1. Stress, Injury, PED’s and Burnout
Problems in Sport
Stress, Injury, PED’s and Burnout

2. Stress and Injury
Stress is leading cause of injury, misuse of PED’s and burnout
Finch et al (1998): 20-30% of total injuries in a given population are sports related
Research: increased stress in life = increased injury in sports
Smith et al (1990): 452 m/f high school athletes, assessed stress, social support, coping skills and # of days off related to injury
Results showed a correlation between stressors and injury, other factors included low social support and low coping skills

4. Explaining the Relationship Between Stress and Injury
Williams et al (1991); stress disrupts attention, reduces peripheral awareness
Anderson & Williams (1999): negative life event stressors were the only significant predictor of injury in 196 college athletes
Smith et al (2000): muscle tension caused by stress interferes with normal coordination, thus increasing rick of injury

5. Stress and Recovery
Cramer et al (2000): natural healing disrupted by high glucocorticoids, impairing the immune response and inhibiting production of growth hormones
Cortisol inhibits recovery of damaged tissues
Perna et al (2003): stress caused impaired sleep patterns and protein synthesis-essential for recovery process

7. Responding To Injury Grief Response Model (Hardy, Crace, 1990)
Coping with 3 stressors (Physical, Psychological and Social) essential to rehab process takes one of 2 forms
Denial: injured players pushes it and make it worse
Anger: about injury’s impact on ability/career
Bargaining: deal making to mitigate the injury
Depression: reality of injury
Acceptance/reorganization: coping can begin
Similar to Kubler-Ross 5 Stages of Grief
Petitpas & Danish (1995): Identity Loss—injury low self –efficacydepressionlow self confidencelow status and motivationidentity loss

8. Cognitive Appraisal Model (Urdy et al, 1997)
“Information Processing” About Injury (Urdy et al)
Stage 1: Amount/type of pain, how/why it happened, consequences and rehab options
Stage 2: emotional upheaval, reactive behaviors—anger, frustration
Stage 3: Developing, outlook and coping

9. Cognitive Appraisal Model (Wiese, Bjornstal, 1998)
Primary Appraisal: what is at stake, challenge, threat, benefit or loss
Secondary Appraisal: how can you cope, options available

11. PED use in last 20 Years Physical considerations
Strength, endurance, alertness, aggression, fatigue, anxiety, wt. gain/loss all can be impacted by PED’s
Psychological considerations
Coping w/stress, self esteem, confidence, respond to external pressures

12. Social considerations
Social learning theory: see model (Bonds, Canseco, Ben Johnson) do it without getting caught (Bandura; Anshel, 1998)
Conformity, coercion, peer pressure
“Game Theory” (Axelrod, 1984): if you don’t use you will be left behind by the using competition (e.g. EPO doping in the Tour de France, roids in MLB), leads to cognitive rationalization that the rewards outweigh the risks of getting caught

14. Physical Effects of Steriods
synthetic derivatives of testosterone, anabolic effects retention of protein to build muscle
“stacking”: combo of different types can be permanent
Injections increase risk of Hepatitis B, HIV
Damage may take years to see (Lyle Alzado)
Feminization Effect in men
Women have “Masculinization Effect”
Acne, wt. gain, liver damage, heart attack, stroke, increased cholesterol, weak tendons (see Bo Carrol), permanent growth halt in teens in both males and females

16. Psychological Effects of Steroids
Mood swings, extreme irritability/aggression (“roid rage”), addiction and withdrawal issues

17. Effects of Other PED’s
Beta blockers: reduce anxiety, blood pressure, heart rate, depresses CNS
Diuretics: wt. loss, dehydration, cramping, kidney stones, increased cholesterol
EPO (erythropoietin): increased oxygen and stamina, risks for blood clots, heart attack, stroke
Narcotics: mask pain, failure to feel injury, overdose threat

18. Causes of Burnout
Cognitive-Affective Stress Model (Smith 1986) how thoughts and feelings influence athlete’s burnout
Stage 1: Situation Demands: demands exceed resources = stress
Stage 2: Cognitive Appraisal: threat vs. challenge appraisal of situation = anxious or excited
Stage 3: Physiological Responses: fight or flight due to appraisal
Stage 4: Behavioral Response: performance issues, cohesion problems, withdrawal

19. Hardiness (Kobasa, 1986) is the key factor to overcoming stressors and resisting burnout; based on 3 factors
Control: person’s ability to influence events
Commitment: person’s refusal to give up
Challenge: person’s willingness to change

20. Mental Toughness Model (Clough and Earle, 2001)
Mental toughness questionnaire resulted in a group of mentally tough subjects and non mentally tough who then did 3 30 minute cycling trials at 30, 50 and 70% max; oxygen uptake and reactions of subjects was recorded
Results showed MT subjects reported lower perceived exertion, even at 70% suggesting MT helps withstand stress/burnout

21. Self Determination Theory (Raedeke, 1997)
Burnout results from lack of intrinsic motivation or control over participation; “have to” rather than “get to” attitude
Factors include: identity = sport, entrapment, social support/demands

22. Preventing Burnout Cognitive Affective Stress Management (Smith, 1980)
Mental/physical coping strategies designed to prevent burnout in 4 steps
Pre-treatment Assessment: interviews to assess the athlete’s stress response and appraisal
Treatment Rationale: athlete analyzes and gains understanding of personal stress reactions
Skill Acquisition: athlete learns relaxation, cognitive restructuring and self talk
Skill Rehearsal: stress is induced to allow athlete to practice new stress reducing skills

23. Stress Inoculation Theory (SIT) Meichenbaum, 1985
Athlete is exposed to increasing levels of stress in 3 stages, thereby enhancing his/her immunity “Learned Resourcefulness”
Stage 1: Conceptualization: athlete becomes aware of +/-- thoughts, self talk, imagery
Stage 2: Rehearsal: practice
Stage 3: Application: athlete encounters low stress and then moves up to moderate then high and applies what was rehearsed in stage 2
Prepare--control--cope--evaluate--overcome