Sports Medicine Research: In the Lab & In the Field: Retired Athletes May Be Set Up for Unhealthy Lifestyles (Sports Med Res)


Wednesday, June 21, 2017

Retired Athletes May Be Set Up for Unhealthy Lifestyles

The Impact of Previous Athletic Experience on Current Physical Fitness in Former Collegiate Athletes and Noncollegiate Athletes

Simon JE, & Docherty CL. Sports Health. 2017; Published online ahead of print

Take Home Message: Former collegiate athletes were less physically fit and healthy than adults who were physically active in college about 30 years after participation.  This highlights a need for early identification, prevention, and education to help these at-risk individuals. 

Participation in sports and vigorous physical activity is typically a positive and healthy part of a young person’s life.  However, a physically active individual is at greater risk of injury, which could negatively affect their long-term wellness.  The authors of this study compared the physical activity health of former NCAA Division I athletes and compared their performance to non-athletes 20 to 40 years after college.  Two hundred participants (100 former athletes and 100 people who were physically active in college) with an average age of 51 years, completed questionnaires and fitness assessments including body fat, flexibility, muscular endurance/strength, and cardiorespiratory endurance tests.  Almost 80% of former athletes suffered an injury that resulted in lost participation time while playing. About half of the athletes reported being diagnosed with osteoarthritis while only 10% of the non-athletes reported being diagnosed with osteoarthritis. Overall, former athletes performed worse in all physical fitness testing (e.g., completing a mile walk on average 2.4 minutes slower) in comparison with non-athletes.  Former athletes also had higher body fat percentages (about 29%) compared with non-athletes (about 21%).

These authors found that former competitive collegiate athletes had worse physical health than non-athletes.  While this is a limited sample, it does open our eyes to the fundamental need for more education focusing on transitioning collegiate athletes into the general population after competitive careers (e.g., long-term wellness).  However, one cannot ignore the high prevalence of injuries.  The question remains whether it is physical issues from their injury that is limiting their current physical activity, or if there are other psychosocial components that may contribute to their overall negative physical health.  This highlights the importance of a new curriculum addition to CAATE’s Proposed Standards for Professional Programs: “Develop and implement wellness strategies to mitigate the risk for long-term health conditions across the lifespan”. The document notes that this includes osteoarthritis. Based on these results, we need to be more proactive in mitigating the risk of poor long-term health outcomes. Interestingly, the former athlete cohort had a relatively large portion of former football players.  It would be interesting to see what the athletes’ competitive weights were versus what they currently weigh.  Football is one of those sports where “larger” individuals may be more successful at certain positions.  It would also be helpful to see if the results of the study were different without football since the physically active cohort did not have the opportunity to compete in a comparable collision sport.  Finally, it would be interesting to see if the number of injuries or whether they were acute or chronic injuries influenced the current physical fitness levels.  Regardless, as clinicians, we need to realize that our patients may go on to live relatively unhealthy lives after they leave our care.  For example, we previously saw that most former college athletes fail to meet recommended exercise guidelines. As healthcare providers, early intervention, education, and preparation for these at-risk athletes should be an essential component of our clinical practice.

Question for Discussion:  Do you talk to your athletes about long-term wellness and healthy living after competitive sport participation?

Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

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Kyle Morris said...

Interesting study Janet and Carrie. I believe this is something that should be focused on more in the healthcare profession, specifically athletic training. So often we are focused on getting an athlete back on the field as quickly and safely as possible, however, it is still part of our duties to consider the long term implications of injuries during sport. I agree that there are many factors that can lead to former athletes being less physically active and feel that early onset OA is a major factor, and again is something that athletic trainers are still not taking as seriously as we should. This article has opened my eyes more to this issue. Thanks for publishing your findings.

maggie lynch said...

The results of this study surprised me, although they do make complete sense when looking at the bigger picture. So often athletic trainers get caught up in the "now" and don't take the time to educate athletes on what life will be like after they're done playing. I think the psychological aspect plays a huge factor as most athletes have identified as such for their whole lives. After sport they can feel as though they have lost their identity which can be a really hard thing to cope with. I'm interested to see where this research goes- thanks for sharing your results!

Nicole Cattano said...

Maggie and Kyle bring up great points. Does anyone habe any good strategies with how to shift our clinical focus from now to longer term?

Kate Hill said...

I think this article makes some good points. As an athletic trainer we definitely look more at the now rather than the long term. A lot of what we do is trying to get the athletes back into the game or back to their sport without really thinking about the patient as a whole. In the athletic training realm we should start looking at the long term outcomes for patients especially after they finish playing a sport. I think that educating the patient may help in the future. Giving the patient the data beforehand about future outcomes can help them think or re-think about the stresses they are placing on their body and modifications can be made. I also liked how this article touched upon the psychological aspect of why former athletes are less physically active. I had not really thought about the fact when the competitive stimulus is taken away the motivation for the patients to exercise ceased. This article makes me look at patients and situations more as whole person even beyond their "athlete" years.

Nicole Cattano said...

Thanks Kate! I think your strategies to educate athletes about outcomes early seems like great advice.

As all commenters have noted - add clinicians we need to shift our afternoon longer term too so that we can see the whole picture to help the patients that we work with.

Why do you think we sometimes focus too much on short term, and how do you think we can change our ways?

Adrienne Dembeck said...

Everyone has made great points so far about this article. I especially enjoyed the psychological aspect of it that was brought up in the text and in the comments. After spending years as a Division I athlete where your entire schedule including workouts, meals, and homework with other athletes, I can imagine that transitioning to the non-competitive life would be a challenge for many individuals. Their sport becomes their identity. After graduation, these athletes are expected to lives their lives normally, so it makes sense to me that the psychological part of this could be a contributing factor to the results of this study. It would be interesting to see if the results of this study would change the way athletes looked at injury and rehabilitation, and if they would make any lifestyle changes based on what their future could look like. I think it would also be interesting to see which specific sport puts athletes most at risk for future injury and decreased activity level. I think that athletic trainers have already been making the effort to talk about the important of long term health with their athletes, however I think that we could do more to address this before an injury actually occurs. I think it would be helpful to incorporate more of this data into discussion with patients and coaches.

Nicole Cattano said...

Adrienne you bring up some very good points. I think what this information it would help us in talking with current athletes and their coaches to try to decide what might be best for education and programming. I really like the idea of trying to find out if there are certain sports that are more at risk than others for future issues. This could be due in part to their level of identity, or injury risks. But right now we just don't know. I think you are really onto something!

Sarah Coronel said...

What a very interesting article! I think that most would be surprised by the results of the study, but as a former college athlete myself, they make sense to me. Maggie mentioned, that some athletes struggle with their identity after they finish their career, and the same thing happened to me. I struggled with finding my identity after basketball was over and there was a time that I chose not to take care of my body as well as I had as an athlete. After reading this article and remembering my own experiences, I understand the importance of educating athletes on long term outcomes and the effects of their decisions. I also agree with the ideas for future research; I think it would be very interesting to see the results of a study that examines whether the injuries sustained by former athletes influence their physical fitness levels or not. The findings could potentially have a large effect on the treatment given by athletic trainers. Thanks for sharing your research!

Nicole Cattano said...

Great points Sarah! I agree, it would be interesting to see what aspects affect people as they get older and potentially why.

Your personal experiences are very important to this. And I like that it helped you revisit that and think more critically about it now that you are further away from it. It seems that you have successfully transitioned. My question back to you is how did your other teammates fare after college?

It seems that some former athletes do maintain their health or actually adapt better and more healthy behaviors. However there are many who go the opposite direction as well. I think trying to understand why some successfully adapt to they're non-athletic Physically Active lives and others do not could be very important. Could it be the severity of their athletic identity or other potential factors?

But I think the most important (and exciting) thing that you brought up is the fact that athletic trainers can have a large effect on this issue. Thanks for commenting!

Dana said...

Thanks for sharing this topic Nicole. This article highlights an issue that seems to be put on the back burner before other topics an Athletic Trainer discusses with their patients. I have enjoyed what everyone else has touched on too.

Like Sarah I experienced the inevitable identity crisis post-competitive play. My timeline started sooner than my peers since I chose not to play soccer collegiately. Of my teammates that I have kept in touch with they are still active and have exercising as part of their lifestyle.

For these former athletes mentioned in this article I wonder how much of their motivation was intrinsic versus extrinsic? Or whether it was a culmination of experiences or one particular moment that generated a sedentary lifestyle. If this is something we can identify I think it can help cater that conversation of sustainable activity to athletes when they are transitioning out of a high-competition environment.

Nicole Cattano said...

Thank you for the comment Dana. I think it is great that you and your former teammates seem to have successfully transitioned into healthy and Physically Active lifestyles. It would be interesting to see if athletes in different sports that may be more susceptible in comparison to another sport. (Since young mentioned soccer). It would also be interesting to see how you and your teammates progress as you get older.

What are some strategies or approaches that you or others have folks utilized for themselves personally or to help athletes that you've worked with?

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