Papillo, and Williams, 2003). Students nagging in sports have positive outcomes like social support and increased academic performance (Jewett et al., 2014). Likewise, Loprinzi, Cardinal, Cardinal, and Corbin (2018) associate sports with increased physical activity levels. Further, researchers indicate that children and adolescents involved in sports have better mental health outcomes (Li et al., 2021). While students have tight schedules due to the demanding nature of studies, they find sports critical in helping them socialize. Athletes get an opportunity to network, which is instrumental for learners. Through sports, learners learn the important skill of social interaction. Here, they discover the importance of associating with peers, conflict management, and communication. Such social skills are important for learners because they prepare them for their future world, which values such social skills. Membership in a sports team increases the net worth of university students, especially where the emphasis is on team success (Zaff, Moore, Papillo & Williams, 2003). For instance, students can receive trophies for participating in sporting activities. According to Tirodimos et al. (2009), receiving trophies gives university students a sense of accomplishment and recognition.
Additionally, recognizing the importance of sports has led to the popularity of organized sports in schools. Data from the Centers for Disease Control and Prevention (2022) demonstrates that 54.1% of children aged six and 17 participated in sports in 2020. When these adolescents proceed to the university, they continue engaging in sports. Sports have become popular in US colleges, attracting players from different institutions. Pope and Pope (2009) agree that colleges use the popularity of their teams to increase their enrolments and tuition. Sports expose universities to many potential learners, increasing the demand for education in particular institutions. Siegfried and Getz (2006) point out that learners tend to choose colleges or universities based on limited information about reputation. Hence, athletics becomes one of the most important tools institutions of higher learning can utilize to affect the prominence of their schools. Universities encourage learners to participate in sporting activities by providing the necessary environment for athletes. Consequently, coaches and facilities lure more university students into becoming athletes (Cross and Fouke, 2019).
The Prevalence of Sports Injury
To understand the psychological effects of the injury on university students, it is instrumental to appreciate the prevalence and impact of sports injuries. Despite being critical for learners, participation in university sports has the adverse implication of leading to injuries. Tracy (2003) observed that the increased number of people participating in sports increased the number of injuries (Tracy 2003). For instance, in the 2020 academic year, 504,619 learners finished the National Collegiate Athletic Association (NCAA) sports in the US (Statista, 2021). This demonstrates that more students are interested in NCAA championship sports while colleges and universities continue to expand opportunities for learners to compete. As the number of university students participating in sports increases, athletes' injuries have increased. Similarly, Lemoyne et al. (2017) analyzed university-level athletes' prevalence and risk factors for injuries. The investigators reported musculoskeletal injuries among the participants, with an average of two injuries per athlete. Lemotne et al. (2017) further noted the distribution of the injuries as follows: ankle (20%), knee (15%), shoulder (13%), head (11%), and back (7%). Acute injuries were prominent among the participants, accounting for 87% of all the reported injuries.
Excessive sports practice, particularly in the competitive context, increases the risk of musculoskeletal injuries. Van Hilst et al. (2015) investigated low back injuries among young athletes playing soccer, hockey, and speed skating. The investigators discovered that the injury prevalence rate among young players was three times more than that of the general population. Several reasons are responsible for the high prevalence of injuries among competitive-level athletes. Firstly, university athletes are required to engage in rigorous training. Such training volume correlates with an increased risk for injuries (Almeida, Williams, Shaffer, and Brodine, 1999). Additionally, rigorous training in high-contact sports increases the risk of injury. For instance, university students engaged in rugby are more vulnerable to injuries because of the high-contact nature of the game (Brooks, Fuller, Kemp, and Reddin, 2008). The high provenance of injuries among university athletes should concern the relevant stakeholders. Coaches, in particular, are key figures in sporting and hold critical roles in reducing the prevalence of injuries (Rees et al., 2021).
Psychological Impact of Sport Injury
Putukian (2016) acknowledges that injury is a major stressor for university athletes and can pose significant challenges. For instance, learners must balance between rigorous academic requirements and athletic demands. The latter requires time and physical fitness. Since academics and sports are demanding, trying to perform and succeed in both can pose serious challenges. The stress increases when a university athlete is injured (Potvin, 2021). According to Petrie (1992), stress remains a major antecedent for more injuries. Stress leads to additional changes like a general distraction, which interferes with an athlete’s performance (Zhang, 2022). Because of stress, athletes demonstrate increased muscle tension and coordinated difficulties, making them more vulnerable to injury. Hence, athletes who sustain small injuries and become stressed become more susceptible to more injuries. At the same time, injured learners must continue their academic studies. Such a strain subjects university athletes injured to more psychological stress. According to Mitchell et al. (2021), injured students because of sport-related activities have been shown to register lower scores for academic performance. Injured learners cannot concentrate well on their studies, especially when the injuries are fatal. When they have to spend some time in the hospital following an injury, it takes away their time from studying. Maajida Aafreen, Vishnu Priya, and GayathriLow (2018) indicate that low academic performance subjects learners stress. Hence, the injured learners get more stressed because of the possibility of poor academic performance.
Additionally, the inability of injured players to deal with the negative feelings ushers them into depression. Problematic responses to injury happen where the symptoms do not resolve or continue to worsen. Depression manifests itself in various ways. The injured athletes may lack appetite and engage in disorderly eating. Others may lack sleep because of the constant negative thoughts about the injury. Some athletes develop excessive sadness, especially when they feel that someone was responsible for the injury (Lebrun et al., 2018). Sadness can also occur when athletes cannot participate in competitive games after troubling aggressively for a long time. Some athletes tend to withdraw from social contact after injuries. They become less outgoing than they used to be because of the shame that injury has brought. Further, depression can cause athletes to become less interested in activities (Forys and Tokuhama-Espinosa, 2022). Even after recovering from their injuries, some players may lose interest in training. Depression can slow the process of recovery from the injury (Wolanin, Gross, and Hong, 2015). It can also make it challenging for athletes to return to training and competition.
Further, injuries can adversely affect the self-esteem of university athletes. Sports majorly boost athletes' self-esteem (Šagát et al., 2021). Here, players gain satisfaction in achieving set objectives, like scoring several goals in a season. According to Omar Fauzee et al. (2014), university students use sports as a constructive way of coping with everyday challenges. In the teams, athletes associate themselves with like-minded people. However, when injuries occur, it makes it challenging for athletes to continue in sports. The feeling of losing one’s identity is familiar among university athletes when injuries (Lockhart, 2010). Instead of practice sessions with teammates, injured players must be content with feelings of alienation, not knowing what will happen next. The disruption that an injury brings has adverse effects on the self-esteem of university athletes (Santi and Pietrantoni, 2013). It removes the ability to participate in competitive activities and reduces excellent athletes to mere spectators.
Moreover, serious injuries and return to sports often accompany psychological consequences that can impact the wellbeing of university athletes and their likelihood of returning to sports. University athletes tend to suffer from reinjuring anxiety. Because of the adverse psychological effects of injuries, university athletes fear that returning to the sport will expose them to another risk of injury. Athletes who experienced a high level of reinjury anxiety had lower confidence in their ability to return to sport. Studies associate reinjury anxiety with psychological changes like diminished concentration and self-confidence (Tripp et al., 2007; Mahirogullari, Oguz, and Ozkan, 2006). Athletes can easily become preoccupied with negative thoughts when they resume training and competition. Nonetheless, Trelstad (2018) demonstrates that injured students can recover. The researcher indicates the need for the players to employ goal-setting, visualization, and stress-management techniques. The investigator indicates that these techniques are critical in reducing negative and increasing positive thoughts.
Relevant Models in Rehabilitation
i) Self-determination theory
Self-determination implies an individual’s ability to choose and manage one’s life. Self-determined individuals have greater control over their lives compared to the non-self-determined, who feel that others control their lives (Wehmeyer, 2020; Patrick and Williams, 2012). Šakan, Žuljević, and Rokvić (2020) demonstrate that the concept of self-determination is critical because it plays a major role in psychological health. The self-determination theory (SDT) demonstrates how being self-determined affects motivation. SDT indicates that individuals are motivated to grow because of three major psychological needs; competence, connection, and autonomy (Vansteenkiste, Ryan, and Soenens, 2020). Under competence, individuals require to master particular tasks and learn different skills. Cook and Artino (2016) show that when individuals feel that they have the necessary skills needed for success, they are more motivated to take actions that will help them achieve the set goals. Connection implies the need for people to experience a sense of belonging to others. Here, people who feel connected have a higher chance of succeeding than those with fewer connections (Gwinn, MacCannell, and Khabbaz, 2017). Autonomy indicates the need for people to feel in control of their behaviors and goals. Feeling in control will push someone to take action that will result in a major change in life.
Earlier SDT research by Ryan and Deci (2000) demonstrates that environmental supports for competence, autonomy, and connectedness lead to a variety of wellbeing, social development, and beneficial performance. Later, Ryan and Deci (2007) found out that an environment that impedes the satisfaction of the same needs causes maladaptive functioning and ill-being. Such individuals are more likely to become irresponsible in their actions. Podlog and Eklund (2009) believe that the degree to which athletes recover and return to sport after injury depends mainly on coaches and rehabilitation specialists satisfying their psychological needs. In this regard, coaches and rehabilitation specialists can play a critical role in helping athletes who have experienced injury develop a sense of autonomy, competence, and relatedness. For instance, Podlog and Eklund (2009) further illustrate that confidence that the previously injured body can persevere the demands of training and competition is critical in allowing players to return to sport. Hence, previously injured university athletes must build confidence in their ability to perform well on returning to sport. In SDT, such athletes should be well-integrated into their teams to feel a sense of belonging. Wadey and Evans (2012) suggest that coaches are better placed to help injured players become more confident in their ability and assist them back into the sport.
ii) The Five-Stage Response
Elizabeth Kübler-Ross, a Swiss psychologist, first introduced the five stages of the grief model based on her work with terminally ill patients. In the book “On Death and Dying,” Kübler-Ross and Kessler (2005) saw a pattern that their patients underwent and expressed in stages. Kübler-Ross noted that the stages are not linear, and n...