Transcript

DALE FORSDYKE

Sports therapist is an important part of the multidisciplinary sports medicine and performance team. They have particular skill sets in terms of injury prevention, the assessment and treatment of sports injuries, and then finally, culminate in with the reconditioning and exercise prescription to ensure that athletes return to sport in a safe, informed, and timely manner.

I think the first thing to mention is that the cause of injury is multifactorial. And there are many internal and external factors that interlink to cause someone to get injured. Psychological factors are just one type of internal risk factor. And certainly, stress and the stress that an athlete is exposed to is one of those factors. Now that stress can come from the sport itself, such as the relationship with the coach, the pressure on fixtures, the pressure on selection, or it can be just as importantly, they're away from sports stress as well.

So for the athletes I work with times of high stress include exams, exit in the programme, selection for international tournament's as well. There are also other psychological factors that might make an athlete more predisposed or have a heightened stress response, such as their personality. Certain personality traits may have higher stress response compared with others, perfectionism, for example, and also coping skills.

So if an athlete is relatively young, such as the athletes I work with, that won't necessarily have the right amount of coping skills or the sufficient coping skills to be able to deal with those stressors, both sport related and non-sport related stressors. We do see spikes in our injury rates during times of high levels of stress. So if I explore some of the reasons why that might be the case, so we've got players who may train or compete, and they may become distracted. So they can't concentrate. They make poor decisions. They're technical, so their skill execution is worse. They may have a narrowed attentional focus, so they miss external cues.

We've also got the increase in muscle tension itself, which really impacts upon the athlete's movement quality so the coordination, the fluidity of the movement itself, the loss of range of motion can all kind of come together to make them more susceptible to injury. And we can add into that in terms of their overall recovery rate. We know that stress will impair their sleep quality and sleep quantity, which is a period where the athletes are going to be recovering the most. And it may also impair their tissue repair as well and tissue adaptations.

Something we haven't really necessarily talked about is illness, which is another leading form of time loss in sport. And we know that stress can suppress immune system, which might make them more susceptible to illness, which again, from managing in a sport's team is difficult because, again, it means your athletes are less available than you want them to be.

We address psychosocial factors in three main ways. Number one is the routine monitoring of players. So on arrival, we look at their wellness to see how they've recovered and their preparedness to train that day with sleep and stress forming one of those questions. And then after training, we want to look at the cognitive load that the players had. So they score out of 10 how cognitively challenging that is, so we get an idea of their accumulated psychological stress.

The second way relates to using the FA's 5C framework to give them some greater psychological skills training and, ultimately, more coping skills to deal with areas or occasions of high levels of stress. The third way is using our return to sport criteria. So we want to return players to sport where they are confident with low levels of anxiety, which ultimately might mean that they're at less risk of re-injury

So one example of a player I've worked with that comes to light is an international player who's having a major kind of stressful occurrence in her life at the moment. She's exiting our programme into senior women's football. So she's getting scouted. She's going for trials. There's that big question mark and uncertainty. She's at school. She's got her mock exams. She's got her GCSE exams. And the third is because she's an international level player obviously getting selected for the next international camp or major international tournament is of big concern to her.

Now of recent, she's had a number of injuries, non-contact injuries. And what we've done with that is we've sat down with her, and we've just done some goal setting to start figuring out, well, what are the major causes of her stress. We've put things in timelines. She's been given some breathing techniques to do. And she's also been given some imagery for when she goes to these trials in order to reduce that stress.