Perceptual andMotor Skills, 1990, 71, 848-850. O Perceptual and Motor Skills 1990
PERCEPTIONS OF ATHLETIC INJURIES BY ATHLETES, COACHES, A N D MEDICAL PROFESSIONALS ' JANE CROSSMAN, JOHN JAMIESON, K. MICHELLE HUME
Lakehead University Summary.-35 athletes, their coaches, and medical professionals independently assessed the disruption, seriousness, and short-term effects of the athletes' athletic injuries. Athletes underestimated the disruption and short-term effects of the injury when compared to medical professionals. 25 lower level athletes and those with no previous serious athletic injury overestimated the short-term effects of their injuries. Coaches overestimated the disrupting effects of the injury for 10 higher level athletes and 25 athletes with no previous injury.
To date most writing pertaining to the relationship between athletic injury and psychological and sociological factors has focused on personality and life-stress events with the central purpose of predicting which athletes are more likely to get injured. The psychological effects of the injury on the athlete and personal expectations has been generally an ignored topic. One possible reason for so little research has been the difficulty of deahng with the wide range of types and seriousnesses of the injuries. We earlier explored a paradigm for identifying excessive psychological effect of an athletic injury by examining the discrepancy between the athletes' perceptions and the ratings of an experienced sports medicine trainer (Crossman & Jamieson, 1985). Athletes significantly overestimated the seriousness of their injuries, but underestimated the disruptive influence on their training and everyday lives. The overestimation of the seriousness of the injury was greatest in those participating at lower levels of competition. The present report describes a replication of our earlier study, with the inclusion of ratings by the coach, to explore how coaches and athletes differ in their perceptions of the effects of athletic injury. Since the coach can have a significant influence on decisions pertaining to athletes' training, it is important to identify whether coaches overestimate the seriousness and disruptive effects of the athletes' injuries, and what factors may influence this perception. Method.-Subjects were 9 male and 26 female athletes ranging in age from 16 to 37 yr. (M = 20.2, SD = 3.7). Twenty-five were competing at either the club or recreational level (referred to in t h s paper as lower level athletes) and 10 were competing at either a provincial, national, or international level (referred to as higher level athletes). 'The authors express their gratitude to Dr. John Porter, Fred Stoot, Kim Hutt, David Slover, Valerie Kuzik, and the many coaches who willin ly gave of their time and knowledge. Re uest reprincs from Jane Crossman, Ph.D., School o f Physical Education and Athletics, ~ a k e l e a d University, 955 Oliver Road, Thunder Bay, Ontario, Canada P7B 5E1.
ATHLETIC INJURIES
849
These athletes were being treated at a sports medicine clinic for injuries which occurred as a direct result of participating in an athletic activity. Some of the injuries being treated were ankle inversion sprains, shoulder tendinitis, knee ligament sprains, soft tissue contusions, and shin splints. The injured athletes completed a questionnaire while waiting to undergo treatment at one of the three sports medicine clinics surveyed. Two clinics were located in Thunder Bay, Ontario and one in Winnipeg, Manitoba. Three questions central to this paper and included in our previous research were answered on a 9-point Likert scale from 1, not at all or no effect to 9, extremely. The questions were: (1) How much has your injury disrupted your everyday activities? (2) What effect has your injury had on your short-term athletic aspirations? (3) I n your opinion, how serious is your athletic injury? A similar questionnaire was given to the medical professional (physiotherapist or physician) attending the injury and to the athletes' coaches. The questionnaires were given to the medical professionals and coaches without their knowledge of the athletes' responses. The reliability had been established by test-retest of 43 injured athletes. A criterion of .8 was necessary for each item before it was included in the final questionnaire. Seven persons with experience in research design and treatment of athletic injuries were asked to assess the items' content validity, i.e., whether questions were worded clearly and unambiguously and whether questions were worded consistently with the central focus of the research. All seven evaluators indicated that data obtained from the questionnaires would reflect the opinion of the subjects regarding the effects of the injury at the time of data collection. Results.-As in the previous study, ratings by the athletes were compared with those of the medical professionals. Athletes rated the disruptive impact (M = 4.1, SD = 2.2) significantly lower ( t = 2.99, p < .01)than did the medicd professionals (M = 5.6, SD = 1.9).They also underestimated the shortterm effects of the injury; athletes' ratings (M = 4.2, SD = 2.6) were significantly lower (t = 2.22, p < .05) than the medical professionals' (M = 5.2, SD = 2.2). Difference scores were calculated between the athletes' ratings and the medical professionals' corresponding ratings. These showed that overestimation of the short-term effects was significantly ( p < .05) greater for athletes participating at lower levels of competition (r = .37) and those who had not previously experienced a serious injury ( r = .33). Overestimation of disruptive effects was also greater in those not previously experiencing a serious injury ( r = .43). The coaches' ratings were also compared to the ratings by the medical professionals. Coaches rated the seriousness of the injury (M = 5.1, SD = 2.1) significantly higher (t= 3.05, p < .01) than did the medical professionals (M = 4.0, SD = 2.3). Difference scores calculated between the coaches' ratings
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and the medical professionals' showed coaches overestimated the disruptive effect for higher level athletes (r = -.28) and those who had not experienced a previous serious injury ( r = .35). Discussion.-The present findings for the athletes' perceptions of their injuries are generally consistent with our previous observations. I n both cases, athletes significantly underestimated the disruptive effects of the injury, and those participating at lower levels of competition were significantly more likely to overestimate the disruptive effects (previous study) or shortterm effects (this study) of the injury. Coaches showed a generally similar pattern. They rated the injury as significantly more serious than did the medical professionals, as had athletes in the previous study. Both coaches and athletes overestimated the disruptive effects of the injury for athletes who had not previously experienced a serious injury. The only major difference between coaches and athletes was that the former overestimated the disruptive effects of the injury for the athletes competing at higher levels, while the higher level athletes underestimated the importance of their injury. This difference may reflect two factors. First, the loss of a higher level athlete by injury is potentially more serious to the team's performance/record and would affect negatively the coach's attitude toward the injury. Second, higher level athletes have generally learned to ignore various minor injuries experienced earlier in their careers and consequently tend to underestimate the potential effect an injury might have on training and performance. REFERENCE
CROSSMAN, J., & JAMIESON, J. (1985) Differences in perce tions of seriousness and disrupting effects of athletic injury as viewed by athletes ancfrheir trainer Perceptual and Motor Skills, 6 1 , 1131-1134. Accepted October 14, 1770.
PERCEPTIONS OF ATHLETIC INJURIES BY ATHLETES, COACHES, A N D MEDICAL PROFESSIONALS ' JANE CROSSMAN, JOHN JAMIESON, K. MICHELLE HUME
Lakehead University Summary.-35 athletes, their coaches, and medical professionals independently assessed the disruption, seriousness, and short-term effects of the athletes' athletic injuries. Athletes underestimated the disruption and short-term effects of the injury when compared to medical professionals. 25 lower level athletes and those with no previous serious athletic injury overestimated the short-term effects of their injuries. Coaches overestimated the disrupting effects of the injury for 10 higher level athletes and 25 athletes with no previous injury.
To date most writing pertaining to the relationship between athletic injury and psychological and sociological factors has focused on personality and life-stress events with the central purpose of predicting which athletes are more likely to get injured. The psychological effects of the injury on the athlete and personal expectations has been generally an ignored topic. One possible reason for so little research has been the difficulty of deahng with the wide range of types and seriousnesses of the injuries. We earlier explored a paradigm for identifying excessive psychological effect of an athletic injury by examining the discrepancy between the athletes' perceptions and the ratings of an experienced sports medicine trainer (Crossman & Jamieson, 1985). Athletes significantly overestimated the seriousness of their injuries, but underestimated the disruptive influence on their training and everyday lives. The overestimation of the seriousness of the injury was greatest in those participating at lower levels of competition. The present report describes a replication of our earlier study, with the inclusion of ratings by the coach, to explore how coaches and athletes differ in their perceptions of the effects of athletic injury. Since the coach can have a significant influence on decisions pertaining to athletes' training, it is important to identify whether coaches overestimate the seriousness and disruptive effects of the athletes' injuries, and what factors may influence this perception. Method.-Subjects were 9 male and 26 female athletes ranging in age from 16 to 37 yr. (M = 20.2, SD = 3.7). Twenty-five were competing at either the club or recreational level (referred to in t h s paper as lower level athletes) and 10 were competing at either a provincial, national, or international level (referred to as higher level athletes). 'The authors express their gratitude to Dr. John Porter, Fred Stoot, Kim Hutt, David Slover, Valerie Kuzik, and the many coaches who willin ly gave of their time and knowledge. Re uest reprincs from Jane Crossman, Ph.D., School o f Physical Education and Athletics, ~ a k e l e a d University, 955 Oliver Road, Thunder Bay, Ontario, Canada P7B 5E1.
ATHLETIC INJURIES
849
These athletes were being treated at a sports medicine clinic for injuries which occurred as a direct result of participating in an athletic activity. Some of the injuries being treated were ankle inversion sprains, shoulder tendinitis, knee ligament sprains, soft tissue contusions, and shin splints. The injured athletes completed a questionnaire while waiting to undergo treatment at one of the three sports medicine clinics surveyed. Two clinics were located in Thunder Bay, Ontario and one in Winnipeg, Manitoba. Three questions central to this paper and included in our previous research were answered on a 9-point Likert scale from 1, not at all or no effect to 9, extremely. The questions were: (1) How much has your injury disrupted your everyday activities? (2) What effect has your injury had on your short-term athletic aspirations? (3) I n your opinion, how serious is your athletic injury? A similar questionnaire was given to the medical professional (physiotherapist or physician) attending the injury and to the athletes' coaches. The questionnaires were given to the medical professionals and coaches without their knowledge of the athletes' responses. The reliability had been established by test-retest of 43 injured athletes. A criterion of .8 was necessary for each item before it was included in the final questionnaire. Seven persons with experience in research design and treatment of athletic injuries were asked to assess the items' content validity, i.e., whether questions were worded clearly and unambiguously and whether questions were worded consistently with the central focus of the research. All seven evaluators indicated that data obtained from the questionnaires would reflect the opinion of the subjects regarding the effects of the injury at the time of data collection. Results.-As in the previous study, ratings by the athletes were compared with those of the medical professionals. Athletes rated the disruptive impact (M = 4.1, SD = 2.2) significantly lower ( t = 2.99, p < .01)than did the medicd professionals (M = 5.6, SD = 1.9).They also underestimated the shortterm effects of the injury; athletes' ratings (M = 4.2, SD = 2.6) were significantly lower (t = 2.22, p < .05) than the medical professionals' (M = 5.2, SD = 2.2). Difference scores were calculated between the athletes' ratings and the medical professionals' corresponding ratings. These showed that overestimation of the short-term effects was significantly ( p < .05) greater for athletes participating at lower levels of competition (r = .37) and those who had not previously experienced a serious injury ( r = .33). Overestimation of disruptive effects was also greater in those not previously experiencing a serious injury ( r = .43). The coaches' ratings were also compared to the ratings by the medical professionals. Coaches rated the seriousness of the injury (M = 5.1, SD = 2.1) significantly higher (t= 3.05, p < .01) than did the medical professionals (M = 4.0, SD = 2.3). Difference scores calculated between the coaches' ratings
850
J. CROSSMAN, ET AL
and the medical professionals' showed coaches overestimated the disruptive effect for higher level athletes (r = -.28) and those who had not experienced a previous serious injury ( r = .35). Discussion.-The present findings for the athletes' perceptions of their injuries are generally consistent with our previous observations. I n both cases, athletes significantly underestimated the disruptive effects of the injury, and those participating at lower levels of competition were significantly more likely to overestimate the disruptive effects (previous study) or shortterm effects (this study) of the injury. Coaches showed a generally similar pattern. They rated the injury as significantly more serious than did the medical professionals, as had athletes in the previous study. Both coaches and athletes overestimated the disruptive effects of the injury for athletes who had not previously experienced a serious injury. The only major difference between coaches and athletes was that the former overestimated the disruptive effects of the injury for the athletes competing at higher levels, while the higher level athletes underestimated the importance of their injury. This difference may reflect two factors. First, the loss of a higher level athlete by injury is potentially more serious to the team's performance/record and would affect negatively the coach's attitude toward the injury. Second, higher level athletes have generally learned to ignore various minor injuries experienced earlier in their careers and consequently tend to underestimate the potential effect an injury might have on training and performance. REFERENCE
CROSSMAN, J., & JAMIESON, J. (1985) Differences in perce tions of seriousness and disrupting effects of athletic injury as viewed by athletes ancfrheir trainer Perceptual and Motor Skills, 6 1 , 1131-1134. Accepted October 14, 1770.
