Should Musculo-Skeletal Screening for Injury Risk Include Assessment of Athlete Self Confidence? (Or Should Coaches Receive Training in Understanding Athlete Self-Efficacy?)

Does Athlete Low Self-Efficacy Predict Injury?

A very interesting articlein the British Journal of Sports Medicine, and subsequent NY Times review , which I found by way of the excellent site The PT Project.

As a Sports Physiotherapist of over 20 years, it is extremely interesting that my profession and indeed the sports science and coaching community have, and continue, to search for predictive factors of injury via musculoskeletal screening.

Indeed, as world renowned Australian Sports Physiotherapist Peter Blanch so aptly noted of musculo-skeletal screening in 2004; the holy grail is the ability to use a set of musculoskeletal tests to predict the likelihood of future injury or poor performance in athletes”. However perhaps we should make a shift and think outside the box , considering not only physical characteristics of the athlete, but also emotional and psychological well being. Whilst these thoughts are certainly not new (and athlete monitoring software used by many professional clubs does take into account athlete well being to assist in the prevention of over-training), my experience in Elite Rugby League would suggest that coaches do not necessarily consider the need for consideration of athlete’s sense of “self confidence” in performance or injury prevention. In my experience many coaches and sports scientists (at least in Rugby League) require education (and readiness to be educated) on the requirements of sports specific behavioral screening tests that may compliment musculoskeletal screening to predict performance and risk of injury. I do find it incredible that enormous funds are invested in training facilities and equipment, whilst findings such as those in the study reviewed note that the utilization of a low cost athlete questionnaire suggest that those athletes who had a low self-efficacy score on the health questionnaire were almost twice as likely to be injured as those who had scored high on that measure.

Clearly performance, and injury prevention, is not just a matter of bigger, stronger, faster, and coaches and teams, in searching for that “extra 1-2%” in performance achieve more by understanding the need to train, not only physical performance, but equally importantly, self-efficacy. Indeed, what is obvious from the research is that to achieve ultimate performance in a team environment a coach needs not only tactical and technical knowledge and expertise of the sport, but behavioral science training and support to ensure that communication and management of players is designed and executed to facilitate maximum athlete self-efficacy.

The take home message here- a “winning coach and team” not only performs in a physically superior way, but exhibits and encourage behaviors that support athlete self-efficacy.


Blanch,P (2004). “It’s Time to Screen Screening” Sportslink: Sports Physiotherapy Australia Jan: p.1,4-5

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