Can stress lead to injury?

Dr Brea Kunstler – Physiotherapist and behavioural scientist, Performance Medicine

Many of us lead stressful lives. Whether you are at school or university and trying to balance family and social life with the challenges of constant study, or if you are working a busy job and need to pay ever-increasing bills and even raise children, it’s all psychologically stressful. People who are unwell also experience psychological stress, particularly when they are concerned about their ability to get better.

There’s psychological stress, like the stress I mentioned above, but there’s also physical stress. Physical stress can come from physical activities. You might perform these activities at work if you have a physically demanding job. You can also experience physical stress during exercise. Every exercise places stress on the body. Some exercises are more stressful than others (e.g. running is more stressful than yoga). Those training for a marathon will have a higher physical stress than those training for a 5km, but training for a 5km can still be a high stress depending on the training status of the person. The more well trained you are, the less stressful the activity will be (unless you are overtraining, where even a little bit of training can be really stressful).

So consider the answer to your simplified ‘stress equation’ where overall stress = psychological stress + physical stress. What’s your overall stress?

Injury prevention

Those with high levels of stress, particularly over long periods of time, have a higher risk of injury¹. Even perceiving a situation as stressful can place athletes at higher risk of injury².

So how do we minimise our stress in the hope to minimise our risk of injury?

Most of the research in using psychological interventions to prevent sports injury focus on stress management interventions³. There is a small effect for psychological interventions on preventing injury, however it’s important to keep in mind that this small effect is based on a small number of studies³.

Stress doesn’t just increase injury risk, but it can also negatively impact rehabilitation from injury. For example, experiencing fear and anxiety associated with return-to-sport after injury can prolong the recovery period. Therefore, it’s important that psychological strategies are included in any rehabilitation program, such as relaxation, goal setting, imagery, self-talk and self confidence training¹.

So keep your stress in check. Remember that stress away from sport can add to the stress experienced during sport, creating a very stressful environment for the body. Stress can increase injury risk, and prolong rehabilitation time, so addressing stress by getting the right psychological (e.g. psychology, counseling) and physical support (e.g. physiotherapy) is important to keep you healthy.


References

1. van de Wouw A. (2022) Advocating a holistic approach for sport injury prevention and rehabilitation. BMJ Journals. http://dx.doi.org/10.1136/bjsports-2022-105695
2. Williams JM. and Andersen MB. Psychosocial antecedents of sport injury: Review and critique of the stress and injury model. Journal of Applied Sport Psychology https://doi.org/10.1080/10413209808406375
3. Gledhill A., Forsdyke D., Murray E. Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness. British Journal of Sports Medicine. http://dx.doi.org/10.1136/bjsports-2017-097694

Need some help achieving your running goals? Book a telehealth appointment with Performance Medicine’s exercise and run coach, Dr Brea Kunstler, to see how she can help you achieve your goals. She can provide a referral to a trusted shoe provider who will give you 10% off the RRP of your new shoes.