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Sexual/physical abuse linked to heightened injury risk among female athletes

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Sexual/physical abuse linked to heightened injury risk among female athletes

Evident for injuries sustained during competition as well as other non-sporting activities

A history of sexual and/or physical abuse is linked to a heightened risk of injury among female track and field athletes, finds research published online in the British Journal of Sports Medicine.

This increased risk was evident for injuries sustained during competition and training as well as for non-sporting activities, the findings indicate.

Several studies have looked at the risk factors for sexual/physical abuse in sport, but few have looked at the potential impact on injury risk both within competition and during other non-sporting activities.

In a bid to address this, the researchers invited 507 of Sweden’s top performing adult and junior field and track athletes to report any sporting injuries which had forced them to drop out of competition and/or training for at least three weeks, and/or any non-sporting injuries, which had required medical treatment within the preceding year.

They were also asked to reveal whether they had ever been sexually or physically abused, and by whom.

Some 197 (39%) complete responses were received, just over half of them from women (53%). The average age of respondents was 23, but ranged from 17 to 37. Most (92%) identified as straight.

Around one in 10 (11%) said they had been sexually abused; women were around three times as likely as men to report this (16% vs 4%).

The perpetrators included coaches and peers (during late teens), suggesting a more nuanced picture than that of the older male coach assaulting younger athletes, say the researchers.

Six athletes (3%) said the abuse had taken place in a sports environment; two said it had driven them to contemplate suicide.

Physical abuse was more common, with nearly one in five (just under 18.5%) saying they had been victimised in this way, and men more likely than women to report this (23% vs 14%). Gay/bisexual athletes were also more likely to report lifetime physical abuse than their straight peers. Physical abusers were predominantly parents/guardians.

The prevalence of sports injuries within the preceding year was just over 55 per cent, and that of non-sporting injuries just under 17 per cent. But striking differences emerged between men and women, analysis of the data showed.

When potentially influential factors were accounted for, physical abuse was associated with a more than 12-fold heightened risk of sustaining a sports injury among female athletes, even though physical abuse was more common among male athletes.

No such heightened risk was observed among the men. And this was 64 per cent lower among those whose parents had fewer than 12 years of formal education.

A history of sexual abuse was associated with an almost 9-fold heightened risk of a non-sporting injury among the women, after taking account of potentially influential factors.

But among the men, frequent drinking was associated with a 6.5-fold heightened risk while getting into athletics after the age of 13 was associated with a significantly lower (91%) risk.

This is an observational study, and as such, can’t prove causality. What’s more, the researchers weren’t able to account for potentially more complex, mediating factors, or the interplay between them.

But they say: “Our results underscore the importance of lifetime abuse and other emotional indicators in the comprehension of injuries sustained by competitive athletes.”

Athletes should be routinely screened for, and encouraged to disclose, abuse, so that they can be offered appropriate help and support, they suggest.

“Just like physical capacities, the competitive athlete’s stress resilience needs to be understood and addressed in educational programming and individual training schedules,” they conclude.

link to paper: https://bjsm.bmj.com/lookup/doi/10.1136/bjsports-2018-099355

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