MINDFULNESS: A NEW CONCEPT IN THE SPORTS INJURIES’
PREVENTION?
Solé, S., Palmi,J. (PhD)
INEFC, Lleida University, Lleida, Spain
Introduction
Methods
Mindfulness is defined as the nonjudgmental focus of one’s attention on the experience that occurs in
the present moment (Kabat-Zinn, 1990).
There are many mindfulness-based therapies such as Mindfulness-based Stress Reduction or MBSR (
Kabat-Zinn, Op. Cit) and Mindfulness-based Cognitive Therapy or MBCT (Segal, Williams, Teasdale,
2002) and they are being used for different health problems such as chronic pain, anxiety and
depression, stress, psoriasis or cancer.
The aim of this study is to identify the actual use of mindfulness therapies in sports psychology and to
investigate the possible aplications of this concept in the prevention and treatment of sports’ injuries.
A literature research was undertaken using Medline, Psychinfo, Web of Science,
Cochrane, Ebscohost, Isi Web of Knowledge databases and references of retrieved
articles. The search included original articles, books and dissertations published up to
2012. For the final selection the books and dissertations were excluded. The main
search terms were mindfulness, sports, stress, sport injury, and risk factor, in different
combinations as needed. All articles were coded for their design, type of control,
study population, and outcome measures. Seven studies were considered eligible for
the present review and are presented in the next table.
STUDY
MINDFULNESS-BASED
INTERVENTION
NUMBER/CHARACTERISTICS OF SUBJECTS
STUDY
DESIGN
CONTROL
GROUP
EVALUATION
SCALES
MAIN FINDINGS
Gardner and Moore, 2004
MAC
Case study 1: 22 year-old intercollegiate swimmer. The
A Mindfulness-Acceptance-Commit ment- 12 sessions. 1 session per week.
protocol was extended by 4 weeks during the competitive
Based approach to athletic performance 1 hour per session
sesssion
enhancement: theoretical considerations. 5 phases: Psychoeducation, Mindfulness,
Value identification and commitment, Case study 2: 37-year-old master's-level female powerAcceptance, Integration and practice
lifter
N=1
PSWQ, SAS, AAQ-16Case study 1:
Performance: best competitive season, winning two meets and achieving two personal-best times
Psychological skills: 39% less in anxiety (PSWQ, SAS) and a 38,2% less in experiencial avoidance (AAQ)
Case study 2:
Performance: best performance and lifted 15% beyond her best master’s level competitive performance
Psychological skills: a reduction of 55,5% in anxiety (SAS) and 44,1% in experiencial avoidance ( AAQ)
Lutkenhouse, 2007
MAC
The case of Jenny: a freshman collegiate 8 sessions. Exercises to do between
athlete experiencing performance
sessions
dysfunction
Some contacts by e-mail after protocol.
N=1
SPQ, YSQ-SF,
Performance: reduction of 25 seconds in her best mile run time. A 61,5% increase in scores performance
PSWQ, SAS, AAQ-R (SPQ). She no longer met criteria for Performance Dysfunction.
Self –evaluation: personal and sportive growth and development, improvement of performance and her
capacity to handle frustration.
Case study 1: qualitative interviews
19 year-old female lacrosse player classified as
experiencing performance dysfunction by the Multilevel
Classification System for Sport Psychology (MCS-SP)
Case study 1: 10 elite swimmers. 40% women.
Case 1:
Bernier et al, 2009
Qualitative
Mindfulness and Acceptance approaches Case study 2: MAC
Case study 2:
interviews
in sport performance
4 introductory sessions. 1 session every 7 elite young golfers (experimental group). 28,5% women Case 2:
month.
6 elite young golfers (control group). 16,6% women
Quasi Exp
Applied exercise was implemented during
the competition period
Kauffman et al, 2009
MSPE
Evaluation of Mindful Sport Perfor mance4 sessions. 1 session per week.
(MSPE): a new approach to promote flow2,5-3 hours per session
in athletes
N= 32/29 . 28,1% women. Amateur athletes from
Washington
21 golfers/2 dropouts
11 archers/1 dropouts
Only 11 athletes completed the 4 sessions
Quasi
Experime.
Schwanhausser, 2009
MAC adapted (7 phases)
Application of the Mindfulness9 sessions. 1 session per week
Acceptance-Commitment (MAC) protocol 45 minuts per session
with an adolescent springboard diver
12 year-old male, high level springboard and platform diver
N=1
13 high level university athletes, average experience of
8,69 years. Participants of different sports.
Experimental group: 6 (33,3% women)
Control group: 7 (28,5% mujeres)
Experimen.
RCT
From the original 52 athletes 25:
4 archers, 8 golfers and 13 long-distance runners
participated in the one-year follow-up of this study.
Quasi
Experim.
Aherne, Moran, Lonsdale, 2011
The effect of mindfulness training on
athletes’ flow: an initial investigation
Mindfulness
training
inspired
in
Mindfulness-Based
Stress
Reduction
(MBSR)
6 sessions. 1 session per week
Daily work with CD
Thompson et al, 2011
MSPE
One year follow-up of Mindful Sport
4 sessions. 1 session per week.
Performance Enhancement (MSPE) with 2,5-3 hours per session
archers, golfers and runners
* See De Petrillo et al, 2009 and Kaufman
et al, 2009
Traditional
psychological
skills training:
goal setting,
imagery, …
OMSAT-3
Case study 1: improvement in the nine flow dimensions (Jackson and Csikszentmihalyi, 1999) and the finding
of a new characteristic: the awareness and acceptance of their bodily sensations during the preperformance
moments.
Case study 2: The coaches emphasized that the 57,1% of golfers in experimental group became more aware
and lucid in their approach to golf and said the intervention was usedful and relevant.
Performance: the 66% of golfers in experimental group improved their national rankings
Psychological skills evaluated with the OMSAT-3 improved significantly in experimental group (p<0.03)
BQ, SAS, MPS, CSCI,Performance: no significant diferences pre-post intervention. The athletes’ opinion about the workshop’s
TOQS, KIMS, DFS- influence on their performance was 6,62 (0-10), and their satisfaction level with their performance increased
W, CEM, TMS, DML, significantly (p<0.01) after workshop.
DSPL, FSS-2, EXT Phsychological skills: no significant diferences in golfers. In the archers significant disminution (p<0.10) of
thought ocurrence (TOQS), increase (p<0.10) of self-conficence (CSCI) and significant increase (p<0.01) of
mindfulness levels (KIMS, TMS). State psychological skills: significant increase of mindfulness level in
archers (p<0.10) and flow level in all athletes (p<0.05).
PCQ, PHMS, SAS, Performance: an increase of 73,3% (PCQ)
AAQ-2, MAAS, FS Psychological skills: increase of a 23% in mindfulness (PHMS y MAAS), a 35,1% in acceptance (AAQ), and a
6,6% in flow levels (DFS-2, FSS-2). Disminution of a 6,4% in anxiety (SAS)
The same
information but
had no contact
with the
teachers.
FSS-2, CAMS-R
Flow: significant increase (p<0.05) in the experimental group (CAMS-R y FSS-2)
The increase in FSS-2 global scores from Time 1 to Time 2 was large (p<0.01) for the experimental group and
non significant (p>0.05) for the control group.
Additional research is needed to investigate the cognitive benefits of mindfulness training and its potential to
increase sport performance
AQ, GQ, RQ, CEM,
FQ, FQ-R, KIMS,
TOQS, SAS, CSCI,
DFS-2, MPS
Performance: athletes’ scores were significantly lower during the year after the workshop: p=0.041 in golfers
and p=0.038 in long-distance runners. In a Likerst scale from 0-5 asking about the performance’s change
during the last year, the mean result was 3,62 and most of them (3 in the Likert scale) said that the changes
could be attributed to the MSPE workshop.
Psychological skills: significant increase (p=0.034) in flow levels (DFS-2), Mindfulness levels (p<0.01)
measured with KIMS and significant decrease (p<0.05) of anxiety (SAS)
SCALES: PSWQ (Penn State Worry Questionnaire), SAS (Sport Anxiety Scale), AAQ-16 (Acceptance and Action Questionnaire), SPQ (Sport Performance Questionnaire), YSQ-SF (Young Schema Questionnaire-Short Form), AAQ-R (Acceptance and Action Questionnaire-Revised), OMSAT-3 (Ottawa Mental Skills), BQ (Background Questionnaire),
TOQS (Thought Ocurrence Questionnaire for Sport), MPS (Multidimensional Perfectionism Scale), KIMS (Kentucky Inventory of Mindfulness Skills), CEM (Workshop and Expectations Measure), TMS (Toronto Mindfulness Scale), PQ (Postworkshop Questionnaire), DFS-2 (Dispositional Flow Scale-2), DML (Daily Mindfulness Log), DSPL (Daily Sport
Performance Log), FSS-2 (Flow State Scale-2), EXT (Exit Questionnaire), PCQ (Performance Classification Questionnaire), PHMS (Philadelphia Mindfulness Scale), AAQ-2 (Action and Acceptance Questionnaire-2), MAAS (Mindfulness Attention Awareness Scale), CAMS-R (Cognitive and Affective Mindfulness Scale-Revised) , AQ (Archery
Questionnaire), GQ (Golf Questionnaire), RQ (Runner Questionnaire), FQ (Follow Up Questionnaire), FQ-R (Follow-up Questionnaire for Runners) , CSCI (Carolina Sport Confidence Inventory).
Discussion and Conclussions
References
The use of mindfulness in sports psychology is very new and it’s been focused in enhancing athletes’ performance
(Birrer, 2012) In our review we observed the next findings: there are a few number of studies, with little samples and
most of them are nonrandomized studies. We also find three case studies. Most of them use two new mindfulnessbased interventions: MSPE and MAC, with a very well defined intervention protocols.
Birrer, D., Rothlin, P., & Morgan, G. (2012). Mindfulness to enhance
athletic performance: theoretical considerations and possible impact
mechanisms. Mindfulness. DOI 10.1007/s12671-012-0109-2
There is not yet sufficient evidence to determinate the magnitude of the effects of these interventions due to the
methodological limitations of the studies. But the results could suggest that these two mindfulness-based interventions,
the Mindfulness-Acceptance-Commitment-Based Approach (MAC) and Mindfulness Sport Performance Enhancement
(MSPE) can be helpful to enhance performance in sport. They also increase the levels of mindfulness, concentration,
acceptation, sense of control, awareness of bodily sensations and decreases the stress and anxiety levels. These are
important variables and risk factors for sports’ injuries prevention and rehabilitation as well.
To our knowledge, there are no studies using these interventions to prevent sports’ injuries but the influence of psychosocial factors is well known (Andersen & Williams, 1993, Heil, 1993, Palmi, 2001). The benefits for the athletes of this
new psychological approach in different variables such as concentration levels, mindfulness, acceptance or anxiety
levels could be used in the prevention and treatment of sports’ injuries. They are being used only to enhance
performance for the moment.
New mindfulness-based interventions for prevention and treatment of sport’s injuries, adapted to different sports and
athletes are suggested and will be the objective of future studies.
CONTACT ADRESSES
jpalmi@inefc.es
ssole@inefc.es
Gardner, F., & Moore, Z. (2009). A Mindfulness-Acceptance-CommitmentBased approach to athletic performance enhancement: theoretical
considerations. Behavior Therapy, 35, 707-723.
Jackson, S.A., & Csikszentmihalyi, M. (1999). Flow in sports: The key to
optimal experience and performances. Champaign, IL: Human Kinetics.
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your
body and mind to face stress, pain and illness. New York: Delacourte.
Kauffman, K., Glass, C., & Arnkoff, D. (2009). Evaluation of Mindful Sport
Performance Enhancement (MSPE): a new approach to promote flow in
athletes. Journal of Clinical Sports Psychology, 4, 334-356.
Palmi, J. (2001). Visión psico-social en la intervención de la lesión
deportiva. Cuadernos de psicología del deporte, 1, 69-80.