The Relationships Among Three Components of
Perceived Risk of Injury, Previous Injuries and Gender
in Non-Contact/Limited Contact Sport Athletes
Jennifer M. Reuter
Sandra E. Short
University of North Dakota
This study examined the relationships among perception of risk of injury, worry/concern of injury, and confidence in avoiding injury. Participants were 154 athletes from three non-contact/limited contact sports (swimming, track, and baseball). Measures included the Perception of Risk of Injury Scale (RISSc; Kontos, Feltz, & Malina, 2000), Worry about Injury in Sports Scale (WISSc; Short et al., 2005), Confidence in Avoiding Injury in Sports Scale (CAISSc; Short et al., 2005), and The Marlowe-Crowne Social Desirability Scale (Crowne & Marlowe, 1960). Correlations between the measures indicated a positive relationship between the fear of injury and probability of injury and a negative relationship between fear of injury and confidence in avoiding injury. There was also a negative relationship between the probability of injury and confidence in avoiding injury. Significant gender differences were only found for the worry in avoiding uncontrollable injuries, with males fearing injury more than females. In regard to previous injury, if an athlete was previously injured, they reported more fear of reinjury and a higher probability of reinjury. Results also showed that if an athlete reported more than one injury in the past 12 months, the more perceived risk of reinjury and reduced confidence an athlete had. With this knowledge, it may be possible to create programs capable of decreasing the negative perceptions and changes in behavior that often increase the fear of injury.
Fear has been defined as anxiety caused by real or possible danger or pain (Solomon, 1984). In sport, fear can be considered as an important psychological barrier to performance. Injury is an aspect of sport that many athletes fear. For recreational or elite athletes, injuries can happen anytime and anywhere (Lai, 1995). For the injured athlete, the experience of sport-related trauma can be fearful and confusing especially if no previous injury experience is available to form a benchmark. Much of the fear related to sport injury and rehabilitation emanates from not knowing what to expect and concern about what sensation and body reactions are appropriate (Flint, 1998).
Decreases in performance associated with injury can be attributed to psychological factors more so than physical factors (Dunn, 1999). The sport medicine community has become aware of the integral role that psychosocial factors play in the injury occurrence and recovery processes (Brewer, Jeffers, Petitpas, & Van Raalte, 1994). For this reason, such constructs like “perceiving fear” and “confidence in avoiding injury” have become important. A review of the literature shows that fear of injury has been conceptualized in three ways; (1) loss of confidence, (2) a worry or concern of being injured, and (3) a risk of being injured. The next sections present each of these approaches and a summary of the research associated with each one.
Fear of Injury as a Loss of Confidence
With injury comes a loss of confidence in return to sport (Doran, 1984). The loss of confidence may be due in part to fear of the same injury recurring. Because of injuries sustained, many athletes are hesitant about returning to the game and are lost to their sport at an early stage of their career. An example of this is a young man, who suffered a broken nose on two occasions and was prone to repeated eyebrow lacerations. He was of superior ability and enjoyed playing his sport, in which no protective gear is usually worn. He was hesitant to play again after the injury, but when he did so, lacked confidence and played below his usual standard (as cited in Doran, 1984).
One of the first impressions that outside observers have of the sport of gymnastics is the risk and danger involved with sport (Snyder & Kane, 1990). While the likelihood of injury is minimized through years of training and proper coaching, even experienced collegiate gymnasts have a “fear factor.” This factor denotes a fear of injury and pain (Snyder, 1990). Gymnasts recognize there are variations between them in the degree of confidence or fear in performing difficult tricks. When asked, a gymnast stated, “oh yeah, the fear of injury is always on your mind, especially when you’re older and you see others who are injured. Some kids have more fear than others. The amount of fear may depend on whether they have had a previous injury” (as cited in Snyder, p. 261).
The fear of reinjury may also act as a factor to loss of confidence when returning to sport. A study by Macchi and Crossman (1995) questioned 26 professional ballet dancers to determine what impact injury had on their lives. The dancers initially reported feeling a host of negative emotions such as anger, fear, distress and depression. As a result of their injury, 42% of the dancers indicated that their attitude toward ballet had changed, that they were more careful when dancing, that they used better technique, and that they stretched more and modified exercises to avoid injury. Two of the ballet dancers expressed worry about reinjury. “Acting on lessons” is a term used by Rose and Jevne (1993) to explain the conscientious attempt of athletes to prevent injuries or in this case, re-injury. A ballet dancer who “acts on lessons” to prevent injury (Rose & Jevne, 1993), demonstrates that the risk of injury influences an individuals behavior during sport by attempting to prevent injury or re-injury.
Magyar and Chase (1996) found that the fear of injury exists when gymnasts lack confidence in their ability to perform successfully in a threatening or taxing situations. Although the study confirmed that the fear of injury can be directly related to a loss of confidence, the study was designed to assess the strategies used by gymnasts to overcome their fear of injury. In order to perform at high competitive levels, one must learn to exercise control over fearful situations.
Fear of Injury as Perceived Risk
Recently there has been an interest in determining athlete’s perceptions of the risk of injury (Kontos, Feltz, & Malina, 2000). Kontos et al. (2000) developed and statistically validated a general scale for the measurement of athlete’s perceptions of risk of injury, called the Perceived Risk of Injury in Sport (RISSc). The RISSc contains six categories: (1) uncontrollable injuries, (2) controllable injuries, (3) overuse injuries, (4) surface related injuries, (5) upper body injury, and (6) reinjury. Each item uses the stem “what do you think are the chances you will…” Responses for each item are made on a scale between 1 (very unlikely() and 6 (very likely).
Analyses examining gender differences for the six RISSc factors were conducted using a sample of 501 adolescent team and individual sport athletes who participated in over 20 different youth sport programs at the scholastic, club, and recreational level. Results showed that males and females differed in their perceptions of risk of injury (Kontos et al., 2000). Females scored higher on all subscales (i.e., controllable, surface-related, overuse, upper-body and reinjury) except for uncontrollable injuries where males reported higher scores. Results also revealed that males reported more previous injuries than females.
Previous injuries might act as a precursor in relation to perceived risk of injury (Kontos et al., 2000). The type, location, severity, and repetitiveness of an injury may also influence perceived risk of injury. For instance, an athlete who has incurred multiple, severe ankle sprains may perceive more risk in playing sports than an athlete who has had only one such injury. Kontos et al. (2000) showed that injured athletes (n = 111) scored higher on all injury subscales when compared to uninjured athletes (n = 241). As stated by Kontos et al. (2000), the RISSc is a viable measure that needs to be further studied, and more research should be conducted with different sport athletes or ages.
Fear of Injury as a Worry or Concern
A third approach to studying the fear of injury was proposed by Dunn (1999). Dunn’s study assessed competitive worry in ice hockey. Results revealed that competitive worry in ice hockey could be structured around a combination of four content domains relating to athletes’ fear of failure, fear of negative social evaluation, fear of injury or physical danger, and the fear of the unknown. He concluded that the constructs of fear of injury or physical danger and fear of the unknown may also play a role in sport anxiety (Dunn, 1999).
Purpose of this Study
To date only one study has examined the relationship between perception of risk of injury, fear of injury, and confidence in avoiding injury in contact/collision sports (Short, Reuter, Brandt, Kontos & Short, 2005). Participants were 380 athletes from 3 collision/contact sports (hockey, soccer, and football). Measures included the Perceived Risk of Injury in Sports Scale (RISSc; Kontos et al., 2000), the Worry about Injury in Sports Scale (WISSc; Short et al., 2005), and the Confidence in Avoiding Injury in Sports Scale (CAISSc; Short et al., 2005). Correlations between the measures showed a positive relationship between fear and risk of injury, and negative relationships between fear and confidence as well as between risk and confidence. Results also showed that those athletes who had been previously injured perceived the highest risk of reinjury, demonstrated the greatest fear of reinjury, and had the least amount of confidence in their ability to avoid reinjury. Additional findings were that females scored significantly higher than did males on every RISSc factor except upper body and uncontrollable. Females who had been injured perceived more risk compared to males who had been previously injured. Risk for males and females were about equal when they had not been previously injured. Risk scores were higher in soccer compared to hockey for males. As for females, risk was stable across all sports. CAISSc scores revealed that confidence in avoiding injury was higher for female soccer players compared to female hockey players, and that male soccer players were slightly less confident than male hockey players. WISSc scores revealed that for upper body injury, female hockey players perceived more fear when compared to males and also perceived more fear when compared to female soccer players. Male soccer players also perceived more fear of controllable injuries when compared to male hockey players and female hockey players perceived more fear when compared to female soccer players.
With respect to past injuries, the sport by gender by injury interaction revealed that male soccer players with a past injury were less confident in avoiding surface related injuries when compared to those with no previous injury. Surface related injury scores also revealed that regardless to sport, females with no previous injury were more confident in their ability to avoid injury compared to females with injury experience.
So far the only research that has been conducted using these three approaches to studying fear of injury has focused on contact/collision sports. It is likely that the fear of injury and pain is also a factor for those athletes who participate in non-contact or limited contact sports as well. Non-contact sports are defined as those who do not involved any type of physical contact such as golf, tennis or swimming (Risser, 1994). Limited contact sports are those sports such as softball and squash, where contact with other athletes or an inanimate object is either occasional or inadvertent. Sports with limited contact, such as downhill skiing and gymnastics, can be as dangerous as the contact/collision sports. Even in non-contact/limited contact sports, injuries can occur.
Therefore, the purpose of this study was to examine the relationship among male and female collegiate aged athletes’ perceptions of risk of injury, confidence in avoiding injury and their fear of injury in non-contact/limited contact sports. A secondary purpose was to compare results from this study to that of contact/collision sports (Short et al., 2005).
Based on previous research in this area (Kontos et al., 2000; Short et al., 2005), several hypotheses were made:
Participants were 154 male and female athletes from three non-contact/limited contact sports (swimming/diving, track and field, baseball/fastpitch). From here on, track and field will be referred to as track, and baseball/fastpitch will be referred to as baseball, unless gender differences are reported. For swimming, there were 18 females and 27 males. For track there were 26 males and 28 females. For baseball there were 25 males. All fastpitch players were female (n = 30). The mean age of the participants was 20.12 years (SD = 2.20; Range: 18 to 31 years). The average length of time participants were involved in their sport ranged from being in their first season to 27 years (M = 7.76, SD = 4.98). The majority of the sample (92%) indicated that they were a “starter” (i.e., that they played more than 50% of each game). Finally, most of the sample played at the Division 2 level (66.9%) followed by Division 3 (26.0%), amateur (6.5%) and Division 1 (0.6%).
The questionnaires used included a background information sheet, the Perception of Risk of Injury Scale (RISSc), the Worry of Injury in Sport Scale (WISSc), the Confidence in Avoiding Injury in Sport Scale (CAISSc), and a Social Desirability Scale. The background information questionnaire asked respondents basic personal information such as age, type of sport and level of sport played. Also included in the questionnaire was previous injury information. The definition of injury “any injury you had in your sport in the past 12 months that required treatment beyond icing and taping” (as used in Kontos et al, 2000; Short et al, 2005), was given and based on the definition, participants responded if they have been injured. If they had been injured, respondents described their most recent and their most serious injuries in more detail.
The Perception of Risk of Injury Scale (RISSc; Kontos et al, 2000) is a 24 item self-report measure to assess one’s perception of risk of injury across different sport situations. Each item used the stem “what do you think are the chances that you will…” There are six subscales dealing with reinjury, surface injuries, upper body injuries, overuse injuries, controllable injuries and uncontrollable injuries. Respondents chose their answers from a Likert-type scale ranging from 1 (very unlikely) to 6 (very likely). Reliabilities (ranging from .77 to .88) (Short et al., 2005) for the RISSc were adequate based on previous studies and were well above the generally accepted values. Nunnally (1978) suggests that instruments used in basic research have a reliability of .70 or higher.
The Worry about Injury in Sport Scale (WISSc; Short et al., 2005) has 24 items that represent the same 6 subscales as the RISSc. The difference is that the stems for each item read: “how worried or concerned are you that you will…” Respondents were instructed to choose their answers using a scale that ranged from 1 (not worried or concerned at all) to 10 (very worried or concerned). Scale reliabilities (obtained by Short et al., 2005) for the WISSc were high and ranged from .79 to .94.
The Confidence in Avoiding Injury in Sport Scale (CAISSc; Short et al., 2005) has 24 items that represent the same six subscales as the RISSc and WISSc. The stem for each item read: “how confident are you in your ability to avoid…” Respondents were asked to rate their confidence on a scale from 0 (not confident at all) to 10 (very confident). According to the Short et al. (2005) study, scale reliabilities show the CAISSc was acceptable at a range of .83 to .96.
The Marlowe-Crowne Social Desirability Scale (Reynolds, 1982) was also administered. The reason for adding this questionnaire was for the interest in the problem of response distortion or social desirability responding. It is common practice for individuals to “fake good” or “fake bad” to certain questions. When asked questions of fear or concern, the tendency for an athlete to appear more confident or less fearful may be probable. Psychological assessment aims for the most accurate description of some cognitive or behavioral attributes. In assessment involving self-reports, this objective is invariably haunted by the possibility of misrepresentation or need for approval (Paulhus, 1986). The need to examine social desirability as a response tendency with self-report measures has been well documented and continues to be a methodological consideration in research. A number of instruments and techniques have been developed for the assessment of social desirability response tendencies. An examination of the current research literature indicated the Marlow-Crowne Social Desirability Scale is the primary social desirability measure in use at this time (Crowne & Marlowe, 1960).
The Marlowe-Crowne, which has been used extensively in personality research for the past 20 years, consists of 33 items and utilizes a true-false response format. Marlowe and Crowne originally chose the items for scale inclusion, on the basis that they describe culturally approved behaviors that have a low incidence of occurrence, and the response to items in the keyed or non-keyed direction have minimal implication of psychopathology. Reliability for the short form of the Marlowe-Crowne questionnaire has shown to be at an acceptable level of .76 (Reynolds, 1982).
Approval to conduct this study was granted by the Institutional Review Board at the University of North Dakota. In order for athletes to participate in the study, coaches of various teams from universities and leagues from the surrounding area were contacted. After consent to administer the questionnaires was received from the coaches, appointments to attend a team meeting, practice or games were made. The participant consent form was read aloud to the participants and further explanations of the questionnaires were made. The entire process took approximately 20-45 minutes, depending on the athlete’s injury information. To provide for confidentiality, questionnaires were put into a sealed envelope, separate from the signed participant consent forms.
The results of this study are presented in 3 sections. The first section contains the reliability analysis, descriptive statistics and comparisons among gender and type of sport for the RISSc, WISSc and CAISSc. The second section shows the relationship between the three primary dependent variables (probability, worry/concern, and confidence in avoiding injury). The third section includes analyses relating each outcome variable to athletes’ previous injury status. All statistical analyses were performed using SPSS (version 10.0.05).
Reliability for the RISSc, WISSc and CAISSc
Cronbach’s alpha coefficient was used to determine the reliability of each measure. A minimum acceptable criterion was set at .70 as suggested by Nunnally (1978). The reliability coefficients for the total measures were: RISSc (.91), WISSc (.84), and the CAISSc (.95) (see Table 1).
Descriptive Statistics for the Measures
For all subscales of the RISSc as well as the total RISSc scores, mean values ranged between 1.18 and 3.37. On a scale of 1-6, these values indicate that participants perceived low to moderate probabilities of being injured in sport. The means and standard deviations for the RISSc are presented in Table 2. A MANOVA was run using sport (track, baseball and swimming) and gender (male and female) as the independent variables and RISSc scores as the dependent variable. Results indicated that there was a statistically significant multivariate effect for type of sport (Pillai’s Trace = 0.72, F (12, 288) = 13.63, p = .00). The main effect for gender (p = .39) and the interaction between sport and gender (p = .88) were not statistically significant. Univariate ANOVAs and pairwise comparisons were evaluated as follow-up tests. These results showed that the sports differed on perceived risk of uncontrollable injuries (F (2, 154) = 45.85, p = .00, Eta2 = .38), and controllable (F (2, 154) = 4.71, p = .01, Eta2 = .06), and upper body (F (2, 154) = 10.09, p = .00, Eta2 = .12), and surface related (F (2, 154) = 3.08, p = .05, Eta2 = .04, and reinjury (F (2, 154) = 11.83, p = .00, Eta2 = .14); all but perceived risk of overuse injuries.
Pairwise comparisons of uncontrollable injury scores indicated a significant difference between all three sports (all about p = .00) with baseball players fearing the most risk and swimmers fearing the least. Risk of controllable injuries showed a significant difference between swimming and baseball (p = .01) with baseball players fearing the most risk and swimmers the least. Same as uncontrollable, risk of upper body injury scores indicated a significant difference between track and swimming (p = .00) and track and baseball (p = .00). In this case, swimmers reported the most fear of upper body injury while track athletes scored the lowest. Risk of reinjury scores indicated a significant difference between track and baseball (p = .00), and baseball and swimming (p = .00). Track athletes perceived the highest risk of reinjury while baseball players perceived the least amount of fear. Overuse injury scores were not significant. All of these differences are shown in Figure 1.
Descriptive statistics for the WISSc according to sport and gender can be found in Table 3. For all WISSc subscales and the total WISSc, mean values ranged between 0.00 and 3.50. Justifiably, the mean value of 0.00 is indicative of female swimmers having no fear of uncontrollable injuries. Questions from this series included; how worried or concerned are you that you will… “Injure yourself in a collision with an opponent,” “be injured from a foul or “cheap shot” from an opponent,” “be injured by more aggressive opponents,” “be injured by bigger or stronger opponents,” and “injure yourself on a piece of dangerous equipment.” Each of these questions deal with uncontrollable factors that are doubtful in the sport of swimming. On a scale of 0-10, these values indicated that participants perceived a low level of fear of being injured in sport.
MANOVA results for the WISSc showed that there was a significant main effect for type of sport (Pillai’s Trace = 0.42, F (12, 288) = 6.37, p = .00). There was also a significant main effect for gender (Pillai’s Trace = .09, F (6, 143) = 2.38, p = .03). The interaction between gender and sport was not statistically significant (p = .69).
Univariate ANOVAs and pairwise comparisons were evaluated as follow-up tests. The only statistically significant results for sport type were for fear in avoiding uncontrollable (F (2, 154) = 19.76, p = .00, Eta2 = .21), and controllable injuries (F (2, 154) = 3.97, p = .02, Eta2 = .05). For gender, only fear of avoiding uncontrollable injuries was statistically significant (F (1, 153) = 9.98, p = .00, Eta2 = .06).
Pairwise comparisons for uncontrollable injury scores indicated a significant difference between all three sports (all about p = .00). Baseball players had the highest amount of fear while swimmers had the least. Same as uncontrollable, controllable injury scores indicated a significant difference between baseball and swimming (p = .02). Baseball players had the highest fear of uncontrollable injuries while swimmers had the lowest. With regard to gender differences in avoiding uncontrollable injuries, males perceived more fear when compared to females (p = .00) (see Figure 2).
Descriptive statistics for the CAISSc according to sport and gender can be found in Table 4. For all CAISSc subscales and the total CAISSc scores, mean values ranged between 5.55 and 9.65. These values indicated that participants were “somewhat” to “very” confident in their ability to avoid injury. MANOVA results for the CAISSc showed that there was a significant main effect for type of sport (Pillai’s Trace = 0.40, F (12, 288) = 6.05, p = .00). The main effect for gender was not statistically significant (p = .16) and the interaction between gender and sport was not statistically significant (p = .19).
Univariate ANOVAs and pairwise comparisons were evaluated as follow-up tests. There were statistically significant differences on all subscales: confidence in avoiding uncontrollable injuries (F (2, 154) = 14.60, p = .00, Eta2 = .17), and controllable (F (2, 154) = 14.76, p = .00, Eta2 = .17), and overuse (F (2, 154) = 5.73, p = .00, Eta2 = .07), and upper body (F (2, 154) = 9.65, p = .00, Eta2 = .12), and surface related (F (2, 154) = 9.38, p = .00, Eta2 = .11), and reinjury (F (2, 154) = 3.53, p = .03, Eta2 = .05).
For all subscales, pairwise comparisons revealed a significant difference between track and baseball, and baseball and swimming. As shown in Figure 3, track athletes had the highest scores for confidence in avoiding uncontrollable injury while baseball players had the lowest scores. Controllable injury scores were highest for swimmers, while baseball players had the lowest. Overuse injury scores were highest for swimmers and lowest for baseball players. Upper body injury scores were highest for track athletes and lowest for baseball players. Surface related scores were highest for track athletes and lowest for baseball players, while reinjury scores were highest for baseball players and lowest for track athletes. It is possible that the high confidence level in track athletes for avoiding surface related injuries, is due to the fact that track athletes have more control over the surface they train and compete on.
Relationships Among Probability of Injury, Worry/Concern about Injury, Confidence in Avoiding Injury
To examine the relationships among the three measures, Pearson product moment correlations were conducted on the total subscale scores (see Table 5). Correlations between the measures indicated a positive relationship between fear of injury and probability of injury (r = .47, p < .01), and negative relationships between fear of injury and confidence in avoiding injury (r = -.25, p < .01), as well as between probability of injury and confidence in avoiding injury (r = -.26, p < .01).
Correlations between the three measures and the Marlowe-Crowne social desirability measure were negative and small and not statistically significant which shows that social desirability was not a factor affecting the participants’ responses to the RISSC, WISSC, and the CAISSc.
Relationships Among Probability of Injury, Worry/Concern about Injury, Confidence in Avoiding Injury and Previous Injury Status
The background information sheet used in this study asked respondents to indicate whether or not they had experienced an injury in the past 12 months. Thirty-three (21% of all) athletes had experienced an injury, while 120 (78% of all) did not. Descriptive statistics for the injured and non-injured groups can be found in Table 6. An ANOVA using the subscale scores for the RISSc, WISSc, and CAISSc as the dependent variables showed the two groups differed significantly in only the perceptions of probability of re-injury (F (1,153) = 5.51, p < .02), and their fear of re-injury (F (1,153) = 9.40, p < .00). If an athlete was previously injured, they reported more fear of re-injury and a higher probability for re-injury.
As a follow-up, another ANOVA was done to determine if there was a relationship between the number of injuries an athlete reported having and the probability, fear and confidence in avoiding re-injury. Shown in Table 7, the 33 athletes who reported an injury were divided into two groups – those who had one injury in the last year (n = 18) and those who reported having more than one (n = 15). The multivariate effect was not statistically significant (p = .23), but a few univariate effects were. There were differences between the groups for: risk of reinjury (F (1,153) = 9.96, p < .00), confidence in avoiding uncontrollable injuries (F (1,153) = 5.03, p < .03), and confidence in avoiding controllable injury (F (1,153) = 3.95, p < .06). Overall the results show that if an athlete had more than one injury in the past 12 months, the more perceived risk of re-injury and reduced confidence the athlete has.
A final ANOVA was run using injury severity as an independent variable and the RISSc, WISSc and CAISSc subscales serving as the dependent variables. Of the 33 athletes who reported an injury, five stated their most serious injury was mild, 18 moderate and 10 severe (see Table 8). There were no statistically significant differences in this analysis; showing that injury severity was not a factor of perceived risk, fear or confidence in avoiding injury.
The purpose of this study was two-fold: to examine the relationship among male and female collegiate aged athletes’ perceptions of risk of injury, confidence in avoiding injury and their fear of injury in non-contact/limited contact sports; and to compare results from this study to that of contact/collision sports (Short et al., 2005). The first hypothesis was there would be a significant positive relationship between previous injury experience and fear of reinjury. According to the study by Short et al. (2005), results showed that previous injury affected the perception of risk of future injuries in that injured athletes reported more fear, greater risk and lowered confidence in avoiding injury. In addition to this evidence, Dunn (1999) suggested that when an actual injury occurs and the athletes can see or are reminded of the dangers of their sport, it seems reasonable that their concerns can reappear. In the current study, results demonstrated that previous injury significantly affected athletes’ fear of being injured. If an athlete had been previously injured, they indeed reported more fear of being injured.
The second hypothesis was that in regard to gender differences, females would experience more fear of injury, less confidence in avoiding injury and perceive more risk of injury than males. With regard to the fear of injury, results of the current study showed that males had more fear of being injured when compared to females in track. However, swimming and baseball results indicated that females had more fear of injury in their respective sports. Results for gender differences in track did not support the hypothesis, however results for baseball and swimming did. The results of this study are contrary to that of the findings by Short et al. (2005), who found that the only significant difference was that females had more fear in regard to uncontrollable injuries. Perhaps the reason for such a different response is the type of sport included in the study. Short et al.’s (2005) study used contact/collision sports. It is possible that athletes who participate in contact sports and are less likely to be fearful of being injured because of beliefs about pain and injury they developed when they were children (Fremerman, 2004). For example, boxing and football players may have belief systems regarding pain that are different from most athletes. While growing up, they could have been “programmed” by their parents to believe it was "no big deal" to break a finger, a leg or an arm. It's possible that a young girl on a team who did not receive this type of programming at an early age may be more susceptible to developing an unfounded fear of injury later in life.
Contrary to our hypothesis, the results of the current study also showed that males were less confident in avoiding injury when compared to females. In regard to perceived risk of injury, findings were consistent with the hypothesis that females perceived more risk of injury than males, which is congruent with the findings of Short et al. (2005) study. The possible reason that males were less confident in avoiding injury in sport may be a result of the possible contact in sport and that notion that males “compete harder” than do females. According to Burnsides (1998), a large body of knowledge indicates the competitive nature of human beings is more prevalently found in males. The general rule is that American males are simply trained to win; however, over the last few decades women have been urged to compete and to accept competitiveness as appropriate and even healthy. The hypothesis that females would perceive more risk than males was inconsistent, with results similar across all sports. Same as track, female swimmers perceived higher risk of injury compared to males, while male baseball players perceived higher risk compared to female fastpitch players. The current study’s results were also inconsistent with the results of the Short et al. (2005) study in which females reported higher risk in reinjury, uncontrollable and total risk of injury scores. The current study found that females reported higher scores on controllable, overuse and surface related injury scores.
Consistent with the hypothesis, correlations between the RISSc, WISSc, and CAISS, indicated a positive relationship between fear of being injured and the risk of injury. The same result was true for the Short et al. (2005) study. The result remains consistent in both studies that with more perceived risk of injury, the less confidence in avoiding injury the athlete will have. A possible reason for concern and risk having an effect on each other may be explained by the fact that some athletes put undo pressure on themselves thinking about the possibility and chance occurrence of injury. As stated by Difiori (2004), when children are participating in an activity and they are controlling the level of intensity themselves, injuries don’t seem to happen very often. But when they are trying to meet some sort of expectation, whether it’s imposed by their friends or an adult, that’s when injuries may occur more commonly. The same could be possible for the collegiate-aged athlete. Another factor of the link between the two might be the athletes’ experience playing the sport. A newcomer to the sport may go into a situation unknowing the dangers or injury avoidance techniques accompanying the sport. According to Walker (2003), injuries in the beginning of the season are quite common. In soccer, 44% of ankle injuries were sustained during the first three months of the season. The time of injury was not assessed in this study.
Unlike the Short et al. (2005) study, there were no significant interactions between gender and sport for the RISSc, WISSc, and CAISSc. There were however, several statistically significant main effects for type of sport, such as perceived risk of uncontrollable injuries, reinjury, controllable, upper body, and surface related. All but perceived risk of overuse injuries were significant. In a comparison between sports on all measures, swimming showed the most perceived risk, fear and least confidence in avoiding overuse injuries. A swimmer’s most common injury fell into the category of the overuse injury (Bragman, 2000; Doyle, 1999; Watson, 1993). Bragman (2000) noted that swimmers are particularly injured in the shoulder and about half of the competitive swimmers over age 12 suffer from shoulder pain. Doyle (1999) also concluded that most swimming injuries occur in the shoulder. Such injuries are the result of improper technique, overuse, and/or weakness or muscle strength imbalance in the shoulder region.
Baseball scores revealed that athletes in the sport perceived the most risk for controllable and uncontrollable injuries. A common fear of injury in baseball is being hit by a ball (Finch & Valuri, 1996). Other common injuries are associated with sliding to base (more common in adults), over-exertion, falls, collision with another player, misjudged catches resulting in finger injuries and being hit by the baseball bat (more common in children). The above injuries are mostly due to uncontrollable factors.
Results revealed that track athletes perceived the highest risk of reinjury. It is understandable that contact with others and inanimate objects are very unlikely in the sport of track, and that the fear of reinjury is a more common ailment. Athletes who completed a thorough rehabilitation may suffer reinjury if the risk factors that led to the problem are not addressed (Difiori, 1999). Track athletes’ schedules can be very grueling and if rest time and proper caring for an injury is not given, the chance of reinjury occurring is very likely. If injury has occurred, aggravating an existing injury with techniques such as leaping, bounding, running and sprinting, may play a part in continuous reinjury (Difiori, 1999). According to Reese (2001), if you have been injured before, you are much more likely to get hurt than an athlete who has been injury free. These comments pertaining to risk of reinjury are likely applicable to all sports; not just track.
As hypothesized, there was a negative relationship between risk and confidence in avoiding injury. There was a consistent finding in this study and Short et al. (2005). Overall, athletes perceived relatively low levels of risk and fear of being injured in their respective sports and were confident in their ability to avoid injury. A suggestion by Short et al. (2005) was that perhaps the reported low levels of fear, perceived risk and high levels of confidence had to do with social desirability responding. This study tested that hypothesis. Correlations between the three measures, (RISSc, WISSc, CAISSc) and the Marlowe-Crowne (1960) were negative and small which shows that social desirability was not a factor in athletes low levels of fear, perceived and high levels of confidence.
The relatively high levels of confidence in avoiding injury reported by participants in this study may be reflective of the level of competitive collegiate athletes. It is possible that high performance athletes have become desensitized to the physical dangers that exist within their sport (Dunn, 1999).
Recommendations for Future Research
Taking a look at professional versus amateur athlete’s perceptions of risk, fear of injury and confidence in avoiding injury, may also be of interest to future researchers. Being that an athlete is paid for his/her performance and is obviously superior in their sport, fear should no longer be an issue. Contrary to that thought, a career ending injury may worry professional athletes’ more than the amateur, as sport is their main financial income.
Further studies in perceived risk of injury could focus on the involvement of the parent. It would be interesting to know whether parents fear their child will be injured and how they maintain confidence in their child avoiding injury. An in depth look at age and type of injury incurred might also be of interest. According to Watson (1993), the type of injury that is most common varies with the age of the person and the level of competition. In young children most injuries are due to falling. In older children, injuries that result from collisions and violence are more common. In older age groups and in top level sportsmen and women, there are less acute injuries and more overuse injuries and those are due to intrinsic factors. These intrinsic factors may be directly related to fear, confidence and risk of injury.
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Correspondence concerning this article should be addressed to: Sandra E. Short, Department of Physical Education and Exercise Science, University of North Dakota, Box 8235, Grand Forks, ND, U.S.A. 58202. Email may be sent to firstname.lastname@example.org