See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/267246364

Injury Occurrence and Psychological Risk Factors in Junior Football Players

Article

CITATIONS READS
6 101

4 authors, including:

Mohammad Hossein Alizadeh Ali Pashabadi

12 PUBLICATIONS   72 CITATIONS   
University of Tehran
2 PUBLICATIONS   15 CITATIONS   
SEE PROFILE
SEE PROFILE

Mehdi Shahbazi
University of Tehran
153 PUBLICATIONS   122 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Investigating the Anticipatory Postural and Synergy Adjustments under different Temporal Pressure and skill levels in Coincidence-Anticipation Timing task. View project

The effect of electromagnetic waves and physical activity on spatial learning and motor function in pregnant rat litters by using fMRI View project

All content following this page was uploaded by Mehdi Shahbazi on 01 June 2018.

The user has requested enhancement of the downloaded file.

World Journal of Sport Sciences 6 (4): 401-405, 2012
ISSN 2078-4724
© IDOSI Publications, 2012
DOI: 10.5829/idosi.wjss.2012.6.4.1155

Injury Occurrence and Psychological Risk Factors in Junior Football Players

Mohammad Hossein Alizadeh, Ali Pashabadi, Seied Mohammad Hosseini and Mehdi Shahbazi

Faculty of Physical Education and Sport sciences, University of Tehran, Tehran, Iran

Abstract: Football is a popular sport with a large number of injuries. It is necessary to understand injury risk
factors to identify the injury-prone athletes and to develop injury prevention plans. Most studies have
addressed physical and biomechanical risk factors but nowadays psychological factors are mentioned as an
important risk factor predictor. The aim of the present study was to examine the psychological factors that could
increase the injury risk among football players. Eighty one junior male football players (16-20 years old)
completed Competitive State Anxiety Inventory (CSAI-2) and previous injury questionnaire. The results of
Pearson correlation analysis revealed significant relationships between injury occurrence, cognitive anxiety
(p<0.05) and somatic anxiety (p<0.05) but no significant relationship was found with self-confidence (p>0.05).
It can be concluded that cognitive and somatic anxiety may increase the injury occurrence due to poor
concentration and physiological changes. The findings support suggestions that psychological factors can
be used to predict injury occurrence and anxiety was the predictor of injuries in junior football players.

Key words: Soccer % Sport injury % Psychological predictor factor % Anxiety % Injury risk factor

INTRODUCTION instability [10,11], lower extremity strength [11-13],

Football is probably the most popular sport
worldwide, with a growing interest and an increasing
number of players. It is a contact sport and challenges
physical fitness by requiring a variety of skills with
different intensities. Nevertheless, football is also
associated with a large number of injuries [1]. Hagglund
(2007) stated that 65%-95% of Swedish elite male football
players encounter at least one injury every year [2].
International football players reported an injury frequency
of 9.4 injuries /1000 h of football practice [3].
It is obvious that injuries have a significant impact on
individual and team performance [4]. Understanding injury
risk factors are essential to identify the injury-prone
athletes and to develop injury prevention strategies. As
injury causation is usually complex, risk factors must be
recognized before interventions are being developed.
Interest in understanding sport injuries has led to the
general conclusion that two major factors influence sport
injury vulnerability: external factors; for instance, type of
sport, weather conditions and player’s position [5] and
internal factors; for example, physiological and
psychological factors [6].
Most studies have addressed physical and
biomechanical risk factors, e.g. abnormal joint kinetics and
kinematics [7-9], joint laxity, mechanical or functional
muscular imbalances [12], decreased range of motion [14],
previous injuries and inadequate rehabilitation [2,14-16].
Some researchers have suggested that certain athletes, as
a result of their personality traits, have a particular
tendency towards injury and individuals’ psychological
state could be related to the injury occurrence [17-18].
Williams and Andersen (2007) found in a review of 40
empirical studies that 85% of those researches showed a
positive relationship between life-event stress and injury
risk [19].
Some models try to establish a connection between
psychological b ackground and the occurrence of
sport injuries. One of the most well known models is
Williams and Andersen’s (1998) stress-injury model.
The model posits the effects of psychological risk
factors on injuries and other sport-related health
outcomes. According to this model, injuries are mediated
by the cumulative effect of acute and/or chronic
physiological stress responses. This model posited that
increased autonomic nervous system activation and
possible simultaneous behavioral disruptions (e.g. sleep
disturbance) resulted from heightened negative affect and
may act in synergy with the demands of heavy exercise to
increase risk of illness and injury [19]. Negative emotion-
linked increase in stress hormones (i.e. cortisol) may
widen or prolong susceptibility to injury that is created

Corresponding Author: Seied Mohammad Hosseini, Faculty of Physical Education,

Tehran University, Tehran, Iran.
401
 World J. Sport Sci., 6 (4): 401-405, 2012
by high-intensity and high-volume training [20]. Williams
and Andersen (1998) divided risk factors into three main
categories: personality, history of stressors and coping
resources. Personality can affect what situations an
athlete apprehends as stressful [19].
Other models are Model of the influence of
psychological factors on sports injury by Junge (2000),
with three distinct psychological categories including
coping resources, psychological stressors and emotional
state [21]. Another one is Johnson and Ivarsson’s (2010)
empirical model of injury risk factors. This model
emphasizes that personality factors, stress and coping
influence the injury risk especially among football players
[22]. Some other important psychological factors are
anxiety (somatic and cognitive) [21] and self-confidence
[23] that are derived from Multi-Dimensional Anxiety
Theory [24].
Ivarsson and Johnson (2010) suggested four
personality trait factors that significantly predicted injury:
somatic trait anxiety, psychic trait anxiety, stress
susceptibility and trait irritability [25]. However,
psychological factors (Inhibition, aggression and risk-
taking) did not emerge as predictors in study of Schwebel
[26]. Bandura (1997) hypothesized that an athlete with low
self-efficacy would also be fearful of the sport
environment and consequently lack confidence in
attaining a positive outcome (e.g. avoiding injury). Hence,
athletes with lower confidence in avoiding injury would
be more likely to be injured than those confident in
avoiding injury [23]. Short et al. (2004) observed negative
relationships between worry/concern and confidence in
avoiding injury; also they cleared that injured athletes
have lowest confidence in their ability to avoid re-injury
[27]. Although the findings of Galambos (2005) supported
suggestions that psychological measures have utility in
predicting athletic injury, they did not mention anxiety as
a predictor factor [28]. Williams and Andersen (1998)
found a positive relationship between a sport injury
occurrence and competitive trait anxiety [19].
The literature shows that psychological factors seem
to have an effect on the risk of soccer injury in
adolescents [29]. Steffen et al. (2008) observed a
relationship between anxiety and injury in young football
player [30]. Johnson and Ivarsson (2010) studied
psychological predictors of sport injuries between junior
male and female football players studying at football high
schools in southwest Sweden. Their results showed that
the main factors were life event stress, somatic trait
anxiety, mistrust and ineffective coping [22].
Sport injury researches focusing on psychological
factors seem to have the potential to discover
psychological factors that might lead to increased or
402
decreased risk of injury among athletes and to make
recommendations to sport medicine teams and
coaches to prevent injuries. The aim of the present
study was to examine psychological factors that could
increase the injury risk among Iranian junior football
players.
MATERIALS AND METHODS
Participants: Participants were 81 male football players of
Tehran Junior Super League Championship (Asia Vision)
who were selected by convenience method. The mean age
of the sample was 17.95 ± 1.139 years (Range =16-20) and
they had 5-9 years of experience in soccer. Those players
in national team were excluded from the study.
Instrument
Anxiety: The Competitive State Anxiety Inventory CSAI-2
was used to measure competitive anxiety [31]. Participants
rated their anxiety responses over the multidimensional
constructs of cognitive anxiety, somatic anxiety and
self-confidence through 27 items with nine items
representative of each construct. Symptom intensity
levels were rated on a scale ranging from 1 (not at all) to
4 (very much so) leading to intensity scores ranging from
9 to 36 for each anxiety and confidence construct. Validity
and reliability of the CSAI-2 in Iranian athletes was
reported by Farokhi and Hakak (2000) [32].
Injury: Self-reported previous injury questionnaire in
various body parts (neck, shoulder, humorous, elbow,
forearm, wrist and fingers, hip, femur, knee, calf, ankle and
fingers and torso) including fracture, sprain and strain
was used for injury occurrence. Participants were asked to
report the number of injuries during the last 12 months by
completing self-reported previous injury questionnaire
following researcher’s explanations [33]. Participants were
required to report only those injuries that required medical
attention or withdrawal from training for one day or more
[34]. Finally, total number of injuries was used in the
statistical analysis.
Data normality was examined by K-S test and then
Pearson correlation was performed to examine the
relationship between anxiety and injury occurrence
(p=0.05).
RESULTS
The majority of football players reported at least one
injury over the previous 12 months (78% of the sample)
with an average of 3.03 (SD= 2.73, range =0-11) injuries
over the previous 12 months (Table 1).
 World J. Sport Sci., 6 (4): 401-405, 2012
Table 1: Demographic characteristics of subjects (n = 81)
Variable Mean
Age (years) 17.95
Height (cm) 175.3
Weight (kg) 70.62
Injury (in 12 month) 3.03
Cognitive Anxiety 22.84
Somatic Anxiety 18.86
Self-confidence 22.93
Table 2: Correlation matrix among the study variables (n = 81)
Variables r P value
Injury- Cognitive Anxiety 0.276*
Injury- Somatic Anxiety 0.237*
Injury-self-confidence -0.143
*- Correlation is significant at 0.05 (2-tailed).
The Pearson correlation analysis revealed significant
relationships between injury occurrence and cognitive
anxiety (r=0.27, p=0.01) and somatic anxiety (r=0.23,
p=0.03). Relationship between self-confidence and injury
occurrence was not significant (r= -0.14, p=0.2) (Table 2).
DISCUSSION
The aim of the present study was to examine the
relationship between psychological factors and injury risk
among junior football players. Results of Pearson
correlation showed a significant relationship between
somatic anxiety (r=0.237) and cognitive anxiety (r=0.276)
with injury occurrence but self-confidence had no
significant association with injury occurrence (r= -0.143).
According to the results (R2×100), somatic and cognitive
anxiety explained 5.6 % and 7.61% of injuries in junior
football player.
The finding is consistent with previous studies
supporting the positive relationship between competitive
trait anxiety and sport injuries. Johnson and Ivarsson
(2010) showed that injured athletes had a significantly
higher level of somatic trait anxiety than non-injured
athletes [22]. Our results are also similar to findings of
Petrie [35], Williams and Andersen, [6], Steffen et al. [30]
and Ivarsson and Johnson [25] establishing a positive
relationship between competitive trait anxiety and sport
injuries.
A potential explanation for the relationship between
cognitive anxiety and injury occurrence is that potentially
stressful situation has a positive effect leading to an
increased level of state anxiety and/or peripheral
narrowing [36]. According to Kerr and Fowler (1988),
athletes with a high level of trait anxiety more often
reported narrowing concentration and attention than
other athletes [37]. These findings could explain
SD why anxiety is often found to be a predictor of
1.13
sport injuries. High anxiety levels also seem to lead to
5.98
7.82
peripheral narrowing, thus higher injury vulnerability.
2.73 Athletes who are not sufficiently apprehensive of
4.9 threatening stimuli could be more likely to throw
5.53 themselves into situations beyond their capacity to
3.96 control [22]. In such cases, the athletes could be
exposed to a high risk of injury. Thus, in the present
study the injury occurrence increased as cognitive anxiety
0.01
raised.
0.03 In the current study, somatic anxiety showed to have
0.2 a significant relationship with injury occurrences which is
consistent with Perna et al. [38], Perna et al. [20] and
Williams and Anderson [19] studies. In an extension of
the Williams and Andersen model, Perna et al. [38]
posited that increased autonomic nervous system
activation and possible concomitant behavioral
disruptions (e.g. sleep disturbance) resulting from
heightened negative affect may act in synergy with the
demands of heavy exercise to increase risk of illness and
injury [20,37]. That is, psychological distress may impair
muscle growth and repair processes by prolonging the
presence of post exercise catabolic hormones (e.g.
cortisol) that also impair immunity and inhibit the
secretion and action of anabolic factors such as growth
hormone and insulin-like growth factors [20]. Negative
emotion-linked increases in stress hormones (i.e. cortisol)
in turn may increase prevalence of injury that is created
by high-intensity and high-volume training illness among
competitive athletes [38]. Extant models posit that when
added to physiological demands of exercise training,
psychological stress may cause interactive perturbations
in attention, affect, behavior and stress hormone mediated
disruptions to immune and skeletal muscle system
recovery [19, 22].
In the present study, there was a negative correlation
between self-confidence and sport injury occurrence but
not significant. Our study was inconsistent with Short
et al. [27] study that found a negative significant
relationship between self-confidence and injury
occurrence; the reason may be the difference in the
number of participants as their sample included 434
subjects in three different sports. Magyar and Chase
(1996) suggested that fear of injury exists when an athlete
lacks confidence in the ability to perform successfully in
a threatening or taxing situation [39]. Injured athletes have
expressed low self-efficacy in their perceived ability to
perform skills and movements required by their specific
sport without re-injuring themselves [40].
403
 World J. Sport Sci., 6 (4): 401-405, 2012
CONCLUSION
According to the results of the present study and
previous researches, psychological aspect seems to be
added to the list of sport injury risk factors; this aspect
along with other risk factors may influence injury
occurrence in junior soccer players. Therefore,
psychological factors should be considered in injury
preventing programs. Future research could be
conducted with a control group to examine possibility
of psychological intervention to prevent sports injuries.
Also, it is necessary in future researches to examine
psychological factors in other skill levels and ages.
REFERENCE
1. Reilly, T. and M. Williams, 2003. Science and soccer,
2nd ed. Routledge, London and New York,
2. Hagglund, M., M. Walde´n and J. Ekstrand, 2006.
previous injury as a risk factor for injury in elite
football: a prospective study over two consecutive
seasons. Br J. Sports Med., 40: 767-772
3. Waldén, M., M. Hägglund and J. Ekstrand, 2005.
UEFA Champions League study: a prospective study
of injuries in professional football during the
2001-2002 season. British Journal of Sports Medicine,
39: 542-546.
4. Kontos, A., 2004. Perceived risk, risk taking,
estimation of ability and injury among adolescent
sport participants. Journal of Pediatric Psychology,
29(6): 447-455.
5. Zarei, M., N. Rahnama and R. Rajabi, 2008. Effect
of soccer player post on rate of sport injury in Iranian
Pro league, Harekat, 39: 65-78
6. Williams, J.M. and M.B. Andersen, 2007.
Psychosocial antecedents of sport injury and
interventions for risk reduction. In: Tenenbaum,
G. and R.C. Eklund, eds. Handbook of sport
psychology, 3rd edn. New York: John Wiley and
Sons, pp: 379-403.
7. Cowley, H.R., K.D. Ford, G.D. Myer, T.W. Kernozek
and T.E. Hewett, 2006. Differences in neuromuscular
strategies between landing and cutting tasks in
female basketball and soccer athletes. J Athl Train,
41: 67-73.
8. Krosshaug, T., J.R. Slauterbeck, L. Engebretsen and
R. Bahr, 2007. Biomechanical analysis of anterior
cruciate ligament injury mechanisms: three-
dimensional motion reconstruction from video
sequences. Scand J. Med. Sci. Sports, 17: 508-519.
404
9. Sigward, S.M. and C.D. Powers, 2007. Loading
characteristics of females exhibiting excessive valgus
moments during cutting, Clin Biomech, 22: 827-833.
10. Ostenberg, A. and H. Roos, 2000. Injury risk factors
in female European football. A prospective study of
123 players during one season. Scand J. Med. Sci.
Sports, 10: 279-285.
11. Soderman, K., H. Alfredson and T. Pietila, 2001.
Werner S. Risk factors for leg injuries in female soccer
players: a prospective investigation during one out-
door season. Knee Surg Sports Traumatol Arthrosc,
9: 313-321.
12. Knapik, J.J., C.L. Bauman, B.H. Jones, J.M. Harris and
L. Vaughan, 1991. Preseason strength and flexibility
imbalances associated with athletic injuries in female
collegiate athletes. Am J. Sports Med., 19: 76-81.
13. Askling, C., J. Karlsson and A. Thorstensson, 2003.
Hamstring injury occurrence in elite soccer players
after preseason strength training with eccentric
overload. Scand J. Med. Sci. Sports, 13: 244-250.
14. Arnason, A., S.B. Sigurdsson, A. Gudmundsson,
I, Holme and Engebretsen L. Bahr, 2004. R. Risk
factors for injuries in football. Am J. Sports
Med., 32: 5-16.
15. Surve, I., M.P. Schwellnus, T. Noakes and
C. Lombard, 1994. A fivefold reduction in the
incidence of recurrent ankle sprains in soccer players
using the Sport-Stirrup orthosis. Am J. Sports Med.,
22: 601-606.
16. Tropp, H., C. Askling and J. Gillquist, 1985.
Prevention of ankle sprains. Am J. Sports Med.,
13: 259-262.
17. Junge, A., J. Dvorak, D. Rosch, T. Graf-Baumann,
J. Chomiak and L. Peterson, 2000. Psychological and
sport-specific characteristics of football players. Am
J. Sport Med., 28: 22-28.
18. Lysens, R.J., M.S. Ostyn and Vanden Y. Auweele,
1989. The accident-prone and overuseprone profiles
of the young athlete. Am J. Sports Med., 17: 612-619.
19. Williams, J.M. and M.B. Andersen, 1998.
Psychosocial antecedents of sport injury: Review
and critique of the stress and injury model. Journal of
Applied Sport Psychology, 10: 5-25.
20. Perna, F.M., M.H. Antoni and A. Baum, 2003.
Cognitive behavioral stress management effects on
injury and illness among competitive athletes: a
randomized clinical trial. Ann Behav Med., 25: 66-73.
21. Junge, A., 2000. The influence of psychological
factors on sports injuries. Review of the literature.
Am J. Sports Med., 28: 10-15.
 World J. Sport Sci., 6 (4): 401-405, 2012
22. Johnson, U. and A. Ivarsson, 2010. Psychological
predictors of sport injuries among junior soccer
players, Scand J. Med. Sci. Sports, 21: 129-136.
23. Bandura, 1997. Self-efficacy: The exercise of control.
New York: Freeman
24. Martens, R., et al. 1990. The Development of the
Competitive State Anxiety Inventory-2 (CSAI-2).
Human Kinetics.
25. Ivarsson, A. and U. Johnson, 2010. Psychological
factors as predictors of injuries among senior soccer
players. A prospective study, Journal of Sports
Science and Medicine, 9: 347-352.
26. Schwebel, D.C. and B.K. Barton, 2006. Temperament
and children’s unintentional injuries. In M. Vollrath
(Ed.), Handbook of personality and health, pp: 51-71.
New York: Wiley.
27. Short, S.E., J. Reuter, J. Brandt, M.W. Short and A.P.
Kontos, 2004. The Relationships Among Three
Components of Perceived Risk of Injury, Previous
Injuries and Gender in Contact Sport Athletes, Online
Journal of Sport Psychology, 6: 3.
28. Galambos, S.A., P.C. Terry and S.A. Locke, 2005.
Psychological predictors of injury among elite
athletes, Br J. Sports Med., 39: 351-354.
29. Emery, C.A., W.H. Meeuwisse. and SE.V. Hartmann,
2005. valuation of risk factors for injury in
Adolescent Soccer: implementation and validation of
an injury surveillance system, Am J. Sports Med.,
33: 1882-1891.
30. Steffen, K., 2008. Injuries in female youth football
Prevention, performance and risk factors, dissertation
from the Norwegian School of Sport Sciences.
31. Martens, R., R.S. Vealey and D. Burton, 1990.
Competitive anxiety in sport: Human Kinetics.
32. Farokhi, A. and E. Hakak, 2000. The comparison
between two type of state and trait anxiety in male
athletes participating in international competitions of
sports and nations cups. Harekat, 4: 55-62.
405
View publication stats
33. Rajabi, R. and H. Samadi, 2008. Laboratory manual of
corrective exercise for post graduated students.
Tehran University Press, Tehran.
34. Deroche, T., Y. Stephan, B.W. Brewer and
C.L. Scanff, 2007. Predictors of perceived
susceptibility to sport-related injury, Personality and
Individual Differences, 43: 2218-2228.
35. Petrie, T.A., 1993. Coping skills, competitive trait
anxiety and playing status: moderation effects on the
life stress-injury relationship. J. Sport Exerc. Psychol.,
15: 261-274.
36. Rogers, T.M. and D.M. Landers, 2005. Mediating
effects of peripheral vision in the life event
stress/athletic injury relationship. J. Sport Exerc.
Psychol., 27: 271-288.
37. Kerr, G. and B. Fowler, 1988. The relationship
between psychological factors and sport injuries.
Sports Med., 6: 127-134.
38. Perna, F.M., M.H. Antoni, M. Kumar, D.H. Cruess
and N. Schneiderman, 1998. Cognitive-behavioral
intervention effects on mood and Cortisol during
athletic training. Annals of Behavioral Medicine.
20: 92-98.
39. Maygar, T.M. and M.A. Chase, 1996. Psychological
strategies used by competitive gymnasts to
overcome fear of injury. USA Gymnastics Online,
http://www.usaymnastics.org/publications/techniq
ue/1996/10/psychological-strategies.html.
40. Doyle, J., N. Gleeson and D. Rees, 1998.
Psychobiology and the athlete with anterior cruciate
ligament (ACL) injury. Sports Medicine, 26: 379-393.