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Role of Psychological Skills Training in Increasing Athletic Pain Tolerance
Abstract
Examined the role of stress inoculation training (SIT) in increasing athletic pain tolerance on an isometric quadriceps task. The SIT paradigm consists of 3 phases: conceptualization, skills acquisition and rehearsal (SAR), and application and follow-through. 47 athletes from the sports of rowing, cycling, and triathlon completed the study, which consisted of performing a wall sit for as long as possible in a pretest–posttest control group design. Ss were assigned to 1 of 3 conditions: SIT, SAR only, or control. Results indicate that Ss receiving training in SIT significantly increased their tolerance time on the wall sit as compared with the control group. There was no difference between Ss who received training in SIT and those who received training in SAR only. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... There are a few types of stress management programs commonly used to help athletes cope more effectively with stress. Stress Inoculation Training (SIT), developed by Meichenbaum, has been successfully applied with athletes (Long, 1984;Whitmarsh & Alderman, 1993;Holm, Beckwith, Ehde, & Tinius, 1996). SIT consists of three phases of treatment: conceptualization, skill acquisition, and application. ...
... This phase is probably the most crucial component in the program, as shown by Whitmarsh and Alderman (1993); they conducted an outcome study that compared a SIT group to a group that only participated in the skill acquisition phase and showed that the latter group was just as effective in increasing athletes' pain tolerance in a wallsit exercise. Other SIT studies with athletes have demonstrated that this intervention helps decrease anxiety, increase academic performance, (Holm et al., 1996) and ...
... For example, a recent study demonstrated that recreational athletes who catastrophized their pain for one year after surgery from an anterior cruciate ligament injury showed a lower likelihood of resuming their previous intensity and level of sporting activity (Tripp, Stanish, Ebel-Lam, Brewer, & Birchard, 2007). Other studies have tailored stress management programs commonly used to help sedentary or athletic people to cope more effectively with pain and discomfort (Hackett & Horan, 1980;Whitmarsh & Alderman, 1993). For example, Whitmarsh and Alderman (1993) showed that athletes who received stress inoculation training (SIT) significantly increased their tolerance to discomfort in a wall-sit exercise, suggesting that SIT may assist athletes in tolerating higher levels of athletic pain during training and competition. ...
... Other studies have tailored stress management programs commonly used to help sedentary or athletic people to cope more effectively with pain and discomfort (Hackett & Horan, 1980;Whitmarsh & Alderman, 1993). For example, Whitmarsh and Alderman (1993) showed that athletes who received stress inoculation training (SIT) significantly increased their tolerance to discomfort in a wall-sit exercise, suggesting that SIT may assist athletes in tolerating higher levels of athletic pain during training and competition. ...
Previous studies have shown how social networks lead athletes to accept pain as a "part of the game," which generates pressure on athletes to continue competing despite being in pain. Little is known, however, about the potential coping strategies that are related to pain behavior in sport. This study of 205 combat athletes examined whether pain coping strategies, including distraction from pain, praying, reinterpreting pain sensations, ignoring pain, and pain catastrophizing, are related to athletes' inclination to play through pain. Results revealed that pain catastrophizing led athletes to reduce their physical involvement in their sport activity. Of particular interest was the moderating effect of ignoring pain such that ignoring pain significantly attenuated the negative effect of pain intensity on athletes' inclination to play through pain. Few studies have tested and supported the contribution of pain coping to the prediction of behavior in real sport situations. By identifying which coping strategies athletes could use to maintain their physical involvement despite being in (sometimes intense) pain, the current study makes an important contribution for tailoring pain management programs for this at-risk population.
... Moreover, these studies generally contained small sample sizes, a lack of appropriate controls and few assessments of psychological dependent measures concomitant with performance.More recent research has included a greater reliance on objective physical performance measures, improved sample sizes, and appropriate controls. For example,Whitmarsh and Alderman (1993) demonstrated a significant improvement in wall-sit duration (a function of pain related mechanisms of fatigue) with stress inoculation training over 2 weeks of training (one hour per week) compared to controls in 45 male and female cyclists, rowers and tri-athletes. In other respects, ...
Cognitive Behavioural Stress Management (CBSM) has demonstrated favourable changes in psychological and biological stress indicators, consistent with reductions in sports injury, and accelerated recovery following surgery. However, the effects of CBSM on the conditioning of athletes remain speculative. The aim of this study was to assess the effects of a CBSM program on measures of the conditioning process, including stress, recovery and performance. Thirty-two rowers (16 males, 16 females; mean age 20.0 years, range 17 - 29 years) preparing for the 2007 Australian Rowing Championships were recruited and stratified into 16 intervention-control matched pairs based on gender, weight class and performance. They were monitored for 17 weeks with one week of assessment before 3 weeks of CBSM for the intervention group and 3 weeks of normal training for the control group, followed by 13 weeks of their usual training. The intervention consisted of 6 one-hour sessions of instruction on the regular use of CBSM methods in response to daily stressors. Measures of perceived stress and recovery were obtained through the Recovery Stress Questionnaire for Athletes (RESTQ-Sport) (Kellman & Kallus, 2001). Rowing performance was assessed by the average power to complete a maximal 2000m ergometer time-trial in the first week of monitoring, and in the 4th, 9th and 17th week. The CBSM group demonstrated a statistically significant improvement in the REST- Sport General Recovery Scale of Success (Wilks’ Lambda = 0.219, F (14,12) = 3.052, p= 0.03) and Sport Specific Recovery Scale of Burnout/Personal Accomplishment (Wilks’ Lambda = 0.218, F (14,12) = 3.079, p = 0.03) compared to the control group across the time-series. No significant differences in 2000m ergometer performance were demonstrated between groups, but after 17 weeks of training the intervention group’s performance was preserved (0.2 ± 3.7%) whereas the control group showed a 2.7 ± 6.3% decrement. It was concluded that CBSM provided some benefits to the athlete’s psychological state and may be a useful strategy to employ in the conditioning process. Further research using a larger sample size is warranted to fully examine the efficacy of CBSM in high performance athletes.
... Pain increases muscle tension so techniques to reduce muscle tension can be beneficial in the healing process. Whitmarsh and Alderman (1993) stated that relaxation techniques such as progressive relaxation can be used to relieve pain and stress which often accompany the recovery process. ...
Using the case study of an 18-year-old track athlete with a chronic Achilles tendinopathy, this article identifies risk factors associated with training for major athletic events, such as the forthcoming Olympic Games, and presents evidence for adopting a multidisciplinary approach to the treatment and management of athletic injury, addressing the physical aspects of the injury, as well as the psychological needs of the athlete. The athlete's GP and practice nurse, as well as a podiatrist and sport psychologist, are all involved in providing an accurate clinical diagnosis, effective physical intervention, and psychological skills training to address emotional issues and encourage adherence to the rehabilitation programme. Nurses, in both secondary and primary care, can play a crucial role; in this case, the practice nurse recognised the adverse impact that the injury was having on the athlete's emotional wellbeing before making a referral to a trained sport psychologist.
... These consequences in turn greatly affects in many emotional, behavioral, sexual, economic, academic and social conflicts of young ages and result in social and physical changes [6,7]. Recently, the importance of psychological skills training (PST) techniques and other relating training techniques have been recognized, and the number of studies on athletes or other patient subjects using psychological training strategies to improve psychological status [19][20][21]. One of the most training techniques affecting on psychological stress is Progressive muscle relaxation (PMR) [9][10][11]. ...
... Recently, the importance of psychological skills training (PST) techniques and other relating trtaining techniques have been recognized, and the number of studies on athletes or other patient subjects using psychological training strategies to improve psychological status [19][20][21]. One of the most training techniques affecting on psychological stress is Progressive muscle relaxation (PMR) [9][10][11]. ...
... The volitional strategies identified above, linked with shielding intentions, appear to be suitable to overcome pain. In a randomized control study, Whitmarsh and Alderman (1993) showed that athletes in a stress-inoculation training program showed significantly better performance times and a higher pain tolerance while performing a physical task. Unfortunately, research exploring pain management among athletes is rare. ...
... Athletes can actively develop their tolerance in this regard; however, it is recommended to do so gradually. Whitmarsh and Alderman [52] have shown that athletes who changed their cognitive patterns greatly improved their time efficiency and increased tolerance to pain during training sessions. Pain experienced during physical effort can be interpreted as a threat to the somatic integrity of an individual and associated with an increased arousal and anxiety [49], which make it even more unpleasant. ...
... Therefore, it may be most efficient to use interventions that have empirical support for improving athletes' responses to pain. In this sample, mindfulness or stress inoculation training (SIT) would be appropriate, as both of these interventions have demonstrated increased ability to accept and tolerate pain (McCracken, Sato, & Taylor, 2013;Ross & Berger, 1996;Whitmarsh & Alderman, 1993). Using these interventions could help athletes better tolerate negative physical sensations and prevent the detrimental impact on HRV following an induction of pain during training or performance. ...
Heart Rate Variability (HRV) technology enables practitioners to analyze the physiological effects of stress. High levels of HRV are associated with improved stress management and sport performance. This study examined the effectiveness of athletes’ (N = 20 collegiate male soccer players) existing mental strategies in maintaining high HRV following three separate stressors. A brief (12-minute) athlete-specific adaptation of a physiological assessment protocol was administered to all athletes. Findings suggest that athletes significantly improved HRV following a cognitive and sport-specific stressor (p < .05); however, athletes were unable to increase HRV following a physical stressor (p > .05). Results suggest athletes were less equipped to cope with physical pain. The process of providing assessment feedback to coaches and athletes is discussed. Finally, clinical and research applications for this brief assessment are introduced and explored.
... Unpleasant sensations indicate that an athlete is pushing their self, and participants recognised that they need to persevere to achieve physiological adaptation from training or a desired outcome from an event. Psychological skills training strategies that help athletes to persevere despite high levels of perceived effort (Blanchfield, Hardy, de Morree, Staiano, & Marcora, 2014) and pain (Whitmarsh & Alderman, 1993) in training and in events could help endurance athletes to achieve these desired outcomes. In the present study, athletes reported difficulties remaining committed to training sessions, and the exercise sensations experienced during training could be a contributing factor. ...
This study aimed to identify psychological demands that are commonly experienced by endurance athletes so that these demands could inform the design of performance-enhancing psychological interventions for endurance athletes. Focus group interviews were conducted with 30 recreational endurance athletes of various sports (running, cycling, and triathlon), distances, and competitive levels to explore the psychological demands of training, competition preparation, and competition participation. An inductive thematic analysis was used to identify psychological demands that were experienced across sports, distances, and competitive levels. Seven themes captured demands that were commonly experienced away from the competitive environment (time investment and lifestyle sacrifices, commitment to training sessions, concerns about optimising training, and exercise sensations during training), preceding an endurance event (pre-event stressors), or during an event (exercise sensations, optimising pacing, and remaining focused despite adversity). Interventions that could be delivered to recreational athletes, who do not typically have access to a sport psychologist, are suggested. Experimental research examining the efficacy of interventions that help endurance athletes to cope with the reported psychological demands is encouraged.
... Bu sporcuların kardiyovasküler sistemlerinin sürekli üst düzey şiddetlerde uyarıldığı ve ağrı toleranslarının daha yüksek olduğu saptanmıştır. [1][2][3] Ord ve Gijsbers'in [1] yaptıkları araştırmada, iskemik ağrı uygulanan sporcuların ağrı eşiği değerleri sedanter bireylerle karşılaştırıldığında bir farklılık gözlenmezken, ağrı toleranslarının daha yüksek olduğu sonucu ortaya çıkmıştır. Antrenmanlarda egzersizin artan şiddeti ile birlikte yükselen sistolik kan basıncının endojen opioid sistemi aktive ettiği ve sonuçta, endorfinlerin "egzersiz sebepli analjezik etkisi"nin ortaya çıktığı düşünülmektedir. ...
The main purpose of this study was to investigate pain perception of the professional volleyball players at rest and maximal cardiovascular stresses during different phases of menstruation.
Thirteen volleyball players from Celal Bayar University were used as the participants of the study. At rest, anthropometric measurements, systolic and diastolic blood pressures were determined. Then, pain tolerance and pain threshold were measured by sphygmomanometer that placed upper part of the arm. Visual Analog Scales (VAS) was used to grade the pain. At the 2nd (menstrual phase) and 14th (ovulation phase) days of menstrual cycle, oxygen consumption (VO(2)), heart rate (KA), blood lactate (KL) pain perception and rate of perceived exertion (RPE) were taken during two incremental maximal exercises testing.
Statistical analysis of this study indicated that at rest pain tolerance and threshold values of the volleyball players were significantly higher during menstruation phase compared to ovulation phase. Also, VO(2) and KL measurements taken at the high intensities during 2nd day of mensturation were statistically higher than that of measurements were done at 14th day of mensturation. Moreover, pain perception of the participants that was measured during 2nd day of menstruation was significantly lower than that of measurements during the 14th days of menstruation (p<0.05). According to results of regression analysis, RPE and KL were two dependent variables that were statistically related to pain perception during two different phases of menstruation.
As a conclusion due to the decrease in pain perception, the intensity of the training could be increased during menstruation period.
... In summary, those involved in the sport injury rehabilitation process and athletes alike have all demonstrated having belief in the value of using imagery for speeding up the recovery process (e.g., Brewer et al., 1994;Green & Bonura, 2007;Ievleva & Orlick, 1991;Richardson & Latuda, 1995). Similarly support for other benefits such as reduction in levels of re-injury anxiety (e.g., Cupal & Brewer, 2001), painmanagement (e.g., Whitmarsh & Alderman, 1993), and preparation for returning back to sport (Johnson, 2000) have also been found. Such a wealth of support is not surprising, as rehabilitation imagery has the potential to address the various concerns and challenges injured athletes face during the rehabilitation process (Taylor & Taylor, 1997). ...
... motivational-affective (involves an evaluation of the negative connotations of the stimuli), and cognitive-evaluative (involves a decision making process, such as "what to do about this pain") (Whitmarsh & Alderman, 1993). ...
... In application of these conclusions that higher categories of ultra-marathon competition require supra-threshold levels of mental toughness and associated self-efficacy, psychological skills training focused on increasing mental toughness and self-efficacy could potentially help in improving the likelihood an athlete would advance into the highest category of ultra-marathon performance. While psychological skills training has been shown to improve athletes' performance in other sports [43,44], there is very limited research that has considered the effects of mental toughness and self-efficacy training programs in ultra-marathon samples. Future research should also consider the development of mental toughness and self-efficacy training programs and interventions specific to the somewhat unique challenges of ultra-marathon. ...
Minimal research has examined psychological processes underpinning ultra-marathon run-ners' performance. This study examined the relationships between mental toughness and self-efficacy with performance in an elite sample of ultra-marathon runners competing in the 2019 Hawaiian Ultra Running Team's Trail 100-mile endurance run (HURT100). The Mental Toughness Questionnaire (SMTQ) and the Endurance Sport Self-Efficacy Scale (ESSES) were completed by 56 elite ultra-marathon runners in the HURT100 (38 males, 18 females; M age = 38.86 years, SD age = 9.23). Findings revealed mental toughness and self-efficacy are highly related constructs (r(54) = 0.72, p < 0.001). Mental toughness and self-efficacy did not significantly relate to ultra-marathon performance (mental toughness and self-efficacy with Ultra-Trail World Tour (UTWT) rank F(2, 53) = 0.738, p = 0.483; mental toughness and self-efficacy with likelihood would finish the HURT100 χ 2 = 0.56, p = 0.756; mental toughness and self-efficacy with HURT100 placing and time F(2, 53) = 1.738, p = 0.186 and F(2, 30) = 2.046, p = 0.147, respectively). However, participants had significantly and meaningfully higher mental toughness (M = 45.42, SD = 4.26, medium and large effect sizes) than athletes from other sports previously published. Our interpretation is that these results taken in conjunction, suggest a threshold of mental toughness that performers require to be of the standard needed to be able to prepare for and compete in elite ultra-marathon events such as the HURT100; once this mental toughness threshold is met, other factors are likely to be more influential in determining elite level ultra-marathon performance.
... It is postulated that pain threshold is relatively constant in an individual, but pain tolerance is strongly modulated by psychological and psychosocial factors [11,27,42,54,55,62]. Coping skills can increase pain control [6,22,23,68,76]. For example, self-efficacy and Egan 1987 [18] Tolerance CPT (time in min to withdrawal) 50 (male) 10 (male) Athletes were randomly chosen from inter-university athletes (M = 22 y; football, boxing, fencing, karate and crosscountry skiing). ...
This study systematically reviewed differences in pain perception between athletes and normally active controls. We screened MEDLINE, Sport-Discus, EMBASE, Web of Science, PsycINFO, PSYNDEX, and the citations of original studies and systematic reviews. All studies on experimentally induced pain that compared pain perception between athletes and normally active controls were eligible. The main outcome measures were pain tolerance and pain threshold. Effects are described as standardized mean differences and were pooled using random-effects models. Fifteen studies including 899 subjects met the inclusion criteria. Twelve of these studies assessed pain tolerance, and 9 studies examined pain threshold. A meta-analysis of these studies revealed that athletes possessed higher pain tolerance compared to normally active controls (effect size calculated as Hedges' g=0.87, 95% confidence interval [CI(95)] 0.53-1.21; P<0.00001), whereas available data on pain threshold were less uniform (Hedges' g=0.69, CI(95) 0.16-1.21; P=0.01). After exclusion of studies with high risk of bias, differences between groups in pain threshold were not significant any longer. Our data suggest that regular physical activity is associated with specific alterations in pain perception. Psychological and biological factors that may be responsible for these alterations are discussed.
The aim of this research is to identify the most widespread
mental skills among professional marathon runners, elites
and strong amateurs, in particular by evaluating whether
the disposition to mindfulness and mental toughness are
predictive of high performance. The investigation was conducted
on a sample of Italian marathon runners (men and
women), by administering three questionnaires. The results
show how the mental factor impacts mainly in the first
30km, to a lesser degree in the last quarter of the race and
in the occurrence of the phenomenon of the “wall”. A marked
predisposition to mindfulness, high levels of self-confidence,
significant disturbances in concentration during the
race and the application of mental practice during training
sessions, are the aspects of a psychological nature most
correlated to performance. On the other hand, mental toughness
does not seem to have a marked relevance. It is concluded
that the mental factor is strongly correlated to high
marathon performance and requires particular attention
for athletes who seek excellent results.
Athletes usually deal with injuries and pain. They seem to have similar pain threshold when compared to non-athletes, although they have higher pain tolerance and the exact cause for that is unknown. High levels for pain tolerance and control can improve performance and time for injury recovery. The literature shows that use of coping strategies can increase pain control; possible differences on coping with pain between athletes and non-athletes are poorly described. The purpose of this study was to evaluate frequency of coping strategies used by athletes and non-athletes of both genders and look for possible association between preferred coping style and pain intensity. The sample included 160 subjects with actual pain experience, 80 athletes (52 male, 28 female) and 80 non-athletes (50 male and 30 female). All subjects were evaluated for pain intensity, frequency and duration and for coping strategies using a questionnaire (SBS-V). The results show that athletes and non-athletes, despite of gender, use with the same frequency coping strategies. The less common coping strategies for all groups were those poor-adaptative (p < 0.001); the most commonly strategy used was self-statement and regulation of body tension (p < 0.001). Female athletes use more frequently poor-adaptative strategies when pain intensity increases (p < 0.05).
The aim of this study was to develop a discomfort questionnaire to elicit the feelings and thoughts of people engaged in running activities. Ten runners who completed a particularly demanding 9-km run were asked to express their feelings and thoughts during the run they had just completed. These responses were recorded and later used as the first pool of items (k = 36). The questionnaire was then given to 171 runners in different distance races throughout the 1995 competitive season. These responses were analysed using exploratory factor analytic techniques and Rasch probabilistic analysis, as well as traditional reliability and validity procedures. The final version of the questionnaire consisted of 32 items divided into eight correlated subscales: proprioceptive symptoms, leg symptoms, respiratory difficulties, disorientation, dryness and heat, task completion thoughts, mental toughness, and head or stomach symptoms. These eight categories can be collapsed into three global categories suggested by researchers of pain: sensory-discriminative, motivational-affective and cognitive-evaluative. Rasch analysis suggested that the motivational-affective and cognitive-evaluative dimensions (i.e. the psychological) are the most experienced (i.e. rated highest). The eight subscales have ecological validity and were found to alter with the demands of different running distances.
A great number of injuries occur in the context of recreational physical activities and competitive athletics. Adherence to sport injury rehabilitation means an injured athlete's compliance (or not) to a sports medicine/injury personnel's instructions of participating in a rehabilitation programme in a clinic, and/or doing rehabilitation exercises at home. It has emerged as an area of interest among physiotherapists and other allied professionals (i.e. sport trainers, physicians). This article reviews compliance among injured athletes in the recovery process by presenting the protection motivation theory, personal investment theory and models of cognitive appraisal. Also it reviews key research findings about these three theoretical models. In addition practical guidelines and specific strategies are offered to sport injury rehabilitation personnel to enhance an athlete's adherence to injury rehabilitation. Sports medicine/injury personnel should educate athletes about their injuries and rehabilitation and increase effective communication and active listening. Also sports medicine/injury personnel should provide social support and encourage positive beliefs of injured athletes. In addition, coping with pain and setting short-term goals help athletes to increase their compliance to programmes of rehabilitation.
The biology and medicine of rowing are briefly reviewed. Effort in a 2000-m race is about 70% aerobic. Because the boat (and in some instances a cox) must be propelled, successful competitors are very tall, with a large lean mass and aerobic power. Large hearts may lead to erroneous diagnoses of a cardiomyopathy. Large respiratory minute volumes must be developed by chest muscles that are also involved in rowing. The vital capacity is typically large, and breathing becomes entrained. Expiration cannot be slowed relative to inspiration (as normally occurs at high rates of ventilation) and the limiting flow velocity may be reached, with the potential for airway collapse. Performance is strongly related to the power output at the "anaerobic threshold", and lactate measures provide a guide to an appropriate intensity of endurance training. Peak blood lactate levels are higher in males (commonly 11-19 mmol . l-1 and occasionally as high as 25 mmol . l-1) than in females (9-11 mmol . l-1), probably because males have a greater muscle mass in relation to blood volume. The skeletal muscles are predominantly slow twitch in type, developing an unusual force and power at low contraction velocities. Many rowers have a suboptimal diet, eating excessive amounts of fat. Lightweight rowers also have problems of weight cycling. Aerobic power and muscle endurance often change by 10% over the season, but such fluctuations can be largely avoided by a well-designed winter training programme. Injuries include back and knee problems, tenosynovitis of the wrist and, since the introduction of large blades, fractures of the costae.
The purpose of the present study was to assess the effect of a time limited cognitive-behavioral stress management program
(CBSM) on mood state and serum cortisol among men and women rowers (N=34) undergoing a period of heavy exercise training.
After controlling for life-event stress (LES), CBSM was hypothesized to reduce negative mood state and cortisol among rowers
during a period of heavy training; mood and cortisol changes over the intervention period were hypothesized to be positively
correlated. LES was positively associated with negative affect at study entry. After covariance for LES, rowing athletes randomly
assigned to the CBSM group experienced significant reductions in depressed mood, fatigue, and cortisol when compared to those
randomized to a control group. Decreases in negative affect and fatigue were also significantly associated with cortisol decrease.
These results suggest that CBSM may exert a positive effect on athletes' adaptation to heavy exercise training.
While sport and exercise psychology has devoted considerable energies towards understanding the effects of injury, the psychology of pain itselfhas received far less attention. The paper briefly reviews primary research in this area in relation to definitional, methodological and theoretical concerns. The difference in pain perception and tolerance between athletes and non athletes and between sports, attentional aspects of pain perception and cognitive coping strategies are also discussed. An integrative model is proposed which links the physiological sensation of pain with a two-stage process of cognitive appraisal and a series of behavioural responses, mediated by extrinsic and intrinsic factors together with cognitive coping strategies. The model also includes a taxonomy of different types of pain which can be experienced during sport.
There is a considerable overlap between behavioral medicine and the closely related field of sport and exercise psychology. Both deal with the human body, its interactions with the physical and social environment, and have as their goals to help that body function as effectively as possible, whether achieving and maintaining health or, at the other end of the continuum, performing at a world class level in an athletic event. The emphasis of this chapter, however, will be on sport and exercise applications of psychological principles, rather than on the more clearly medical applications. The point of view taken will be primarily from a behaviorological perspective.
Los autores no solo presentan datos que respaldan la influencia del Pensamiento en el Rendimiento en la práctica deportiva de la alta competición, sino que además realizan un amplia propuesta de estrategias basadas en el uso y manejo de la Atención/concentración, la Imaginería y el Auto-habla. El análisis conlleva pautas y criterios diferenciados para deportes como las pruebas de fondo, deportes individuales o deportes de adversario/oposición.
Cognitive behavioral stress management (CBSM) has previously been found to reduce fatigue, depression, and cortisol response to heavy exercise training among competitive collegiate athletes and to speed physical and psychological recovery from surgery. Our study assessed the efficacy of a CBSM program to reduce the frequency of injury and illness among collegiate athletes in a randomized, single-blind, controlled clinical trial. Following assessment of baseline medical history, mood state, stress, cortisol, sleep, alcohol use, and exercise training, collegiate rowers were stratified by gender and competitive level and randomly assigned to either a control group or a CBSM group. Exercise training information and psychosocial assessments were repeated immediately following the intervention period, and health care providers who were blinded to participant assignment recorded the frequency of medical visits and the number of days injured or ill until the end of the season. Athletes randomly assigned to a CBSM group experienced significant reductions in the number of illness and injury days as compared to control group athletes. CBSM participants also had half the number of health service visits as did controls. The data suggest that a time-limited CBSM intervention designed specifically for an athlete population may be an effective prophylactic treatment to reduce the incidence of injury and illness among competitive collegiate athletes.
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