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Psychology and socioculture of sport injury: Does gender matter?

11/30/2009

At the third Tucker Table of the fall, we had the opportunity to hear from five sport psychology colleagues and their perceptions on the relationship between gender and sport injury. Each of the scholars provided an excerpt from their presentation – and attempted to answer the question, does gender matter when it comes to sport injury?

Does gender matter in sport injury occurrence and socioculture ?
Diane Wiese-
Bjornstal, Ph.D., Associate Professor of Kinesiology

Common elements in most sport injury surveillance studies reflect a three pronged definition of sport injury: an injury that (a) occurred in sport activities (b) was seen by a medical professional, and (c) resulted in time loss from sport activities. Using studies reflecting this definition along with the time- controlling standard of calculating injury rate s that reflect injuries per 1000 athlete-exposures (one athlete-exposure equals one athlete participating in one practice or game), what are the gender similarities and differences with respect to sport injury?

In interscholastic and intercollegiate sports, males and females in the comparable team sports of basketball, soccer, and base/softball show quite similar overall injury rates. Most sports for both males and females have higher injury rates (a) in games than practices, and (b) in college than in high school. Certain specific sport injuries such as ACL and concussion are often held up as reflecting gender differences. Surveillance evidence illustrates that while females have higher rates for intercollegiate ACL and concussion sport injuries than males, they have lower overall incidences of these sport injuries in both adolescence and early adulthood. With overall sport injury rates being somewhat gender- comparable, and with higher rates of ACL and concussion injury evidenced in female athletes, what injury is it that males sustain at higher rates? There is some evidence to indicate that the answer might be fractures. In sum, gender does matter in some aspects of sport injury surveillance, but not in others.

The risk of sport injury is affected by many biological, environmental, psychological and sociocultural factors. As an example, sport and gender socioculture affect athletes’ willingness to take risks and tolerate pain and injury in the pursuit of athletic excellence. Research on sport socioculture reflects that both females and males commonly embrace hiding, disrespecting, unwelcoming and depersonalizing pain, and feel pressure from coaches, teammates and other social sources to play through pain and injury. Gender-different pain and injury themes illustrate that females (a) are more likely than males to discuss injury openly with others, (b) find their feelings of attractiveness, femininity and sexuality negatively affected by physical markers of injury, and (c) report a double- gender standard in medical services and treatment that disadvantages their health and recoveries. Again it is seen that gender does matter in some aspects of sport injury socioculture, but not in others.

Does gender matter in post-sport injury psychological response?
Ayanna Franklin
, B.S., M.A. Student in Kinesiology

Unfortunately, injury is a common aspect of participating in sport; therefore, athletes are constantly dealing with both the physical and psychological repercussions of sport injury. In terms of the psychological response to injury it is important to answer the question: Does gender matter? In other words, understanding how both males and females react to injury will allow for a greater perspective on how to most effectively relate to athletes as they cope with post injury situations.

According to the integrated model of response to sport injury there are various personal and situational factors that can affect an athlete’s response, as well as cognitive, emotional, and behavioral responses that an athlete may experience. When examining research concerning two particular features of this model (social support and emotional response) it is clear that gender does matter! Research suggests that females often seek out and use social support more often than males, and males tend to deal more on an individual and introspective level with injury. Studies also show that both males and females experience similar feelings of anger and frustration; however, males tend to express irritability and are less likely to verbally express emotions, while females are more apt to verbally express emotions.

Overall there are many factors that affect how an individual may respond to injury, but research confirms that acknowledging gender in relation to post injury response is important in understanding the recovery process.

Does gender matter in sports medicine professional & coach interactions in sport injury situations ?
Monique Foster, B.S., ATC, M.Ed. Student in Applied Kinesiology

When discussing athletic trainers and gender it is important to not only look at the gender of the athletic trainer but also the gender of the athlete being treated. The athletic trainer needs to understand the differences between the genders on emotional and psychological levels. Research shows that athletes are more comfortable when seeking same-gender athletic trainer help for a wide range of sport injuries. Male athletes have been found to be more comfortable seeking psychological help from female athletic trainers, perhaps because women are viewed as better communicators with respect to emotions. But looking at the statistics on athletic trainers in the workplace, it is clear that males still make up well over half of the population. Significantly more female than male athletic trainers report that they have conflicts between their family responsibilities and their work, and burnout is more commonly reported among female athletic trainers. As a result, female athletes may have less access to female athletic trainers that their same-gender treatment preferences would wish.

Similar gender-disparities are evident in coaching, and these also hold consequences for sport injury situations. Since Title IX in 1972 there has been a large increase in female sports teams and participation, but a significant decrease in women coaches. According to NCAA data, head positions held by women in intercollegiate sports has gone down from 90% to 44% during this time. Research shows that female assistant coaches are less likely to pursue head positions unless they have been under the guidance of female head coaches, and so with fewer female head coaches there are also fewer female assistant coaches coming through the pipeline for future head coaching positions. These disparities affect the psychology and socioculture of sport injury situations. According to research evidence, for example, male coaches find it more acceptable to expect both their male and female athletes to play while in pain, and are more likely than female coaches to make athletes feel guilty about not playing due to injury.

Gender does matter for athletic trainers and coaches. Gender matters for athletic trainers to be able to provide appropriate care to all athletes. Gender matters in coaching with regard to expecting athletes to playing in pain, as well as being a role model for younger coaches.

Does gender matter in military training injury ?
Tara Robertson, ATC,
CSCS, U . S . Army National Guard, M.A. Student in Kinesiology

Recent research has shown many similarities between sport and military performance. Researchers believe that both domains can benefit from literature cross-study. An advantage in using the military population in sport performance research is that there is a great deal of uniformity in training which equalizes risk for men and women. There is also a greater opportunity to study multiple aspects of musculoskeletal injury in the military population due to the high frequency of reported injury: 2,500 injuries for every 1,000 personnel.

The highest predictors of musculoskeletal injury in the military are gender neutral; self efficacy/self expectation and physical fitness levels. The female gender was a predictor in its self where multiple studies showed females injury rates from 2 to 2.5 times as high as males. After controlling for physical fitness levels and actual reports of injury, however, the risk rate was found not to be statistically significant between genders.

When looking at predictors of recovery from injury, women were more motivated to recover from injury and are overall more satisfied with their military career than their male counter parts. Though women seem to have a more positive experience in the military, when injured, their functional outcomes and quality of life score are much lower along with women having longer stays in the hospital versus their male counter parts with comparable injuries. This can be explained by research illustrating that women experience injury more emotionally than men, along with society feeling the need to overprotect women in part because when released from the hospital they return to their work and home related responsibilities more quickly than their recovery levels would recommend.

Does gender matter for injuries in the military? For pre-injury rates, no it does not. For predictors of recovery, yes it does.

Does gender matter in sport injury psychology interventions?
Jim
Winges, M.S., Certified Consultant (AASP), Ph.D. Student in Kinesiology

Research chronicling successful and beneficial psychological intervention techniques for sport injury prevention and rehabilitation is commonplace. Conversely, there has been very little research examining gender as a factor in sport injury psychology interventions. There are two primary goals to a sport injury psychology intervention: first, to identify the subjective meaning of an injury to an athlete, and second, teaching and strengthening the athlete’s coping resources. Social support and communicative differences between the genders have been noted by several authors, whose suggest that female athletes receive greater social support and are more communicative than male peers during sport injury rehabilitation. Collegiate females also report higher average contributions of the coaches’ emotion challenge support than male peers. Of the research that has examined intervention techniques, very little has empirically compared males and females use or performance of techniques such as imagery, goal setting, relaxation, biofeedback, systematic desensitization, or positive self talk. What little research there is has resulted in questionable and conflicting results. Because of this gap in the gender and sport injury intervention literature there is not enough support to contradict the gender similarities hypothesis; however, gender may play a moderating role in the social support processes that surround injury and rehabilitation.

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