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Fear-Avoidance Following Musculoskeletal Injury in Male Adolescent Gaelic Footballers.

CONTEXT:
Gaelic football participation provides a wealth of benefits but a risk of musculoskeletal injury also exists. Injury is associated with physical consequences, including pain, discomfort, loss of function, time absent from school/sport, considerable medical expenses along with placing undue pressure on emergency services and hospital staff. Concurrent psychological consequences, such as fear-avoidance, can also occur causing psychological distress. There is a current dearth of available research examining the psychology of injury in male adolescent Gaelic footballers.


OBJECTIVE:
To examine fear-avoidance post-injury in male adolescent Gaelic footballers, the effect of pain, time-loss, injury severity and previous injury on the extent of fear-avoidance and the usefulness of a modified Athlete Fear Avoidance Questionnaire (mAFAQ) as a screening tool for predicting injury.


DESIGN:
Prospective cohort study.


SETTING:
Recreational clubs.


PARTICIPANTS:
97 male adolescent club Gaelic footballers (13.4±1.1 years).


INTERVENTIONS:
Musculoskeletal injuries sustained during Gaelic football participation, defined as any injury sustained during training or competition causing restricted performance or time lost from play,1 were assessed and recorded weekly by a Certified Athletic and Rehabilitation Therapist. Injuries requiring time loss from participation were classed as time-loss injuries. Injury characteristics that included type, nature, location, severity and pain were recorded.


MAIN OUTCOME MEASURES:
Injured players completed the Athlete Fear Avoidance Questionnaire (AFAQ), a measure of injury-related fear-avoidance following injury assessment (AFAQ1). With time-loss injuries, the AFAQ was completed again (AFAQ2) prior to return to play. mAFAQ was completed at baseline.


RESULTS:
Twenty-two injuries were recorded during the season with fear-avoidance evident post-injury that significantly decreased before returning to play. Fear-avoidance post-injury was higher in those with greater pain but time-loss, injury severity and previous injury did not significantly affect the extent of fear-avoidance. Baseline fear-avoidance did not predict injury.


CONCLUSIONS:
Psychological rehabilitation is recommended for managing post-injury psychological distress in male adolescent Gaelic footballers.