Perception of injury risk among amateur Muay Thai fighters

Although regular physical activity is widely encouraged for its health benefits, participation in sport is not without risk. Indeed, sports injury is identified as a major public health problem in Western societies. Based on stress theory adapted from earlier theoretical models, (Andersen and Williams 1988; Williams and Andersen 1998) Junge (Junge 2000) proposed an integrative theoretical model of the influence of psychological factors on injury occurrence. Investigations to date have focused on psychological factors associated with the susceptibility to injury during sports participation, namely: psychosocial stressors (e.g., life events and everyday problems), coping resources (e.g., coping skills, social support and health behavior) and personality traits (e.g., general anxiety, competitive anxiety, and mental fatigue).(Junge 2000).

There are, moreover, good reasons to think that athletes’ subjective perception of risk of injury is likely to influence their sports safety behavior. For instance, cognitive-behavioral theories propose that athletes’ decisions are based on assessing the probability of outcomes and consequences of engaging, or not engaging, in a behaviour (Ajzen 1991; Janz and Becker 1984; Siesmaa et al. 2011). This suggests that athletes who underestimate the risk of injury engage in more risk-taking behaviors, whereas athletes who overestimate the risk adopt preventive behaviors. Indeed, studies have indicated that perceived risk is a good indicator of actual risk-taking behaviour (Kontos 2004).

Several factors might influence the relationship between perceived risk and risk-taking, thereby making it difficult to ascertain the true nature of the relationship (Kontos 2004; Morrongiello and Lasenby?Lessard 2007). These factors include: individual characteristics such as previous experiences (both positive and negative), personal motivations, gender, age, and behavioral attributes; family factors such as parenting style, parenting attributes, and sibling effects; and social-situational factors such as observational influences, situational influences, and persuasion influences (Morrongiello and Lasenby?Lessard 2007).

One particular individual characteristic is athletes’ perceived confidence to negotiate their own risk of injury. Bandura (Bandura 1997) theorized that individuals with high self-efficacy—that is, those who believe they can succeed in specific situations—may overestimate their own ability, which subsequently may lead to underestimating their actual risk of injury and thus deciding to engage in riskier behaviour (Llewellyn et al. 2008). Conversely, individuals with low self-efficacy may underestimate their own ability to negotiate risk, which in turn results in overestimating the risk of injury and adopting less risky behavior (i.e., “playing it safe”).

There is a substantial body of health psychology literature describing people’s perception of risk compared to that of their peers (Klein and Helweg-Larsen 2002). Some individuals have a tendency to report being less likely than their peers to experience negative events (e.g., injury) and more likely than others to experience positive events (e.g., winning a tournament); whereas other individuals have a tendency towards the converse, that is, to report being more likely than others to experience a negative event and less likely to experience a positive event. The former tendency is known as comparative optimism or unrealistic optimism, while the latter is referred to as comparative pessimism or unrealistic (Klein and Helweg-Larsen 2002; Martha and Laurendeau 2010; Moen and Rundmo 2005).

Although such perceived comparative risk (PCR) may influence athletes’ decisions to engage in risk-taking behavior, and thus also be linked the occurrence of injury, only a few studies have investigated PCR in high-risk athletic populations to date (Martha and Laurendeau 2010; Moen and Rundmo 2005; Lystad et al. 2015). Moreover, the findings have been contradictory in that high-risk athletes have reported their risk of injury to be either similar to that of their peers, (Martha and Laurendeau 2010) or comparatively optimistic (Moen and Rundmo 2005; Lystad et al. 2015).

Muay Thai is a style of kickboxing that allows full-contact blows to an unprotected head, torso and legs, and, as in any combat sport, there is an inherent risk of injury. Previous observational studies have shown there is a substantial risk of injury in competitive kickboxing (Lystad 2015a; Zazryn et al. 2003). None of these studies, however, have investigated the potential role of psychological risk factors and, consequently, little is known about the perception of injury risk among these athletes. Notwithstanding the important role risk perception may play in the occurrence and prevention of sports injuries, there is very limited empirical data pertaining to athletes in full-contact combat sports such as Muay Thai. Because the development and successful implementation of effective injury prevention policies for combat sports are likely to benefit from an increased understanding of the perception of injury risk and sport safety attitudes and behavior of its participants, further study is warranted (Finch et al. 2002).

The purpose of this study, therefore, was to examine the injury risk perception among Muay Thai fighters. The specific objectives were: (1) to determine their perceived risk of injury in a range of sports, including Muay Thai; (2) to determine their perceived risk of injury to themselves; (3) to determine their perceived comparative risk of injury; and (4) to explore factors which may predict their perceived risk of injury and perceived comparative risk of injury.