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Review
. 2024 Mar-Apr;16(2):222-229.
doi: 10.1177/19417381231179678. Epub 2023 Jun 16.

How Mental Health Affects Injury Risk and Outcomes in Athletes

Davis L Rogers  1 , Miho J Tanaka  2 , Andrew J Cosgarea  1 , Richard D Ginsburg  3 , Geoffrey M Dreher  1
Affiliations
Review

How Mental Health Affects Injury Risk and Outcomes in Athletes

Davis L Rogers et al. Sports Health. 2024 Mar-Apr.

Abstract

Context: The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care.

Evidence acquisition: We searched PubMed for pertinent peer-reviewed studies.

Study design: Clinical review.

Level of evidence: Level 5.

Results: There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes.

Conclusion: Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.

Keywords: athlete; injury; mental health; psychology; sport.

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Conflict of interest statement

The following authors declared potential conflicts of interest: G.D. has received speaking fees from Rowan University. M.T. has received research funding from Fujifilm, consulting fees from Johnson & Johnson, and honorarium from AO North America.

Figures

Figure 1.
Figure 1.
A vicious cycle. Diagram depicting the relationship between mental health and physical injury, also demonstrating areas in which identification and intervention can improve care of the athlete.
See this image and copyright information in PMC

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