Prior Injury, Health-Related Quality of Life, Disablement, and Physical Activity in Former Women’s Soccer Players

Cross SJ, Gill DL, Brown PK, Reifsteck EJ. J Athl Train 1 January 2022; 57 (1): 92–98. doi:

Full Text Freely Available

Take-Home Message

A former female collegiate athlete with a history of severe knee injury may experience poorer quality of life than those without a history of injury. Clinicians need to consider a patient’s long-term outcomes during the rehabilitation of a severe injury.


Some former collegiate athletes experience poor health-related quality of life after graduation (see related posts below). Unfortunately, it remains unclear which athletes are more likely to experience poor long-term health outcomes. If we can identify risk factors for poor long-term outcomes (e.g., severe injury), we could educate patients and implement prevention strategies to help preserve someone’s long-term wellness.

Study Goal

The authors conducted a cross-sectional online survey to measure the relationship between injury history and health-related quality of life, disablement, and physical activity among National Collegiate Athletic Association Division I women’s soccer players. 


The authors surveyed 382 former NCAA DI women’s soccer players with an average age of 36 years to complete an online survey that measured injury history, health-related quality of life, disablement, and physical activity. The authors used 3 validated questionnaires: 1) Adult Global Helath Measure to measure health-related quality of life, 2) the Disablement in the Physically Active Scale to measure disablement, and 3) the Godin Leisure-Time Physical Activity Questionnaire to measure physical activity. They also used two exploratory questions for participants to rate how their past injuries impacted their current health. The authors defined a severe injury as any injury that kept the person out of sport participation for at least 21 days.


More than two-thirds of former athletes reported a severe injury during their playing career. Someone who reported a severe injury was more likely to report worse physical health-related quality of life and disablement than someone without a history of injury. A severe injury did not predict mental health or physical activity. Most participants (82%) rated their health as very good or excellent. However, over half of the participants listed concerns with their health, most frequently citing joint health (39%) and mental health (18%). When just examining people that reported a severe injury, almost one in three reported their injury often or practically always hindered their ability to participate in recreational activities, physical activity, or sports.


These findings suggest that in former female athletes, a severe injury may lead to lower long-term health-related quality of life and negatively impact former female athletes’ ability to participate in physical activity. On the surface, if we look at the average quality of life scores, it would appear that those with and without a history of injury are doing as well, if not better, than the general population. However, we cannot let this obscure that some former athletes are experiencing concerning outcomes. For example, 2 in 5 former athletes reported a concern about joint health, and almost 1 in 5 reported a mental health concern. It would be interesting to see future studies that follow collegiate athletes during their playing career and then as they transition after graduation and the years that follow. This type of study may provide important insight into whether athletes are graduating with poor quality of life or developing it over time. These future findings could have implications for addressing this problem with our current patients.

Clinical Implications

Clinicians should be aware that some former athletes experience poor long-term outcomes and be prepared to counsel athletes on the importance of continued exercise/rehabilitation to maintain or improve their health-related quality of life after participation in organized athletics.  

Questions for Discussion

Should there be more extensive rehabilitation plans after/at discharge to maintain or improve the quality of life in athletes after an injury?

Do colleges/universities have a responsibility to athletes who suffered a severe injury to continue to provide medical counseling for a brief period after the athlete has discontinued play or left the institution?

Related Posts

  1. Our Patients Should know what to expect: Long-term Wellness of Former Collegiate Athletes
  2. Former Division III Female Collegiate Athletes Report Better Overall Long-Term Health
  3. Retired Athletes May Be Set Up for Unhealthy Lifestyles
  4. Does your Level of Exercise Match Up Against Retired Elite Athletes?…Probably!
  5. Stop! In the Name of Long-Term Joint Health
  6. Looking in The Crystal Ball: Life After College Sports

Written by Mitchell Barnhart
Reviewed by Jeffrey Driban

9 EBP CEU Courses