Associations between retirement reasons, chronic pain, athletic identity, and depressive symptoms among former professional footballers

Background: Retirement from professional sport has been recognised as a major psychological stressor, and there is a need to identify factors that increase the risk of mental health problems after career termination. The current study examined associations between career-ending injury, chronic pain, athletic identity and depressive symptomology in retired professional footballers. Methods: A cross-sectional study was performed with 307 retired male footballers who had played within a professional United Kingdom league. Participants completed measures of depressive symptoms (Short Depression-Happiness Scale), chronic pain (Pain Intensity Numerical Rating Scale), and athletic identity (Athletic Identity Measurement Scale), and reported their reasons for retirement. Results: A total of 48 participants (16%) met the cut-off score for possible cases of clinically-relevant depression. These participants were more recently retired, and had higher athletic identity than those without depressive symptoms. Former players with depressive symptoms were more likely to cite injury as a retirement reason, and report higher levels of ongoing injury-related pain. Multivariate logistic regression revealed that presence of depressive symptoms was independently associated with retirement through injury (OR = 3.44; 95% CI = 1.39, 8.51), higher pain levels (OR = 1.38; 95% CI = 1.02, 1.86), and increased athletic identity (OR = 1.28; 95% CI = 1.14, 1.44). Conclusions: Career-ending injury is strongly associated with higher odds of depressive symptomology during retirement, while experiencing chronic pain, and maintaining a high sense of athletic identity, are additional potential contributors.