Abstract

The psychological factors influencing a return to sport has gained increased research attention. In the current investigation, we explored professional basketball players’ perceptions of the psychosocial and behavioral factors facilitating a return to performance equal to or exceeding previous performance standards. We also sought to describe athletes’ experiences – both positive and negative – of returning to sport following injury recovery. Ten Italian professional male basketball players (age range 22–36 years), were retrospectively interviewed in relation to three time-periods: (1) from the commencement of rehabilitation to their first official competition, (2) the first official competition, and (3) the 6-months following the initial competition. Qualitative content analysis of the data revealed numerous themes across the three time periods. In regards to Period 1, participants indicated that social support, investment in rehabilitation and training programs, coping skills and motivation were fundamental in reaching pre-injury performance levels. During their first official game (i.e., Period 2), athletes reported that realistic performance expectations, focusing on the performance, positive emotions, motivation, arousal and social support facilitated their return to sport. Athletes, however, also described a predominance of factors that hindered their return to pre- injury levels (i.e., low confidence in personal abilities, decrements in skill execution and dysfunctional physical sensations). Moreover, participants typically described a substandard level of performance during their first competition back following injury. In recounting experiences during the 6 months following their first official game, basketballers reported improvements in skill execution and highlighted the importance of coping skills, motivation and social support. The process of restoring self-confidence in one’s ability to successfully perform was perceived as crucial in enabling participants to move beyond a mere return to sport to a return to high performance – that is, to reach a level of proficiency equal to or exceeding previous performance standards. Findings support the relevance of cognitive, emotional and behavioral responses highlighted in the Integrated Model and suggest the importance of addressing psychological factors throughout the return-to-sport process. Finally, results from the present study hold a number of practical implications for athletes’ aiming to achieve a return to pre-injury levels.

Highlights

  • Return to sport following injury is a critical moment in the life of athletes and often represents the culmination of weeks to months of rehabilitative efforts (Podlog and Eklund, 2006)

  • For professional athletes in particular whose career prospects likely depend upon the ability to compete at or exceeding their pre-injury status, the culmination of injury rehabilitation is a return to full performance levels (Johnson and Podlog, 2014)

  • Recent meta-analyses have demonstrated that athletes’ ability to attain or surpass pre-injury performance levels is not determined solely by the attainment of satisfactory clinical outcomes and physical functioning (Grassi et al, 2015; Ardern et al, 2016). These reviews have highlighted the relevance of psychological factors in predicting return to previous competitive levels, in the context of elite sports where achieving optimal performance is of critical importance (Schilaty et al, 2016)

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Summary

Introduction

Return to sport following injury is a critical moment in the life of athletes and often represents the culmination of weeks to months (or longer) of rehabilitative efforts (Podlog and Eklund, 2006). Recent meta-analyses have demonstrated that athletes’ ability to attain or surpass pre-injury performance levels is not determined solely by the attainment of satisfactory clinical outcomes and physical functioning (Grassi et al, 2015; Ardern et al, 2016). Rather, these reviews have highlighted the relevance of psychological factors in predicting return to previous competitive levels, in the context of elite sports where achieving optimal performance is of critical importance (Schilaty et al, 2016)

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