Athletes need to be psychologically prepared for practices and competition in order to reduce the risk of injury. Research has demonstrated a positive relationship between stressful life situations, especially those with high negative stress, and injury occurrence. In understanding the stress - injury relationship, Nideffer points out that muscle tension increases in response to stress. Increased tension in the antagonist and agonistic muscle groups results in reduced flexibility and loss of motor coordination. Increased muscular tension also slows reaction time, which reduces the athlete's ability to respond.
Mental, as well as physical, fatigue can contribute to injury occurrence. The attention factor - the ability to maintain a high level of concentration - requires a large amount of energy; when combined with a rigorous training program, reduced attention can result. This may lead to slowed reaction times and loss of neuromuscular coordination, thus increasing the potential for injury. Athletes who have sustained an injury realize that they have to be ready mentally for return to sport to avoid risking reinjury. The role of attentional focus and muscular tension can be a major problem. Fear and/or worry about a second injury can cause stress and increased muscular tension. Preliminary studies have addressed hardiness (commitment, control, and challenge) of the athlete as a moderating factor in the stress - injury relationship. Athletes who exhibit greater qualities of this trait may be better able to control the attentional processing of information and in turn reduce the potential for occurrence of a second injury.
