Depression and Pain in Retired Professional Football Players

Thomas L. Schwenk; Daniel W. Gorenflo; Richard R. Dopp; Eric Hipple

Disclosures

Med Sci Sports Exerc. 2007;39(4):599-605. 

In This Article

Abstract and Introduction

Purpose: 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.
Methods: 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%).
Results: 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.
Conclusion: 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.

The transition made by professional athletes from a full-time elite athletic career to retirement has received considerable comment in the sports media[4,5] but little formal study. It is generally believed that the transition is difficult and traumatic because of the sudden cessation of the intense demands of elite athletic performance, compounded by the sudden loss of the athlete's intense devotion to professional athletic competition and its attendant rewards. At the elite level, the athlete's life is fully organized around his or her performance, as are support personnel and extensive logistic and financial resources. On retirement, athletes have reported jarring transitions to a life in which the focus of such intense commitment is unclear, the resources and personnel that organized and managed their lives away from the competition venue are lost, and the rewards, both emotional and financial, are diminished. Previous studies have assessed the risk of suicide in active college athletes,[10] the risk of depression in college graduates who were previously varsity athletes,[13] the association between concussion experienced during active professional football participation and the diagnosis of mild cognitive impairment later in life,[8] and analyses of case series of suicide in professional athletes[4] or injured athletes,[20] but we know of no studies in which the prevalence and impact of depression and pain have been assessed in a more structured way among retired National Football League (NFL) players.

We surveyed retired NFL players who are members of the National Football League Players Association (NFLPA), regarding the life domains in which problems were encountered in making the transition from active competition to retirement, the magnitude and impact of such difficulty, barriers to seeking and receiving assistance in resolving these difficulties, symptoms of and experiences with depression and chronic pain, and recommendations for how these problems could be remedied and how retirement could be made more successful and satisfying.

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