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Kew ME, Dave U, Marmor W, Olsen R, Jivanelli B, Tsai SHL, Kuo LT, Ling DI. Sex Differences in Mental Health Symptoms in Elite Athletes: A Systematic Review and Meta-analysis. Sports Health 2024:19417381241264491. [PMID: 39129353 DOI: 10.1177/19417381241264491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024] Open
Abstract
CONTEXT Mental health is a growing area of concern for elite athletes. OBJECTIVE To determine the sex differences in mental health symptoms in elite athletes. DATA SOURCES PubMed, EMBASE, and Cochrane Library databases were used. STUDY SELECTION Included studies included comparisons of mental health symptoms of athletes by sex. STUDY DESIGN Systematic review and meta-analysis were conducted following the PRISMA guidelines. LEVEL OF EVIDENCE Level 2a. DATA EXTRACTION The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model. RESULTS Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30). CONCLUSION Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.
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Affiliation(s)
- Michelle E Kew
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Udit Dave
- Tulane University School of Medicine, New Orleans, Louisiana
| | - William Marmor
- University of Miami, Department of Orthopaedics, Miami, Florida
| | - Reena Olsen
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York
| | - Bridget Jivanelli
- Kim Barrett Memorial Library, HSS Education Institute, Hospital for Special Surgery, New York, New York
| | - Sung Huang Laurent Tsai
- Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Chiayi County, Taiwan and School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Tseng Kuo
- School of Medicine, Chang Gung University, Taoyuan, Taiwan and Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan
| | - Daphne I Ling
- Sports Medicine Institute, Hospital for Special Surgery, New York, New York, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and Department of Population Health Sciences, Weill Cornell Medical College, New York, New York
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Niering M, Klass A, Wolf-Belala N, Seifert J. Prevalence, severity, and predictors of self-reported depression in ultra-distance runners: An online survey based on 265 athletes. Injury 2024; 55:111790. [PMID: 39146612 DOI: 10.1016/j.injury.2024.111790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/14/2024] [Accepted: 08/03/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Literature suggests a high prevalence of mental health disorders among athletes practicing elite and extreme sports. One of the most commonly encountered disorders in this group of individuals is depression. OBJECTIVE The aim of this study was to examine the prevalence, severity, and risk factors of symptoms of self-reported depression among ultra-distance runners. METHODS Data was collected using an online survey (February to April 2023) and included 265 (age 48.35 ± 10.52 years) adult ultra-runners. The Beck Depression Inventory-II (BDI-II) was used to measure self-reported depression. Additional variables comprised basic sociodemographic information and information regarding training, ultramarathon experience, and previous injury. Descriptive and interferential statistics were performed using JASP Version 0.16.4. RESULTS We found that 21.9 % (n = 58) of ultra-runners suffered from self-reported depression (i.e., BDI-II score ≥ 14) with an average BDI-II score of 22.7 ± 7.1 (moderately severe symptoms). Female ultra-runners had a higher prevalence (30.8 %) of self-reported depression than males (16.2 %, p = .001). Logistic regression revealed that ultra-runners without previous sports injury (p = .01) and those of increasing age (p = .003) had a significantly lower risk of self-reported depression. Similarly, linear regression showed the absence of injury (p < .001) and increasing age (p = .02) resulted in significantly lower BDI-II scores. Training volume in distance and hours per week as well as ultra-running experience did not show any significant association. CONCLUSIONS Affecting more than one-fifth of our collective, depressive symptoms appear to be highly prevalent among ultra-runners. Our findings underline the importance of screening for clinical depression, especially among injured athletes. However, the previously assumed peculiarities of the sport in the area of high training volume do not appear to be a significant factor.
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Affiliation(s)
- Marc Niering
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany
| | - Alexander Klass
- Triagon Academy Munich, School of Sports, Psychology and Education, Ismaning, Germany
| | - Nacera Wolf-Belala
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany
| | - Johanna Seifert
- Institute of Biomechanics and Neuroscience, Nordic Science, Hannover, Germany; Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany.
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Tranaeus U, Gledhill A, Johnson U, Podlog L, Wadey R, Wiese Bjornstal D, Ivarsson A. 50 Years of Research on the Psychology of Sport Injury: A Consensus Statement. Sports Med 2024; 54:1733-1748. [PMID: 38862845 PMCID: PMC11258162 DOI: 10.1007/s40279-024-02045-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/13/2024]
Abstract
Factors influencing sport injury risk, rehabilitation outcomes, and return to sport processes have been the focus in various research disciplines (sports medicine, psychology and sociology). One discipline, with over 50 years of scholarship, is the psychology of sport injury. Despite the research in this field, there is no evidence-based consensus to inform professional practice. The aim of this original and timely consensus statement is to summarise psychological sport injury research and provide consensus recommendations for sport practitioners seeking to implement psychological principles into clinical practice. A total of seven experts with extensive experience outlined the consensus objectives and identified three psychology of sport injury sub-domains: risk, rehabilitation and return to sport. The researchers, grouped in pairs, prepared initial drafts of assigned sub-domains. The group met in Stockholm, and the three texts were merged into a draft and revised in an iterative process. Stress responses are the strongest psychological risk factor for acute injuries. Intra- and interpersonal factors, as well as sociocultural factors, are demonstrated psychosocial risk factors for overuse injuries. Stress management and mindfulness interventions to prevent injuries have been successfully implemented. The rehabilitation process may influence athlete's cognitive, emotional, and behavioural responses. Social support, mindfulness, acceptance-based practices, and cognitive-behavioural based intervention programs reduce negative reactions. Return to sport includes various stages and different trajectories. Returning athletes typically experience concerns regarding competence, autonomy, and relatedness. It is recommended that athletes focus on the physical, technical, and psychological demands of their sport as they progress to increasingly intense activities. Interdisciplinary collaboration (e.g., sports medicine and psychology) would be beneficial in enhancing clinical practice and improving athlete outcomes.
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Affiliation(s)
- Ulrika Tranaeus
- Stockholm Sports Trauma Research Centre, FIFA Medical Centre of Excellence, The Swedish School of Sport and Health Sciences, GIH, Box 5626, 114 86, Stockholm, Sweden.
- Department of Physiology, Nutrition, Biomechanics, Sport Performance and Exercise Research and Innovation Centre-Stockholm, SPERIC-S, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
- Unit of Intervention and Implementation for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Adam Gledhill
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Urban Johnson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Leslie Podlog
- School of Kinesiology and Physical Activity Sciences, Faculté de Médecine, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche, CHU-Saint Justine, Montreal, QC, Canada
| | - Ross Wadey
- St Mary's University, Twickenham, London, UK
| | | | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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Thomas GA, Bradson ML, Riegler KE, Sakamoto MS, Arnett PA. Association Between Co-occurring Anxiety and Depressive Symptoms at Baseline and Risk for Sports-Related Concussion in Collegiate Athletes. Orthop J Sports Med 2024; 12:23259671241255932. [PMID: 38911122 PMCID: PMC11191608 DOI: 10.1177/23259671241255932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/01/2024] [Indexed: 06/25/2024] Open
Abstract
Background There is limited research examining whether mental health problems increase the risk for future concussions, even though these problems are highly prevalent in college-aged populations-including student-athletes. Purpose/Hypothesis To examine whether affective disturbance (ie, depressive and anxiety symptoms) at baseline increases the risk for prospective concussion. It was hypothesized that athletes with co-occurring depressive/anxiety symptoms would incur the greatest risk for injury. Methods A total of 878 collegiate athletes completed baseline neuropsychological testing. Athletes were separated into the following 4 groups based on self-reported anxiety and depressive symptoms at baseline: healthy controls; depressive symptoms alone; anxiety symptoms alone; and co-occurring depressive and anxiety symptoms. Of the 878 athletes, 88 sustained future concussions. Logistic regression was conducted with prospective concussion (yes/no) as the outcome and the affective group as the predictor. Sport was included as a covariate. Results After controlling for sport, athletes in the co-occurring depressive/anxiety symptoms group were more than twice as likely to be diagnosed with a future concussion compared with healthy controls (odds ratio, 2.72 [95% CI, 1.33-5.57]; P = .01). The co-occurring depressive/anxiety symptoms group also showed an increased risk for prospective concussion compared with the depressive symptoms alone and anxiety symptoms alone groups, respectively. However, the results were not statistically significant. Athletes in the depressive symptoms alone and anxiety symptoms alone groups did not show a significantly increased risk for prospective concussion compared with healthy controls. Conclusion Athletes with co-occurring depressive/anxiety symptoms at baseline showed a notably increased risk of being diagnosed with a future concussion, even after controlling for sport. This suggests that co-occurring depressive/anxiety symptoms infer a unique risk that is associated with a greater susceptibility to concussion diagnosis.
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Affiliation(s)
- Garrett A. Thomas
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Megan L. Bradson
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kaitlin E. Riegler
- Princeton Neuropsychology-Sports Concussion Center of New Jersey, Princeton, New Jersey, USA
| | - McKenna S. Sakamoto
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Peter A. Arnett
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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McClean ZJ, Pasanen K, Lun V, Charest J, Herzog W, Werthner P, Black A, Vleuten RV, Lacoste E, Jordan MJ. A Biopsychosocial Model for Understanding Training Load, Fatigue, and Musculoskeletal Sport Injury in University Athletes: A Scoping Review. J Strength Cond Res 2024; 38:1177-1188. [PMID: 38781473 DOI: 10.1519/jsc.0000000000004789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT McClean, ZJ, Pasanen, K, Lun, V, Charest, J, Herzog, W, Werthner, P, Black, A, Vleuten, RV, Lacoste, E, and Jordan, MJ. A biopsychosocial model for understanding training load, fatigue, and musculoskeletal sport injury in university athletes: A scoping review. J Strength Cond Res 38(6): 1177-1188, 2024-The impact of musculoskeletal (MSK) injury on athlete health and performance has been studied extensively in youth sport and elite sport. Current research examining the relationship between training load, injury, and fatigue in university athletes is sparse. Furthermore, a range of contextual factors that influence the training load-fatigue-injury relationship exist, necessitating an integrative biopsychosocial model to address primary and secondary injury prevention research. The objectives of this review were (a) to review the scientific literature examining the relationship between training load, fatigue, and MSK injury in university athletes and (b) to use this review in conjunction with a transdisciplinary research team to identify biopsychosocial factors that influence MSK injury and develop an updated, holistic biopsychosocial model to inform injury prevention research and practice in university sport. Ten articles were identified for inclusion in this review. Key findings were an absence of injury surveillance methodology and contextual factors that can influence the training load-fatigue-MSK injury relationship. We highlight the inclusion of academic load, social load, and mental health load as key variables contributing to a multifactorial, gendered environmental, scientific inquiry on sport injury and reinjury in university sport. An integrative biopsychosocial model for MSK injury in university sport is presented that can be used to study the biological, psychological, and social factors that modulate injury and reinjury risk in university athletes. Finally, we provide an example of how causal inference can be used to maximize the utility of longitudinally collected observational data that is characteristic of sport performance research in university sport.
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Affiliation(s)
- Zachary J McClean
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Victor Lun
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- École de Psychologie, Université Laval, Québec, Quebec, Canada; and
- Center for Sleep & Human Performance, Calgary, Alberta, Canada
| | - Walter Herzog
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Penny Werthner
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Amanda Black
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Reid Vander Vleuten
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Elise Lacoste
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Matthew J Jordan
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Integrative Neuromuscular Sport Performance Lab, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Center, University of Calgary, Calgary, Alberta, Canada
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6
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Yoshida N, Miyazaki S, Waki H, Minakawa Y, Koido M, Mashimo S. Health status of university football athletes through multidimensional screening. PHYSICIAN SPORTSMED 2024; 52:291-298. [PMID: 37548493 DOI: 10.1080/00913847.2023.2246178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/22/2023] [Accepted: 08/06/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Adequate conditioning results from various physical, environmental, and psychological factors in sports activities. In this study, we aimed to clarify the concurrence and relevance of injuries, psychological problems, and sleep disturbance in university football (soccer) players. Biomechanical characteristics and risk factors for those injuries were also investigated. METHODS Overall, 1,084 university football players participated in this cross-sectional study using a web-based health history questionnaire. Assessments were made via the presence of injuries for physical problems, the Athlete Psychological Strain Questionnaire (APSQ) for psychological problems, and the Athlete Sleep Screening Questionnaire (ASSQ) for sleep difficulties. RESULTS There were 200 (19%) athletes with injuries; 413 (38%) of these were APSQ-positive, 246 (23%) were ASSQ-positive, and 468 (43%) athletes had no physical, psychological, or sleep problems. APSQ-positive respondents were significantly more likely to have a current injury than those who were APSQ-negative. No significant difference was observed between the number of ASSQ-positive and -negative respondents and current injuries. Those with sleep problems were significantly more likely to have psychological problems. CONCLUSION More than 60% of university football players had one or more physical, psychological, or sleep problems. Players may have co-occurring problems, and it is important to address them for these athletes to reach peak performance.
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Affiliation(s)
- Naruto Yoshida
- Department of Sport and Wellness, Rikkyo University, Saitama, Japan
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Shogo Miyazaki
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Hideaki Waki
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Yoichi Minakawa
- Department of Acupuncture and Moxibustion, Faculty of Health Care, Teikyo Heisei University, Tokyo, Japan
| | - Masaaki Koido
- Faculty of Health and Sport Science, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Sonoko Mashimo
- Institute for Liberal Arts and Sciences, Osaka Electro-Communication University, Neyagawa, Osaka, Japan
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Leduc JG, Boucher F, Marques DL, Brunelle E. Basic psychological need satisfaction of collegiate athletes: the unique and interactive effects of team identification and LMX quality. Front Sports Act Living 2024; 6:1342995. [PMID: 38756189 PMCID: PMC11096468 DOI: 10.3389/fspor.2024.1342995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose The present study sought to understand the relationships between team identification, leader-member exchange (LMX) quality, and the basic psychological need satisfaction of collegiate athletes, as well as the moderating role of coach-athlete LMX quality. Methods Self-reported data from 319 collegiate athletes were analyzed using SPSS version 29. The relationships between the study variables were tested by moderation analysis using PROCESS macro model 1. Results Regression analyses showed team identification to be positively related to the satisfaction of the needs for competence and relatedness, while LMX quality was positively related to the satisfaction of the needs for competence and autonomy. Furthermore, moderation analyses showed that LMX quality positively moderated the relationship between team identification and the satisfaction of the needs for competence and relatedness. Conclusion The results of this study highlight the important role that team identification and LMX quality play in the satisfaction of the basic psychological needs of collegiate athletes. The implications of these results for the optimal functioning of collegiate athletes are discussed.
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Affiliation(s)
- Joé G. Leduc
- Department of Management, John Molson School of Business, Concordia University, Montreal, QC, Canada
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Ahmad CS, Hellwinkel JE, Ahmed R, Alexander FJ, Reynolds AW, Piasecki DP, Bottiglieri TS, Lynch TS, Popkin CA, Saltzman BM, Trofa DP. Impacts of the Early COVID-19 Pandemic on Depressive Symptoms and Mental Health Among Student-Athletes. Open Access J Sports Med 2024; 15:19-28. [PMID: 38523629 PMCID: PMC10959820 DOI: 10.2147/oajsm.s392977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 07/06/2023] [Indexed: 03/26/2024] Open
Abstract
Objective Social distancing protocols due to the COVID-19 pandemic resulted in premature ending of athletic seasons and cancellation of upcoming seasons, placing significant stress on young athletes. Inability to play or forced early retirement has significant consequences on athlete's mental health, as demonstrated by an extensive body of injury literature. We hypothesize that premature suspension and cancellation of athletic events due to the COVID-19 pandemic leads to higher incidence of depressive symptoms among high-school and collegiate athletes. Further, athletes who strongly derive their sense of self-worth centered around athletics would have higher rates of depressive symptoms. Methods High school and collegiate athletes were evaluated for depressive symptoms, emotional health and athletic identity measures through validated assessment instruments from May 2020 through July 2020. The Patient-Reported Outcomes Measurement Information System Depression Computer Adaptive Test (PROMIS-10 Depression CAT), Veterans RAND-12 (VR-12), which comprises both a physical and mental health component, and Athletic Identity Measurement Scale (AIMS) were utilized. Results Mental health assessments were completed by 515 athletes (52.4% male, 47.6% female; .84.5% collegiate, 15.5% high school). Female athletes scored significantly worse than males on VR-12 mental health assessments, as well as PROMIS-10 Depression scores; however, males scored significantly lower than females on VR-12 physical health assessments, irrespective of education level. Athletes who had strong associations with athletics as central to their personal identity exhibited worse psychologic impact on VR-12 mental health and PROMIS-10 Depression measures and female athletes in this cohort reported greater depressive symptoms than males. Conclusion Social distancing protocols due to the COVID-19 pandemic have limited athlete's ability to participate in sports at the training and competition level. Higher rates of depressive symptoms in high school and college athletes have resulted among female athletes and those who identify strongly as an athlete.
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Affiliation(s)
- Christopher S Ahmad
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Justin E Hellwinkel
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Rifat Ahmed
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Frank J Alexander
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Alan W Reynolds
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Dana P Piasecki
- Sports Medicine Center, OrthoCarolina, Charlotte, NC, 28207, USA
- Musculoskeletal Institute, Atrium Health, Charlotte, NC, 28207, USA
| | - Thomas S Bottiglieri
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - T Sean Lynch
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Charles A Popkin
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
| | - Bryan M Saltzman
- Sports Medicine Center, OrthoCarolina, Charlotte, NC, 28207, USA
- Musculoskeletal Institute, Atrium Health, Charlotte, NC, 28207, USA
| | - David P Trofa
- Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, 10032, USA
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Rogers DL, Tanaka MJ, Cosgarea AJ, Ginsburg RD, Dreher GM. How Mental Health Affects Injury Risk and Outcomes in Athletes. Sports Health 2024; 16:222-229. [PMID: 37326145 PMCID: PMC10916780 DOI: 10.1177/19417381231179678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
CONTEXT The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care. EVIDENCE ACQUISITION We searched PubMed for pertinent peer-reviewed studies. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 5. RESULTS There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes. CONCLUSION Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
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Affiliation(s)
- Davis L Rogers
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew J Cosgarea
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard D Ginsburg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey M Dreher
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
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McAllister TW, Kenny R, Harezlak J, Harland J, McCrea MA, Pasquina P, Broglio SP. Profile of brief symptom inventory-18 (BSI-18) scores in collegiate athletes: A CARE Consortium study. Clin Neuropsychol 2024:1-16. [PMID: 38369458 DOI: 10.1080/13854046.2024.2315728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/05/2023] [Indexed: 02/20/2024]
Abstract
Objective: The goal of this study was to characterize normative scores for the Brief Symptom Inventory (BSI-18) in collegiate athletes to inform decision making about the need for psychological health services in this group. Methods: Collegiate student-athletes (N = 20,034) from 25 universities completed the BSI-18 at their preseason baseline assessment. A subgroup (n = 5,387) underwent multiple baseline assessments. Global Severity Index (GSI) scores were compared to community norms and across multiple timepoints. Results: Collegiate athletes reported significantly lower GSI scores than published community norms (p<.001). Published GSI threshold scores for "caseness", identified only 2 per 100 athletes (≥ the 98th percentile) as needing further evaluation. Using a GSI score ≥ than the cohort's 90th percentile, 11.4 per 100 athletes would merit additional evaluation. These individuals were more likely to report a history of psychiatric diagnosis (Odds ratio [95% CI] 2.745 [2.480, 3.039]), as well as ≥ 2 prior concussions (p<.001). GSI scores were not highly correlated across timepoints. Suicidal ideation was rare (n = 230; 1.15%). Conclusions: For collegiate student-athletes, published BSI-18 threshold scores identify only extreme outliers who might benefit from additional behavioral health evaluation. Alternatively, use of threshold scores ≥ the 90th percentile identifies a more realistic 11.4% of the population, with higher likelihood of prior concussion and/or psychiatric disorders.
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Affiliation(s)
- Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rachel Kenny
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jaroslaw Harezlak
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN, USA
| | - Jody Harland
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Michael A McCrea
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Paul Pasquina
- Department of Physical Medicine and Rehabilitation, Uniformed Services University, Bethesda, MD, USA
| | - Steven P Broglio
- Michigan Concussion Center, University of Michigan, Ann Arbor, MI, USA
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Yunus FM, Standage C, Walsh C, Lockhart P, Thompson K, Keough M, Krank M, Hadwin A, Conrod PJ, Stewart SH. High peak drinking levels mediate the relation between impulsive personality and injury risk in emerging adults. Inj Epidemiol 2024; 11:5. [PMID: 38350989 PMCID: PMC10863178 DOI: 10.1186/s40621-024-00487-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/26/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Alcohol-induced injury is one of the leading causes of preventable morbidity and mortality. We investigated the relationship between impulsive personality and physical injury (e.g. falls, sports), and whether peak drinking quantity specifically, and/or risky behaviour more generally, mediates the relationship between impulsivity and injury in undergraduates. METHOD We used data from the winter 2021 UniVenture survey with 1316 first- and second-year undergraduate students aged 18-25 years (79.5% female) from five Canadian Universities. Students completed an online survey regarding their demographics, personality, alcohol use, risky behaviours, and injury experiences. Impulsivity was measured with the substance use risk profile scale, past 30-day peak alcohol use with the quantity-frequency-peak Alcohol Use Index, general risky behaviour with the risky behaviour questionnaire, and past 6-month injury experience with the World Health Organization's (2017) injury measurement questionnaire. RESULTS Of 1316 total participants, 12.9% (n = 170) reported having sustained a physical injury in the past 6 months. Mean impulsivity, peak drinking quantity, and risky behaviour scores were significantly higher among those who reported vs. did not report injury. Impulsivity and peak drinking quantity, but not general risky behaviour, predicted injury in a multi-level generalized mixed model. Mediation analyses supported impulsivity as both a direct predictor of physical injury and an indirect predictor through increased peak drinking (both p < .05), but not through general risky behaviour. CONCLUSION Results imply emerging adults with impulsive tendencies should be identified for selective injury prevention programs and suggest targeting their heavy drinking to decrease their risk for physical injury.
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Affiliation(s)
- Fakir Md Yunus
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Catherine Standage
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Department of Clinical Psychology, University of Prince Edward Island, Charlottetown, PE, C1A 4P3, Canada
| | - Chantal Walsh
- Injury Free Nova Scotia, Halifax, NS, B3K 0E4, Canada
| | - Peri Lockhart
- Injury Free Nova Scotia, Halifax, NS, B3K 0E4, Canada
| | - Kara Thompson
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, B2G 2W5, Canada
| | - Matthew Keough
- Department of Psychology, York University, Toronto, ON, M3J 1P3, Canada
| | - Marvin Krank
- Department of Psychology, University of British Columbia, Kelowna, BC, V1V 1V7, Canada
| | - Allyson Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - Patricia J Conrod
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, QC, H3T 1J4, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
- Department of Psychiatry, Dalhousie University, Halifax, NS, B3H 2E2, Canada.
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Werner T, Michel-Kröhler A, Berti S, Wessa M. Not All Injuries Are the Same: Different Patterns in Sports Injuries and Their Psychosocial Correlates. Sports (Basel) 2023; 11:237. [PMID: 38133104 PMCID: PMC10747018 DOI: 10.3390/sports11120237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/17/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
Sports injuries are ubiquitous and can have far-reaching consequences for athletes (e.g., health, performance). Previous studies have examined various psychosocial influencing factors (e.g., stress), but have mostly focused on only one or two injury characteristics (e.g., frequency), neglecting the broader injury pattern. Thus, the present study aimed to obtain a more differentiated picture of potentially different injury patterns and related profiles of psychosocial factors. We investigated a sample of 213 athletes from a cross-sectional online study. Current injury status, frequency, severity, chronicity, medical treatment, and rehabilitation measures were subjected to cluster analysis indicating a 3-cluster solution with predominantly chronically injured athletes (n = 54), athletes not seeking treatment (n = 62), and athletes utilizing medical treatment and rehabilitation (n = 97). Building on the Model of Stress and Athletic Injury, we subsequently conducted three multivariate analyses of variance (MANOVAs) to examine whether the obtained clusters differed in terms of personality factors (e.g., athletic identity), history of stressors (e.g., life events), and coping resources (e.g., self-compassion). We observed significant differences in all three categories of psychosocial variables implying different intervention possibilities for different injury patterns in the future.
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Affiliation(s)
- Tabea Werner
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (T.W.); (A.M.-K.); (S.B.)
| | - Alena Michel-Kröhler
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (T.W.); (A.M.-K.); (S.B.)
| | - Stefan Berti
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (T.W.); (A.M.-K.); (S.B.)
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany; (T.W.); (A.M.-K.); (S.B.)
- Research Group Wessa, Leibniz-Institute for Resilience Research, 55122 Mainz, Germany
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Davis J, Doyle B, Ishii H, Jayanthi N. S.P.O.R.R.T.-A Comprehensive Approach to the Assessment and Non-Operative Management of Overuse Knee Conditions in Youth Athletes. Curr Rev Musculoskelet Med 2023; 16:627-638. [PMID: 37999828 PMCID: PMC10733244 DOI: 10.1007/s12178-023-09874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE OF REVIEW The evaluation of a young athlete with an overuse injury to the knee involves a comprehensive approach. There are a number of elements to consider including assessments of skeletal maturity (biologic maturation), workload (training load + competition load), sport specialization status, and biomechanics. The type of injury and treatment, as well as future prognosis, may be influenced by these and other factors. RECENT FINDINGS Calculating the percentage of predicted adult height (PPAH) is a valuable tool in assessing overuse injury patterns and diagnoses in youth athletes. Modifiable and non-modifiable overuse injury risk factors require monitoring from clinicians as young athletes mature and develop over time. Training and rehabilitation programs should be adapted to account for these. In this manuscript, we seek to introduce a novel, comprehensive approach: S.P.O.R.R.T. (Skeletal Maturity, Prior Injury Risk, One Sport Specialization, Rehabilitation, Return to Play, Training Recommendations) (Fig. 1). Overuse, non-traumatic injuries to the knee in youth athletes will be presented in a case-based and evidence-based model to provide a framework for a comprehensive approach to the assessment and treatment of youth athletes with overuse injuries.
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Affiliation(s)
- Jacob Davis
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
- Georgia Institute of Technology, Sports Medicine, Atlanta, GA, USA
| | - Bridget Doyle
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Haruki Ishii
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA
| | - Neeru Jayanthi
- Emory Sports Medicine Center, 6335 Hospital Parkway, Suite 302, Johns Creek, GA, 30097, USA.
- Emory Sports Performance & Research Center (SPARC), 4450 Falcon Pkwy, Flowery Branch, GA, USA.
- Emory University School of Medicine, Department of Orthopedics and Family Medicine, Atlanta, GA, USA.
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Edwards B, Froehle AW. Factors Affecting Anxiety-Related Symptoms, Diagnosis, and Treatment Among Collegiate Student-Athletes in the National College Health Assessment. J Athl Train 2023; 58:722-732. [PMID: 37737433 PMCID: PMC11215730 DOI: 10.4085/1062-6050-0334.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
CONTEXT Increased attention continues to be placed on best practices for assisting student-athletes who show symptoms of a mental health illness. One of the most common mental health concerns for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can help student-athletes find early intervention. OBJECTIVE To elucidate specific attributes associated with an increased likelihood of anxiety symptoms and treatment avoidance to help athletic trainers and other practitioners better identify and assist high-risk individuals. DESIGN Cross-sectional study. SETTING Colleges and universities in the United States. PATIENTS OR OTHER PARTICIPANTS A total of 51 882 varsity athletes who completed the National College Health Assessment between 2011 and 2019. MAIN OUTCOME MEASURE(S) Survey responses (self-report) to questions related to anxiety symptoms and disorders cross-sectioned into 9 predictors: year in school, gender, sexual orientation, race and ethnicity, international student status, school type, received information on stress reduction or depression or anxiety, anxiety about impeding academic performance, and history of mental health treatment in the last year. RESULTS More than three-fourths (82.9%, n = 43 016) of student-athletes reported feeling overwhelmed because of all that they had to do in their daily activities, whereas only half (47.5%, n = 24 645) of student-athletes described overwhelming anxiety as a symptom. Gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment had large effects on these 2 symptoms. However, of the student-athletes who reported overwhelming anxiety as a symptom, only one-fourth (22.9%, n = 5649) indicated they received a diagnosis of anxiety with or without treatment. CONCLUSIONS Factors such as the year in school and availability of mental health information appeared to have little effect on the experience of anxiety-related symptoms and the propensity to seek treatment. However, other factors, including gender, sexual orientation, race and ethnicity, school type, and previous mental health treatment, did have important effects. Our study provides additional evidence that the stresses placed on collegiate student-athletes frequently led to feelings of being overwhelmed and, eventually, anxiety disorder diagnoses. However, most student-athletes experiencing anxiety-related symptoms still did not seek a diagnosis with or without treatment.
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Affiliation(s)
- Brian Edwards
- Department of Kinesiology and Health, Wright State University, Fairborn, OH
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Junge A, Wellmann K, Zech A. Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues. Scand J Med Sci Sports 2023; 33:1866-1873. [PMID: 37309991 DOI: 10.1111/sms.14426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 04/13/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players. AIMS To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population. METHODS Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). RESULTS One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy. CONCLUSION It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.
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Affiliation(s)
- Astrid Junge
- Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg (MSH), Hamburg, Germany
- Center for Health in Performing Arts, Medical School Hamburg (MSH), Hamburg, Germany
| | - Kai Wellmann
- Department of Human Movement Science and Exercise Physiology, Friedrich Schiller University Jena, Jena, Germany
| | - Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Friedrich Schiller University Jena, Jena, Germany
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Michaels C, Holman A, Teramoto M, Bellendir T, Krautgasser-Tolman S, Willick SE. Descriptive Analysis of Mental and Physical Wellness in Collegiate Dancers. J Dance Med Sci 2023; 27:173-179. [PMID: 37264604 PMCID: PMC10456971 DOI: 10.1177/1089313x231178091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Understanding the physical and mental health of collegiate dancers is important for developing appropriate screening protocols and treatment interventions. This study aims to provide descriptive data on the overall health, injury burden, and well-being of a group of collegiate dancers, including the interactions between injury, nutrition, and mental health, to provide insight for wellness screening and interventions in collegiate dance programs. METHODS Members of the School of Dance at the University of Utah were sent an electronic general health survey. The survey included questions regarding medical history, family history, injuries, diet, sleep quality, symptoms of depression and anxiety, and history of eating disorders. RESULTS Of the 231 dancers who received the survey, 198 responded (response rate = 85.7%). Fifty 2% of respondents had an active injury. Symptoms of depression and anxiety were common (35.4%), and 37.4% of the dancers were interested in receiving mental health support. Symptoms of depression and anxiety had a significant association with both a history of injury and active injuries (P = .033 and .039, respectively). History of eating disorder was also significantly associated with active injuries (P = .005). The most commonly injured body area was ankle or foot (n = 144, 72.7%), followed by lower leg or shin (n = 76, 38.4%), and knee (n = 61, 30.8%). Over a quarter of the dancers (n = 54, 27.3%) reported having trouble sleeping, and 9.1% reported having a history of eating disorder. CONCLUSIONS This study highlights the important interplay between mental health, sleep, nutrition, and injury. These results show that in a group of collegiate dancers, active injuries and mental health concerns are common, and that there are statistically significant associations between injury, nutrition, and mental health. These data provide insight into factors that affect dancer wellness and help inform future screening and intervention protocols for dance programs.
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Affiliation(s)
- Chris Michaels
- University of Utah Orthopaedic Center
- University of Utah School of Dance
| | | | - Masaru Teramoto
- University of Utah Department of Physical Medicine & Rehabilitation, Salt Lake City, UT
| | - Trina Bellendir
- University of Utah Department of Physical Therapy and Athletic Training, Salt Lake City, UT
| | | | - Stuart E. Willick
- University of Utah Department of Physical Medicine & Rehabilitation, Salt Lake City, UT
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Casey E, Bonanno J, Cheng J, Abutalib Z, Kranz K, Kruse D, Thomas C, Faustin M. Return to sport in elite gymnastics: Unprecedented training interruptions provide lessons for the future. PM R 2023; 15:881-890. [PMID: 36281922 DOI: 10.1002/pmrj.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/07/2022] [Accepted: 07/20/2022] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Year-round training is standard for elite gymnasts in the United States, but the coronavirus disease 2019 (COVID-19) pandemic led to unprecedented training interruptions. The effect of these training disruptions is unknown. OBJECTIVE This study aimed to describe and compare training interruptions in elite gymnasts before and during the pandemic, the time it took to return to the prior level of gymnastics training, the development of injuries during return to gymnastics training, and gymnast-reported difficulty in and nervousness about returning to prior level of gymnastics training. DESIGN Retrospective study. SETTING Anonymous online surveys distributed to elite gymnasts in the United States. PARTICIPANTS A total of 184 current elite gymnasts who completed the surveys were included. This represented an overall response rate of 52.3% (184/352). INTERVENTIONS None. MAIN OUTCOME MEASURES Information was collected about training interruptions and time, nervousness, difficulty, and injury during return to gymnastics. RESULTS Gymnasts reported significantly longer training interruptions due to COVID-19 than before the pandemic (8.7 ± 4.4 vs. 4.4 ± 7.9 weeks, p < .001), but duration of return to prior gymnastics level was similar (4.6 ± 2.7 vs. 3.7 ± 4.8 weeks, p = .106). Of the 137 gymnasts who had returned to training by the time of the survey, 46 (33.6%) reported an injury during their return to gymnastics. A high degree of nervousness to return to gymnastics was significantly associated with greater risks of injury upon return (risk ratio [RR] 2.7, 95% confidence interval [CI]: 1.6-4.7; p < .001) and difficulty returning to prior level (RR 3.4, 95% CI: 1.7-6.6; p < .001). CONCLUSION Pandemic-related training interruption was significantly greater in duration than prior interruptions, but time required for return to gymnastics was similar. Gymnasts may be at increased risk of injury during return to gymnastics if experiencing nervousness about returning following a break in training. These findings provide guidance for gymnasts' return from training interruptions and may refute the long-held belief that gymnasts should not take time away from training due to fear of injury or difficulty regaining skills.
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Affiliation(s)
- Ellen Casey
- Department of Physiatry, Hospital for Special Surgery, New York, New York, USA
- USA Gymnastics, Indianapolis, Indiana, USA
| | - Joseph Bonanno
- Department of Physiatry, Hospital for Special Surgery, New York, New York, USA
| | - Jennifer Cheng
- Department of Physiatry, Hospital for Special Surgery, New York, New York, USA
| | - Zafir Abutalib
- Biostatistics Core, Hospital for Special Surgery, New York, New York, USA
| | | | - David Kruse
- USA Gymnastics, Indianapolis, Indiana, USA
- Hoag Orthopedic Institute, Irvine, California, USA
| | | | - Marcia Faustin
- USA Gymnastics, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, University of California, Davis, Sacramento, California, USA
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Marconcin P, Silva AL, Flôres F, Nunes A, Lourenço JF, Peralta M, Minghelli B. Association between Musculoskeletal Injuries and Depressive Symptoms among Athletes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6130. [PMID: 37372717 DOI: 10.3390/ijerph20126130] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/16/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
Musculoskeletal (MSK) injuries have a significant physical and psychological influence on an athlete's life. A systematic review of prospective cohort, cross-sectional, and case-control studies was undertaken in this study to analyze the association between MSK injuries with depressive symptoms in athletes. We searched on PubMed, Web of Science, and Scopus, with data inception to 15 February 2023. The methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). Of the 3677 potential studies only nine were included. These studies showed a bidirectional association between MSK injuries and depressive symptoms. Athletes with MSK injuries had higher levels of depressive symptoms, which raises the likelihood of experiencing depression in the future. Women athletes had higher levels of depressive symptoms compared with men. The presence of depressive symptoms is a significant predictor of disability in athletes. Our findings suggest that coaches should be more aware of depressive symptoms, in order to prevent MSK injuries, and to monitor athletes following an MSK injury.
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Affiliation(s)
- Priscila Marconcin
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
- Centro Interdisciplinar de Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada-Dafundo, 1499-002 Lisboa, Portugal
| | - Ana Lúcia Silva
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
- Centro Interdisciplinar de Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada-Dafundo, 1499-002 Lisboa, Portugal
| | - Fábio Flôres
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
| | - Alexandre Nunes
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
| | - Joana Filipa Lourenço
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
| | - Miguel Peralta
- Centro Interdisciplinar de Performance Humana (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada-Dafundo, 1499-002 Lisboa, Portugal
- Instituto de Saúde Ambiental (ISAMB), Faculdade de Medicina, Universidade de Lisboa, 1495-751 Lisboa, Portugal
| | - Beatriz Minghelli
- KinesioLab, Research Unit in Human Movement, Piaget Institute, Av. João Paulo II, lote 544, 2º andar, 1950-157 Lisboa, Portugal
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Buckley TA, Bryk KN, Enrique AL, Kaminski TW, Hunzinger KJ, Oldham JR. Clinical Mental Health Measures and Prediction of Postconcussion Musculoskeletal Injury. J Athl Train 2023; 58:401-407. [PMID: 35788664 PMCID: PMC11220908 DOI: 10.4085/1062-6050-0595.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT The rate of lower extremity musculoskeletal injury (LE MSK) is elevated after concussion; however, the underlying mechanism has not been elucidated. Physical characteristics have been investigated despite poorer mental health being a common postconcussion complaint and linked to MSKs. OBJECTIVE To evaluate the role of mental health as a predictor of postconcussion LE MSK. DESIGN Case-control study. SETTING Intercollegiate athletic training facility. PATIENTS OR OTHER PARTICIPANTS A total of 67 National Collegiate Athletic Association Division I student-athletes (n = 39 females) who had been diagnosed with a sport-related concussion. MAIN OUTCOME MEASURE(S) The Brief Symptom Inventory-18, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale (SWLS) measures were completed at baseline (preseason) and on the day participants were cleared for unrestricted return to play (RTP) after a concussion. Two binary logistic regressions were used to predict postconcussion LE MSK within a year, one for the baseline time point and the second for the RTP time point. A 2 (group: LE MSK, no LE MSK)-by-2 (time: baseline, RTP) repeated-measures analysis of variance compared performance between baseline and RTP. RESULTS Subsequent LE MSKs were sustained by 44 participants (65.7%). The only significant predictor of postconcussion LE MSK was the SWLS score at RTP, with Exp(B) = 0.64, indicating that an increased (improved) SWLS score was associated with a lower LE MSK rate. No significant interactions were present between mental health measures and subsequent MSK (P values = .105-.885). CONCLUSIONS Limited associations were evident between postconcussion LE MSK and scores on commonly used measures of anxiety, depression, and satisfaction with life. Reported increased satisfaction with life was associated with a decreased injury risk, which warrants further attention. Our results suggest that these measures of anxiety, depression, and satisfaction with life have limited value in assisting sports medicine clinicians with determining which student-athletes are at elevated risk of postconcussion LE MSK.
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Affiliation(s)
- Thomas A. Buckley
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
| | - Kelsey N. Bryk
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
| | - Alexander L. Enrique
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
| | - Thomas W. Kaminski
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
| | - Katherine J. Hunzinger
- Department of Kinesiology and Applied Physiology and Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware, Newark
| | - Jessie R. Oldham
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond
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Müller S, Gabbett T, McNeil D. Reducing Injury Risk and Improving Skill: How a Psycho-Perceptual-Motor Approach Can Benefit High-Performance Sport. Sports Health 2023; 15:315-317. [PMID: 37092885 PMCID: PMC10170223 DOI: 10.1177/19417381231156437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
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Vähi I, Rips L, Varblane A, Pääsuke M. Musculoskeletal Injury Risk in a Military Cadet Population Participating in an Injury-Prevention Program. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:356. [PMID: 36837558 PMCID: PMC9961050 DOI: 10.3390/medicina59020356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and Objectives: Musculoskeletal injuries are a major health hazard among military personnel. Previous research has proposed several exercise-based strategies for prevention. The purpose of this study was to investigate the effect of an exercise-based injury-prevention program on the incidence of musculoskeletal injury, motor performance and psychosocial status. Materials and Methods: Thirty-six Estonian Military Academy cadets were randomly assigned into either an intervention or control group. The intervention group followed a neuromuscular exercise-based injury-prevention warm-up program, three times per week for 6 months. The control group continued with the usual warm-up. The main outcome measure was injury incidence during the study period. Additionally, evaluation of isokinetic lower-extremity strength, postural sway, physical fitness and psychosocial status was included pre- and post-intervention. Results: During the 6-month study period, the musculoskeletal injury incidence was 43% in the intervention group and 54% in the control group (RR = 0.8; 95% CI = 0.41 to 1.99). The noted 20% risk reduction was not statistically significant (p = 0.59). Furthermore, there were no statistically significant differences between the intervention and control group in motor performance or psychosocial status measures. Conclusions: In conclusion, no effect of the exercise-based injury-prevention program on injury risk, motor performance or psychosocial status could be detected.
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Affiliation(s)
- Ivar Vähi
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Ujula 4, 51008 Tartu, Estonia
| | - Leho Rips
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
- Sports Medicine and Rehabilitation Clinic, Tartu University Hospital, Puusepa 1a, 50406 Tartu, Estonia
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, Estonia
| | - Ahti Varblane
- Estonian Military Academy, War and Disaster Medicine Centre, Riia 12, 51010 Tartu, Estonia
| | - Mati Pääsuke
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Ujula 4, 51008 Tartu, Estonia
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Kroshus E, Coakley S, Conway D, Chew K, Blair N, Mohler JM, Wagner J, Hainline B. Addressing mental health needs of NCAA student-athletes of colour: foundational concepts from the NCAA Summit on Diverse Student-Athlete Mental Health and Well-Being. Br J Sports Med 2023; 57:137-145. [PMID: 36657824 DOI: 10.1136/bjsports-2022-105891] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/24/2023]
Abstract
We sought to identify concepts that may facilitate National Collegiate Athletic Association efforts to assist member institutions in addressing the mental health needs of student-athletes of colour. A two-step process was followed to generate and refine concepts, guided by Delphi methodology. First, a scoping review was conducted, including original peer-reviewed research articles that quantified or qualitatively described determinant(s) of racial or ethnic differences in athlete mental health or mental healthcare. Next, a multiday virtual meeting was facilitated to review the results of the scoping review, discuss lived experiences and generate potential concepts. Participants included a racially and ethnically diverse group of student-athletes, medical and mental health professionals, athletics administrators, diversity, equity and inclusion experts, health educators and representatives from leading organisations involved in athlete mental health. Through the consensus process, participants identified 42 concepts that member institutions might consider implementing on their campuses. Concepts were largely focused on organisational policies and practices such as staffing diversity and inclusion, expanded options for clinical support (ie, identity-relevant support groups) and within-organisation accountability. Concepts related to specific areas for stakeholder education were also identified. Institutions have the potential to play an important role in supporting the mental well being of student-athletes of colour, and the present concepts can help inform institutional action. While concepts proposed are believed to be broadly relevant across athletics settings, they would need to be further considered and tailored to reflect setting-specific organisational structures, resources and needs.
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Affiliation(s)
- Emily Kroshus
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA .,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Stephany Coakley
- Department of Intercollegiate Athletics, Temple University, Philadelphia, Pennsylvania, USA
| | - Darryl Conway
- Department of Intercollegiate Athletics, University of Michigan, Ann Arbor, Michigan, USA
| | - Kenneth Chew
- Student Counseling Center, Indiana State University, Terre Haute, Indiana, USA
| | - Niya Blair
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | - Jessica M Mohler
- Midshipmen Development Center, US Naval Institute, Annapolis, Maryland, USA
| | - Jessica Wagner
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | - Brian Hainline
- National Collegiate Athletic Association, Indianapolis, Indiana, USA
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23
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Weber SR, Winkelmann ZK, Monsma EV, Arent SM, Torres-McGehee TM. An Examination of Depression, Anxiety, and Self-Esteem in Collegiate Student-Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1211. [PMID: 36673967 PMCID: PMC9858692 DOI: 10.3390/ijerph20021211] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/07/2023] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
Mental health research exists for student-athletes in the areas of depression, anxiety, and self-esteem prevalence. However, updated prevalence rates and assessment of risks across sports, academic status, and genders are needed. Filling the gaps in research assists in the creation of patient-centered mental health screening and interventions designed for student-athletes. Therefore, the purpose is to examine the prevalence of depression, anxiety, and self-esteem in collegiate student-athletes and differences between sex, academic status, and sport type, and identify associations for risks. Using a cross-sectional design, collegiate student-athletes were surveyed to assess for risks of depression, anxiety, and self-esteem. With the use of SPSS, Chi-square analyses and multinomial logistic regressions were used. Student-athletes (22.3%) were at risk for depression, anxiety (12.5%), and low self-esteem (8%). No significant differences were found for sex, academic status, and sport type for depression or self-esteem; however, significant differences occurred for state and trait anxiety by sex. A significant association for depression and anxiety risk was found with females at risk. Depression and anxiety are present within student-athletes, regardless of sport type. Females are at a higher risk; however, all student-athletes would benefit from the creation of validated, patient-centered mental health screenings and psychotherapeutic interventions.
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Affiliation(s)
- Samantha R. Weber
- Department of Nursing and Health Science, Limestone University, Gaffney, SC 29340, USA
| | - Zachary K. Winkelmann
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
| | - Eva V. Monsma
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA
| | - Shawn M. Arent
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA
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24
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Moreton A, Wahesh E, Schmidt CD. Indirect effect of mindfulness on psychological distress via sleep hygiene in division I college student athletes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1936-1940. [PMID: 33151828 DOI: 10.1080/07448481.2020.1842416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 09/16/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThe unique demands placed on Division I student athletes (SAs) puts them at risk of experiencing poor sleep and increased psychological distress. Researchers have found that mindfulness improves well-being, directly and indirectly via sleep behaviors; however, it is not known if these relationships hold up within a sample of SAs. Thus, this study examined the indirect effect of mindfulness on psychological distress through sleep hygiene in SAs. Participants and methods: A sample of 269 Division I SAs were surveyed on their psychological distress, sleep hygiene, and mindfulness in 2018-2019. Results: Mindfulness directly and indirectly influenced psychological distress via sleep hygiene (B = -0.03, SE = 0.01, 95% CI [-0.05, -0.01]) such that increased mindfulness was associated with improved sleep hygiene and reduced distress. Conclusions: The results show the impact of mindfulness on sleep hygiene and psychological distress. Training SAs in mindfulness might improve sleep behaviors and in turn well-being.
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Affiliation(s)
- Amanda Moreton
- Department of Education and Counseling, Villanova University, Villanova, Pennsylvania, USA
| | - Edward Wahesh
- Department of Education and Counseling, Villanova University, Villanova, Pennsylvania, USA
| | - Christopher D Schmidt
- Department of Education and Counseling, Villanova University, Villanova, Pennsylvania, USA
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25
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Wei W, Liu W. Sleep Pattern Is Related to Mental Health among Chinese Collegiate Student Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158961. [PMID: 35897332 PMCID: PMC9329793 DOI: 10.3390/ijerph19158961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 02/04/2023]
Abstract
Regarding the association between sleep and napping duration and mental health in young and older adults, some studies indicated a positive association, while others indicated a negative, or no, association between them. Moreover, collegiate student athletes have different mental health stressors, such as training pressure, improving sports performance, and relationships with coaches. Therefore, sleep is important for athletes. Whether sleep duration is related to their mental health is unclear. Thus, this study aimed to examine the association between nighttime sleep duration, daytime napping duration, and mental health among collegiate student athletees. This cross-sectional study included 700 college athletes. Sleep and daytime napping durations were assessed using a self-reported questionnaire. The Zung Self-rating Depression Scale and Generalized Anxiety Disorder-7 assessed mental health. A multivariate logistic regression analysis was conducted to examine the adjusted association between sleep duration and mental health. In this study, the odds ratios for depression and anxiety symptoms were significantly higher for short sleep duration (<7 h). Additionally, a significant positive association was found between daytime napping duration and the prevalence of depression. This study indicates that short nighttime sleep and long daytime napping duration may be risk factors for collegiate student athletes’ mental health, having important implications for educators and coaches.
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Affiliation(s)
- Wei Wei
- School of Physical Education, Central China Normal University, 152 Luoyu Road, Wuhan 430079, China
- Department of Physical Education, Hohai University, 1 Xikang Road, Nanjing 210098, China
- Correspondence: (W.W.); (W.L.)
| | - Weimin Liu
- School of Physical Education, Central China Normal University, 152 Luoyu Road, Wuhan 430079, China
- Correspondence: (W.W.); (W.L.)
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26
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Charest J, Grandner MA. Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health: An Update. Sleep Med Clin 2022; 17:263-282. [PMID: 35659079 DOI: 10.1016/j.jsmc.2022.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Sleep health is an important consideration for athletic performance. Athletes are at high risk of insufficient sleep duration, poor sleep quality, daytime sleepiness and fatigue, suboptimal sleep schedules, irregular sleep schedules, and sleep and circadian disorders. These issues likely have an impact on athletic performance via several domains. Sleep loss and/or poor sleep quality can impair muscular strength, speed, and other aspects of physical performance. Sleep issues can also increase risk of concussions and other injuries and impair recovery after injury. Cognitive performance is also impacted in several domains, including vigilance, learning and memory, decision making, and creativity.
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Affiliation(s)
- Jonathan Charest
- Department of Psychology, Universite Laval, Quebec City, Quebec, Canada; Centre for Sleep and Human Performance, #106, 51 Sunpark Drive Southeast, Calgary, Alberta T2X 3V4, Canada; Department of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona, 1501 North Campbell Avenue, PO Box 245002, Tucson, AZ 8524-5002, USA.
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27
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Iona T, Raimo S, Coco D, Tortella P, Masala D, Ammendolia A, Mannocci A, La Torre G. Specialization and Injury Risk in Different Youth Sports: A Bio-Emotional Social Approach. Front Psychol 2022; 13:818739. [PMID: 35369204 PMCID: PMC8966678 DOI: 10.3389/fpsyg.2022.818739] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
Aims Sport specialization is an actual trend in youth athletes, but it can increase injury risk. The aim was to determine the eventual correlation between sports specialization and injury risk in various sports, using a biopsychosocial approach. Methods 169 sport-specialized athletes completed [(38 female, 131 male); overall (11.2 ± 2.7 years), (56.28 ± 15.72 kg), (161.3 ± 15.52 cm)] a self-reported questionnaire regarding sociodemographic (age, gender, educational level), physical-attitudinal, injuries and psychological-attitudinal To analyze data univariate and correlate analyses were used. Results Of 169 athletes enrolled, 53% were single-sport specialized (reported participation in one sport and trained > 8 months/year). In team sports (100%, OR = 0.75; p = 0.022) a high risk of having to remain at rest for up to 1 month because of overuse was observed. Males who suffered direct trauma (70%; OR = 1.03; p = 0.006) in the team group (95%, OR = 0.09; p = 0.008) were more exposed to that type of injury, and also the type of specialization figured significantly (p = 0.047). In addition, interoceptive awareness correlates with injury (95%, 1.04, p = 0.01). This study shows that, even though young athletes seem to be at a high risk of becoming injured, early team sport specialization and a high performance level cannot be considered to be the only risk factors.
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Affiliation(s)
- Teresa Iona
- Department of Surgical and Medicine Science, University of Magna Graecia, Catanzaro, Italy
| | - Simona Raimo
- Department of Surgical and Medicine Science, University of Magna Graecia, Catanzaro, Italy
| | - Daniele Coco
- Department of Education, Roma Tre University, Rome, Italy
| | | | - Daniele Masala
- Department of Surgical and Medicine Science, University of Magna Graecia, Catanzaro, Italy
| | - Antonio Ammendolia
- Department of Surgical and Medicine Science, University of Magna Graecia, Catanzaro, Italy
| | - Alice Mannocci
- Faculty of Economics, Universitas Mercatorum, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, University of Sapienza, Rome, Italy
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28
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Depression, Anxiety, and Help-Seeking Among NCAA Division III Athletes at a Historically Women’s College. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2022. [DOI: 10.1123/jcsp.2021-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study explored depression, anxiety, and help-seeking at a National Collegiate Athletic Association Division III historically women’s college in the United States, while taking into account gender identities outside of male and female. An online survey including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and help-seeking measures were completed by 109 student-athletes. Participants’ ages ranged from 18 to 22. Within the sample, 59.7% of participants identified as LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, among other identities) and 8.3% identified as genderqueer/gender-nonconforming. A total of 33.0% of the participants reported symptoms of depression, while 28.5% reported symptoms of anxiety. Genderqueer/gender-nonconforming athletes reported higher rates of anxiety than athletes who identified as women. Higher rates of depression and anxiety were related to higher levels of formal help-seeking. The results indicate that student-athletes at a historically women’s college may be experiencing higher levels of depression and anxiety than student-athletes in other contexts and have more positive views toward help-seeking. Student-athletes who identify outside of the gender binary may be at higher risk for anxiety.
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30
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Collegiate Student-Athlete Psychological Distress and Counseling Utilization During COVID-19. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2022. [DOI: 10.1123/jcsp.2021-0091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The onset of COVID-19 and cancellation of collegiate sports may have exacerbated student-athletes’ psychological distress. Within a national sample of collegiate athletes (N = 5,755; 66.7% women), we determined how gender and race related to rates of depression, stress, and counseling use at the beginning of the pandemic (April/May 2020). Overall, 26.5% (n = 1,526) and 10.6% (n = 612) endorsed clinical levels of depression and stress, respectively; 25.1% (n = 1,443) and 69.7% (n = 4,014) reported subclinical levels. Few athletes (2.3%–17.1%) reported counseling use before or after the onset of COVID-19; those who did reported higher levels of depression and stress than those who never sought services. The female athletes reported higher rates of depression, stress, and counseling use than the male athletes. There were no race effects. Athletic departments must address their student-athletes’ psychological distress by facilitating a higher use of mental health services.
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31
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Clement D, Tranaeus U, Johnson U, Stenling A, Ivarsson A. Profiles of psychosocial factors: Can they be used to predict injury risk? Scand J Med Sci Sports 2021; 32:782-788. [PMID: 34862984 DOI: 10.1111/sms.14110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/05/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022]
Abstract
The creation of risk profiles using the model of stress and athletic injury (J Appl Sport Psychol. 1998;10(1):5) represents a proposed shift from the reductionism paradigm to the complex sport approach in an attempt to formulate prevention strategies to combat the increasing number of injuries being reported in sporting populations. As a result, the primary purpose of this study was to: (a) identify different risk profiles based on psychosocial factors associated with the Williams and Andersen's model of stress and athletic injury model; and (b) examine potential differences in the frequency of injuries across these risk profiles. A prospective research design was utilized with a sample of 117 competitive soccer players (81 males and 36 females) from Sweden and the United States of America. Data was collected at two time points over the course of three months. At time 1 (beginning of the season) - a demographic information sheet, the Life Event Survey for Collegiate Athletes (LESCA), Sport Competitive Anxiety Test (SCAT), and Brief Cope were administered. At time two (T2), three months after the initial data collection, participants' traumatic injuries were recorded. Latent profile analysis (LPA) showed that 3 profiles solution showed best fit to data. Players in profile 1 and 2 reported fewer injuries compared to players in profile 3. However, whereas individuals in profile 1 had a lower predictive risk of sustaining an injury when compared to those in profile 3, both profiles had similar anxiety levels and use of coping strategies with differing stress levels. These findings suggest that the interaction between different proposed risk factors might influence injury risk.
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Affiliation(s)
| | - Ulrika Tranaeus
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | | | | | - Andreas Ivarsson
- Halmstad University, Halmstad, Sweden.,Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
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32
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Abstract
ABSTRACT Interventions to promote athlete health and performance have traditionally been focused on the physical elements of injury and training. More recently, however, increasing attention has been placed on the mental aspects of athlete health, with emerging evidence suggesting that injury risk and athletic performance are significantly affected by athlete well-being. Mindfulness meditation has been shown to have significant benefits for a number of physical and mental health outcomes in various clinical populations, and recent research has explored how mindfulness may enhance athletic performance, improve athlete mental health, reduce injury risk, and perhaps even facilitate recovery from injury. As awareness of mindfulness as a noninvasive, low-risk, and accessible intervention increases in the Western society, use among athletes has increased as well. Health care providers should be aware of this evidence in order to guide athletes regarding the use of mindfulness as an intervention to potentially improve athlete health and performance.
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Affiliation(s)
- Scott A Anderson
- Department of Kinesiology, Watson Human Performance Laboratory, Center for Healthy Minds, University of Wisconsin-Madison, Madison, WI
| | | | - Drew Watson
- Department of Orthopedics & Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI
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33
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Athlete Preparticipation Physical Evaluation. Sports Med Arthrosc Rev 2021; 29:200-206. [PMID: 34730121 DOI: 10.1097/jsa.0000000000000330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Preparticipation evaluations (PPE) are both a traditional and legal requirement by many governing bodies for sport. The ideal goal of the PPE is safe participation in sport for athletes. This article provides an overview of common PPE elements and current best practice recommendations. Descriptions of every possible examination are published elsewhere and are beyond the intent of this article. Additional considerations for transgender, masters athletes, and Special Olympians are also outside the scope of this review, but are well covered in The Preparticipation Physical Evaluation, fifth edition monograph.
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34
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Fossati C, Torre G, Vasta S, Giombini A, Quaranta F, Papalia R, Pigozzi F. Physical Exercise and Mental Health: The Routes of a Reciprocal Relation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312364. [PMID: 34886090 PMCID: PMC8656946 DOI: 10.3390/ijerph182312364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 01/18/2023]
Abstract
Sport participation and exercise practice are considered to be beneficial for mental status, yielding an improved mood and better quality of life. On the other hand, good mental fitness is thought to lead to better physical status and sport performance. The key aim of this narrative review is to provide an unstructured overview on the topic with special considerations on the role of mental and physical health to summarize the evidence on their reciprocal influence. While very few papers describe the role of mental health measures in affecting physical performance, more evidence is available concerning the effect of exercise and sport in improving mental health outcomes. Furthermore, there is a consistent role of depressive and anxiety symptoms in influencing the risk of sport injury in either recreational or elite athletes. Moreover, the importance of investigating mental health issues in elite and retired athletes is highlighted. On the basis of the available literature, several biases were found to affect the provided evidence mainly because of the complexity of a proper study design in this field.
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Affiliation(s)
- Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Guglielmo Torre
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
- Correspondence:
| | - Sebastiano Vasta
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Arrigo Giombini
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Federico Quaranta
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy; (S.V.); (R.P.)
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy; (C.F.); (A.G.); (F.Q.); (F.P.)
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35
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Jayanthi N, Schley S, Cumming SP, Myer GD, Saffel H, Hartwig T, Gabbett TJ. Developmental Training Model for the Sport Specialized Youth Athlete: A Dynamic Strategy for Individualizing Load-Response During Maturation. Sports Health 2021; 14:142-153. [PMID: 34763556 DOI: 10.1177/19417381211056088] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
CONTEXT Most available data on athletic development training models focus on adult or professional athletes, where increasing workload capacity and performance is a primary goal. Development pathways in youth athletes generally emphasize multisport participation rather than sport specialization to optimize motor skill acquisition and to minimize injury risk. Other models emphasize the need for accumulation of sport- and skill-specific hours to develop elite-level status. Despite recommendations against sport specialization, many youth athletes still specialize and need guidance on training and competition. Medical and sport professionals also recommend progressive, gradual increases in workloads to enhance resilience to the demands of high-level competition. There is no accepted model of risk stratification and return to play for training a specialized youth athlete through periods of injury and maturation. In this review, we present individualized training models for specialized youth athletes that (1) prioritize performance for healthy, resilient youth athletes and (2) are adaptable through vulnerable maturational periods and injury. EVIDENCE ACQUISITION Nonsystematic review with critical appraisal of existing literature. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 4. RESULTS A number of factors must be considered when developing training programs for young athletes: (1) the effect of sport specialization on athlete development and injury, (2) biological maturation, (3) motor and coordination deficits in specialized youth athletes, and (4) workload progressions and response to load. CONCLUSION Load-sensitive athletes with multiple risk factors may need medical evaluation, frequent monitoring, and a program designed to restore local tissue and sport-specific capacity. Load-naive athletes, who are often skeletally immature, will likely benefit from serial monitoring and should train and compete with caution, while load-tolerant athletes may only need occasional monitoring and progress to optimum loads. STRENGTH OF RECOMMENDATION TAXONOMY (SORT) B.
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Affiliation(s)
- Neeru Jayanthi
- Departments of Orthopaedics and Family Medicine, Emory School of Medicine, Atlanta, Georgia.,Emory Sports Medicine Center, Johns Creek, Georgia.,Emory Sport Performance and Research Center, Flowery Branch, Georgia
| | | | - Sean P Cumming
- Department for Health, University of Bath, Bath, United Kingdom
| | - Gregory D Myer
- Emory Sports Medicine Center, Johns Creek, Georgia.,Emory Sport Performance and Research Center, Flowery Branch, Georgia.,Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia.,The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts
| | - Heather Saffel
- South Bend-Notre Dame Sports Medicine Fellowship, Beacon Bone & Joint Specialists, South Bend, Indiana
| | - Tim Hartwig
- School of Behavioural and Health Sciences, Strathfield Campus, Australian Catholic University, Strathfield, New South Wales, Australia
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, Queensland, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
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36
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Recreational Screen Time and Anxiety among College Athletes: Findings from Shanghai. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147470. [PMID: 34299928 PMCID: PMC8306689 DOI: 10.3390/ijerph18147470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022]
Abstract
To better understand the behavioral factors contributing to the mental health status among student athletes, we examined the link between recreational screen time and college student athlete’s anxieties. This cross-sectional study was conducted among 278 college student athletes from Shanghai, China, aged between 17 and 25 years old (M = 19.4, SD = 1.5). Multivariate regression analyses, controlled for age, gender, rural vs. urban residency, and individual vs. team sports factors, were performed to analyze the association between their average daily recreational screen time in a week and their dispositional anxiety, pre-competition anxiety, and anxiety during competition, which were measured by the Chinese version of validated psychometric scales among athlete population. Significant results were found in both dispositional anxiety and situational anxiety in relation to recreational screen time among college athletes. Conclusions: Our findings indicate that excessive recreational screen time is a risk indicator of college student athletes’ dispositional anxiety, pre-competition anxiety, and anxiety during competition.
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37
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Compassionate Coach and Psychological Quality of Life in Portuguese Athletes: Effect of Mediating Variables. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2020-0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aimed to test a model that hypothesized that the compassionate coach, as perceived by the athletes, has an impact on athlete-related social safeness and psychological health, through shame and self-criticism. The sample comprised 270 Portuguese adult athletes, who practiced different competitive sports. The path analysis results confirmed the adequacy of the proposed model, which explained 45% of the psychological health’s variance. Results demonstrated that athletes who perceive their coaches as more compassionate tend to present higher levels of social safeness (feelings of belonging to the team) and of psychological health, through lower levels of shame and self-criticism. These novel findings suggest the importance of the adoption of supportive, warm, safe, and compassionate attitudes from coaches in athletes’ mental health. This study also offers important insights by suggesting that feelings of acceptance and connectedness in team relationships may be at the root of athletes’ emotional processes and well-being.
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38
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National Collegiate Athletic Association Athletic Departments’ Mental Health Screening Practices: Who, What, When, and How. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2021. [DOI: 10.1123/jcsp.2021-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
College student athletes face unique, sport-related stressors that may lead to, or exacerbate, mental health (MH) concerns and symptoms. Although the National Collegiate Athletic Association has identified MH screening as a best practice, minimal data exist regarding contemporary screening practices. We explored National Collegiate Athletic Association Division I (DI), Division II (DII), and Division III (DIII) athletic departments’ current MH screening practices (N = 264). Compared with DII/DIII (53%), a greater percentage of Division I (89%) conducted formal MH screening. At DII/DIII institutions, athletic trainers were more likely to both administer and review screeners than any other sports medicine professional; sport psychologists primarily oversaw these tasks at DI schools. DI, compared with DII/DIII, institutions were more likely to have had a student athlete attempt suicide (62% vs. 40%) and participate in inpatient treatment (69% vs. 43%). There is a clear need for the National Collegiate Athletic Association to continue to promote policies that support MH screening and to create mechanisms in which it can monitor institutional involvement.
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Chandler AJ, Arent MA, Cintineo HP, Torres-McGehee TM, Winkelmann ZK, Arent SM. The Impacts of COVID-19 on Collegiate Student-Athlete Training, Health, and Well-Being. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021. [DOI: 10.1249/tjx.0000000000000173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Abstract
OBJECTIVES To describe and delineate the epidemiological profile of concussion injuries in individuals with attention-deficit/hyperactivity disorder (ADHD) by identifying characteristics associated with poorer outcomes. SETTING One hundred forty-four multidisciplinary concussion-specialized clinics across Canada. PARTICIPANTS Two hundred twenty-two individuals with a diagnosis of ADHD aged 7 to 53 years who sustained a concussion within the last year. DESIGN Multicenter cohort study. MAIN MEASURES Candidate predictor variables (ie, age, sex, concussion history, loss of consciousness, and internalized and learning disorder comorbidities) were collected through oral interviews. Concussion outcomes (ie, symptom severity and total number of symptoms experienced) were assessed with the Sport Concussion Assessment Tool. RESULTS Older age, female sex, and the presence of an internalized disorder predicted poorer concussion outcomes in individuals with ADHD. Males with ADHD reported significantly worse concussion outcomes with increasing age, while outcomes remained fairly stable across age in females. CONCLUSION The current findings represent a promising step toward the optimization of concussion management in individuals with ADHD. With a more thorough understanding of the demographic and comorbidity variables, clinical care decisions and intervention strategies can be developed to help individuals with ADHD who might be at a higher risk of poorer outcomes following a concussion.
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Young J, Neil ER, Granger K, Walker SE, Chadburn JL, Eberman LE. Preparedness, Confidence, and Best Practices in Preventing, Recognizing, Managing Mental Health Cases in NCAA Institutions. J Athl Train 2020; 58:446975. [PMID: 33150415 PMCID: PMC10072099 DOI: 10.4085/129-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Currently, the National Collegiate Athletic Association (NCAA) recommends written policies and procedures that outline steps to support student athletes facing a mental health challenge and the referral processes for emergency and non-emergency mental health situations. OBJECTIVE To assess the mental health policies and procedures implemented and athletic trainers' perceived confidence in preventing, recognizing and managing routine and crisis mental health cases across all three divisions of NCAA athletics. DESIGN Cross-sectional survey design and chart review. SETTING Online survey Participants: Athletic trainers with clinical responsibility at NCAA member institutions (n=1091, 21.5% response rate). MAIN OUTCOME MEASURE(S) Confidence in screening, preventative patient education, recognizing and referring routine and emergency mental health conditions (5-point Likert scale: 1= not at all confident, 2= hardly confident, 3= somewhat confident, 4= fairly confident, 5=very confident) using a content-validated survey (Cronbach's α=0.904) and mental health policy and procedure chart review. RESULTS Respondents indicated they felt "fairly confident" with screening (40.21%, n=76/189) for risk of any mental health condition and "fairly confident" in implementing preventative patient education (42.11%, n=80/190). Respondents were "fairly confident" they could recognize (48.95%, n=93/190) and refer (45.79%, n=87/190) routine mental health conditions. Respondents were "fairly confident" they could recognize (46.84%, n=89/190), but "very confident" (46.32%, n=88/190) they could refer mental health emergencies. Policies lacked separate procedures for specific emergency mental health situations such as suicidal/homicidal ideation (36.1%), sexual assault (33.3%), substance abuse (19.4%), and confusional state (13.9%). Policies lacked prevention measures such as student athlete involvement (16.7%) in annual mental health education (16.7%). CONCLUSIONS While athletic trainers were generally confident in their ability to address emergency and routine mental health conditions, opportunities exist to improve policies for prevention, screening, and referral. Best practice guidelines should be used as a guide to develop policies that foster an environment of mental health wellness.
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Affiliation(s)
- Julia Young
- Doctor of Athletic Training Program, Department of Applied Medicine & Rehabilitation, Indiana State University, Terre Haute
| | - Elizabeth R. Neil
- Athletic Training Programs, College of Public Health, Temple University, Philadelphia, PA
| | - Kelcey Granger
- School of Kinesiology, College of Health, Ball State University, Muncie, IN
| | - Stacy E. Walker
- School of Kinesiology, College of Health, Ball State University, Muncie, IN
| | | | - Lindsey E. Eberman
- Doctor of Athletic Training Program, Department of Applied Medicine & Rehabilitation, Indiana State University, Terre Haute
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Stokes KA, Jones B, Bennett M, Close GL, Gill N, Hull JH, Kasper AM, Kemp SP, Mellalieu SD, Peirce N, Stewart B, Wall BT, West SW, Cross M. Returning to Play after Prolonged Training Restrictions in Professional Collision Sports. Int J Sports Med 2020; 41:895-911. [PMID: 32483768 PMCID: PMC7799169 DOI: 10.1055/a-1180-3692] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
The COVID-19 pandemic in 2020 has resulted in widespread training disruption in many sports. Some athletes have access to facilities and equipment, while others have limited or no access, severely limiting their training practices. A primary concern is that the maintenance of key physical qualities (e. g. strength, power, high-speed running ability, acceleration, deceleration and change of direction), game-specific contact skills (e. g. tackling) and decision-making ability, are challenged, impacting performance and injury risk on resumption of training and competition. In extended periods of reduced training, without targeted intervention, changes in body composition and function can be profound. However, there are strategies that can dramatically mitigate potential losses, including resistance training to failure with lighter loads, plyometric training, exposure to high-speed running to ensure appropriate hamstring conditioning, and nutritional intervention. Athletes may require psychological support given the challenges associated with isolation and a change in regular training routine. While training restrictions may result in a decrease in some physical and psychological qualities, athletes can return in a positive state following an enforced period of rest and recovery. On return to training, the focus should be on progression of all aspects of training, taking into account the status of individual athletes.
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Affiliation(s)
- Keith A. Stokes
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Leeds Beckett University
Carnegie Faculty, Leeds, United Kingdom of Great Britain and Northern
Ireland
- Leeds Rhinos Rugby League Club, Leeds, United Kingdom of Great Britain and
Northern Ireland
- England Performance Unit, Rugby Football League Ltd, Leeds, United Kingdom
of Great Britain and Northern Ireland
- Division of Exercise Science and Sports Medicine, University of Cape Town,
Faculty of Health Sciences, Cape Town, South Africa
| | - Mark Bennett
- Rugby Union of Russia, Moscow, Russian Federation
- Applied Sport Technology Exercise and Medicine Research Centre (A-STEM),
Swansea University College of Engineering, Swansea, United Kingdom of Great Britain
and Northern Ireland
| | - Graeme L. Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, United Kingdom of Great Britain and Northern
Irelan
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
| | - Nicholas Gill
- New Zealand Rugby Union, Wellington, New Zealand
- Te HuatakiWaiora School of Health, University of Waikato, Hamilton, New
Zealand
| | - James H. Hull
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United
Kingdom of Great Britain and Northern Ireland
| | - Andreas M. Kasper
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
| | - Simon P.T. Kemp
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Stephen D. Mellalieu
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan
University, Cardiff, United Kingdom of Great Britain and Northern
Ireland
| | - Nicholas Peirce
- Sport Science & Medicine, England and Wales Cricket Board,
Loughborough, United Kingdom of Great Britain and Northern Ireland
| | - Bob Stewart
- Medical Services, Rugby Football Union, Twickenham, United Kingdom of Great
Britain and Northern Ireland
| | - Benjamin T. Wall
- School of Sport and Health Sciences, University of Exeter, Exeter, United
Kingdom of Great Britain and Northern Ireland
| | - Stephen W. West
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
| | - Matthew Cross
- Department for Health, University of Bath, Bath, United Kingdom of Great
Britain and Northern Ireland
- Professional Rugby Department, Rugby Football Union, Twickenham, United
Kingdom of Great Britain and Northern Ireland
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Espí-López GV, Serra-Añó P, Cuenca-Martínez F, Suso-Martí L, Inglés M. Comparison Between Classic and Light Touch Massage on Psychological and Physical Functional Variables in Athletes: a Randomized Pilot Trial. Int J Ther Massage Bodywork 2020; 13:30-37. [PMID: 32922579 PMCID: PMC7454233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite the general belief of the benefits and the widespread use of massage in sport field, there are limited empirical data on possible effectiveness of massage on psychological and physical functional variables. PURPOSE The main objective of the present study was to compare the effectiveness of classical and light touch massage on psychological and physical functional variables in athletes. SETTING Athletic club of Valencia. PARTICIPANTS 20 amateur athletes were recruited from two athletic clubs. RESEARCH DESIGN A single-blind, randomized, pilot-placebo trial. INTERVENTION The subjects were randomly allocated to two different groups: a) Massage group (MG) (n=10); b) Control group (CG) (n=10). The intervention period lasted one month (one session per week). MAIN OUTCOME MEASURES Assessment of the participants was performed at baseline and 24 hours following the completion of the intervention. Outcome measures included hip flexion, knee extension, and mood state. RESULTS The results suggest that MG obtained better results on physical variables (p < .05). However, for both groups, trends suggest significant improvements in the overall mood state of the participants (p < .05). CONCLUSION Our results suggest that classic massage could be an effective intervention to improve functional physical variables in athletes. However, trends suggest that a light touch intervention could provoke improvements in physiological measures.
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Affiliation(s)
- Gemma V. Espí-López
- Corresponding author: Gemma Victoria Espí-López, PT, PhD, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia c/ Gascó Oliag Street, 5. 46010 Valencia, Spain,
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Lopes Dos Santos M, Uftring M, Stahl CA, Lockie RG, Alvar B, Mann JB, Dawes JJ. Stress in Academic and Athletic Performance in Collegiate Athletes: A Narrative Review of Sources and Monitoring Strategies. Front Sports Act Living 2020; 2:42. [PMID: 33345034 PMCID: PMC7739829 DOI: 10.3389/fspor.2020.00042] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
College students are required to manage a variety of stressors related to academic, social, and financial commitments. In addition to the burdens facing most college students, collegiate athletes must devote a substantial amount of time to improving their sporting abilities. The strength and conditioning professional sees the athlete on nearly a daily basis and is able to recognize the changes in performance and behavior an athlete may exhibit as a result of these stressors. As such, the strength and conditioning professional may serve an integral role in the monitoring of these stressors and may be able to alter training programs to improve both performance and wellness. The purpose of this paper is to discuss stressors experienced by collegiate athletes, developing an early detection system through monitoring techniques that identify the detrimental effects of stress, and discuss appropriate stress management strategies for this population.
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Affiliation(s)
- Marcel Lopes Dos Santos
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, United States
| | - Melissa Uftring
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, United States
| | - Cody A Stahl
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, United States
| | - Robert G Lockie
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | - Brent Alvar
- Department of Kinesiology, Point Loma Nazarene University, San Diego, CA, United States
| | - J Bryan Mann
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States
| | - J Jay Dawes
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, OK, United States
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Kmush BL, Mackowski M, Ehrlich J, Walia B, Owora A, Sanders S. Association of Professional Football Cumulative Head Impact Index Scores With All-Cause Mortality Among National Football League Players. JAMA Netw Open 2020; 3:e204442. [PMID: 32391891 PMCID: PMC7215260 DOI: 10.1001/jamanetworkopen.2020.4442] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 03/05/2020] [Indexed: 01/16/2023] Open
Abstract
Importance Long-term adverse health outcomes, particularly those associated with repetitive head impacts, are of growing concern among US-style football players in the US and Canada. Objective To assess whether exposure to repetitive head impacts during a professional football career is associated with an increase in the risk of all-cause mortality. Design, Setting, and Participants This retrospective cohort study included 13 912 players in the 1969 to 2017 National Football League (NFL) seasons. All cause-mortality up until July 1, 2018, was included. Data collection was performed from July 13, 2017, to July 1, 2018, as reported in the Pro Football Reference. Exposures The main exposure was a professional football cumulative head impact index (pfCHII). The pfCHII was measured by combining cumulative padded practice time and games played summed during seasons of play reported in the Pro Football Reference and a player position risk adjustment from helmet accelerometer studies. Main Outcomes and Measures Demographic characteristics except for the pfCHII were calculated for 14 366 players with complete follow-up. The pfCHII was calculated for 13 912 players (eliminating the 454 specials teams players). Cox proportional hazards regression was used to compare hazard ratios (HRs) of death by repetitive head impacts. Analyses were unadjusted and adjusted for birth year, body mass index, and height. Results Among 14 366 NFL players who had follow-up for analysis, the mean (SD) age was 47.3 (14.8) years, the mean (SD) body mass index was 29.6 (3.9), and 763 of 14 366 players (5.3%) had died. Among 13 912 players in the pfCHII analysis, the median pfCHII was 32.63 (interquartile range, 13.71-66.12). A 1-log increase in pfCHII was significantly associated with an increased hazard of death for the 1969 to 2017 seasons (HR, 2.02; 95% CI, 1.21-3.37; P = .01) after adjustment. The quadratic pfCHII was also statistically significant (HR, 0.91; 95% CI, 0.85-0.98; P = .01), indicating that the hazard of death increased at a decreasing rate, whereas the pfCHII increased. Conclusions and Relevance The findings suggest that an increase in repetitive head impacts is associated with an increased hazard of death among NFL players. Reduction in repetitive head impacts from playing football or other activities through additional rule and equipment changes may be associated with reduced mortality.
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Affiliation(s)
- Brittany L. Kmush
- Department of Public Health, Syracuse University, Syracuse, New York
| | | | - Justin Ehrlich
- Department of Sport Analytics, Syracuse University, Syracuse, New York
| | - Bhavneet Walia
- Department of Public Health, Syracuse University, Syracuse, New York
| | - Arthur Owora
- Department of Public Health, Syracuse University, Syracuse, New York
- Currently with Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington
| | - Shane Sanders
- Department of Sport Analytics, Syracuse University, Syracuse, New York
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Sutcliffe JH, Greenberger PA. Identifying Psychological Difficulties in College Athletes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2216-2219. [PMID: 32209401 DOI: 10.1016/j.jaip.2020.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022]
Abstract
Psychological conditions occur frequently in college students. One contributing factor is the onset of most mental health disorders occurring in late adolescence and early adulthood, as well as the identity formation and individuation that is typical of this developmental stage. Precollege trauma (emotional, physical, sexual, and witness to violence) and lower socioeconomic status can set the stage for psychological difficulties. Some of many stressors that may affect college athletes include peer pressures, independence, need to please family, friends, and coaches, high level of expectations with a very strong commitment to succeeding and winning in competitive and intense intercollegiate sports, time management for academic demands, sports, relationships, and well-being, mood status, history of mental illness, injuries including concussions, and adjusting to the length of time for recovery from injuries, fears of reinjury, or return-to-play concerns, managing body and weight concerns related to performance, and unexpected medical conditions such as infectious mononucleosis. A case is presented of a patient who is a college student-athlete with mild intermittent asthma and seasonal allergic rhinitis who was found to have generalized anxiety, surreptitious cannabis use, and bulimic symptoms. He was angry at his position coach because of lack of playing time.
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Affiliation(s)
- Julie H Sutcliffe
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, Calif
| | - Paul A Greenberger
- Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
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Muir IL, Munroe-Chandler KJ. Using Infographics to Promote Athletes’ Mental Health: Recommendations for Sport Psychology Consultants. JOURNAL OF SPORT PSYCHOLOGY IN ACTION 2020. [DOI: 10.1080/21520704.2020.1738607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Harris SA, Chivers PT, McIntyre FL, Piggott B, Bulsara M, Farringdon FH. Exploring the association between recent concussion, subconcussive impacts and depressive symptoms in male Australian Football players. BMJ Open Sport Exerc Med 2020; 6:e000655. [PMID: 32201617 PMCID: PMC7061895 DOI: 10.1136/bmjsem-2019-000655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To explore the association between depressive symptoms and recent head-related trauma (diagnosed concussion, subconcussive impacts) in semiprofessional male Australian Football (AF) players. Methods Sixty-nine semiprofessional male players from a West Australian Football League (WAFL) club participated in the study (Mage=21.81, SD=2.91 years). Depressive symptoms were measured using the Centre for Epidemiological Studies Depression Scale. Injuries and potential confounding variables (eg, pre-existing mental health condition; alcohol or drug hangovers; experiencing a stressful event) were self-reported anonymously using the WAFL Injury Report Survey. Both tools were administered every 2-weeks over the first 22-weeks of the WAFL season. Controlling for potential confounding variables and other injuries, a repeated measures generalised estimating equations model assessed the risk of clinically relevant depressive symptoms occurring, when diagnosed concussion or subconcussive impacts were experienced. Results A total of 10 concussions and 183 subconcussive impacts were reported. Players who experienced a concussion were almost nine times more likely to experience clinically relevant depressive symptoms (OR 8.88, 95% CI 2.65 to 29.77, p<0.001). Although elevated, depressive symptoms following subconcussive impacts were not statistically significant (OR 1.13, 95% CI 0.67 to 1.92, p=0.641). Conclusion These findings indicate that semiprofessional AF athletes may be at risk of experiencing depressive symptoms after concussion. Severity (concussion vs subconcussive impacts) and dose (number of impacts) appear to have an important relationship with depressive symptom outcomes in this cohort and should be considered for further research and management of player welfare.
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Affiliation(s)
- Sarah Ann Harris
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Paola T Chivers
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.,Exercise Medicine Research Institute and School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Fleur L McIntyre
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Ben Piggott
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Max Bulsara
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Fiona H Farringdon
- School of Health Sciences, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
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Charest J, Grandner MA. Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin 2020; 15:41-57. [PMID: 32005349 PMCID: PMC9960533 DOI: 10.1016/j.jsmc.2019.11.005] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Research has characterized the sleep of elite athletes and attempted to identify factors associated with athletic performance, cognition, health, and mental well-being. Sleep is a fundamental component of performance optimization among elite athletes, yet only recently embraced by sport organizations as an important part of training and recovery. Sleep plays a crucial role in physical and cognitive performance and is an important factor in reducing risk of injury. This article aims to highlight the prevalence of poor sleep, describe its impacts, and address the issue of sport culture surrounding healthy sleep.
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Affiliation(s)
- Jonathan Charest
- Department of Psychology, Universite Laval, Quebec City, Quebec, Canada; Centre for Sleep and Human Performance, #106, 51 Sunpark Drive Southeast, Calgary, Alberta T2X 3V4, Canada
| | - Michael A Grandner
- Department of Psychiatry, University of Arizona, 1501 North Campbell Avenue, PO Box 245002, Tucson, AZ 8524-5002, USA.
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Taylor MK, Hernández LM, Sessoms PH, Kawamura C, Fraser JJ. Trauma Exposure and Functional Movement Characteristics of Male Tactical Athletes. J Athl Train 2020; 55:384-389. [PMID: 32058798 DOI: 10.4085/1062-6050-111-19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Tactical athletes commonly experience high levels of physical stress, which may increase their risk of musculoskeletal injury. It is critical to understand psychological predictors of functional movement (FM), which may help prevent musculoskeletal injury in this population. OBJECTIVE To determine the associations of combat and trauma exposure with FM characteristics of male tactical athletes. Secondary objectives were to explore confounding influences of age and physical injury history as well as the mediating role of bodily pain. DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Eighty-two healthy, male, active-duty US Navy Explosive Ordnance Disposal personnel (age = 34.0 ± 6.7 years). MAIN OUTCOME MEASURE(S) Participants completed measures of combat exposure, trauma exposure, physical injury history, and bodily pain. We assessed FM characteristics (ie, Functional Movement Screen [FMS], Y-Balance Test), from which we derived a composite functional status (CFS) measure. Hypotheses were tested using correlational and multiple regression (causal-steps) models. RESULTS In unadjusted models, trauma exposure was inversely associated with the FMS (P = .005) and CFS (P = .009) scores. In adjusted models, these relationships were robust to the confounding influences of age and physical injury history. Trauma exposure and bodily pain were substantive, independent predictors of FMS and CFS in causal-steps models (all P values < .05), implying additive rather than mediated effects (R2adj = 0.18-0.20). Combat exposure did not predict FM characteristics. CONCLUSIONS To our knowledge, this is the first evidence of the influence of trauma exposure on the FM characteristics of male tactical athletes, independent of age, physical injury, and bodily pain. This program of research may help to advance the prevention and treatment of musculoskeletal injuries in the tactical environment.
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Affiliation(s)
- Marcus K Taylor
- Biobehavioral Sciences Lab, Naval Health Research Center, San Diego, CA.,Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | - Lisa M Hernández
- Biobehavioral Sciences Lab, Naval Health Research Center, San Diego, CA.,Leidos, Inc, San Diego, CA
| | - Pinata H Sessoms
- Physical and Cognitive Research Laboratory, Naval Health Research Center, San Diego, CA.,Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | | | - John J Fraser
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA
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