Long-Term Impacts


Lead Author(s): 

Kenneth L. Cameron, PhD, MPH, ATC
Haley A. Bookbinder, MEd, ATC
Brett D. Owens, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

While we still have a rudimentary understanding of the impact that musculoskeletal injuries sustained by collegiate athletes have on long-term health outcomes, studies have recently begun to examine health-related quality of life in current and former NCAA athletes. McAllister et al1 evaluated health-related quality of life in NCAA Division I athletes using the SF-362 and examined the association between scores, injury history and severity. Collegiate athletes who reported a history of mild injury had significantly lower physical component summary scale scores, role physical scores, bodily pain scores, social function scores, and general health scores on the SF-36 when compared to those with no history of injury. Collegiate athletes who reported a serious injury had significantly lower scores on all SF-36 component scores when compared to athletes with no history of injury.  Similar results were observed in a separate study that examined NCAA Division I and Division II athletes.3

More recently, studies have examined health-related quality of life in former NCAA athletes. Sorenson et al4 reported that former NCAA Division I athletes were significantly more likely to have joint-related health concerns when compared to non-athletes and were 14 times more likely to seek professional treatment for their symptoms. They also reported that the prevalence of joint related health concerns was significantly higher in older former athletes when compared to younger former athletes.

In a similar study, Simon et al5 examined health-related quality of life in former NCAA Division I athletes and former non-athletes using the Patient-Reported Outcomes Measurement Information System (PROMIS).6 They reported that former collegiate athletes report significantly worse scores for 5 of the 7 PROMIS scales examined when compared to non-athletes. Specifically, former athletes reported poorer scores on the physical function, depression, fatigue, sleep disturbances, and pain interference scales. There were no differences noted between former NCAA athletes and non-athletes for the anxiety and satisfaction with participation in social roles scales. The authors also noted that former collegiate athletes reported significantly more major injuries, chronic injuries, daily limitations, and physical activity limitations when compared to non-athletes.

Overall, these studies suggest that NCAA athletes who sustain injuries during their college years have significantly lower health-related quality of life scores, and that these scores may get worse with time, particularly for joint-related health issues and long-term major and chronic injuries. Decreased health-related quality of life in former college athletes may also contribute to greater daily activity and physical activity limitations when compared to non-athletes and may lead to significant chronic health comorbidities. Further research is needed to determine which factors contribute to the poorer health-related quality of life outcomes observed among former collegiate athletes in these studies.

  • 1. McAllister DR, Motamedi AR, Hame SL, Shapiro MS, Dorey FJ. Quality of life assessment in elite collegiate athletes. Am J Sports Med. 2001;29(6):806-810.
  • 2. The Short Form-36 was derived from the General Health Survey of the Medical Outcomes Study by Stewart and colleagues (1988). It is one of the most widely used generic measures of health-related quality of life and has been shown to discriminate between subjects with different chronic conditions and between subjects with different severity levels of the same disease. The SF-36 has also demonstrated sensitivity to significant treatment effects in a variety of patient populations.
  • 3. Huffman GR, Park J, Roser-Jones C, Sennett BJ, Yagnik G, Webner D. Normative SF-36 values in competing NCAA intercollegiate athletes differ from values in the general population. J Bone Joint Surg Am. 2008;90(3):471-476.
  • 4. Sorenson SC, Romano R, Scholefield RM, et al. Holistic life-span health outcomes among elite intercollegiate student-athletes. J Athl Train. 2014;49(5):684-695.
  • 5. Simon JE, Docherty CL. Current health-related quality of life is lower in former Division I collegiate athletes than in non-collegiate athletes. Am J Sports Med. 2014;42(2):423-429.
  • 6. PROMIS uses modern measurement theory to assess patient–reported health status for physical, mental, and social well–being to reliably and validly measure patient–reported outcomes (PROs) for clinical research and practice.


  • Fourth Edition

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