Okay, I admit – I’m being a little sensationalistic with the title.
But my point still stands.
I don’t need to elaborate on that.
But, what I do need to talk about (now that I have your attention) is the role of behaviour in injury prevention, and how athletes, trainers, researchers, and entire sports associations need to start paying more attention to it.
That’s right – preventing injuries isn’t just about bio-mechanics and bio-chemistry. Would fixing some obscure ‘muscle imbalance’ help the dude in the picture above? Sure, this is an extreme example. But this needs to be considered for any activity with risk of injury.
After reading this, you might think behaviour is the most important factor of all.
So what do we mean by behaviour?
- What do you mean by behaviour?
– an example
- Behaviour And Injury Risk – A Crash Course
– Types of Behaviour
– How Behaviours can Influence Injury Risk
– How Injury Risk can Influence Behaviour
- What Researchers Need To Do
– Present researcher better
– Do research on ‘real-life’ situations
- What Sports People Need To Do
– Associations, Coaches, Trainers, Therapists, etc.
What do you mean by behaviour?
You’re mom didn’t tell you to behave as a child just because you were an embarrassing kid. Behaving well helps you stay socially accepted, employed, and safe.
But what about injury prevention?
“Head injuries in soccer provide a good example of multiple behaviours influencing injury risk. As shown by Arnason et al., most head injuries in soccer are due to illegal use of the elbow while heading the ball (player behaviour). The same study also indicated that this illegal elbow use preceding a head injury is often not penalized by the referee (referee behaviour). Hence, it was postulated that stricter enforcement of the rules may prevent head injury in soccer. During the 2006 World Cup, the FIFA (Fédération Internationale de Football Association), in an attempt to reinforce athlete behaviours, instructed the referees to implement the ‘elbow rule’ more strictly (sports association behaviour). This resulted in a drastic decline of the number of head injuries from 25 in the 2002 World Cup to 13 in the 2006 event. ”
If you want a more impressive sounding number – that’s a 50% reduction in head injuries, just from a simple policy change.
Nice. Better than stretching… just kidding… or am I?
As you can see, improving behaviour (and thus preventing injuries) is the responsibility of the athletes, coaches, referees, and even entire sports associations. Furthermore, it’s also the responsibility of the researchers who are studying this stuff.
We’ll talk more about this later.
First… how can behaviour affect injury risk?
Behaviour And Injury Risk – A Crash Course
The 2010 article quoted above 1 reviewed a lot of important concepts on this topic. It included what ‘behaviour’ is in this context, how it relates to injury risk, and vice-versa – how injury risk can change behaviour.
Let’s review without getting into too many boring details.
Types of Behaviour:
- Conscious Planned Behaviour – “A planned or controlled reaction that is driven by an intention to perform a specific behaviour.”Of course, a persons intentions can be influenced by numerous factors – such as attitude, social norms, confidence, motivation, environment, and even politics! It’s important to be aware of these influences and be sure that you aren’t making any bad decisions based on them.
- Unconscious Automatic Behaviour– Automatic behaviours that you aren’t even aware of. This doesn’t just include reflexes or highly skilled techniques. This also includes habitslike always wearing a helmet, or knee pads.When unconscious behaviours are increasing injury risk, it’s important to identify them. This means changing them from unconscious to conscious!
How Behaviours can Influence Injury Risk:
This stuff shouldn’t be much of a surprise:
- Direct– These are behaviours that themselves can be considered risk factors.
- Doing something stupid. (the researchers didn’t really say this – but I am)For example, trying to spin on your head the first time you try b-boying (breaking), even though you can’t even stand on your head. Yup, I’ve seen this.
- NOT doing something SMART. The authors explain the most clear ‘direct’ behaviour that can increase risk of injury is the non-useof proper protective measures.For example, not using a hockey mask when you are a goalie.
- Indirect– Behaviours that can increase or decrease the influence of other risk factors are ‘indirect’.For example, after an ankle sprain, there is a ‘neuro-motor’ deficit – a lack of coordination that increases risk of re-injury. While that deficit is the true risk factor here, not doing something to improve it (like coordination training) is neglectful – therefore indirectly increasing risk of re-injury.
How Injury Risk can Influence Behaviour:
It can work the other way around too:
- ‘Risk Compensation’– It’s possible that when someone does something that lowers injury risk, they may end up just taking more chances. In their head, they have a ‘base-line’ for injury risk that they are comfortable with.So when wearing those knee pads, you may end up just doing crazier things with your knees.
- Behavioural Change After Injury– This could be good or bad.
- Bad – people may lose confidence in themselves after an injury – and people with a low ‘self-estimation of ability’ have higher rates of injury! 4
- Good – on the flip side, after suffering from an injury, people may also smarten the hell up and stop doing stupid things.
What Researchers Need To Do:
- Present Research Better.
First of all, researchers need to do a better job translating their research so people can actually use it.
This is a given, and can involve being more involved with the media, learning to present findings in understandable terms, and presenting more useful statistics.
- Do research on ‘real-life’ situations.
Furthermore, they have to think a little more about what they are studying.
In 2006, researcher Caroline Finch wrote a paper calling to attention the fact that – despite a lot of new science on the topic – there hasn’t been much of a decrease in injuries over the last few decades. She writes: “only research that can, and will, be adopted by sports participants, their coaches and sporting bodies will prevent injuries”. 5
Very good point. It doesn’t matter how good some special technique or equipment or policy/ rule change is at decreasing injuries… if people aren’t going to use the advice, it’s useless!
Researchers cannot simply stop at efficacy trials (which are studies testing out whether or not stuff works in an experimental situation – and important first step, of course) and then write a book thinking they know how to prevent injuries. They also need to run ‘clinical’ or ‘field’ studies that test to see if things work in real life 6, 7, 5. So far, this hasn’t been done nearly enough. 8
What Sports People Need To Do:
Associations, Coaches, Trainers, Therapists, etc.
“There is nothing more frightful than an active ignorance.” – Johann Wolfgang von Goethe
There is a ton of research out there. Yeah, yeah… researchers write boring science articles that are difficult to read. I know. That’s why I am doing this blog.
But as we see from the FIFA example quoted at the beginning – associations, coaches, trainers, and referees all have a tremendous impact on injury risk.
So if it’s your job to be advising and/or taking care of athletes, you need to read some stuff. Or, e-mail the researchers and ask them questions. They would probably love to talk about their nerdy work.
- Educate yourself. Yes, it works. For example: learning pain science actually reduces and prevents pain! Keep learning about your body. There is a ton of information on the internet. However, you must attain this information from a good source… like this site… :D
- Let me be real for a second here… stop expecting everyone listed above to hold your hand. It’s your body; it’s your career. How long do you want to last?
Stop doing stupid things.