Background Psychosocial factors have achieved growing acceptance in their role in successful return to sport. However, as yet, few studies have demonstrated which of the commonly cited psychosocial variables can most strongly predict re-injury rates in competitive athletes. Understanding this could support clinicians in best directing valuable resource towards the holistic support of injured athletes, with a view to facilitating a successful return to sport.

Objective To examine whether social support, psychological readiness to return to sport and re-injury anxiety can predict re-injury in competitive athletes

Design Retrospective, cross-sectional study.

Setting Competitive sport.

Participants 141 competitive athletes, from a range of sports, aged 19 to 24 years (mean age: 20.1 years; SD 1.1 years; 72 male and 69 female).

Interventions (or Assessment of Risk Factors) Independent variables injury time-loss, perceived availability of social support, psychological readiness to return to sport and re-injury anxiety.

Main Outcome Measurements Re-injury.

Results There was a significant difference (p = <0.001) between competitive athletes who re-injured the same injury versus those who didn’t. Specifically, re-injury anxiety was lower in athletes who did not re-injure, and perceived availability of social support and psychological readiness to return to sport were higher in athletes who did not re-injure. Athletes who did not re-injure also had a longer return to sport. There was no significant difference in injury rates between male and female athletes (p = .105). Regression analysis indicated that 61.9% of variance in re-injury rates was predicted by the included predictor variables, with the most significant predictors of reduced re-injury risk being perceived availability of informational support (p = 0.003) and time out of sport (p= 0.003).

Conclusions Clinicians seeking to reduce the risk of re-injury in competitive athletes should consider strategies to reduce reinjury anxiety and facilitate the provision of social support, specifically the provision of high-quality informational support. Delayed return to sport is also important in reducing the risk of re-injury.