Top

Published in:

01-11-2010 | Current Opinion

Behaviour, the Key Factor for Sports Injury Prevention

Authors: Dr Evert A. L. M. Verhagen, Maartje M. van Stralen, Willem van Mechelen

Published in: Sports Medicine | Issue 11/2010

Abstract

Safety in sports and physical activity is an important prerequisite for continuing participation in sports, as well as for maintenance of a healthy physically active lifestyle. For this reason, prevention, reduction and control of sports injuries are important goals for society as a whole. Recent advances in sports medicine discuss the need for research on real-life injury prevention. Such views call for a more behavioural approach when it comes to actual sports injury prevention. Nevertheless, the role of behaviour in sports injury prevention remains under-researched. In order to push the field of sports injury prevention forward, this article provides an overview of the relationship between behaviour and sports injury risk.

Different types of behaviour relate to injury risk factors and injury mechanisms. Behaviour that influences risk factors and injury mechanisms is not confined only to the athlete. Various types of behaviour by, for example, the coach, referee, physical therapist or sports associations, also influence risk factors and injury mechanisms. In addition, multiple behaviours often act together. Some types of behaviour may directly affect injury risk and are by definition a risk factor. Other behaviours may only affect risk factors and injury mechanisms, and influence injury risk indirectly.

Recent ideas on injury prevention that call for studies on real-life injury prevention still rely heavily on preventive measures that are established through efficacy research.A serious limitation in such an approach is that one expects that proven preventive measures will be adopted if the determinants and influences of sports safety behaviours are understood. Therefore, if one truly wants to prevent sports injuries in a real-life situation, a broader research focus is needed. In trying to do so, we need to look at lessons learned from other fields of injury prevention research.

van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries: a review of concepts. Sports Med 1992; 14: 82–99PubMedCrossRef

Meeuwisse W. Assessing causation in sport injury: a multifactorial model. Clin J Sport Med 1994; 4: 166–70CrossRef

Bahr R, Krosshaug T. Understanding injury mechanisms: a key component of preventing injuries in sports. Br J Sports Med 2005; 39: 324–9PubMedCrossRef

Meeuwisse WH, Tyreman H, Hagel B, et al. A dynamic model of etiology in sport injury: the recursive nature ofrisk and causation. Clin J Sport Med 2007; 17: 215–9PubMedCrossRef

Finch C. A new framework for research leading to sports injury prevention. J Sci Med Sport 2006; 9: 3–9PubMedCrossRef

Timpka T, Ekstrand J, Svnastrom L. From sports injury prevention to safety promotion in sports. Sports Med 2006; 36: 733–45PubMedCrossRef

McIntosh A. Risk compensation, motivation, injuries, and biomechanics in competitive sport. Br J Sports Med 2005; 39: 2–3PubMedCrossRef

van Tiggelen D, Wickes S, Stevens V, et al. Effective prevention of sports injuries: a model integrating efficacy, efficiency,compliance and risk taking behaviour. Br J Sports Med 2008; 42: 648–52PubMedCrossRef

McGlashan AJ, Finch CF. The extent to which behavioural models are used in sport injury prevention research. Sports Med 2010; 40 (10): 841–58PubMedCrossRef

10.

Yang J, Bowling JM, Lewis MA, et al. Use of discretionary protective equipment in high school athletes: prevalenceand determinants. Am J Public Health 2005; 95 (11): 1996–2002PubMedCrossRef

11.

Eime R, Owen N, Finch CF. Protective eyewear promotion: applying principles of behaviour change in the design of asquash injury prevention programme. Sports Med 2004; 34 (10): 629–38PubMedCrossRef

12.

Simpson J, Chalmers D, Waller A. The New Zealand Rugby Injury and Performance Project: developing ‘Tackling Rugby Injury’, a national injury prevention program. Health Promot J Aust 2002; 13 (1): 44–50

13.

Deroche T, Stephan Y, Castanier C. Social cognitive determinants of the intention to wear safety gear among adultin-line skaters. Accid Anal Prev 2009; 41: 1064–9PubMedCrossRef

14.

Andersen PA, Buller DB, Scott MD, et al. Prevalence and diffusion of helmet use at ski areas in Western North America in 2001-02. Inj Prev 2004; 10: 358–62PubMedCrossRef

15.

de Nooijer J, de Wit M, Steenhuis I. Why young Dutch inline skaters do (not) use protection equipment. Eur J Public Health 2004; 14: 178–81PubMedCrossRef

16.

Williams-Avery R, MacKinnon DP. Injuries and use of protective equipment among college in-line skaters. Accid Anal Prev 1996; 28 (6): 779–84PubMedCrossRef

17.

Rosen JC, Johnson RJ, Lefebvre MF, et al. Behavioral determinants of skiers’ failure to adjust release bindings. Clin Sports Med 1982; 1 (2): 209–15PubMed

18.

Iversen MD, Friden C. Pilot study of female high school basketball players’ anterior cruciate ligament injury knowledge,attitudes, and practices. Scand J Med Sci Sports 2009; 19 (4): 595–602PubMedCrossRef

19.

Finch C, Donohue S, Donohue S. Safety attitudes and beliefsof junior Australian football players. Inj Prev 2002; 8: 151–4PubMedCrossRef

20.

Sawyer RJ, Hamdallah M, White D, et al. High school coaches’ assessments, intentions to use, and use of a concussionprevention toolkit: Centres for Disease Controland Prevention’s heads up, concussion in high schoolsports. Health Promo Prac 2010; 11 (1): 34–43CrossRef

21.

Rosenstock I. Historical origins of the health belief model. Health Educ Quart 1974; 2: 1–8CrossRef

22.

Ajzen I. The theory of planned behavior. Organ Behav Hum Dec 1991; 50: 179–211CrossRef

23.

Rogers RW. A protection motivation theory of fear appeal and attitude change. J Psychol 1975; 91: 93–114CrossRef

24.

Rotter JB. Generalized expectancies of internal versus external control of reinforcements. Psychol Monogr 1966; 80 (1): 1–28PubMedCrossRef

25.

Lajunen T, Räsänen M. Can social psychological models be used to promote bicycle helmet use among teenagers? Acomparison of the Health Belief Model, Theory of Planned Behavior and the Locus of Control. J Safety Res 2004; 5: 115–23CrossRef

26.

Christakou A, Lavallee D. Rehabilitation from sports injuries: from theory to practice. Perspect Public Heal 2009; 129: 120–6CrossRef

27.

Verplanken B, Orbell S. Reflections on past behavior: a selfreport index of habit strength. J Appl Psychol 2003; 33 (6): 1313–30CrossRef

28.

Verplanken B. Beyond frequency: habit as mental construct. Brit J Soc Pscyhol 2006; 45: 639–56CrossRef

29.

Wood W, Tam L, Guerrero Wit M. Changing circumstances, disrupting habits. J Pers Soc Psychol 2005; 88: 918–33PubMedCrossRef

30.

Veplanken B. Habits and implementation intentions. In: Kerr J, Weitkunat R, Moretti M, editors. The ABC of behavioral change. Oxford: Elsevier Science, 2005: 99–109

31.

Gissane C, White J, Kerr K, et al. An operational model to investigate contact sports injuries. Med Sci Sports Exerc 2001; 33: 1999–2003PubMedCrossRef

32.

Collard DC, Chinapaw MJ, van Mechelen W, et al. Design of the iPlay study: systematic development of a physicalactivity injury prevention programme for primary schoolchildren. Sports Med 2009; 39 (11): 889–901PubMedCrossRef

33.

Chalmers DJ. Injury prevention in sport: not yet part of the game? Inj Prev 2002; 8: IV 22–5CrossRef

34.

Arnason A, Tenga A, Engebretsen L, et al. A prospective video-based analysis of injury situations in elite male football. Am J Sports Med 2004; 32: 1459–65PubMedCrossRef

35.

Dvorak J, Junge A, Grimm K, et al. Medical report from the 2006 FIFA World Cup Germany. Br J Sports Med 2007; 4: 578–81CrossRef

36.

Sherker S, Cassell E. Preventing in-line skating injuries: how effective are the countermeasures? Sports Med 1999; 28: 325–35PubMedCrossRef

37.

Warda L, Harlos S, Klassen TP, et al. An observational study of protective equipment use among in-line skaters. Inj Prev 1998; 4: 198–202PubMedCrossRef

38.

Schuster M, Israeli A. Survey of injuries and protective gear worn by in-line skaters in public parks. Am J Phys Med Rehab 1999; 78: 7–10CrossRef

39.

Osberg JS, Stiles SC. Safety behavior of in-line skaters. Inj Prev 2000; 6: 229–31PubMedCrossRef

40.

Jerosch J, Heidjann J, Thorwesten L, et al. Injury pattern and acceptance of passive and active injury prophylaxis forinline skating. Knee Surg Sport Tr A 1998; 6: 44–9CrossRef

41.

Heitkamp HC, Horstmann T, Schalinski H. In-line skating: injuries and prevention. J Sports Med Phys Fit 2000; 40: 247–53

42.

Beirness DJ, Foss RD, Desmond KJ. Use of protective equipment by in-line skaters: an observational study. Inj Prev 2001; 7: 51–5PubMedCrossRef

43.

Verhagen EALM, Van der Beek AJ, Bouter LM, et al. A one season prospective cohort study of volleyball injuries. Br JSports Med 2004; 38: 477–81CrossRef

44.

Freeman MA. Instability to the foot after injuries to the lateral ligament of the ankle. J Bone Joint Surg Br 1965; 47: 669–77PubMed

45.

Brand RL, Black HM, Cox JS. The natural history of inadequately treated ankle sprain. Am J Sports Med 1977; 5: 248–53PubMedCrossRef

46.

Ekstrand J, Gillquist J. Soccer injuries and their mechanisms: a prospective study. Med Sci Sports Exerc 1983; 15: 267–70PubMedCrossRef

47.

Tropp H, Odenrick P. Postural control in single limb stance. J Orthop Res 1988; 6: 833–9PubMedCrossRef

48.

Bahr R, Lian O, Bahr IA. A twofold reduction in the incidence of acute ankle sprains in volleyball after the introductionof an injury prevention program: a prospectivecohort study. Scand J Med Sci Sports 1997; 7: 172–7PubMedCrossRef

49.

Wedderkopp N, Kaltoft M, Lundgaard B, et al. Prevention of injuries in young female players in European teamhandball: a prospective intervention study. Scand J Med Sci Sports 1999; 9: 41–7PubMedCrossRef

50.

Verhagen EA, van der Beek AJ, Twisk JWR, et al. The effect of a proprioceptive balance board training program for theprevention of ankle sprains: a prospective controlled trial. Am J Sports Med 2004; 32: 1385–93PubMedCrossRef

51.

Emery CA, Rose MS, McAllister JR, et al. A prevention strategy to reduce the incidence of injury in high schoolbasketball: a cluster randomized controlled trial. Clin JSport Med 2007; 17: 17–24CrossRef

52.

Bouter LM. Spanningsbehoefte en ongevalsrisico bij sportbeoefening. Geneeskunde en Sport 1986; 19: 205–8

53.

Hagel B, Meeuwisse W. Risk compensation: a “side effect” of sport injury prevention? Clin J Sport Med 2004; 14: 193–6PubMedCrossRef

54.

Morrow P, McQuillen E, Eaton L, et al. Downhill ski fatalities: the Vermont experience. J Trauma 1988; 28: 95–100PubMedCrossRef

55.

Tough SC, Butt JC. A review of fatal injuries associated with downhill skiing. Am J Forensic Med Pathol 1993; 14: 12–6PubMedCrossRef

56.

Torg JS, Truex R, Quedenfeld TC, et al. The national football head and neck injury registry: report and conclusions1978. JAMA 1979; 241: 1477–9PubMedCrossRef

57.

LaPrade RF, Burnett QM, Zarzour R, et al. The effect of the mandatory use of face masks on facial lacerations andhead and neck injuries in ice hockey: a prospective study. Am J Sports Med 1995; 23: 773–5CrossRef

58.

Murray TM, Livingston LA. Hockey helmets, face masks, and injurious behavior. Pediatrics 1995; 95 (3): 419–21PubMed

59.

Hood M. Shoulder pads. In: Hood M, editor. Preparation performance and patch up: guide to fitness training and injury prevention. Auckland: Reed Publishers, 1987: 25–6

60.

Reynen PD, Clancy WG. Cervical spine injury, hockey helmets, and face masks. Am J Sports Med 1994; 22: 167–70PubMedCrossRef

61.

Taimela S, Kujala UM, Osterman K. Intrinsic risk factors and athletic injuries. Sports Med 1990; 9 (4): 205–15PubMedCrossRef

62.

van Mechelen W, Twisk J, Molendijk A, et al. Subject-related risk factors for sports injuries: a 1-yr prospectivestudy in young adults. Med Sci Sports Exerc 1996; 28 (9): 1171–9PubMedCrossRef

63.

Kelley MJ. Psychological risk factors and sports injuries. J Sports Med Phys Fitness 1990; 30: 202–21PubMed

64.

Kontos A. Perceived risk, risk taking, estimation of ability and injury among adolescent sport participants. J Pediatr Psychol 2004; 29: 447–55PubMedCrossRef

65.

Glasgow R, Lichtenstein E, Marcus A. Why don’t we see more translation of health promotion research to practice?Rethinking the efficacy-to-effectiveness transition. Am JPublic Health 2003; 93 (8): 1261–7CrossRef

66.

Gielen AC, Sleet DA, DiClemente RJ, editors. Injury and violence prevention: behavioral science theories, methods,and applications. San Francisco (CA): John Wiley & Sons Inc., 2006: 576

67.

Robertson L. Injury epidemiology: research and control strategies. 3rd rev. ed. New York: Oxford University Press, 2007: 264

68.

Trifiletti LB, Gielen AC, Sleet DA, et al. Behavioral and social sciences theories and models: are they used in unintentionalinjury prevention research? Health Educ Res 2005; 20: 298–307PubMedCrossRef

69.

Gielen AC, Girasek DC. Integrating perspectives on the prevention of unintentional injuries. In: Schneiderman N, Speers MA, Siva JM, et al., editors. Integrating behavioraland social sciences with public health. Washington, DC: Clin Psychol (New York), 2000: 203–30

70.

Gielen AC, Sleet D. Application of behavioral-change theories and methods to injury prevention. Epidemiol Rev 2003; 25: 65–76PubMedCrossRef

71.

Gielen AC. Health education and injury control: integrating approaches. Health Educ Q 1992; 19: 203–18PubMedCrossRef

72.

Thompson NJ, Sleet D, Sacks JJ. Increasing the use of bicycle helmets: lessons from behavioral science. Patient Educ Couns 2002; 46: 191–7PubMedCrossRef

Title: Behaviour, the Key Factor for Sports Injury Prevention
Authors: Dr Evert A. L. M. Verhagen
Maartje M. van Stralen
Willem van Mechelen
Publication date: 01-11-2010
Publisher: Springer International Publishing
Published in: Sports Medicine / Issue 11/2010
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI: https://doi.org/10.2165/11536890-000000000-00000

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Behaviour, the Key Factor for Sports Injury Prevention

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2010

Physical Fitness Profiles of Young Men

The Impact of Training Modalities on the Clinical Benefits of Exercise Intervention in Patients with Cardiovascular Disease Risk or Type 2 Diabetes Mellitus

The Effect of Playing Surface on Injury Rate

Sport Psychiatry

Short-Term Recovery from Prolonged Exercise