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How Stress Can Contribute to Injury

A wide variety of stress related problems can increase your risk of injury. We give you the tools to combat them. 

Our psychology is not only crucial to how we perform but also plays a vital role in predisposition to injury. While previously the mind and body would be regarded separately, modern medicine now understands that our thoughts, beliefs and emotions are intrinsically linked to our physiology. The mind and body closely interact. To try and heal the body without paying attention to the mind and vice versa is, well, mindless.

Who is at risk?

Generally, in medicine, we split stress into intrinsic and extrinsic. Intrinsic stress is the type of stress we place on ourselves while extrinsic stress is caused by external factors. An increased susceptibility to injury has be found to occur with both of these types of stress. People who tend to be generally anxious or of a nervous, jittery disposition and those who become very nervous or anxious in certain situations, such as before a big competition are more likely to suffer injury. It is not only those who inherently tend to be more anxious that have a higher injury risk. People with a “Type A” personality, those who are irritable or untrusting of others and people with have poor coping strategies to deal with stress also have a higher risk of injury. 

External stress also plays a role in injury risk. Negative life events, daily hassles and strains and stress related to training itself such as feeling stiff or tense, feeling vulnerable to injury and feeling insufficient rested all contribute to an increased likelihood of injury. 

How Does Stress Increase Risk of Injury?

Stress impacts the body in a number of ways. The mind and body interact through a continuous flow of hormones, neurotransmitters and immune cells from one to the other. One such hormone, cortisol, is under the control of the hypothalamic-pituitary-adrenal (HPA) axis. This elegant axis uses a biofeedback loop whereby a gland in the brain senses what is going on in the body and then releases chemicals that stimulate the adrenal glands in our stomach to produce cortisol, the “stress hormone”. 

Our brain also controls the release of a calming hormone. Oxytocin promotes growth and repair as well as creating feelings of well-being and reducing sensations of pain and anxiety. 

Stress also impacts our injury risk in other ways. Athletes who are under stress have reduced peripheral vision compared to athletes who are not stressed. Pressure also makes athletes more distractible and increases muscle tension. These factors lead to increased fatigue and crucially impair both timing and coordination predisposing to injury. 

Using the Mind To Prevent Injury

It is vitally important to be proactive in using a psychological approach to prevent injury. There are several techniques that can help you become more mentally resilient. This not only can help reduce the risk of injury but also promote recovery and prevent and minor injury from becoming a major one. There are 5 key steps to managing stress and reducing risk of injury. 

Check-In: It’s vital to understand what are the triggers are for you to feel good and what makes feel down. Knowing these triggers means that you can invest time in the tasks that will make you feel good and minimise the tasks that make you feel bad. A great tool for this is the Hassles and Uplifts Scale. This is completed before bed to establish what annoyed you that day and what gave you a lift. Another great tool you could use for this is the app Inflow. 

Manage Load: By tracking your mood you can see when you are under the most stress. At these times you can mitigate injury risk by dialling down your training a little. A good tool to assist with this is measuring heart rate variability (HRV). The app HRV4Training is great for this. HRV gives us a clue as to how we have recovered from the previous day’s training and stress and can act as a guide to how much training load you should take on each day. 

Build Resilience: Developing resilience to adverse life events is hugely important in both injury prevention and rehabilitation. When faced with a difficult or stressful situation use of the ABCDE Method can help you understand the relationship between negative life events and the thoughts and feelings that arise from them. This method helps challenge any negative beliefs you may have leaving you energised. 

Chill-Out Like a Pro: Learning to relax properly is a real skill that takes time to develop. Different relaxation techniques suit different people and you can find what works best for you using by “checking-in” on your mood regularly. Meditation, mindfulness, reading, Centering, Progressive muscular relaxation, spending time with friends or family may all work. Experiment to find which works best for you. 

Go with the Flow: Having an approach that is geared towards mastering a task or process is much more likely to lead to success and satisfaction than a task that is focused on a bettering someone else. A task mastery approach is also more likely to help you get in the “flow state” or “zone” where you become fully immersed in what you are doing and stresses and strains fall away. 

Be Positive: There are a number of tools that can help your psychology become more “positive’ even if that is not your natural disposition. A gratitude journal filled out first thing in the morning listing three or four things that you are grateful for that day is a fantastic way to start the day. Throughout the day, performing small acts of kindness and generosity and engaging with other people by smiling and chatting is fantastic for maintaining positive feelings.

Dr. Hugh Coyne

Private GP Parsons Green