Injuries, Insults and Applause: A focus group study and recommendations for training and resources.

What is the context?

Sport participation is positive for physical and mental health. With rates of mental health difficulty rising among young people – especially since the start of the pandemic – the importance of mentally healthy activities, such as sport, is greater than ever.

But youth sport can also be a mentally challenging environment. Juggling schoolwork, a social life and sport commitments can be stressful – and some styles of coaching and parenting can create extra pressures and worries. These stresses can increase the risk of sport injury, which, in turn, can separate young people from teammates, friends and the sport they enjoy and lead to negative psychological impacts.  

Young people’s perspectives are most often poorly represented in sport governance. However, listening and responding to their experiences and ideas for improvements can help create healthier sport experiences and thriving environments that support long-term participation. To address this need, Podium Analytics and the Centre for Mental Health worked with young people to co-develop four research aims. 

What are the study objectives?

The four research aims for this study are as follows:

1. To explore the psychological impact of injuries leading to time away from sport and how young people deal with these. 
2. To explore what support young people would find helpful when recovering from sports injuries.
3. To identify common sources of sport-related stress.
4. To understand what creates a positive sporting environment for young people

What was our approach?

We developed our research plan with four young people in sport (three females and one male, ages 13–18 years). The group indicated that key issues were being heard by their PE teachers and coaches when they raised concerns about injuries, how injuries made them feel, and what support they receive during injury.

They advised us on how to best construct the focus groups, how to encourage open discussion and how to maintain a safe, youth-friendly environment that would drive engagement. Based on their feedback, we revised the study plan and finalised our research questions to reflect these priorities.

We conducted seven online focus groups, each with between three and six participants (see infographic). Discussions, guided by a schedule of questions, were audio recorded, transcribed and analysed by researchers from Podium and Centre for Mental Health.

Partcipant demographics:

What did we find?

Psychological impact of injuries
Young people described negative responses including anxiety, fear, anger, frustration and loss of identity. Some described returning to sport before they were physically or mental ready. A handful mentioned how time out post-injury provided a breathing space to assess progress and appreciate the importance of sport.

What support would be helpful?
Young people told us they often relied on establishing their own coping strategies when injured because there is little formal, sport-endorsed support available. Their asks included a supportive network of peers and adults, having a return-to-play plan, alternative ways to be involved in sport while recovering, and help maintaining motivation to return to play.  Many reflected that a coaching culture more accepting of time out for recovery would be helpful. 

Sources of sport-related stress
Young people talked about performance-based worries, selection pressure, injury, balancing schoolwork and training, letting others down and competition-related anxiety.

What makes a positive sport environment?
Young people emphasised that coaches, peers and family can all make positive contributions to their sporting experience – and their injury recovery – by being encouraging, inclusive, respectful and well balanced. They wanted to be coached to an age- appropriate standard and intensity.

What are the strengths and limitations of this work?

This project is a step to towards giving young people a bigger voice in sport governance. We spoke to young people from racialised communities, so our findings can contribute to removing barriers to participation in these marginalised groups.

Our sample is relatively small and, as such, should be interpreted with caution: different sports have different patterns of injury, while age and sex may influence what are considered useful coping strategies.

Our recommendations

There is scope to meet the needs identified by young people by giving them the tools to cope with stress in sport, which would help them develop resilience to injury and the rehabilitation process, and enhance their motivation to return to sport post-injury and benefit from long-term participation in sport. 

The needs young people expressed can only be addressed through systems-level change and action by sport National Governing Bodies (NGBs), clubs, schools, coaches, families and young people themselves.

We have developed five recommendations to meet these needs:

1. Co-design of education and training to provide informed, wrap-around support for young people out of sport through injury.
2. Development of peer support for young people experiencing injury-related social or emotional problems.
3. NGBs develop club-based mental health ‘champions’ who can advise young people, coaches and families on return-to-play plans post-injury.
4. Specific injury-related resources for families when children join clubs.
5. An implementation and evaluation framework to monitor progress and support system-wide change.

Project team

• Dr Huong Le, Children and Young People’s Mental Health Researcher, Centre for Mental Health
• Dr Catherine Wheatley, Mental Health & Psychological Wellbeing Manager, Podium Analytics
• Kat Jones, Schools and Clubs Lead, Podium Analytics
• Glenn Hunter, Director of Research and Innovation, Podium Analytics
• Kadra Abdinasir, Associate Director of Policy, Centre for Mental Health

Podium and Centre for Mental Health

Podium conducted the study in collaboration with the Centre for Mental Health, an independent charity that takes the lead in challenging injustices in policies, systems and society, so that everyone can have better mental health. You can read more about their work at https://www.centreformentalhealth.org.uk

What’s next?

We are working to implement the key recommendations for the report. Our initial focus is the development of peer-to-peer resources for young people, the results of which we will share in 2024.