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Injury-Proneness is the state of having a high likelihood of being injured. People who are subject to high rates of injury are usually described as "injury-prone". Although this term is usually used to refer to an athlete, it can also be used to describe non-athletes as well. This term is often used to label athletes who are injured frequently preventing them from playing their respective sport. Research has been done in order to identify the reasons behind an injury-prone athlete. There are physiological and psychological variations between athletes and some variations lead to a higher likelihood of injury. Some physiological variations include different body structures and bone density. Some psychological variations include personality traits and anxiety. Some injuries become more apparent based on the type of sport played by the athlete.

Causes of Injury-Proneness

Physiological Causes

In a study done by Stanford University’s department of developmental biology and genetics, the genes responsible for the production of collagen, the main component of tendons and ligaments, were found to be less in those who had suffered ACL injuries. The specific gene observed is named COL1A1 and has been linked to other soft-tissue injuries. A correlation was found when these subjects who had torn their ACL were four times more likely than uninjured study subjects to have a blood relative who suffered the same injury. This suggests that genetics are partly responsible for ACL injuries. Most human traits are influenced by multiple genes and it was discovered that COL5A1 gene was also linked to a higher risk of injury in the ACL, Achilles tendon, and higher risk of muscle cramps. More research was done on runners in the Two Oceans Marathon in South Africa and found that those with muscle cramps had a strong correlation with the COL5A1 gene. Genetic markers have been identified to be correlated with bone-mineral density that allows clinicians to identify the risk of bone fractures. In a study from the BMC Genetics journal, one gene combination was associated with a risk of stress fracture that was four times higher. In another study from the Archives of Pediatric Adolescent Medicine, osteoporosis and an increased rate of stress fracture in young women ran in the family.

Psychological Causes

Personality traits have been correlated with higher rates of injury. In one study, personality tests were given to runners suffering from tibial stress fractures. These personality tests were used to categorize these runners into a Type-A or Type-B personality. It was found that those with a Type-A personality were more likely to develop stress fractures. These runners were characterized with an internal locus of control meaning they would attribute their poor performance on their own ability. They were also highly motivated and used running as a method to improve their mood or deal with stress. This motivated the runners to run harder than normal.

Anxiety was also measured as a risk factor in athletes suffering from injury. In one study, 81 soccer players were evaluated with the Competitive State Anxiety Inventory and an injury questionnaire. Traits of anxiety and injury were found to be correlated with one another. The researchers explained this through peripheral narrowing, a symptom of cognitive anxiety, which causes the athlete’s concentration and attention to become lower. The research also found that this psychological factor had somatic factors as well. Somatic anxiety, anxiety with physiological symptoms, lead to more physical effects on the body. Due to high levels of anxiety, the increased autonomic nervous system and behavioral disruptions work with the demands of exercise and can lead to injury. The psychological distress prevents proper muscle growth and repair by stopping catabolic hormones from allowing the body to recover after exercise.

The effect psychosocial risk factors play on injury risk was investigated on athletes who had suffered an injury in the following days of a psychosocial risk factor which is any event that affects the person’s psychological response in their area of work. After interviewing these athletes, four themes were found that were linked to injury occurrence: history of stressors, personal factors, fatigue, and ineffective coping. If a person had a high history of stressors, the amount of stress the athlete was put under was higher leading to worse health and a higher risk for injury. Personal factors, especially low motivation, played a role as athletes who had low motivation for the sport trained poorly. Low motivation leads to a lower self-esteem and well-being of the athlete. Fatigue played a role in injury as a fatigued state caused decreased performance leading to a higher risk for injury. The athletes with less coping mechanisms were subject to higher levels of stress and anxiety which are correlated with a higher risk of injury.

A trend of injury was noted in athletes with concussions. In one study, athletes who played soccer, hockey, handball, and floorball were monitored and the athlete who sustained a concussion had a higher risk of injury afterwards their concussion but the risk did not increase before the concussion. The researchers made the conclusion that the risk of injury was not due to the concussions themselves but rather on the higher risk behavior these athletes showed. These athletes regardless of sex or gender played more aggressively and made risky plays that placed them in dangerous scenarios.

Types of Sports and Injuries

Football

Reggie Bush, an NFL player who has struggled with injuries throughout his career

Specific sports have a higher correlation of specific injuries. In football, the injuries can be divided into four categories: traumatic injuries, concussions, overuse injuries, and heat injuries. Traumatic injuries can be divided into two more categories: knee injuries and shoulder injuries. Concussions are a change in mental state due to impact to the head. Overuse injuries often include back pain due to overuse which does not allow the body to recover. Heat injuries often occur and lead to cramping, heat exhaustion, and heat stroke.

In a study conducted on NFL players, the players’ injury history was analyzed over a period of two years from the years 2009 and 2016. When a player was injured once, the risk of missing time was 35%. When the player was injured twice, the risk of missing time was 41%. When a player was injured multiple times (6+ injuries in two seasons), the risk began to plateau around 55-60%. The research showed that injuries in the same location are correlated with each other such as lower extremity muscles. However, two injuries that did not associate with each other were the face and upper extremity bone and joint injuries.

Soccer

Soccer injuries have a higher correlation with lower body injuries. Some of these injuries include ankle sprain, knee sprain, calf strains, clavicle fractures, foot fractures, kneecap bursitis, and meniscal tear. Upper body injuries include wrist fractures due to falling and concussions due to impact to the head.

Baseball

The most common injuries in baseball occur in the upper extremities. Due to pitchers using their arm extensively, pitchers have a high rate of injury. Common injuries among pitchers include muscle strains, labral tears, rotator cuff injuries, shoulder instabiliy, UCL sprain of the elbow, and the thrower's elbow.

In youth baseball, up to 74% of baseball players (ages 8–18) report arm pain while throwing. 23% of the players report injury histories related to overuse which is the leading factor of injury in youth baseball. The professional level has no correlation between overuse and increased rates of injury possibly due to improved training, preventative methods, and medical staff.