A mixed-methods comparison of psychological and cultural factors influencing injury decisions in soccer players

Background and Study Aim. Injuries are a common challenge in competitive sports and often influence athletes’ career trajectories. Decisions made during these situations can determine both immediate performance and long-term health outcomes. A particular concern arises when players choose to continue participation despite physical harm, as these choices are shaped by complex psychological and cultural factors. The aim of this study was to compare injury-related decision-making patterns between professional and semi-professional soccer players using a mixed-methods approach. Materials and Methods. Sixty male soccer players (30 professional, 30 semi-professional) from Manipur, aged 18–30 years, participated. Quantitative data were collected using a 25-item Injury-Related Decision-Making Questionnaire (IRDMQ), validated through expert review (IOC = 0.87) and construct validity (KMO = 0.812; Bartlett’s Test of Sphericity, p < .001). Five subscales were assessed: Obsessive Passion (OP), Athletic Identity (AI), Pain Tolerance (PT), Motivation (MO), and External Pressure (EP). Results. Professional players scored significantly higher in OP (4.52 ± 0.65), AI (4.68 ± 0.58), and EP (4.39 ± 0.62) than semi-professionals (3.89 ± 0.71, 4.02 ± 0.64, and 3.81 ± 0.66; p < 0.01). Differences in PT and MO were present but not statistically significant. Qualitative interviews supported these findings, showing stronger emotional and cultural motivations in professionals to play through injury. Conclusions. Professional players demonstrate a stronger psychological drive based on passion and identity. These results highlight the need for targeted interventions to safeguard long-term health and support informed decision-making.