SPIRITUALITY IN COLLEGIATE ATHLETICS AND SPORTS MEDICINE:
PERCEPTIONS, SOURCES AND SUSTAINABILITY
By
Carrie Janiski

A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
MASTER OF SCIENCE
Kinesiology
2012

ABSTRACT
SPIRITUALITY IN COLLEGIATE ATHLETICS AND SPORTS MEDICINE:
PERCEPTIONS, SOURCES AND SUSTAINABILITY
By
Carrie Janiski
Spirituality plays an important role in sport and exercise, in addition to health and
general well-being. Examining the topic of spirituality in sport and sports medicine
necessitates the use of in-depth and descriptive qualitative analysis to discover fresh
insight in a new and exciting field of study. In this investigation, individual interviews of
six athletes were performed to discuss the meaning and importance of spirituality in
their own sport experience. Audiotapes were transcribed to text and inductively
analyzed under grounded theory, particularly utilizing the concepts of Glaser and
Strauss’s constant comparison analysis. The athletes agreed that spirituality is
significant as well as elusive and difficult to define. All six athletes agreed that spirituality
is a part of their lives and can be a source of strength or comfort during difficult times.
However, the individual experience during a team prayer and the purpose of team
prayer evoked mixed feelings amongst the athletes. Several athletes shared their
experiences with season or career-ending injuries and how their spirituality helped them
through the difficult times, the times of transition and the emotions involved. We found
that spirituality was not being addressed in the delivery of sports medicine services to
the student-athlete. The athletes we spoke with had varying opinions as to whether or
not this is necessary and gave many suggestions for how to offer spiritual resources in
a meaningful way.

This thesis is dedicated to the athletes and patients who enrich my life everyday.

iii

ACKNOWLEDGEMENTS

I am grateful for the invaluable assistance of many individuals in this endeavor. I
extend my sincerest thanks to Dr. Jeff Kovan, thesis committee chair, for his
thoughtfulness and support throughout the development and execution of this project. I
also thank Dr. Sally Nogle for serving on the thesis committee and especially for her
assistance with recruiting. I thank Dr. Dan Gould for serving on the thesis committee
and for his expertise and direction, particularly in the initial phases of literature review
and methodology. I am thankful for the guidance of Dr. Tracey Covassin over the many
hurdles encountered while completing this degree and thesis project. In addition to
these mentors, advisors and committee members, I also thank Jo Ann Janes in the
Department of Kinesiology for her patience, support and assistance with the requisite
paperwork and red tape.
I am thankful for the support of the administration, faculty and staff of the
Michigan State University College of Osteopathic Medicine while in the pursuit of dual
degree programs, particularly Dr. Gail Riegle and Dr. William Falls. I appreciate the
loving support of my friends and family throughout this process, especially Julie, Molly
and Jeni.
Finally, this thesis would not be possible without the athletes who generously
donated their time and willingly shared their stories with me. I thank them for bringing to
this project their honesty, their openness and their joy.

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TABLE OF CONTENTS

CHAPTERS
Introduction

1

Methods
Subjects
Design
Analysis

7
7
8

Results
Demographics
General Opinions and Definitions
Personal Practices and Beliefs
Team Practices
Spirituality in Sport

9
10
13
15
18

Discussion
General Opinions and Definitions
Personal Practices and Beliefs
Team Practices
Spirituality in Sport
Limitations
Conclusion
APPENDICES

24
26
27
28
29
30
32

Appendix A: Interview Script

34

Appendix B: Definitions for Discussion

36

REFERENCES

37

v

INTRODUCTION

Spirituality plays an important role in sport and exercise, in addition to health and
general well-being. Research supports the link between a lack of spiritual well-being
and poor health. For example, in a study of college-age women, diminished spiritual
well-being was correlated to increased stress, obesity and hypertension (Hawks,
Goudy, & Gast, 2003). Particularly, the authors found a significant correlation between
decreased spiritual well-being and increased tendency for emotional eating (r= -0.22; p=
0.0015). Another study linked an increased stress level to decreased spiritual wellbeing, with one in five survey respondents reporting anger as a result of things felt to be
out of their control (Ramey, 2005). This connection was supported by descriptive terms
such as “overworked” and “out of balance.” Interestingly, the author also found a
significant correlation (p= 0.04) between increased stress and high cholesterol levels.
This study used mailed surveys to collect self-reported information from members of a
private college with a response rate of 62% (n=402). The surveys included questions
regarding stress, spirituality and health history.
Spirituality is also significant in psychiatric conditions and disorders. In a
literature review of 80 published and unpublished research studies regarding religion
and depression, the research shows a connection between religious involvement and
reduced risk for depressive symptoms (McCullough & Larson, 1999). In the treatment
of eating disorders, one study compared the effectiveness of spiritual intervention to
cognitive and emotional support groups (Richards, Berrett, Hardman & Eggett, 2006).
The authors randomly assigned 122 women receiving inpatient care to a spiritual

1

intervention group, a cognitive and emotional support group or a control group. The
authors found that patients in the spiritual intervention group improved quicker than
those in the other groups and were significantly lower in psychological symptoms at the
end of treatment. A study of addictive behaviors in undergraduate students found an
inverse relationship between spirituality and tobacco and alcohol abuse (Leigh, Bowen,
& Marlatt). As a component of their “Introduction to Psychology” class, 196
undergraduate students completed a self-report survey for use in this study. Spirituality
was defined inclusively as separate from religiousness and measured using the
Spirituality Assessment Scale (SAS) and the Spiritual Transcendence Index (STI). An
additional finding of interest was a strong correlation between substance abuse and
self-awareness, which prompted the authors to suggest additional exploration of this
relationship. Walker and Bishop found that a significant (p<0.01) inverse relationship
exists between religiosity, religious beliefs and practices, and suicidal ideation (2005).
This relationship was demonstrated in a survey study of 459 college students, with a
mean age of 20.88 ± 3.08, using the Beck Suicide Scale (BSS) and the Religious
Orientation Scale (ROS).
Many scientific studies have shown a correlation between religion and health
outcomes. As a result, healthcare providers are researching and developing models for
the inclusion of spirituality into the delivery of healthcare. Even healthcare
organizations are exploring the standardized integration of spirituality into healthcare
practices (Graber & Johnson, 2001). Graber and Johnson support the use of spirituality
by healthcare workers and suggest identifying the “core, common spiritual values” (p48)
that reflect the values of the organization as a whole before attempting to integrate

2

spirituality into practice. One study used individual interviews of 16 women with endstage renal disease (ESRD), ages 29 to 77, to reveal four common suggestions the
women had to nurses for integrating spirituality into their healthcare: display genuine
caring, build relationships, initiate spiritual dialogue and mobilize spiritual resources
(Tanyl, Werner, Recine, & Sperstad, 2006). Another such study with the goal of
creating a model of spirituality to further understanding and education in health care
found six principle components of spirituality (McSherry, 2006). Fifty-three participants
participated in interviews, consisting of healthcare professionals (n=28), chaplains
(n=7), patients (n=14) and the public (n=4). The interview transcripts were coded using
grounded theory and resulted in the following six principal components: individuality,
inclusivity, integrated, inter/intra-disciplinary, innate and institution.
In his book “The Rebirth of the Clinic,” Dr. Sulmasy asserts that it is not only an
option, it is a “moral obligation” (p162) to attend to the spiritual needs of our patients
(Sulmasy, 2006). He defends his position by refuting those that say spirituality in
medicine is irrelevant, too intimate or offensive. Sulmasy contends that spirituality is
relevant if you expand your view of medicine from a reduced, science based view. In
response to the question of intimacy, he supports spirituality because patients give their
physicians the most intimate details from every other aspect of their lives and, in fact,
most patients are interested in the inclusion of spirituality into their healthcare. From his
own practice, Sulmasy states that the majority of his patients welcome questions of
meaning, relationships and values to discern a sense of spirituality and do not find such
questions offensive. From such discussion and published research, we can clearly
understand that people routinely want their spirituality integrated into their healthcare.

3

However, literature supporting the importance of spirituality in sports medicine
and exercise is limited. Watson and Nesti recently published a review of literature that
addresses spirituality in sport psychology (Watson & Nesti, 2005). This review
summarizes the research thus far that incorporates spirituality in sport and addresses
the need for further and extensive investigation. According to Watson and Nesti, the
majority of spirituality research in sport relates to flow and peak performance. For
example, Dillon and Tait (2000) studied 62 students at a Division III college and showed
a significant relationship between flow and spirituality, defined as “experiencing the
presence of a power, a force, an energy, or a God close to you” (p93). To participate,
each student reported that they were currently or in the past a member of a sports team.
The students completed the Spirituality in Sports Test (SIST), which asks if athletes feel
guided or helped during sport or able to be positive about mistakes, the Zone Test (ZT),
which asks about feelings of mastery and power, and the Athletic Coping Skills
Inventory-28 (ACSI-28), which assesses an athlete’s psychological abilities related to
sport. A significant correlation (r= -0.49; p= 0.001) between scores on the SIST and ZT
supported a relationship between spirituality and being in the zone.
Another study illustrates the importance of spirituality in athletes’ lives
(Vernacchia, McGuire, Reardon, & Templin, 2000). In this qualitative study, 15 Olympic
track and field athletes were interviewed individually and the textual data was then
analyzed for themes. The athletes were shown to rely on spirituality or religion to
overcome adversity, handle an injury or lend more meaning to success and failure.
Other studies have shown the importance of spirituality in career retirement or careerending injury (Lavallee, Nesti, Borkoles, Cockerill & Edge, 2000, as cited in Watson &

4

Nesti, 2005) and in improving general health and well-being through regular exercise
practice (Berger, Pargman, & Weinberg, 2002, as cited in Watson & Nesti, 2005).
Previous studies have also shown the important contributions of psychological and
social factors, many consistent with the realm of spirituality, as primary stress sources
associated with burned out junior tennis players (Gould, Tuffey, Udry & Loehr, 1996),
national champion figure skaters (Gould, Jackson & Finch, 1993) and US alpine and
free style skiers facing season-ending injuries (Gould, Udry, Bridges & Beck, 1997).
Considerable attention has been given to the study of Christian prayer in sport
(Acevedo, Dzewaltowski, Gill, & Noble, 1992; Park, 2000, as cited in Watson & Nesti,
2005). For example, in a recent qualitative study of nine former athletes of Division I
schools, all participants were Christian (Czech, Wrisberg, Fisher, Thompson, & Hayes,
2004). Following individual interviews, the researchers found that, “ritualistic activity
has a powerful influence on athletes” (p6). However, the majority of research in sport
focuses on a religious practice of a specific sect. Research is very limited that explores
the influence of other religions or practices – meditation, Islam, Buddhism – in the world
of sport and exercise. But, how does prayer and religion fit in to spirituality and does
spirituality mean the same thing as religiosity?
Spirituality is difficult to define. In previous studies, there exists a multitude of
definitions of the term spirituality, including “happiness with self,” “sense of peace,” “a
relationship with a higher power,” “internalized beliefs that attribute meaning and
intrinsic value to one’s life,” and “religious practice and behavior” (Ramey, 2005; Walker
& Bishop, 2005). Some authors include religiosity under the umbrella of spirituality as
“an inner search for meaning or fulfillment that may be undertaken by anyone,

5

regardless of religion,” (Graber & Johnson, 2001) indicating that “everyone has a
spirituality whether he/she is religious, secular, atheist or agnostic” (Foglio, 2005). Yet
other authors use general terminology to define spirituality, such as mindfulness
“separate from religiousness or religiosity” (Leigh, Bowen, & Marlatt, 2005), “the need
to commune with something transcendent or nonmaterial in nature,” (Galek, Flannelly,
Vane, & Galek, 2005) or as an “individual phenomenon, embodying relational aspects
and one’s search for life’s meaning and purpose” (Paloutzian & Ellison, 1982 and Tanyi,
2002 as cited in Tanyi et al, 2006). Even the dictionary gives multiple religious and nonreligious options for the definition of spirituality (Merriam-Webster’s Collegiate
Dictionary, 2003).
Patton (1990) writes that, “the purpose of applied research and evaluation is to
inform action, enhance decision making and apply knowledge...” (p12). Examining the
topic of spirituality in sport and sports medicine necessitates the use of in-depth and
descriptive qualitative analysis to discover fresh insight in a new and exciting field of
study (Gould, Damarjian, & Medbery, 1999). Previous research supports the
relationship between spirituality and health as well as spirituality and peak performance.
We hope to uncover a set of representative constructs that assist in the care of the
athlete’s spiritual well being. We also expect to find that spiritual needs are not being
addressed sufficiently to aid in the health and performance of the student-athlete.

6

METHODS

Subjects
Individual interviews of six athletes were performed to discuss the meaning and
importance of spirituality in their own sport experience. After obtaining Institutional
Review Board (IRB) approval, a general recruiting email was sent to all varsity athletes
on campus through the Student-Athlete Support Services Office. Purposeful selection
of six athletes allowed for the involvement of athletes who were thought to be articulate,
honest and willing to share personal experience, without any preference to spiritual or
religious background. Participation in these interviews was voluntary. Inclusion criteria
included being a varsity athlete at Michigan State University ages 18 to 25 years old.

Design
Each athlete participated in an interview lasting between 60 to 70 minutes. Each
interview was recorded using a digital audio recorder and performed by the same two
investigators. The interviewers conducted in-depth interviews using open-ended
questions and active listening skills such as paraphrasing to collect data. We adopted
an inclusive scheme with religion representing just one way to practice or achieve
spirituality. Each session was organized into five sections to obtain information in the
following categories: demographics, general opinions and definitions, personal practices
and beliefs, team practices and spirituality in sport (Appendix A).

7

The interviewers sought information to aid in answering the five major questions
posed by this study:
1. How do college athletes define spirituality?
2. What are your spiritual needs?
3. From what sources do you fulfill those needs?
4. Are your spiritual needs being met as a student-athlete within athletics and
sports medicine?
5. How does your spirituality influence your participation in sport?

Analysis
Audiotapes were transcribed to text and inductively analyzed by the author.
Categories, themes and typologies were identified on cross-case analysis of each
section of the interview using grounded theory under the guidance of Glaser and
Strauss’s (1967) constant comparison analysis. The transcriptions were each read and
re-read for understanding, significant statements were identified to represent themes
within each section of the interview, themes were grouped into categories and
categories were validated using the original data and cross-case analysis.

8

RESULTS

Demographics
Six athletes, ages 19 to 21, were interviewed between March 24, 2010 and June
15, 2012 utilizing an interview guide to standardize the format (Appendix A). They
represented soccer, basketball, rowing, cross-country, track and field and gymnastics.
Their academic standing was either junior or senior but their athletic eligibility status
ranged from sophomore to senior. They were all from suburban communities in
Michigan or Illinois. Five of the six athletes grew up in a household with both their
mother and father. One grew up with her mother and stepfather but maintains a
relationship with her biological father. All six athletes had at least one sibling, two were
the oldest child, three were the youngest child and one was a middle child. All six
athletes identified strong ties with their family. All six athletes identified with a religious
upbringing and various degrees of continued involvement with religious practice: one
athlete was raised Lutheran and continued to practice this religion locally. Two athletes
were raised Catholic and found their involvement with this religion to gradually decline
during high school and have not continued to actively practice Catholicism locally. One
athlete identified a “strong Catholic background” and continued to practice this religion
actively while in college. Two athletes stated they were raised Christian, of no specific
denomination, one continued to practice actively and the other had been less active
while in college, stating, “it’s been harder to find people that believe the same things
that you do.”

9

General Opinions and Definitions
To open the interview and explore the subject material, each athlete was asked
“What comes to mind when you hear the term spirituality?” Responses from the six
athletes varied with different examples of experiences, for example “if you just climbed a
mountain and you’re on top looking over everything, that has to be a pretty big moment,
just like ‘God is so awesome, look at everything he’s done.’” Another athlete spoke of
reflection before games, remembering that he had used college as a motivation for
game performance while he was in high school, so now he thinks of “all the times I
wanted to be here so bad.” Others gave examples of thoughts, such as “spirituality is
more of a broad term than religion or something,” a belief that “ it’s almost like my own
mind’s well being, my own inner peace,” imagery like “a cross with rays shooting out of
it,” and people, such as an aunt who shares “inspirational stuff that she’s found to her to
be very meaningful.” One athlete said that spirituality is “a feeling, too, just a very good
feeling, like a feeling of joy and contentment, a peaceful feeling.” However, all six
athletes made an initial statement that evoked faith, religion or a higher power. Three
athletes spoke about faith: “faith is part of it,” “my faith obviously,” and “my own personal
faith.” One athlete stated, “religion and what God you believe in,” another stated, “just
God, your beliefs… what your beliefs are and what kind of guides you;” yet another
athlete said, “just believing in something greater than this world.”
When asked to give their own definition of the word ‘spirituality,’ the athletes each
expressed that this was a difficult task. However, they agreed that spirituality is
significant as well as elusive, such as “having a belief in something more than what you
can tangibly see,” that it “gives you kind of a reason for doing the things that you do.”

10

One said, “one’s own way of gathering their thoughts to be okay or to be at their best
possible mindset… just looking at everything in perspective.” Another athlete stated,
“anything having to do with the non-physical, non-intellectual realm… just this other
realm that’s a part of you, a part of your overall being… not measurable, but it affects
how you live.” Another agreed with “the belief in something greater than this world.”
Spirituality in practice can be an individual or group or community endeavor. The
athletes interviewed for this project identified the individual component as being the
most meaningful part of spirituality in their own lives. One athlete stated, “spirituality
gives you a way of defining… what you need to believe on your own, what helps you be
better.” Another said she has her “own journey… maturation and my own study and
prayer life.” However, three athletes also felt that group or community practice added a
valuable dimension to their individual practices, that they could be “in the company of
other people… get feedback and get strength and comfort from each other.” Another
athlete stated that she could “also learn some even more intimate things in a group…
you also open up something totally different that you might not have thought of on your
own.”
The individual emphasis on spiritual practice was evident as athletes gave
examples of behaviors or actions they associated with spirituality in action. One stated,
“you go out and be a better person… do something nice for somebody.” Another
athlete thought of her spirituality as “what guides me… I’m more spiritual in times when I
feel like I need to be confident in myself.” One athlete said the action of being spiritual
involved “prayer… doing the right thing… treating everyone as if they were your brother

11

and sister… helping others, putting yourself out in the community, doing everything you
can.”
To conclude the discussion on the definition and practice of spirituality, the
athletes were shown two different definitions (Appendix B) and asked to reflect on each.
The first definition incorporates broader language and is representative of a definition
that does not rely on religion or religious principles. The second definition includes
language that is more suggestive of religious principles, such as creation, rituals and
moral code. Most athletes in this study think of spirituality as a broader term and
thought the first definition was appropriate to reflect this. However, they all responded
positively to both definitions and identified themselves as thinking of spirituality as
something “probably just in the middle” or that the second definition could “be like a
subheading” of the first because it is “more specific.” Another athlete said that her
definitions would be, “if not right in the middle, more towards the meaning and purpose.”
One athlete remarked on “practices and stuff, that’s an important part of religion but not
necessarily spirituality.” Another stated that, “you can’t just have something that
provides meaning without doing practices and having beliefs… it comes with one
another.” One athlete expressed frustration with the morals and rituals imposed by a
structured religion she’d grown up in, stating, “all of a sudden, some the beliefs I have,
they don’t match up.” Another athlete expressed similar frustrations with his previous
religious group, stating “I don’t know that I relate with them so much and that’s what
almost turns me off… more of a saying they do it than actually living it,” that “a lot of
people think they can do whatever they want as long as they go to church on Sunday.”

12

Each athlete spoke of their background and continued evolution in spiritual identity and
practice.

Personal Practices and Beliefs
All six athletes agreed that spirituality is a part of their lives and can be a source
of strength or comfort during difficult times. One felts that it “is a part of my life that’s
very comforting… in times that I need confidence or I need purpose or I need help with
making a decision.” Another athlete stated that “it’s a way to get through things and it’s
a way to just seeing the world in different perspectives… I feel like it’s made me
empathetic as a person… a lot more accepting.” One athlete said that spirituality was
helpful in “getting me through every single day… Just having something to know that
I’m doing all this for a purpose. There’s so much comfort in the fact that I can only
control so much.” Another stated that it “gives meaning to my life and gives me hope
and helps me deal with the things that come my way.” One athlete stated that
spirituality is always helpful, but “especially when I’m going through injuries and things
or when I’m just going through hard times in my life.”
The athletes had differing views on their current level of spirituality, half said they
were satisfied and half said they were not. One athlete was not satisfied with her current
level of spirituality, stating, “I love growing and learning more and becoming stronger in
the principles that I’m weak in and my specific faith and just trusting more and loving
more.” Another athlete stated, “I would like to make it more part of my daily life rather
than just when I have struggles.” One athlete thought her “faith’s been challenged a lot
here,” moving away from home and a community where “everyone believed

13

predominantly the same thing,” to a college campus and encountering “a lot of different
philosophies about religion and about different faiths.” She was uncomfortable with
generalizations about religious practices as discussed in anthropology courses and the
topic of evolution as discussed in biology courses. She felt that “it’s more about a faith
and a relationship with God, which you don’t need rituals for… I believe a lot of the
rituals, they’ve kind of lost what they were supposed to be.” Another athlete stated, “I’m
pretty good where I’m at, but I could still do a little bit more.”
As spiritual needs varied widely, as did the individual resources used by these
athletes to fulfill those needs. One athlete spoke about group activities such as bible
study and church attendance as valuable resources. Another athlete said, “I just pray
and read my bible,” but that “I always feel closer to God when I’m actually doing some
sort of service and helping people.” Another stated, “I’m lucky to have a lot of good
people around me,” that family is a main source of support, but if “family wasn’t there,
then I might lean more on the whole [religious] route.” One athlete identified a source of
strength as, “sometimes just knowing that people are there for you.” Another said, “I do
the Bible, but then my teammates are my biggest resources,” going on to talk about
specific teammates who were heavily involved with Bible study, as was her mother, who
was also a great source of support. This same athlete remarked that her relationship
with her mother as a source of support had progressed after she started college,
stating, “it was cool to see how that changed from her having to force me to go to
church to all of a sudden we were actually talking about it, rather than arguing about it.”
The athletes easily identified sources of spiritual support and strength. We then
asked about the transition to the college environment and how that impacted their

14

spiritual practices and their ability to utilize or find resources. One spoke of becoming
involved in team or group activities on campus, including bible study. Another said, “I
have had to do a lot of the searching out on my own… We have readily available the
trainers for your physical needs and then we have counselors and things like that, but I
don’t think that we have any spiritual counselors.” One athlete said, “I think they kind of
found me. I didn’t really go out and pursue anything.” One athlete remarked that the
coaches do sometimes mention religious groups on campus for the athletes when doing
recruiting activities.

Team Practices
Several athletes identified team members or group activities as sources of
spiritual support. They were then asked to reflect on team prayer. Four of the athletes
stated that their teams routinely engage in a pre-game prayer. One said, “I don’t even
really see that as a prayer because it’s the same prayer,” stating instead that she saw
this act as more of a ritual or routine than a prayer. She voiced support of this practice
but stated some concern for people with different backgrounds and beliefs, saying, “I
just don’t want to make people uncomfortable.” Another athlete felt more positively
about a pre-game prayer, stating, “a lot of people look forward to it… it was nice, one
last check-in… I think everyone does enjoy it, we don’t really talk about spirituality or
religion.” However, she did say, “some people might just go along with it because that’s
what we do.” Another felt that “it’s comforting. It’s the last time you get a chance to
really be there and be with people who believe in he same things that you do; believe in
the team together and are looking for the same kind of guidance that you’re looking for.”

15

One athlete stated, “It’s personal time for everybody… some people will just go down for
a second and then just walk out, while other people will be there for a minute or so.”
Another athlete said, “it should be asked of the team if that’s okay… If we have
someone on our team that doesn’t want to be part of that, they should have the ability to
not be a part of it.” One of the athletes who did not have a team prayer experience said,
“I wouldn’t want to force the whole team to do that because they might not believe in the
same things.” The other said, “I think it’s fine, nobody should get offended by that.”
The individual experience during a team prayer differed for each athlete. For
those that participated in this activity with their own team, they offered their own
personal experiences. Several spoke about having other things on their mind than the
group prayer being spoken out loud. One said, “Different things are going on. I
probably am more in to the individual prayer.” Another athlete stated, “confidence is
such a huge thing in sports and believing in yourself is so hug that when you have God
and when you have all of your teammates backing you, it makes it a lot easier.”
Another said it’s “like telling me what this means to me. What I need to do, why I’m
doing this… I try to remind myself before that how special it is, so I can give it that extra
push.” One athlete stated, “I like it… it’s a more personal gain out of that than saying
that the prayer benefited everyone around us.” For the two athletes whose teams did
not engage in team prayer, they offered their own individual pre-game experiences.
One said she would pray because, “it’s a very comforting thing to know that the race is
in God’s hands.” The other stated, “it’s important to keeping you grounded and doing
what you need to do.”

16

When discussing their feelings while observing team prayer, either as a unified
team or when mixed with another team’s members, the athletes reported both positive
and negative opinions. One athlete stated, “I love the fact that people from both teams
come together.” Another said, “That just makes me smile. I think that it’s great.”
However, another athlete stated, “I’d be curious what they’d be praying on… there is
praying just to pray, then I question why that’s happening… then it almost seems like it’s
being put on the pedestal.” One athlete said, “it’s beneficial… they have every right to
go out there and do that… I would say it’s okay to do and anyone can partake in it.”
Another athlete said, “I think really well of them that they’re at least being grateful and
being thankful for their game.” Another agreed, saying, “I think that that’s good that
they’re still praying, win or lose, you know, they still recognize God’s up there.”
The purpose of team prayer also evoked mixed feelings amongst the athletes.
One said, “I feel like it kind of sends a message… setting that stereotype that prayer is
just something you do to get somewhere, to get something, and that’s really not what
it’s about at all,” going on to say that, “prayer is important, but I feel like the reasons are
kind of wrong.” Another athlete stated, “it would depend on who it was coming from…
it’s more about tradition… that right there shows that it’s not about actually saying a
prayer to God; it’s more about the idea of just how things are done.” One athlete said,
“you want to get the word out, that’s kind of the whole point of what they’re doing.”
Another athlete stated, “It’s definitely an act of community, it really solidifies that
camaraderie of the team and focuses everyone’s purpose of being there.” Another
agreed with the sentiment of community, saying, “It’s like a unifying thing before you
go.”

17

Spirituality in Sport
Athletes were then asked to reflect upon their own spirituality and how it
contributed to their ability to face adversity. One athlete said, “it was nice to take a little
break from everything.” Another said that her spirituality helped in the way of, “just
giving me hope and being able to persevere in the face of it. Knowing that it’s all in
God’s plan and so I just need to trust that. It takes a lot of worrying, a lot of weight off.”
Another athlete discussed dealing with the emotions of increased stress and said, “a lot
of times I do turn to going and looking at some scriptures on strength, or how to face
things. I think it helps me.” Another athlete agreed that her spirituality contributes to
how she faces challenge, stating, “it allows me to not be very intimidated by a lot of
things… I feel like I’ll be okay no matter what I end up doing.” Another said, “it’s nice to
just have someone that you can just talk to really quick and have them listen to you and
know that they’re just going to be confident in you and your abilities.”
All six athletes had faced challenging events during their collegiate athletic
careers, three had dealt with season or career-ending injuries. They shared their
experiences and how their spirituality helped them through the difficult times, the times
of transition and the emotions involved. When one athlete suffered a season-ending
injury, “I’d just come off the best season I’d had so far.” Her spirituality allowed her to,
“look at it from a new perspective… look at the things that being injured, in a way,
allowed me to do,” and to find the “hidden blessings that came out of being injured.”
She talked about shifting her perspective. “Running is still important to me, but there
are other things that I need to make more important in my life.”

18

Another athlete talked about suffering season-ending injuries two seasons in a
row, the first her freshman year was “one of the hardest experiences of my entire life
just based… on physical pain.” For her, the transition from home to college was difficult
enough because she was so close to family, the injury “was just like the cherry on top…
I wasn’t really connected… I grew a lot. I learned a lot. I changed totally from who I
was in high school.” She stated that there were resources, groups on campus, but she
couldn’t physically get to them because of her injury. After working through
rehabilitation for the first injury, she sustained a new injury at the beginning of the next
season. “That one was a lot harder in terms of the shock,” she said. “You never know
the plan. You never know what’s coming in the future… I know that having a good
attitude can make a difference.” She then talked about corresponding with a high
school student who had suffered the same injury and the impact of that meaningful
interaction on her, “when you just trust and follow the plan then it’s going to be fine.”
Her strategy for working through these injuries was “all about surrender… After injury
it’s hard. Injuries are hard for people, especially when their whole life is their
performance on the court or on the field.” She found her spirituality to provide her with
meaning and purpose outside of her sport as “you can’t find your happiness and your
worth” in one specific thing about your life on Earth. She found that “injuries are
amazing ways to show” that it’s not about “what you do while you’re here, but how you
live your life.”
Another athlete had recently suffered a career-ending injury. She had previously
suffered other injuries, some of which required surgery. She explained that when this
injury occurred, “in my head, something or someone told that I was… done.” At the time

19

of the interview, she was still actively participating in rehabilitation and not participating
in team activities because “it’s just too hard for me still to bet here and watch
everyone… I still get jealous.” Her aunt was, “the first one to tell me that… life goes on”
without her sport. She stated that throughout the experience, she’s “become more
spiritual” and has found this to be “more of an opportunity, that it was the “right choice to
come here and get in my experience and meet some great people.” While dealing with
all the emotions, she stated that “it became a lot of whys… trying to understand that
things are going to happen for a reason.” She said that it is still “really hard to not be
jealous and be angry towards people who have come back after me,” but she’s learning
and accepting that, “it’s okay that I’m feeling this way and that it’s normal.” Her
spirituality played a big role in her progress through this transition, “just knowing that I
have someone to talk to that will just listen to whatever I’m feeling, whatever is on my
mind makes it a lot easier to handle.” She was “moving on toward medical school… it’s
been the right path for me… I don’t think I could give up what I’ve gotten so far.”
When the other athletes each discussed what it might be like to face a careerending injury, one stated, “I would be pretty devastated for a while… I’d have to believe
this was meant to happen for some reason, so there must be something better than
that, that I should be doing with my life.” Another said, “I think it would really stink and I
would be really mad for a while but I think I’d get through it.” Another athlete said, “I
would have to reorient my thinking… I’m not exactly sure how I would deal with that.”
Going through that transition and the emotions involved, one athlete imagined, would be
“pretty overwhelming.” Another athlete stated, “I would get bigger in my faith.” Another
talked about her close circle of friends through her major of study at the university,

20

saying “I’d just be spending more time with them.” Two other athletes talked specifically
about their belief in God providing some guidance, that “God wouldn’t let me go through
something like that if He didn’t think I could handle it,” and that “things that you wouldn’t
say to your family are things you might say to yourself or to God.”
All of the athletes felt that their spirituality contributed positively to their
experiences as an athlete, some more directly than others. One athlete said, “knowing
that someone else believes in you and believes in your abilities… comforts me and
makes me feel better” about the quality of athletic performance, regardless of the
outcome. Another stated that spirituality makes her a better athlete “at times, if I
continue going on this path, understanding more, working on it more.” Another athlete
discussed how the practice of spirituality has impacted her as a student-athlete, saying,
“my friendships with my teammates are definitely better… more developed than they
would have been otherwise.” One athlete talked about sport as a spiritual practice,
saying “that’s the time I feel closest to God… when I’m actually physically running… just
being out in creation and just being close to it and close to God and just having that
feeling of being alive again.”
The role of spirituality within sports medicine was disputed. Two athletes did not
think it was a necessary or relevant component of healthcare. One said, “that’s
something you’ve got to find out for yourself, if you choose to believe it.” The same
athlete thought that the psychological services provided by the sports medicine
department “would be suitable enough,” and went on to discuss a group available on
campus, Athletes in Action, that meets weekly to “unite being an athlete and believing in
God,” stating that “I think that’s accomplished everything.” Another athlete stated that

21

“it’s not technically your [sports medicine staff] job,” stating, “I love the idea, I’m just not
sure if people would” take advantage of any spiritual services or resources offered by
the Athletic Department. The same athlete stated, “as soon as you structure it, it…
changes the dynamic a little bit, it changes the perception of it.” However, the athlete
said, “I think that there could be no hurt that could come” from making a service or
resource available.
The remaining four athletes spoke positively about spirituality having a place
within the realm of sports medicine. One stated, “I think it shouldn’t be ignored… that’s
definitely an area that I would want help if I needed it.” The same athlete thought that
spirituality is a part of a person and, therefore, when caring for anyone in a holistic
manner, that it’s “an important piece.” This athlete had dealt with a season-ending
injury and said it would have been “nice to have someone to talk to about it” or “to just
have ways to still be involved with the team.” She explained that injury creates a divide
within a team between the uninjured athletes and the injured athletes, each group
spending more time together in their respective practice or rehabilitation activities. “It’s
like all your friends become the injured group, as so when you’re not injured, you lose
your friends,” stated the athlete. Another athlete thought that spirituality had a role in
injury and recovery but, “someone would have to pretty low and out of options for them
to pick up something new right then, to not fall back on something that they’ve always
fallen back on and to pick up something new.” The same athlete gave an example of
dealing with an injury, when the coach took the time to call him and “showed some care
towards me and actually thought about me.” However, when discussing the coaches’
responsiveness to injured athletes, this athlete thought that it “definitely depends who

22

gets hurt on how it is responded to.” The extra attention, “felt good, so you don’t feel
like it’s terrible about your injury so you’re not as useless as you actually are.” The
athlete thought that the coach reaching out was helpful, that this might be the best
person to do so, “going the coach’s route is actually a good idea.” Another athlete
stated, “it would be great if you could hand out a piece of paper that had some
resources,” as an adjunct to the information that student-athletes receive from the
Athletic Department, “it should just be an FYI kind of thing… I don’t think they should
make people feel like they are being told they should do this.” However, when asked
about incorporating spirituality into individual injury and recovery, the same athlete said,
“this would take a lot more work on getting to know the people that come in with
injuries.” The athlete didn’t think that all sports medicine or athletic staff needed to have
a religious background, but that someone could “set this up for you… have a resource
and maybe someone who does deal with injury, people who have injuries can address
in a spiritual fashion… that would be very helpful.”
When discussing a recent career-ending injury, one athlete said, “whenever I got
hurt, I really didn’t feel like anyone was really reaching out to see how I was.” This
athlete felt that “a lot of people would find it very helpful” for spirituality to be a topic
addressed by the sports medicine staff, both with and without injury, but didn’t “know
how it would be really addressed.” She said, “I feel like a lot of things are easier to
achieve and easier to overcome when you’re spiritual or when you believe in
something.”

23

DISCUSSION

The relationship between spirituality and health is supported by previous
research, both quantitative and qualitative, in the literature. We found that spirituality
was not being addressed in the delivery of sports medicine services to the studentathlete. However, the athletes we spoke with had varying opinions as to whether or not
this is necessary. Spirituality is highly individualized for each athlete, although there
were some common themes that arose from in-depth discussion in four main
categories: general opinions and definitions, personal practices and beliefs, team
practices and spirituality in sport.

General Opinions and Definitions
The term spirituality evoked both religious and non-religious experiences, people,
imagery, thoughts and feelings. The only specific example of an experience that
represented spirituality given at this opening stage of the interview was mountain
climbing. However, experiences described in response to other interview questions
included running, community service, prayer, participation in group prayer, bible study
or church activities. The persons and deities that were described in conjunction with the
idea of spirituality included family members, teammates, God, pastors and Buddha.
Family members and teammates were the most often mentioned. Thoughts and
feelings discussed included greater purpose, scripture, joy, contentment, morals, inner
peace, reflection, faith and beliefs. Faith was a term mentioned by three of the athletes

24

and all six athletes made mention of faith, religion or a higher power when discussing
spirituality.
The practice of spirituality may be illustrated in either individual or group efforts.
These athletes identified the individual component as being the most meaningful part of
spirituality in their own lives. They most commonly described praying and ‘doing the
right thing’ as individual practices, which also included service, getting the Word out,
rituals and bible study. Half of those interviewed felt that group or community practice
added a valuable dimension to their individual practices. The types of group of
community practice discussed included bible study, church attendance, service or
making a bigger impact than can be accomplished by an individual.
The definition of spirituality proved to be elusive yet significant. The most
common themes used to define this term were beliefs, guidance and intangible. Other
themes included perspective and greater purpose. When discussing the definitions
provided (Appendix B), all but one athlete stated that these were not equal entities. Half
of the athletes placed their personal definition of spirituality midway between the given
definitions that range from a sense of meaning and purpose to structured religious
principles or creations, rituals and moral code. The first definition was described as
broad, general, perfect and representative of a path. The second definition was
described as more specific, a subheading or definitive of a religious group. One athlete
suggested that the two definitions are dependent upon each other for a full view of
spirituality.
During this discussion of definitions, several athletes expressed frustration with
the morals and rituals imposed by a structured religion they had been raised with as

25

children. They spoke about their own individual beliefs not always being in sync with
church mandates and the hypocrisy of many church attendees. Each athlete had
already identified some type of religious background and a varying degree of continued
involvement in religious practice. The different stages of personal spiritual development
were evident across interviews. Some athletes easily conversed about spirituality as a
topic as well as their own spirituality and beliefs, having obviously attended to this
aspect of their development. Other athletes struggled with the conversation, some
having difficulty with the topic or definition of spirituality, some uncertain about the
meaning and role of spirituality in their own lives. The theme of personal spiritual
evolution was a strong thread throughout each interview, underscoring the importance
of personal development and growth during the college-aged years.

Personal Practices and Beliefs
The athletes identified spirituality as a source of strength or comfort during
difficult times. The themes that emerged as they discussed how spirituality serves them
included: guidance, coping/comfort, empathy and meaning. The athletes said they
found their spirituality most useful to them in times of struggle, difficult decision-making,
low confidence or loss of control. They were split evenly when asked if they were
satisfied with their current level of spirituality. Growth was the common theme among
those that said they were not satisfied with their current level of spirituality. Several
athletes mentioned that they would like spirituality to become a part of their daily lives
instead of relying on their beliefs or practices only in times of struggle, again indicating
the importance of personal spiritual development in this age group.

26

The athletes had different opinions on the definition and practice of spirituality,
but they largely garnered strength from common spiritual resources, including: family,
prayer, faith and ritual. The transition from home to the college environment proved to
be an initial source of stress for many but didn’t seem to negatively impact their ability to
fulfill their spiritual needs, as the majority of their needs were very individual, mobile
and/or accessible, such as family, prayer and ritual. Interestingly, one athlete spoke
about the reliance on already established resources when faced with adversity,
highlighting the possible advantage of arriving at the new college environment with a
strong spiritual background and identity. This small group of athletes easily
demonstrated the spectrum of personal growth and development during the college
years, which could be positively affected by attending to the spiritual needs of athletes
when they arrive on campus and before they face injury and/or adversity.

Team Practices
Team prayer was actively practiced by four of the athletes. The discussion about
team prayer organized into two primary categories: team prayer as a positive
experience and team prayer as a mandate. Several athletes expressed that team
prayer, although typically viewed as a positive experience in this group, should not be
forced on everyone. One athlete wondered if other athletes participate simply because
it’s expected as a ritual or part of the pre-game routine.
The individual experience during a team prayer differs for each athlete. The
individual gain from this experience did organize into common themes:
camaraderie/unity, learning and personal reflection. The majority of athletes spoke to

27

either camaraderie/unity or personal reflection as the primary outcome of team prayer.
However, the athletes reflection on their own observation of team prayer lead to two
opposite categories, positive themes of gratefulness and tradition and negative themes
of questionable motives and harmful image. The purpose of team prayer also evoked
mixed feelings amongst the athletes, demonstrating the same positive and negative
themes.

Spirituality in Sport
The athletes acquired some ability to face adversity from their spiritual resources.
They indicated the themes of perseverance and hope as general contributions to their
life skills. Of the six athletes, three stated they had suffered season or career ending
injury. Spirituality was cited as a significant factor during injury and recovery for all
three of these athletes. The thoughts and emotions they faced included jealousy,
anger, sadness, fear, conflict, frustration and pain. Their sources of strength during
these trials and times of transition organized into themes, including: family, prayer,
perspective/meaning, opportunity/growth and acceptance/powerlessness.
Other athletes discussed what it might be like to face a career-ending injury,
suggesting some of the same thoughts and emotions that had been discussed by those
athletes who had experienced a significant injury: devastation, anger, sadness and
frustration. They also identified some of the same sources of strength they might draw
upon in that situation, such as family and faith. As previously discussed, one athlete
specified that being in this situation would be a time to draw upon already established
practices and sources of strength or comfort. Spirituality was identified as contributing

28

positively to the student-athlete experience, with an overarching theme of
companionship.
The athletes disagreed on the role of spirituality within sports medicine. Two
athletes did not think it was a necessary or relevant component of healthcare, however
both indicated that spirituality is being or ought to be addressed elsewhere. The other
athletes believed that spirituality should exist as a component of sports medicine. The
mechanism of incorporating into sports medicine was discussed, with suggestions that
included: ask the athlete how they are doing or what else they need to heal, pray for or
with the athlete, have someone on call for athletes to talk to, identify coaches or
teammates that could be involved with spiritual guidance, provide a list of resources for
athletes to investigate or use at their discretion or forming injured athlete support
groups. One athlete suggested that if spiritual resources were more structured or
required within sports medicine, this might negatively alter the dynamic of the intended
environment of spiritual guidance or community.

Limitations
The scope of this study is limited to collegiate athletes at Michigan State
University and participation is voluntary. The sample size is small due to the qualitative
methodology. This cohort may be useful as a representative sample of collegiateathletes but may not be generalizable to athletes or exercisers of other ages or
locations. We presume that we receive honest answers from those student-athletes
participating in the interviews. A potential limitation of this study is the lack of random
sampling in an exclusive population.

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Conclusion
Spirituality is largely an individual entity and practice for athletes, defined in
many different ways. We did identify some common themes for the definition and
practice of spirituality, personal practices and beliefs, team practices and the role of
spirituality in sport. We conclude that spirituality is not being routinely addressed in the
delivery of sports medicine to student-athletes. The athletes we spoke with had varying
opinions as to whether or not this is necessary, but also offered many suggestions for
how to offer spiritual resources in a meaningful way.
The athletes in this study found individual spiritual practices to be the most
meaningful; they also demonstrate considerable variability in their beliefs, practices and
stages of personal spiritual growth. Of the suggestions given for integrating spirituality
into the delivery of sports healthcare, all but one were focused on a personal interaction
with the individual athlete. Established practices, beliefs and resources were cited as
being most helpful in times of adversity, particularly in the setting of illness or injury.
Injury and recovery create significant stress in the lives of our student athletes; the
sources of stress may very well be more social and psychological than physical. The
individualized attention given to the whole patient should include that person’s
spirituality and beliefs, with questions of meaning, relationships and values. In the field
of sports medicine it may also be beneficial to provide support for the personal spiritual
development of collegiate athletes as they transition away from family and face new
challenges.
The literature supports a relationship between spirituality and health. However,
the role of spirituality within the realm of sports medicine has not been previously

30

investigated. Future study could use this information to facilitate development of a new
survey tool along with the use of already validated surveys to obtain a larger data set
from a greater number of subjects to further explore the role of spirituality in sports
medicine.

31

APPENDICES

32

APPENDIX A: INTERVIEW SCRIPT

I. Demographics
a. Name
b. Age
c. Year in School
d. Varsity Sport
e. Hometown
f. Family structure at home (parents, siblings, grandparents)
g. Religious affiliation
II. General Opinions and Definitions
a. What comes to mind when you hear the term "spirituality?"
1. Experiences
2. People
3. Thoughts
b. How would you define the term "spirituality?"
c. How do you think of spirituality in practice?
1. Individual
2. Group/Community
d. Definitions of Spirituality - What is your reaction to each of these? (Appendix B)
1. Meaning/Purpose
2. Religion

33

APPENDIX A: INTERVIEW SCRIPT (continued)

III. Personal Practices and Beliefs
a. Is spirituality a part of your life/identity? How so? What does it do for you?
b. When/where do you find it to be most useful to you?
1. Personal situation/challenge
c. Are you satisfied with you current level of spirituality? Why? or Why not?
d. How do you fulfill your spiritual needs? Resources?
e. How are those needs being met in this new environment?
IV. Team Practices
a. What do you think about team prayer?
b. Why do you think teams pray together?
c. What do you get out this experience?
d. How do you feel observing this experience?
V. Spirituality in Sport
a. How does spirituality contribute to your life skills? facing adversity?
b. How has spirituality been a part of injury? recovery?
c. Think of the most challenging thing you’ve been through in the last 4 years.
1. Describe your thoughts/emotions.
2. What helped with this transition?
3. What helped with the strong emotions?
4. Any other thoughts about the process of dealing with this experience?

34

APPENDIX A: INTERVIEW SCRIPT (continued)

d. Imagine facing a career-ending injury. Describe your thoughts/emotions.
1. What would help with this transition?
2. What would help with the strong emotions?
3. Any other thoughts? What else might help?
e. Could/does spirituality help you be a better athlete? How so?
f. How do you think spirituality fits in to your experience as a student-athlete?
g. Should spirituality be addressed by sports medicine staff? How so?
1. Should we provide resources to help cultivate your spirituality?
2. What are some ways we could do this?

35

APPENDIX B: DEFINITIONS FOR DISCUSSION

1. Spirituality is a set of practices or beliefs that give people a sense of meaning or
purpose in their lives.

2. Spirituality is a set of beliefs concerning the cause, nature, and purpose of the
universe, especially when considered as the creation of a supernatural agency or
agencies, usually involving devotional and ritual observances, and often containing a
moral code governing the conduct of human affairs.

36

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