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Exploring the psychological aspects of sport injury
Exploring the psychological aspects of sport injury

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3.1 Social support in practice

Forsdyke et al. (2016) identified that having trust in the rehabilitation provider, feeling wanted by others and satisfaction with social support were associated with positive rehabilitation outcomes. Social support is considered to be a multidimensional construct with different categories of social support possible, including (Arvinen-Barrow and Pack, 2013):

  • emotional
  • technical
  • informational
  • tangible, and
  • motivational support.

Table 1 defines these different categories of social support.

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Interactive Table 1 Different categories of social support (adapted from Arvinen-Barrow and Pack, 2013, pp. 122–3)
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Table 1 Different categories of social support (adapted from Arvinen-Barrow and Pack, 2013, pp. 122–3)
Categories of social supportSub-typesDefinition
EmotionalEsteem supportEnacting behaviours that bolster an individual’s self confidence, sense of competence or self-esteem, perhaps through provision of positive feedback or by demonstrating belief in the individual’s ability to cope with injury.
ListeningActively listening to the individual whilst refraining from giving advice or making judgement. This should involve sharing both positive (e.g. joys of rehabilitation success) and negative (e.g. setback frustrations) thoughts and feelings associated with rehabilitation.
Emotional supportProviding an individual with impartial assistance during emotionally difficult times and demonstrating acceptance, empathy and encouragement should they experience setbacks, thus facilitating a sense of comfort and security.
Emotional challengeChallenging the individual to do their utmost to overcome obstacles to goal-achievement, and structuring support so as to facilitate motivation toward rehabilitation.
Shared social realityActing as a ‘reality touchstone’ by verifying an individual’s perception of the current situation and social context, thus potentially providing a sense of ‘normalisation’.
TechnicalTechnical appreciationDemonstrating an acknowledgement of an individual’s achievements, or reinforcing effort and intensity during a rehabilitation session.
Technical challengeEncouraging individuals to achieve more, to be excited about their work and progress, and to seek new ways in which they might rehabilitate.
InformationalPersonal assistanceProviding advice, guidance and assistance in the form of time, skill, knowledge and expertise targeted directly at problem-solving or feedback relating to rehabilitation.
TangibleMaterial assistanceProviding tangible assistance such as the provision of transport to rehabilitation, assistance with general household duties, and financial support thus directly facilitating an individual’s chances of goal achievement.
Technical challengeEncouraging individuals to achieve more, to be excited about their work and progress, and to seek new ways in which they might rehabilitate.
MotivationalMotivationalEncouraging individuals to overcome, or give into, various barriers during the rehabilitation process.
Interactive Table 1 Different categories of social support (adapted from Arvinen-Barrow and Pack, 2013, pp. 122–3)
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Activity 3 Social support in practice

Timing: Allow about 15 minutes

Our case studies Travis and Lois have been asked to identify three key sources of social support they have drawn upon during their rehabilitation (see below). Select either Lois or Travis and then for each person they have identified consider what type of social support each person might provide.

Table 2: Case studies: social support
Lois (sprinter)
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A female athlete, Lois, is poised ready to sprint at the starting line of an athletic race track. Her hands are in position against the starting line, she is on her toes and her head is tilted upwards, looking down the track, towards the camera. The sun is shining.

Travis (exercise participant)
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A man in a white gym vest is doing push ups on a wooden deck. As he presses up, he is looking up towards the camera, smiling. This is Travis who is an exercise participant.

Coach (Wilma)
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Husband (Trevor)
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Sport psychologist (Amir)
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Physiotherapist (Lydia)
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Boyfriend (Dave)
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Personal trainer (Melissa)
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Discussion

Interestingly, both Lois and Travis have identified a mixture of personal and professional relationships. Different people can provide a range of different types of social support, but you might expect a partner (here, Dave or Trevor) to particularly provide emotional, tangible and motivational support. You might have thought that a coach or trainer would particularly provide technical, informational and motivational support. However, with an established coach–athlete relationship such as that between Lois and Wilma, there would likely be emotional support too.

Coaches are considered to be an important source of social support during sport injury (Newman and Weiss, 2018). A sport psychologist would likely predominantly provide emotional, tangible, informational and motivational support. A physiotherapist would be expected to predominantly provide technical, informational and motivational support, but a good physiotherapist would also provide emotional support.

The sources of social support discussed in Activity 3 focus on individual relationships, but it is important to note that group sources of social support can also be highly effective. The video below describes one such example – a sport injury support group.

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Transcript: Video 4

DR. NORAH SIMPSON:
There is a critical need to be able to provide additional support services to injured athletes research evidence suggests that injured athletes experience higher levels of distress and may have difficulty coping following an injury, but we don't really know the best way to help these athletes during their recovery. So our clinical services and our funding that was provided by the NCAA has allowed us to study a new pilot clinical service we've developed at Stanford and to really look to see how effective is the programme and how we're being able to meet student needs.
The clinical service we developed is an injured athlete recovery support group, and it is run by my collaborator on this grant Dr. Lisa Post. And each group meets eight weeks in a row. Each meeting has a particular topic that we focus on for the first part of the group.
It may be increasing effective communication, reducing stress, increasing social support, and so there is some education and some skills that we teach the athletes. And then the second half of the group is a facilitated discussion where the athletes can bring in things that they've been dealing with on that particular week, and there is both a group support component and also we like to draw in some of the skills that we're teaching the students.
Some athletes are newly injured and are really grappling with the beginning part of the recovery process and some athletes are farther along in the process and may be thinking more about what it means to potentially be medically retiring from the sport. There is a collective identity of struggling with injury as a collegiate athlete, but there are a range of points in that process where injured athletes may, may benefit from this type of service.
I think the thing that I'm most proud of is some of the responses that we've had from students after participating in the group. We've had comments like this is the first place on campus that I've really felt that somebody's understood my injury and the impact that it's had on me. And that really speaks to me regarding the impact of that group and us being able to be able to help these student athletes in their recovery process.Our goal in the long term is to have this be a permanent service that's available to Stanford athletes. And as we formalise the programme, we'll be able to make this support programme perhaps be something that's available to other campuses who may be interested in sharing in this resource as well.
End transcript: Video 4
Video 4
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Having looked at how all these different interventions can help recovery from sport injury next you’ll reflect on what this means to you.