Have you ever noticed that certain athletes seem more prone to injury than others? The study of why injuries occur and the factors that might place one athlete at greater risk than another have long been of interest to experts and athletes alike. For the past two decades, psychosocial factors have become increasingly recognized as significant factors in sports performance, injury prevention, rehabilitation, and management. The result of this research is an injury risk profile that sports parents should be aware of as they lead children through their journey in sports.

As far back as 1985 sports medicine experts have advised that, “pre-exercise evaluations” should focus on the three body systems - musculoskeletal, cardiovascular, and psychological [italics added] (Sports Medicine, November 1985, Volume 2, Issue 6, pp 413–431).

The Sport Injury Risk Profile (SIRP; Wiese-Bjornstal 2009) shows the many factors affecting sport injury risk. This gives athletes and their parents a means of understanding how psychological and socio-cultural factors operate interactively with physical and environmental factors within the larger context of sport injury risk, according to Susan Kay Hillman, editor of Core Concepts in Athletic Training and Therapy (Human Kinetics, 2012)

Divided into INTERNAL/Personal and EXTERNAL/Environmental factors, The SIRP identifies specific examples of elements within each the four major contributors to the profiles that have been linked to sport injury risk. When these risks are identified, “interventions directed at better managing these aspects have the potential to reduce risk of sport injury in the same way in which other more common athletic training interventions, such as changes in training and conditioning protocols or the use of protective equipment, reduce risks”, says Hillman.

We know from research (Acad Pediatr. 2014 Jul-Aug;14(4):390-7. doi: 10.1016/j.acap.2014.03.012), that kids who fall on the Autism Spectrum have a 12% greater injury risk than children without ASD. We also know that compared to children without ADHD, children with ADHD are more likely to be injured and often have more severe injuries (aboutkidshealth.ca and LiveScience.com). Take the following example: a child takes medication for his ADHD every morning before school starts; he hasn’t been prescribed an extended-release (XR) form of his medication, so it starts to wear off right around the end of the school day, when practice is about to start. When the medication wears off, the athlete starts to feel tired, emotionally on edge and his focus wanes; hence, injury risk rises. Children and teens who have experienced trauma should also be added to the risk profile. In some instances, medications they take for anxiety and/or depression can impact performance. In other cases, stress from pressure to perform and (perceived) fear of what will happen if they fail can increase risk for injury, by drawing attention away from the task of performing.

The SIRP model has guided much of the research on psychological and socio-cultural influences on vulnerability to sport injury. There is a psychological influence on the occurrence of sport injury, according to this model writes Hillman: “is the stress response. Essentially, the more ‘stress’ participants perceive, the more vulnerable they are to injury, particularly if they do not have sufficient coping resources for managing the stress. Stress-related changes that occur in attention and cognition (e.g., tunnel vision, attention turning inward toward personal thoughts rather than focusing outward on the risks in the sporting environment) and physiology (such as increased muscle tension and increased heart rate) can negatively affect [young athletes’] behaviors and performance, which in turn increase the risk of injury.”

Take the time to discuss the Sports Injury Risk Profile with your child athletes, particularly focusing on the psychological factors:



• Has your child had an event that is a life stressor?
• What have you done to help your child work through this trauma?
• Does your child have coping skills in place to manage stress? 
• Is your child’s mood challenged?
• Do you encourage your child to have a positive mindset?

Discussing psychological factors as a family, seeking assistance when needed and communicating with your child’s coach about psychological factors that may impact your child athlete can significantly reduce the risk of sports injury for your child athletes. 

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