A Qualitative Assessment of Return to Sport in Collegiate Athletes: Does Gender Matter?

Abstract

Introduction: Participation of female athletes in collegiate athletics continues to rise, but there remains a significant underrepresentation of this growth in the literature and lack of knowledge regarding the impact of gender on the college athlete experience. Our goal was to explore how collegiate female and male athletes perceive and approach return to sport after orthopaedic surgery. Methods: Semi-structured, open-ended interviews were conducted with collegiate varsity athletes from a single institution who underwent orthopaedic surgery following injury with at least two years follow-up. Athletes were asked about factors influencing recovery, rehabilitation, and their return to or retirement from sport. Codes, categories, and themes were derived within and across genders. Results: Fifteen athletes (six females and nine males) were interviewed individually. Athletes shared similar experiences following injury, citing similar motivations driving them back to sport. Athletes stressed the importance of the athlete role to their identity regardless of gender. Our analysis revealed two gender-related challenges: male athletes commonly felt weight change was a barrier to successful recovery and often led to self-consciousness; while females expressed frustrations in lack of empathy from those they turned to for support. Conclusion: Female and male athletes shared some common supporting and challenging factors in return to sport following orthopaedic surgery. The most important findings of the present study were the differentiated challenges male versus female athletes experienced. Female athletes found difficulty with interpersonal relationships and external support, while male athletes struggled internally with their own body image and changing self-concept. This qualitative study provides a nuanced look at the experience of varsity athletes returning to sport following surgery. An understanding of the gendered experiences of collegiate athletes is critical to ensure all athletes in this unique population are supported as they cope with injury and seek to return to sport.

Preseason Eccentric Strength Is Not Associated with Hamstring Strain Injury: A Prospective Study in Collegiate Athletes

“…An overwhelming majority of known evidence supporting HSI risk factors is based on study samples of exclusively male athletes (11,12,(14)(15)(16). Despite female participants in collegiate sports being at an all-time high (47% of Division I athletes in 2019-2020; NCAA database), a known underrepresentation of female athletes in the sports medicine literature continues to exist (25)(26)(27). To the best of our knowledge, this study is the first to include female athletes when determining the association between eccentric hamstring strength and subsequent HSI.…”

Optimizing Health and Athletic Performance for Women

“…Being female, young, having a limited experience of injury, negative emotion, and perceptions of isolation are factors related to less successful outcomes of rehabilitation [ 79 ]. Female primary care sports medicine physicians and orthopedic sports medicine surgeons may be able to better understand the experiences of female athletes, critical to ensure that they are supported as they cope with injury and seek to successfully return to sport [ 80 ].…”

Differences in athletic identity, sport participation, and psychosocial factors following anterior cruciate ligament rehabilitation in youth athletes

“…The current return-to-sport criteria primarily emphasize physical measures of readiness; however, psychological measures of rehabilitation, such as athletic identity, may also be valuable due to the influence of injury and rehabilitation on these metrics ( Lochbaum et al, 2022 ). For example, depressive symptoms and loss of motivation over rehabilitation, which lead to worsened physical function, may be increased in those with high athletic identity ( Christino et al, 2015 ; Morgan et al, 2020 ; Renton et al, 2021 ), particularly high athletic identity youth ( Manuel et al, 2002 ; Chow et al, 2016 ; McKay et al, 2019 ; Edison et al, 2021 ; Nyland and Pyle, 2022 ). Athletes may also display greater catastrophizing thinking patterns and emotional trauma ( Shuer and Dietrich, 1997 ; Padaki et al, 2018 ; Costa et al, 2020 ).…”