Psychological Factors Predict Soccer Injuries

As the World Cup continues in Brazil, several star players have been left out due to injuries: French winger Franck Ribery due to a back problem, Colombia’s striker Radamel Falcao out with a torn ACL, Germany’s Marco Reus’ ankle injury, Italy’s midfielder Riccardo Montolivo’s broken tibia, and Theo Walcott of England as the result of a knee issue. Awareness of psychological variables can be useful to health professions and coaches who work with players of various levels.

An estimated 65 to 95 percent of elite players sustain a performance-limiting injury in a single season, and research has repeatedly demonstrated that psychological variables such as perfectionism, Type A behaviors, and trait anxiety lead to increased frequency and severity of injuries. The realm of sports psychology lends insight into states of mind which can be predictive of injury.

“Interest in the pathogenesis of sport injuries has led to the general conclusion that two major factors influence injury vulnerability: external factors (e.g. type of sport and weather conditions) and internal factors (e.g. physiological and psychological factors),” note Johnson and Ivarsson, researchers who have focused on psychological predictors of soccer injuries.

Jean Williams’ and Mark Andersen’s stress injury model has been frequently cited in subsequent research. Williams and Andersen proposed that certain psychological traits exacerbate the stress response, which in turn has physiological manifestations making injury more probable. The specific mechanisms by which researchers have suggested that injury occurrences and severity increase as a result of psychological factors include distraction, the narrowing of peripheral vision, muscle tension, and impaired coordination.

Ivarsson et al. also cite Rogers and Landers, whose research found that “peripheral narrowing mediated the relationship between major stressors (i.e. negative life-event stress) and injury occurrence.”

Ivarsson et al. note that “in addition to having to cope with the physical stresses of injury (e.g. pain, discomfort, the rigors of rehabilitation), athletes must contend with the psychosocial stresses of injury such as threats to self-esteem, threats to athletic career involvement, and isolation from peers. Given the profound physical and psychosocial burden of injury, prediction efforts aimed at minimizing injury risk are important.” 

The element of celebrity that accompanies the World Cup introduces a new level of potential stressors in the form of media scrutiny. Recall the frenzy surrounding charges that star French players had relations with an underage prostitute, or the players from Ghana who last month threatened to boycott the game over money concerns. Marital problems and career uncertainty are just some of the sources of stress potentially affecting professional athletes’ performance and therefore safety.

In their own prospective study involving 56 professional Swedish Premier League soccer players, both male and female, Ivarsson et al. used a “Hassle and Uplift Scale” to delve into the players’ perceptions of their “daily hassles,” such as family issues and work relationships, and how these might impact the risk of injury.

They found that “negative life event stress had an indirect effect on injury occurrence through daily hassle,” and that “trait anxiety was indirectly related to injury risk through negative life event stress and daily hassles.” To explain the indirect nature of the injury effect of personality traits, they point to a study by Perna et al., who found that negative emotions were associated with physiological responses, and concluded that “attempts to decrease injury risk should address both the cognitive-affective component of stress and the somatic responses that are likely the causal mechanism behind injury occurrence.”

Similar findings apply to other types of players, such as high school age soccer players and rugby players. With FIFA reporting that more than 270 million people are involved in soccer worldwide, athletes of varying levels could benefit from using the information to better prevent injury. Stressors are ubiquitous, but how athletes perceive and react to them affects their risk of getting hurt while participating in sports. Interventions by coaches and health care professionals, particularly with regard to stress management, could potentially decrease the incidence or severity of injuries.


Devantier, C. (2011). Psychological Predictors of Injury among Professional Soccer Players Sport Science Review, XX (5-6) DOI: 10.2478/v10237-011-0062-3

Ivarsson A, Johnson U, & Podlog L (2013). Psychological predictors of injury occurrence: a prospective investigation of professional Swedish soccer players. Journal of sport rehabilitation, 22 (1), 19-26 PMID: 23404909

Johnson U, & Ivarsson A (2011). Psychological predictors of sport injuries among junior soccer players. Scandinavian journal of medicine & science in sports, 21 (1), 129-36 PMID: 20136759

Williams, J., & Andersen, M. (1998). Psychosocial antecedents of sport injury: Review and critique of the stress and injury model’ Journal of Applied Sport Psychology, 10 (1), 5-25 DOI: 10.1080/10413209808406375

Image via dotshock / Shutterstock.

Lindsay Myers, MBA, MPH

Lindsay E. Myers, MBA, MPH, is a national healthcare consultant. Ms. Myers has served as Chief Financial Officer, Director, and Consultant to hospitals, physician practices, hospices, social services agencies, and public health clinics. She lives in Sarasota, Florida.
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