The meaning of injury to the elite athlete: A systematic review

In the pursuit of a successful career in elite sports, athletes mostly rely on their physical abilities. An injury can threaten such a career, thereby representing a potentially critical life event that carries considerable meaning to the affected athlete. Qualitative literature exploring injury experiences in elite athletes is therefore seeking to frame injury through the athlete's own voice. With this systematic review, we aimed to answer the research question What is the meaning of injuries to the elite athlete? by reviewing existing qualitative research exploring the meaning of injury as told from the athlete's perspective. We constructed five overarching themes of meaning through thematic synthesis of 29 original studies: (1) unwelcome disruption - Injury as potential career threat; (2) destruction - My life (as an athlete) is over; (3) reinforcement - Relighting the fire; (4) going through the motions - Injury as an inherent part of elite sport; and (5) time-out - Respite and perspective. These meanings were neither exclusive nor static but constructed according to the situation at the moment of injury and could later be adapted depending on social context and specific circumstances. To better support injured athletes, practitioners need to be aware of the importance of the subjective meaning that athletes construct for individual injuries. Understanding these meanings enables practitioners to aid athletes in changing previously negative meanings into more positive ones. Our findings therefore call for improvements in the individualized support of elite athletes that leaves space for open communication about the meanings that athletes attach to their injury experiences.