Skin in the game: a multimethod exploration of the impact of social support on wound healing rate in sport

Injury occurrence is associated with a range of emotional, performance, and economic costs in sport and understanding how athletes may recover from injury more quicklyis of interest to multiple stakeholders. The aim of this thesis was to contribute to what is known about the outcomes of social support on injury-healing in sport, using multiple methods to inform this understanding. Initially, a narrative and scoping review informed the design and execution of 3 empirical studies, namely (1) a crosssectional study (n=51) exploring the influence of biopsychosocial variables (daily stress, perceived social support, heart rate variability) on would healing (transepidermal water loss), (2), an online group intervention (n=65) designed to enhance perceived social support, and (3) a single-subject design with a female CrossFit athlete using a counselling-based intervention to examine the influence of social support on wound healing. These empirical studies are supported by a reflective confessional tale, to shape further study of social support in sport. Broadly, results suggested that (1) social support is associated with beneficial rehabilitation outcomes (chapters 2, 3, 7), (2) social support may have a positive impact on the autonomic nervous system implicated in wound healing (chapters 2, 4, 7), (3) that emotional support (but not informational support, tangible support) could moderate the stress and water loss relationship (chapter 4), (4) that an online psycho-education session could enhance perceived emotional support in the participant population (Chapter 6),(5) that all areas of social support could be improved with a counselling intervention and that healing rate and heart rate variability can be positively increased by increasing social support (chapter 7). Future research could consider the framework of Polyvagal Theory and particularly the social engagement theory, to further generate experimental research, and develop understanding and application in this domain of inquiry.