It is well known that sport participation carries a set of physical health benefits: reduced all-cause mortality, longer lifespan, and reduced risks of diabetes, cardiovascular disease and osteoporosis, among others.
On the negative side sports practice brings an injury risk, which can have a long-lasting physical and psychological impact. Injury can cause negative emotions, impair quality of life (QOL) and decrease physical activity, independently of functional recovery. In this sense, sport-related concussions are related to reduced QOL and depression in former athletes, and joint injury is associated with a higher risk of osteoarthritis.
Nevertheless, what happens with athletes after retirement is less known. In former elite athletes, osteoarthritis is more prevalent, and sometimes accompanied by distress, common mental disorders and reduced QOL. These negative physical effects may be counteracted by the positive psychosocial health effects of sport participation: resilience, improved mental health, reduced stress and sense of group belonging.
Adaptation to a life without sport appears more difficult when the athlete retires involuntarily, due to an injury or not being selected. It may result in negative emotions as social exclusion, betrayal or loss of identity. Things change with voluntary retirement, usually accompanied by a sense of achievement and transition to a different life style.
A recent systematic review of the existing scientific literature has found 17 eligible articles about QOL in former athletes. Physical and mental components were given a score (PCS Physical Component Score and MCS Mental Component Score) to determine the level of QOL. Main results are exposed as follow:
- Former athletes with no history of concussion or osteoarthritis reported better PCS scores than the general population. Other athletes though showed lower PCS scores, that could be explained by the sport (contact or collision modality), reasons for retirement, chronic pain or osteoarthritis.
- As for the mental state, all former athletes showed better MCS scores than general population, even in those athletes with lower PCS scores, showing a discordance between physical and mental aspects affecting QOL.
- A large population-based study in the United States found that people with arthritis were more likely to have physically and mentally unhealthy days compared to aged-matched individuals. Even athletes with osteoarthritis symptoms had a healthier mental state than this population: they were more satisfied with their lives. It looks that competitive sport gave them mental strength, and high levels of resilience and pain coping capabilities.
The main limitations of these studies were that they didn´t consider: current physical activity levels, differences among sport disciplines, time from retirement, length of sport participation, and that many of them were done only in males.
- In former professional athletes, on average, physical components of QOL were similar, while mental components of QOL were better than in the general population. Discordance between physical and mental components of QOL highlights the importance of using measurement instruments to differentiate among these components. Life satisfaction should also be evaluated.
- Sport participation can have long-term physical consequences that negatively impact QOL: disciplines involving collision/contact, involuntary retirement from sport, and a history of concussion and/or osteoarthritis.
- However, sport participation may also have positive mental effects that extend beyond retirement and enhance quality of life.
Quality of Life and Life Satisfaction in Former Athletes: A Systematic Review and Meta-Analysis.
Filbay S, Pandya T, Thomas B, McKay C, Adams J, Arden N
Sports Med. 2019 Aug 19. doi: 10.1007/s40279-019-01163-0. [Epub ahead of print]