Analysis: given the mental challenges imposed by the pandemic, it may be time to include the mind in the dialogue around rugby injuries

We are experiencing a worldwide "pause" at the moment. It seems that life is on hold, as Covid-19 case numbers and vaccination roll-out plans continue to lead hourly news bulletins. For many, sport is providing a brief respite from the pandemic, with everyone doing what they do best: players playing and spectators spectating.

While the Men's Six Nations Championship is now underway, rugby has suffered some setbacks, with the Women's Six Nations postponed and the Lions Tour to South Africa teetering on unsteady ground. Following the last pandemic-related gap in competition, there was much discussion about the elevated risk of injury for players because they hadn’t completed the same duration, intensity, or type of training while away from their teammates.

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From RTÉ Radio 1's Morning Ireland, Dr Barry O Driscoll, former medical advisor to World Rugby, on the long-term effects of concussion on rugby players

But what often gets lost in discussions on injury is the importance of psychological risk factors. Despite longstanding evidence supporting the psychology of sport injury prediction and prevention, there is little public discourse on this topic. Given the mental challenges imposed on most people during the pandemic, perhaps it is time to expand the dialogue on rugby injury to include the all-important mind.

According to the Stress and Injury Model, there are three primary psychological factors that affect a player's susceptibility to injury: personal history of stressors (daily hassles, chronic stress), personality (competitive anxiety, aggressiveness), and use of coping resources (social support, self-care). These factors impact a player’s response to a potentially stressful athletic situation. For example, if a player does not feel that they can overcome the demands of an upcoming match, they are likely to exhibit an elevated stress response that decreases their peripheral vision, which may hinder their ability to see and respond to an oncoming tackle, thereby increasing the impact of that tackle and subsequent likelihood of injury.

Stress and Injury Model showing the relationship between psychological factors and injury in sport

As a sport with a relatively high incidence of injury and growing participation numbers, it is important for stakeholders to maximise player safety. The Irish Rugby Injury Surveillance Project, based at the University of Limerick, comprises an international, multidisciplinary research team that is paving the way in this area, having collected injury data from school and amateur club players for several years. This data, and the recent addition of training load measurements, seeks to inform future best practice around injury prevention.

As of autumn 2020, psychology has been included in the remit of the project. Literature on this topic in rugby is scarce, with most studies focusing on soccer and American football revealing that negative life event stress is one of the strongest psychological predictors of injury. Accounting for chronic stressors and daily hassles, negative life event stress is likely more of an issue in 2021 than in recent memory, with the Covid-19 pandemic causing physical, emotional, and social turmoil around the world. It follows, therefore, that rugby injuries may increase, as players worry about the health and wellbeing of loved ones, not to mention the uncertainty surrounding their own competitive careers.

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From RTÉ 2fm's Game On, Dr Michael Collins, an internationally renowned expert in sports-related concussion, joins the show for a discussion around sports injuries

Turning to personality, it is reasonable for a provincial player, for example, to experience heightened anxiety on the pitch during the ongoing Pro14 championship, given that recent disruptions (eg positive Covid-19 cases; requirements to restrict movements) may have hindered their preparation.

In the current world we live in, simply telling a rugby player to "stay positive" or "control the controllables" has limited use. These people need to learn tangible psychological skills in order to combat stressors and buffer coping resources. Coaches are keen to prioritise technical training, strength and conditioning, and strategy, but there is definitely scope to make psychological skills training an essential component of all players' preparation.

For players sceptical of psychological skills training, they need not look far for proof of its efficacy

Education is a critical first step in increasing people’s awareness of the psychological risk factors for injury and subsequent importance of psychological skills training in injury prevention. Programming specific weekly timeslots for mindfulness, just as a coach would schedule a pitch session, would equip players with concrete tools (such as breathing techniques) to reduce anxiety, a potential precursor to injury. Ensuring players timetable in self-care, such as proper nutrition and adequate sleep, would enhance their ability to cope in the face of a potentially stressful situation, thereby offering a protective effect.

For players sceptical of psychological skills training, they need not look far for proof of its efficacy. Countless scientific papers provide strong evidence to back up the anecdotal experiences of athletes who attest to the importance of psychological skills training, from Michael Phelps to Paul O'Connell to the current All-Ireland hurling and football champions, Limerick and Dublin. With many competitions on hold and physical preparations justifiably hampered by public health advice, there couldn’t be a better time to invest in a psychological toolbox to minimise injury and maximise performance.


The views expressed here are those of the author and do not represent or reflect the views of RTÉ