Literature Review
Sports-related injuries have increased the demand and debate surrounding the associated injuries on athletes’ mental health. After an injury, some athletes can no longer play their favorite game or take a long time to resume playing. The American Medical Society for Sports Medicine established that after an injury, the associated psychological response includes self-medication to avoid being away from the game or sustaining injuries when playing, leading to some athletes being addicted to their prescribed painkillers (Chang et al., 2020). In sports, injury is linked to various mental conditions, including depression, suicide ideation and attempt, sleep disorders, eating disorders, attention deficit, anxiety, and stress (Chang et al., 2020; Abbott et al., 2019; Gervis et al., 2019). These mental health concerns arise because of fears of re-injury, inability to play at the same capacity and ability, or not being able to play again at all. Regardless of the playing level, a beginner or a professional, such a possibility may interfere with their mental health. This is confirmed by Gervis et al. (2019), who involved 11 counselors with an experience of a mean of 4 years Working with long-term injured players and registered with the professional footballers’ association. The counselors have worked with individuals who have played for 5-20 years in various leagues, and the purpose of the study was to determine “whether long-term injury plays a role in the mental health issues which current and former professional footballers’ experience” (Gervis et al., 2019). The data was collected through interviews, confirming that injury interferes with the athletes’ mental health, most resulting in addictions, with substance abuse and gambling being the most common. Others go into depression because such injuries usually force early retirement and others battle with identity crises outside their sport. Though the study was limited to the counselors working in the United Kingdom and the athletes they have worked with, making it difficult to know the exact population of the sporting world they represent, it confirmed that injury plays a role in the mental health of the athletes. It provides vital information to this study by providing examples of athletes’ mental conditions resulting from the injury.
Abbott et al. (2019) involved the players rather than medical professionals in understanding this situation further. Their research hypothesized that “injury, not being selected to play games, and high training loads negatively affect the players’ mental health” (Abbott et al., 2019). In this case, 25 professional soccer players were involved, who were competing in the under-23 championships in England. They completed a 37-week Warwick-Edinurgh Mental Wellbeing Scale through the 2017/2018 season. According to the study, this scale was a reliable measure of the mental well-being of the involved individuals. The study found that the participants’ mental well-being was significantly low when injured than when not injured and was unaffected by the match results. The biggest variance in mental well-being by 40% resulted from the days out of the game due to injury throughout the season. When not being selected to play and having to stay out because of the injury accounted for a 50% variation in mental well-being scores (Abbott et al., 2019). One of the limitations of this study was the small number of participants compared to the number of athletes in the U.K. and the world. Regardless of this limitation, the authors confirmed their hypothesis. The article contributes to the present study by providing valuable information from the players via their mental well-being scores that there is a positive correlation between mental health and injury among athletes.
To address the psychological factors in athletes, especially personality issues and psychological responses to injury and illness, the American Medical Society for Sports Medicine involved a panel of experts in providing evidence-based practices necessary for treating and preventing mental health issues. This panel consisted of an athletic trainer, a clinical psychologist, and a sports psychiatrist who conducted an in-depth literature review using PubMed, SportsDiscus, and Cochrane database. The key findings include “stress consistently demonstrates a relationship with injury and ability to rehabilitate from injury and return to sport” (Chang et al., 2019). Further, different athletes have unique risk factors for various mental health conditions; for example, suicide ideation as an indicator of a mental condition like depression is higher among football athletes compared to any other sport among college athletes. The research was limited to inadequate published data. However, it provided vital prevention measures, including the sports healthcare team being effectively trained to detect early signs of mental health conditions, especially among athletes with injuries and illnesses. It achieves its purpose by providing effective interventions. Also, it prompts this study to establish solutions to the mental health impacts on athletes after getting injured, contributing to the knowledge development of psychology.
Truong et al. (2020) conducted a scoping review to evaluate evidence associated with the “psychological, social and contextual factors across the recovery stages following a traumatic time-loss sport-related knee injury to identify key themes and knowledge gaps.” All 77 articles identified fear and anxiety of returning to the game, re-injury, psychological readiness, identity crisis, and other mental health indicators as important factors during recovery. Key findings contributing to this study are that mental health creates unique emotional barriers like fear and anxiety throughout the recovery process, and 40% state fear as a factor for not returning to the sport (Truong et al., 2020). Though the study was limited to inadequate articles about knee injury as most data concerned ACL injuries, it managed to make the impact and presence of psychological factors in the recovery process.
Therefore, based on the data from the articles in this literature review, there is a negative mental health impact on athletes who have had an injury. This information incorporates various types of injury because as established especially from the sources involving experts that deal with athletes (Gervis et al.,2019 and Chang et al., 2019) the negative impacts are present regardless of the level of playing, sport, or kind of injury. The identified mental condition include depression, suicide ideation and attempt, sleep disorders, eating disorders, attention deficit, anxiety, and stress. According to Truong et al. (2020), the negative mental health impacts are evidenced in slowing the recovery process at all stages, including returning to the game stage through fear of re-injury or not being good enough because of the injury. However, as established by Abbott et al. (2019), there are inconsistencies in what the sporting medical profession is doing to prevent this impact. Identifying this gap is important because the aim of any medical professional is to improve health outcomes, which this study helps to fill by expounding on the issue and providing solutions to this growing problem.
References
Abbott, W., Brownlee, T. E., Harper, L. D., Naughton, R. J., Richardson, A., & Clifford, T. (2019). A season-long investigation into the effects of injury, match selection and training load on mental wellbeing in professional under 23 soccer players: A team case study. European Journal of Sport Science, 19(9), 1250–1256. http://researchonline.ljmu.ac.uk/id/eprint/10515/3/A%20season%20long%20investigation%20into%20the%20effects%20of%20injury%2C%20match%20selection%20and%20training%20load%20on%20mental%20wellbeing%20in%20professional%20under%2023%20soccer%20players%20A%20team%20case%20study.pdf
Chang, C., Putukian, M., Aerni, G., Diamond, A., Hong, G., Ingram, Y., … & Wolanin, A. (2020). Mental health issues and psychological factors in athletes: detection, management, effect on performance and prevention: American Medical Society for Sports Medicine Position Statement—Executive Summary. British journal of sports medicine, 54(4), 216-220. https://bjsm.bmj.com/content/54/4/216.?int_source=trendmd&int_medium=cpc&int_campaign=usage-042019
Gervis, M., Pickford, H., & Hau, T. (2019). Professional footballers’ association counselors’ perceptions of the role long-term injury plays in mental health issues presented by current and former players. Journal of Clinical Sport Psychology, 13(3), 451–468. https://bura.brunel.ac.uk/bitstream/2438/19671/5/FullText.pdf
Truong, L. K., Mosewich, A. D., Holt, C. J., Le, C. Y., Miciak, M., & Whittaker, J. L. (2020). Psychological, social and contextual factors across recovery stages following a sport-related knee injury: a scoping review. British journal of sports medicine, 54(19), 1149–1156. https://bjsm.bmj.com/content/54/19/1149.abstract
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