Abstract
The science of sports injury control, including both its cause and prevention, has largely been informed by a biomedical and mechanistic model of health. Traditional scientific practice in sports injury research has routinely involved collapsing the broader socioecological landscape down in order to analyse individual-level determinants of injury - whether biomechanical and/or behavioural. This approach has made key gains for sports injury prevention research and should be further encouraged and allowed to evolve naturally. However, the public health, Applied Human Factors and Ergonomics, and injury epidemiological literature more broadly, has accepted the value of a socioecological paradigm for better understanding disease and injury processes, and sports injury research will fall further behind unless it does the same. A complementary and alternative conceptual approach towards injury control known as systems thinking that builds on socioecological science, both methodologically and analytically, is readily available and fast developing in other research areas. This review outlines the historical progression of causal concepts in the field of epidemiology over the course of the modern scientific era. From here, causal concepts in injury epidemiology, and models of aetiology as found in the context of sports injury research are presented. The paper finishes by proposing a new research agenda that considers the potential for a systems thinking approach to further enhance sports injury aetiological understanding. A complementary systems paradigm, however, will require that sports injury epidemiologists bring their knowledge and skillsets forwards in an attempt to use, adapt, and even refine existing systems-based approaches. Alongside the natural development of conventional scientific methodologies and analyses in sports injury research, progressing forwards to a systems paradigm is now required.
Highlights
The science of sports injury control, including both its cause and prevention, has largely been informed by a biomedical and mechanistic model of health
In the sports injury literature, there have been a number of examples that discuss or illustrate causality from a general prevention perspective (Meeuwisse 1994a, b; Gissane et al 2001; Bahr and Holme 2003; Bahr and Krosshaug 2005; McIntosh 2005). Notwithstanding these examples, causal theory in sports injury epidemiology has entered into a period of inertia despite the availability of alternative conceptual causal approaches
The first section of this narrative review discusses the historical progression of causal concepts in the field of epidemiology more generally
Summary
The science of sports injury control, including both its cause and prevention, has largely been informed by a biomedical and mechanistic model of health. Causal concepts in the broader field of injury epidemiology, and models of aetiology as found in the context of sports injury research are presented.
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