Practitioner Perspectives on the Association Between Mental Fatigue and Injury Risk in High-Performance Sport: A Mixed Methods Study

This study aimed to investigate the perceptions of practitioners involved in injury management within high-performance sport on the potential interaction between mental fatigue and injury risk, including perceived mechanisms. A sequential explanatory design was used, with phase one implementing a cross-sectional survey and phase two utilising semi-structured interviews. An electronic survey of multi-disciplinary practitioners working in high-performance sport, specifically invasion-based team sports, was conducted. Topics included the mechanisms by which mental fatigue may influence risk of injury, potential sex differences, mental fatigue and injury prevention and areas for future research. Preliminary data analysis guided the development of the phase two interview schedule, which aimed to gain a deeper understanding of the association and perceived mechanisms. Forty-five participants completed the phase one survey, and eight participants completed the phase two semi-structured interviews. The primary findings of this study suggest that practitioners working in high-performance sport perceive a link between mental fatigue and risk of injury, primarily acute noncontact injuries. Proposed mechanisms include impaired motor control, poor biomechanics and reduced cognitive function. However, isolating mental fatigue as a direct factor is difficult, due to challenges distinguishing between mental and physical fatigue. The findings of this study indicate practitioners perceive an association between mental fatigue and risk of injury. Future research focused on the mechanisms linking mental fatigue to injury risk is required to empirically examine and determine the validity of this perception. However, athlete management strategies regarding mental fatigue may be incorporated into practice to potentially limit the risk of athlete injury.