J Sport Rehabil. 2019 Jan 01;28(1):46-51. doi: 10.1123/jsr.2017-0103.
Do Exercisers With Musculoskeletal Injuries Report Symptoms of Depression and Stress?.
Journal of sport rehabilitation
Mia Beck Lichtenstein, Claire Gudex, Kjeld Andersen, Anders Bo Bojesen, Uffe Jørgensen
PMID: 28872439
DOI: 10.1123/jsr.2017-0103
Abstract
CONTEXT: Sports injuries in athletes can lead to negative emotional responses in terms of anger, anxiety, confusion, and sadness. Severe injuries can be understood as a stressful life event with increased levels of psychological distress, but injury assessment and rehabilitation typically focus on somatic symptoms.
OBJECTIVE: The primary aim of this study was to estimate the prevalence of depression and emotional stress and to measure self-rated health in regular exercisers presenting to a sports medicine clinic with musculoskeletal injury. The secondary aim was to identify psychosocial factors associated with depression in injured exercisers and the potential need for psychological counseling.
DESIGN: A cross-sectional survey study.
SETTING: A sports medicine clinic for injuries of the foot, knee, or shoulder.
PARTICIPANTS: Regular exercisers with present injuries (N = 694) and exercisers without injuries (N = 494). Regular exercisers were defined as those undertaking moderate exercise at least once a week.
INTERVENTION: A questionnaire survey completed on paper by patients in a sports medicine clinic and a web-based version completed by online sports communities.
MAIN OUTCOME MEASURES: Participants completed the Major Depression Inventory, Perceived Stress Scale, health-related quality of life, and questions on sociodemographics, exercise habits, and injury history.
RESULTS: Symptoms of depression were reported by 12% of injured exercisers and 5% of noninjured controls (P < .001). Clinical stress was found in 30% of injured exercisers and 22% of controls (P = .002), and the EQ-5D-5L Visual Analog Scale score was lower for injured (69 [SD = 19]) than noninjured exercisers (87 [SD = 13], P < .001). Injured exercisers with symptoms of depression reported high stress levels and impaired daily functioning, were younger, and were more likely to have over 10 days injury-related work absence.
CONCLUSIONS: The authors recommend psychological assessment of exercisers attending a sports medicine clinic for musculoskeletal injury and a supplemental clinical psychological interview for suspected depression or stress-related psychopathology.
Keywords: emotional stress; interdisciplinary interventions; regular exercise; sport injury
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