Depression and Pain in Retired Professional Football Players

Department of Family Medicine, Depression Center, University of Michigan, Ann Arbor, MI 48109, USA.
Medicine &amp Science in Sports &amp Exercise (Impact Factor: 3.98). 05/2007; 39(4):599-605. DOI: 10.1249/mss.0b013e31802fa679
Source: PubMed


To assess the prevalence of depressive symptoms and difficulty with pain in retired professional football players, difficulties with the transition from active athletic competition to retirement, perceptions of barriers to receiving assistance for those difficulties, and recommended programs to provide such assistance.
Survey sent to 3377 retired members of the National Football League Players Association (NFLPA), with usable responses received from 1617 members (functional response rate, 48.6%).
Respondents were categorized as experiencing no to mild depression (N=1366; 84.5%) or moderate to severe depression (N=237; 14.7%). Respondents were also categorized according to whether they reported difficulty with pain as not or somewhat common (N=837; 51.8%) versus quite or very common (N=769; 47.6%). Respondents most frequently reported trouble sleeping, financial difficulties, marital or relationship problems, and problems with fitness, exercise, and aging, all of which were strongly correlated with the presence of moderate to severe depression and with quite or very common difficulty with pain. The same difficulties were even more commonly experienced by respondents who reported both moderate to severe depression and quite or very common difficulty with pain, compared with those who reported low scores in both domains.
Retired professional football players experience levels of depressive symptoms similar to those of the general population, but the impact of these symptoms is compounded by high levels of difficulty with pain. The combination of depression and pain is strongly predictive of significant difficulties with sleep, social relationships, financial difficulties, and problems with exercise and fitness. A hypothesis explaining this association is that significant musculoskeletal disability and chronic pain interferes with physical activity and fitness during retirement and increases the risk of depression.

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    • "Such career uncertainty often further leaves athletes vulnerable to anxiety (Lavallee & Robinson, 2007). Athletes may also struggle with their changing bodies (Lavallee & Robinson, 2007) and depression associated with ongoing chronic pain resulting from injuries sustained during sporting careers (Schwenk et al., 2007). Accordingly, the retirement from elite sport can constitute a significant risk to athletes' psychological health and well-being. "
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    ABSTRACT: Retirement from elite sport can be highly distressing for athletes, and many report experiencing depression and anxiety in adjusting to this transition. In this article, a discursive psychological approach is employed to explore constructions of choice and identity around elite athletes’ retirements within Australian newsprint media. Within these accounts, three ‘types’ of retirements were identified: retirements occurring in relation to age, injury, or active choice. Retiring with individual agency and at an appropriate time was repeatedly privileged, whereas retiring in different ways was routinely problematised. In privileging particular ways of retiring, certain identity positions were made more accessible than others. Consequently, certain actions and choices are deemed appropriate (or not) for athletes, ultimately constraining decision-making around retirement. The implications of such limited identity positions and choices are explored in relation to the psychological distress and clinical concerns that emerge among many athletes in the transition out of elite sport.
    Australian Journal of Psychology 06/2013; 65(2):88-97. DOI:10.1111/j.1742-9536.2012.00060.x · 1.08 Impact Factor
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    • "One published US study [51] that surveyed college student-athletes found that the top rated reasons for not seeking help from counselling services were ‘no need’, not wanting to experience ‘personal discomfort’, worrying about the ‘perceptions of others’, and a lack of ‘time’. Another US study [52] of the opinions of older (M = 53.4 years) retired football players, found that these athletes reported the following as barriers to seeking help: not recognising they had a problem, embarrassment, feeling “weak” if they got help, no insurance, travel and time constraints, and a preference for relying on family and friends, or spiritual means for help. "
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    BMC Psychiatry 09/2012; 12(1):157. DOI:10.1186/1471-244X-12-157 · 2.21 Impact Factor
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    • "NFL football is a collision sport laden with serious injury and medical risks (Selden et al., 2009). Data from the NFL indicate that up to 68% of NFL players may be injured in any given year (Halchin, 2008), potentially leading to long term consequences from an increased risk for more serious injury (Schwenk et al., 2007; Orchard and Seward, 2002) and pain. "
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    ABSTRACT: Athletes with injury-related pain, especially National Football League (NFL) players, are at increased risk for opioid use and misuse which may result in medical, psychiatric and social problems. This is the first study to evaluate the intersection of sports pain and opioid use and misuse among former NFL players. A telephone survey of 644 retired NFL players from the 2009 Retired Players Association Directory was conducted (53.4% completion rate) from March to August 2010. Over half (52%) used opioids during their NFL career with 71% reporting misuse. Additionally, 15% of NFL misusers currently misused vs. 5% among players who used just as prescribed during their NFL career. Prevalence of current opioid use was 7%-3 times the rate of the general population. Multivariate analyses indicated that significant NFL pain increased the adjusted odds (AOR) of any current opioid use vs. non-use (AOR 6.76, 95%CI 2.88-15.87), as did moderate to severe mental impairment (AOR 1.88, 95%CI 1.19-2.98) and heavy drinking in the past week (AOR 2.15, 95%CI 1.17-3.98). Undiagnosed concussions singly predicted current misuse vs. use just as prescribed (AOR 4.25, 95%CI 1.12-16.22). Three variables predicted current misuse vs. non-use: significant pain (AOR 8.33, 95%CI 1.98-35.04), undiagnosed concussions (AOR 3.51, 95%CI 1.98-35.04) and heavy drinking (AOR 3.48, 95%CI 1.63-7.41). Players who misused during their NFL career were most likely to misuse currently compared to others. Current misuse was associated with more NFL pain, undiagnosed concussions and heavy drinking. Longitudinal studies are needed to determine the long term effects of opioid misuse among athletes.
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