TA1: Different factors which influence the risk and severity of injury

What you need to know

• The extrinsic factors that can influence the risk and severity of injury within sporting activity.

There are many external factors that will influence the level of risk and how severe any injuries may be.

Types of factors Influence

There is a chance we may get injured when we participate in any sport. How many people do you know in your class who have been injured playing sport? There are many different reasons why we may get injured. These reasons are due to extrinsic and intrinsic factors. • Extrinsic factors are things that are external to us – they are related to the sporting activity. Examples of extrinsic factors are found in the diagram below. • Intrinsic factors are internal – they are the things we should be able to control. (See page 25 to find out more about the intrinsic factors that could influence injury.)

Each factor can affect one or more of the other factors. For example: • Each type of sport is played in a specific environment. For example, basketball may be played indoors in a gym or sports hall, or outside on a hard court. These different environments will affect the risk and type of injury. • The environment will affect the equipment required. For example, a sprinter may choose to wear studded shoes rather than spiked shoes, depending on the running surface. • The type of sport affects the method of coaching/instructing/leading. For example, a group being coached to throw the javelin may require greater supervision than a group who are practising for the 800m run. Extrinsic factors Types of sports activity Coaching/Instructing/Leading Extrinsic factors DRAFT

Equipment Environment

Practise it!

Identify the type of factor being described below: is it extrinsic or intrinsic? ‘These factors are external to us – they are related to the sporting activity.’ (1 mark)

Remember it!

• Intrinsic and extrinsic factors influence the risk and severity of injury • Extrinsic factors can influence other extrinsic factors.

What you need to know

• How different sporting activities can influence the risk of injury.

It is possible to become injured participating in just about any sporting activity. However, the type of injury and how badly you can be injured will vary depending on the sport being played.

Individual sports Snooker has a low risk of injury as the players take it in turns to take shots and play in a controlled and safe environment. Team sports Team games like football can result in injury due to collisions between players or hard impact with the playing area if they slip.

Write down as many different sporting activities as you can. Place each sport in your list with similar sports. Order each group of sports as low, medium or high risk of injury.

Create a table of reasons for your sport risk groupings.

High risk of injury Medium risk of injury

Contact sports In some contact sports, such as boxing, the intention is to physically hurt your opponent – so the risk of injury is high.

Remember it!

Low risk of injury

Extreme sports Extreme sports like mountain biking have a very high risk of injury due to the environment they take place in. 1 Which one of the following sports is most likely to have the highest risk of injury? Tick (3) the correct response. Practise it!DRAFT a Badminton singles b Golf c Mixed martial arts fighting d Swimming

(1 mark)

2 State one reason why gymnastics has a greater risk of injury than table tennis. (1 mark)

Opponent can touch you Can collide with other players Play on your own

What you need to know

• How the extrinsic factors relating to coaching, instructing and leading can influence the type and severity of injury.

The diagram below summarises the influence of coaching, instructing and leading on the risk and severity of sporting injury.

Knowledge of techniques/ rules/regulations Coaching/ Experience instructing/ leading Ethical standards/ behaviour Communication Supervision Communication and supervision – two of the extrinsic factors relating to coaching, instructing and leading – are considered in more detail here. Communication Effective communication is essential to reduce the risk of injury. Communication skills include being a good listener and the ability to build rapport with players. Being clear visually and verbally when explaining a technique also means a performer will understand what the coach is trying to tell them or show them. This enables them to learn: • the correct technique • the correct rules/regulations • when to use different techniques • positive ethical standards and behaviour.

Supervision Appropriate leadership skills will help to keep the session injury-free, so the players remain safe. Some sports require less supervision, such as table tennis, although the coach should still be present to monitor and feedback on technique. Higher risk activities such as gymnastics need a greater, closer level of supervision. A properly supervised session means that the coach can see how capable the performers are, allowing the coach to set age- and skillappropriate practices. DRAFT

Practise it!

An instructor is teaching a group to swim. Using an example, explain how good communication reduces the risk of injury for the swimming group. (2 marks)

Remember it!

• Each of the extrinsic factors stated in the diagram above can influence each other. • For example, communication can influence how well rules are understood, and experience can influence the quality of communication.

What you need to know

• How the extrinsic factors relating to coaching, instructing and leading can influence the type and severity of injury.

Technique, rules, regulations

• Think of an Olympic weightlifter attempting to lift 200 kg overhead or a trampolinist attempting a double somersault: an error in technique would result in severe injury for either performer. • Rules and regulations are in place to make the game entertaining, but they also to make it safe for the players. For example, in football, rules are designed to protect – therefore players are penalised for using excessive force (kicking, tripping, holding or biting). • In the UK, 6000 people were asked about their sports injuries. Those surveyed felt that a lack of appropriate application of safety rules accounted for 14% of the injuries. Ethical standards/behaviour As sports performers, we are all expected to display: honesty, integrity, responsibility, self-discipline. When we play sport, whoever is teaching or leading us should reinforce these values. If we play fairly, we are less likely to injure ourselves and others. Rules of a sporting activity help to direct our behaviour, such as the requirement to follow the rules to be allowed to play. As dangerous behaviour is against the rules of many sports, this reduces the risk of injury, although some performers still behave outside of the rules and cause injury to others. An example of rule-breaking and dangerous behaviour is Mike Tyson biting off part of Evander Holyfield’s ear in a 1997 boxing match.

Experience Our experience and the experience of those teaching us will also increase or decrease the risk of injury during sporting activity. If we are new to a sport, the coach must make sure we learn techniques correctly. They should ensure that we play with others of similar experience. Imagine the New Zealand rugby squad playing against a local inexperienced team: the risk of injury would increase dramatically! With greater experience, coaches may learn the best ways of maintaining safety in terms of the techniques they teach. It is also important that experienced coaches attend coaching updates to make sure they remain knowledgeable about the best ways to keep their players safe. Remember it!Revise it!DRAFT Give an example of how each of the extrinsic factors of coaching/instructing/leading could increase or decrease the risk of injury in a sport of your choice. There are five extrinsic factors associated with coaching/instructing/leading: 1 Communication 2 Supervision 3 Knowledge of technique, rules and regulations 4 Ethical standards/behaviour 5 Experience

What you need to know

• How the extrinsic factor of the environment can influence the type and severity of sporting injury.

Environment

The influence of the environment on risk and severity of injury is summarised below.

Weather/temperature conditions Some weather conditions just make the activity harder to play, while others affect the potential for injury, such as icy tennis courts and strong winds if sailing.

Playing surface and surrounding area

• Different types of playing surfaces affect risk. For example, in football, grass (a natural surface) has less risk than some types of artificial surfaces. • It is important to have the correct footwear for the playing surface. Without this, the risk of injury increases. • The surrounding area can also be hazardous. For example, the metal frame of a trampoline needs padding. Human interaction • Other performers/participants – even in individual events. For example, in the 5000m run, other participants can cause injury with their spikes if the runners are close together. • There is a greater risk of injury in team and contact sports, for example boxing and rugby, because of the contact between players. • Officials should lower the risk of injury by enforcing safety rules. • Spectators may cause participants to try too hard, making them more reckless. Spectators may even be hurt, for example if they are struck with a golf ball. Risk of injury Long-distance athletes often prefer to complete their events in the cooler parts of the day to avoid becoming too hot and getting exhausted. Think about the following sports and how the playing surface alters the risk of injury: • grass court tennis vs tennis on a hard court • swimming in a pool vs open water swimming • field hockey vs ice hockey. Human interaction in sport, team games and contact sports will introduce a greater risk of injury because of interaction with the other participants.

Severity of injury Just because there is an increased risk of injury, doesn’t mean the injury will be more severe. Normally, as the risk of injury increases the severity of injury – or how bad the injury is – reduces; otherwise, people would stop playing. For example, playing hockey on ice increases the risk of injury from falling, but the padded clothing worn by the players helps to reduce the severity of the fall. More extreme activities like skydiving should have a low risk of injury, due to the safety checksDRAFT carried out before the jump. The environment is another extrinsic factor influencing the risk and severity of injury. The environment means: the weather and temperature, the playing surface, and the level of human interaction during the activity.

Practise it!

Describe one way that a cold, icy day could increase the risk of injury in a game of rugby or netball. (2 marks)

Remember it!

What you need to know

• How the extrinsic factor equipment can influence the type and severity of injury.

Protective equipment Performance equipment

Protective equipment makes it safer for performers to participate in sport. For example: • Padding placed around posts that are on or near the field of play, such as around rugby posts or the metal structures supporting chair lifts on ski-runs, reduce the impact if performers run into them. • Buoyancy aids such as life jackets are used to keep people afloat if they fall in the water during water sports, to prevent drowning. Performance equipment helps sports players to train harder and play better. For example: • In tennis, the use of a machine ball feeder allows the player to practise shots to improve their technique. • Weights designed to be worn on the soles of the shoes allow players to strengthen their legs and jump higher when they are not wearing them.

Clothing Clothing and aid performance, such as a streamlined swimsuit that cuts down on drag (water resistance). Specialist clothing is also designed for safety, for example: • Specialised gloves in sports like cricket and baseball protect the hands of the players from being struck by the ball when it is travelling at high speed. • Safety glasses worn by squash players stop the ball entering the eye. • Equipment is an extrinsic factor that can influence the risk of severity of injury. • Equipment is designed to help performance as well as providing protection while playing.

Footwear Lightweight trainers increase the players speed and performance, whatever the sport. Specialist footwear also has safety benefits, for example: • Ski boots prevent movement at the ankle, so the skier is less likely to break a bone when they fall. • Football boots and rugby boots have special mouldings or studs designed to give the player better grip with the ground, so they don’t slip. DRAFT

Practise it!

Using a named contact sport, state two pieces of protective equipment or clothing. (2 marks)

Remember it!

What you need to know

• How the different extrinsic factors influence each other • How the extrinsic factors compare and contrast to each other in influencing risk and severity of injury.

Although some sports, such as rugby, seem to present a greater risk of injury, appropriate management of the other extrinsic factors make the sport far less dangerous than activities such as road cycling where it is harder to control all the extrinsic factors (for example, other traffic).

Influence of extrinsic factors Rugby is a type of contact sport which increases the risk of injury. The other extrinsic factors influence the risk due to the type of sport and make it safer. For example: Extrinsic factor Influence Example Coaching/ instructing/ leading Coaches teach correct techniques The scrum technique reduces risk of neck injury. Coaches teach players appropriate behaviours on the pitch Coaches teach discipline, reducing aggression on the pitch. Environment The match official checks the playing surface before the game To check the pitch is not frozen. To check there are no hazards on the pitch. The match officials enforce the laws of the game Enforced laws include no tackling above the shoulder, reducing the risk of neck injury. Equipment The match official checks equipment Checks there is padding around the goalposts and that the players kit is compliant with the laws of the game. Compare and contrast Different extrinsic factors have a greater influence on risk and severity of injury depending on the type of sport. For example: Type of sport activity Extrinsic factor with greatest influence on risk and severity of injury Reason Skydiving Equipment, protective equipment If the parachute malfunctions the skydiver could die from the impact injuries when they land. MMA Environment, other performers The opponents will be trying to hurt each other in order to win. Gymnastics floor routine Coaching/instructing/leading, knowledge of techniques

If the coach does not teach the correct DRAFT techniques the gymnast will become injured when attempting tumbling.

Practise it!

State three things you can do as a player in a team sport to reduce the risk of injury to you and others during a game. (3 marks)

Remember it!

• The different extrinsic factors all influence each other. • By changing an extrinsic factor, you can alter the amount of risk of injury.

What you need to know

• The intrinsic factors that can influence the risk and severity of injury within sporting activity.

Intrinsic factors relate to us, rather than the sporting activity we are participating in. There are four types of intrinsic factors: individual variables, psychological factors, reasons for aggression and mental strategies.

Influence Each type of intrinsic factor can affect the risk and severity of injury. For example: • The technique or ability of a person (individual variable) will alter the risk. For example, an experienced trampolinist completing a summersault should have a lower risk of injury than a beginner trying the same movement. • Weight (individual variable) can also affect the risk of injury. For example, there is thought to be a higher risk of injury among underweight and overweight runners due to the forces acting on the skeleton when running. Individual variables Some individual variables, such as gender and age, have most influence if competing against others who are a different gender or age. This is normally due to the differences in physique of the players: the smaller player being at greater risk of injury in contact sports such as boxing or rugby. Therefore, for these sports, teams are not mixed and are for specific age groups. The individual variables that influence the risk of injury are: • age • experience • weight • fitness levels • technique/ability

• nutrition/hydration • medical conditions • sleep • previous/recurring injuries • gender. • Intrinsic factors are internal to Remember it! 1 Create a diagram to show which individual Revise it!DRAFT variables could influence other individual the performer. variables – for example, age could • There are four groups of intrinsic factors: influence the amount of experience individual variables, psychological someone has. (Remember: not all variables factors, reasons for aggression and will influence other individual variables.) mental strategies. 2 Explain each of the links in your diagram – • Intrinsic factors influence the risk of injury. for example, a younger person might • Some individual variables influence other not have played a sport for as long as an individual variables. older player.

What you need to know

• The individual variables that can influence the risk and severity of injury within sporting activity.

Nutrition Hydration

Nutrition is about all the things we eat. We should all have a balanced diet that gives us the correct mix of nutrients. The food we eat:

• provides energy for exercise • helps our muscles to recover from exercise • helps us to remain healthy and focused. Without the correct nutrition, we increase the risk of injury. For example: • lack of nutrition for muscle recovery/repair • poor decision-making because of low energy can lead to accidental injury • lack of bone density, resulting in more brittle bones and increased risk of stress fractures.

Medical conditions Medical conditions can increase the risk of injury, although participants usually put measures in place to minimise these risks. Medical condition Risk Diabetes Performers’ blood sugar levels may become too low, risking hypoglycaemia. Epilepsy Performers may experience seizures, increasing the risk of drowning if swimming alone. Sudden cardiac arrest (SCA) Although uncommon, sudden loss of heart function can result in death, during or after exercise. Hypothermia If a performer’s body temperature falls below 35°C due to prolonged exposure to the cold, they may become confused or even lose consciousness.

Hydration is about making sure we drink enough liquid each day. It is recommended we drink a minimum of 6–8 glasses of liquid a day, and more if we are exercising. Without enough fluid we risk becoming dehydrated, which increases the risk of muscle strain, heat exhaustion, dizziness and nausea. Sleep A lack of sleep has been linked to increased risk of injury in sport. This may be due to: • reduced reaction times, making it harder to avoid another player • a lowered immune system, meaning participants are more likely to pick up colds • lack of time for muscle recovery after exercise, so increasing risk of muscle injury. Previous/recurring injuries The risk of future injury increases if we have been injured in the past. This could be due to not correcting the error that caused the injury to begin with. For example: • overloading our bodies in training • insufficient time for recovery • not being fit enough at the start of the playing season • poor technique. DRAFT

Practise it!

Using a practical example, describe how dehydration could increase the risk of injury. (2 marks)

Remember it!

• It is essential to have a balanced diet and drink enough fluids to remain hydrated. • Rest is critical to enable recovery.

What you need to know

• The psychological factors that can influence the risk and severity of injury in sport.

Psychological factors Motivation

Psychological factors can affect the risk and severity of injury. Motivation is what drives us to do something. It is easier to act if we are highly motivated, and harder to act if we are not motivated.

If motivation levels are too high when we play sport, we can become reckless. This means we may go into a tackle too aggressively or without the correct technique. This could cause an injury to an opponent or to ourselves. Performing with a low level of motivation can also increase the risk of injury, for example, not going into a tackle with enough effort or having a lack of concentration that leads to an error in technique.

Aggression Confidence Anxiety/stress Motivation

Psychological factors Arousal

Arousal Arousal shows how motivated we are. Controlling our arousal level is a good way to improve our performance and reduce the risk of injury. Different types of sports require different levels of arousal. For example, putting in golf will require relatively low levels of arousal compared to tackling in American football.

Anxiety/stress Some people are naturally more anxious than others, but in some sporting situations anyone’s anxiety can increase, for example: • before taking a match-winning penalty • performing in front of a large audience • playing at trials to get into a higher team. Uncontrolled levels of anxiety could affect the performer’s concentration and increase the risk of injury through poor technique or poor judgement. A drop in technique can also lead to a drop in confidence, increasing anxiety further. • Motivation is the thing that energises us to Remember it! 1 Create a personal profile based on the Revise it!DRAFT following psychological factors: do something. • How motivated are you when you play? • If our level of motivation or arousal is too low • Do you get stressed/anxious? or too high our performance will suffer, and the risk of injury will increase. • How confident are you when you play? • Different sporting situations can increase our • Do any individual variables affect the level of anxiety/stress. psychological factors? 2 Compare your profile with that of another class member who plays a totally different sport.

Are there differences in your profiles? Who has the greatest risk of injury?

What you need to know

• How aggression and confidence can influence the risk and severity of injury within sporting activity • The two types of aggression: channelled aggression and direct aggression.

Direct aggression Channelled aggression

The rugby player who is trying to hit the other player in the photo below is demonstrating direct aggression. This type of aggression involves physical contact and is against the rules of the game. In some sports, aggression is acceptable and within the rules of the activity. For example, in boxing and martial arts, where the aim is to hurt the opponent to win. Aggression is any behaviour where there is intention to injure or harm another player.

Confidence When someone is feeling confident, they feel good about their ability to play well. Our self-confidence can vary depending on the sporting situation we are in. Are there times when you feel more confident within your activity? Maybe you feel more confident when playing a weaker opposition? Our self-confidence links to our motivation, arousal and anxiety levels. The greater our self-confidence, normally the more motivated we are to perform. However, in the same way that we can become over-motivated or over-aroused, we can become over-confident. This can have a negative effect on our performance and cause us to become anxious, meaning we lose focus, our performance becomes worse and the risk of injury increases.

Poor performance

Increased risk of injury

Drop in confidence Increase in anxiety DRAFT

Practise it!

Explain the difference between direct and channelled aggression. (2 marks)

Remember it!

• Aggression is the intent to harm. • Direct aggression is outside of the rules. • Channelled aggression is within the rules of some sports.

What you need to know

• The reasons why people become aggressive when playing sport.

It is important to know the difference between aggression and assertion. Players need to be assertive in games – they need to be forceful – but this needs to be within the rules of the game.

Level of performance Many factors affect how well we play, for example: • the quality of the opposition • our level of fitness • our preparation for the game (nutrition, hydration, sleep). If we begin to play badly, we might start to become frustrated with our game. If our opponent is the reason for the bad play – for example, if they mark so well in football that we cannot get into a scoring position or we keep losing possession – then our frustration may become directed towards our opponent. If this happens, we are at risk of acting aggressively towards them. Retaliation Some performers deliberately set out to upset their opponents. This could be through shirt holding or pushing when the official isn’t looking, or through hurtful comments. Whatever the method, the purpose is the same: to make the opponent lose focus and play badly. Depending on their personality, the player may react badly to this type of behaviour and retaliate by becoming more aggressive. There have been very clear examples of retaliation in professional sport, for example: Zinedine Zidane’s head-butt in the 2006 World Cup final, after which he was sent off.

Pressure to win and PEDs The importance of the outcome of a sporting situation will increase the pressure on players to perform well. For example, there will be much more pressure on players before a cup game than a friendly game. The pressure to perform well can come from the performer, the coach, or from spectators (such as parents and fans). The increase in pressure can make players more aggressive.

Performance enhancing drugs, or PEDs, can also increase aggression. Anabolic steroids in particular are associated with aggression. Officials The quality of the officiating of a game will affect aggression levels. Well-managed games will reduce aggression, but if a player feels there have been several poor decisions in favour of the opposition, they might become aggressive.DRAFT

Practise it!

State how the quality of the opposition can influence an opponent’s level of aggression. (1 mark)

Remember it!

Factors that increase aggression in sport: • level of performance • retaliation • pressure to win • poor officiating • performance enhancing drugs (PEDs).

What you need to know

• The methods we can use to help reduce the risk of becoming aggressive due to over-arousal or loss of focus, and being injured or causing injury as a result.

Control Mental rehearsal

There are many things that could cause us to become aggressive in sport. These factors, or triggers, can occur before or during play. We need ways to combat them so we do not become aggressive. This will allow us to play at our best and reduces the risk of injury.

Mental rehearsal Imagery Mental strategies Selective attention Mental rehearsal is where the performer imagines themselves performing in the activity they are about to play. This could be: • navigating the turns on a slalom ski course • the routine they are about to perform in gymnastics • a tactic they have been working on for a goal line pass or corner kick • any isolated technique they are worried about performing. Mental rehearsal allows the player to mentally practise performing a task. This can increase confidence, allowing them to cope with anxiety.

Imagery Imagery is a type of relaxation technique. The performer creates pictures in their mind to help reduce anxiety levels and therefore control their arousal. This helps to increase confidence and reduces the risk of the player becoming aggressive when they start to play. The images could be, for example: • pictures of places where they feel calm, such as the beach, away from the pressure of competition • recreations of past successful moments in games, such as perfect executing a skill.

Selective attention Selective attention is a process that allows the performer to filter out anything irrelevant to the performance. This might be: • the crowd • negative comments from the opposition • information on the side of the playing area • other players on a neighbouring pitch or court. Selective attention enables the performer to increase their focus on the things most likely to bring them success – that is, what they need to do. For example, in a game of tennis, the performer DRAFT may focus their attention on the position of the opponent’s racket as they hit the ball, so they can respond more effectively to the shot.

Practise it!

Explain one advantage to a sprinter of using selective attention on the blocks at the start of the race. (2 marks)

Remember it!

The mental strategies to help us focus and reduce the risk of us becoming aggressive in sport are mental rehearsal, imagery and selective attention.

What you need to know

• How extrinsic and intrinsic factors create different levels of risk in different types of sport.

Low-risk factors

Played indoors in a temperature- Low level of controlled ability just means environment on a loss in this sport specialised and not injury. flooring. If over-aroused, Poor coaching players may lack may lead to poor focus on cues from performance their opponent rather than and play wild injury. shots, but this has limited injury risk.

Minimal equipment required. Players are wearing appropriate clothing and footwear. High-risk factors

Poor coaching If over-aroused, may lead to hiker may lack serious injury, focus, resulting for example if in poor route the rope is selection that incorrectly secured. may lead to a fall.

High risk due to extreme cold and risk of falling great heights. Low level of ability makes errors more likely, which could result in a fall.

Due to hazardous nature of activity, it requires specialist safety equipment, such as a harness and ice pick. DRAFT

Revise it!

Think of two other contrasting sports and compare how different examples of the extrinsic and intrinsic factors affect the risk involved in each activity.

Remember it!

The same risk factor, e.g., the environment, can create a different level of risk depending on the sport and the other extrinsic and intrinsic factors.