Playing sport injured is associated with osteoarthritis, joint pain and worse health related quality of life: A cross sectional study

Abstract

Background: Sports participants are faced with the decision to continue or cease play when injured.The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain; and compare findings in elite and recreational athletes.Methods: The Cricket Health and Wellbeing Study cohort was used for this study. Inclusion criteria were: age ≥18 years, played ≥1 cricket season. Questionnaire data collected included a history of playing sport injured, SF-8 (physical (PCS) and mental (MCS) component scores), physician-diagnosed osteoarthritis, and persistent joint pain (most days of the last month). Multivariable linear regressions and logistic regressions were performed. Continuous covariates were handled using fractional polynomials. Models were adjusted for age, sex, cricket-seasons played, playing status, joint injury, and orthopaedic surgery. All participants (n=2,233) were included in HRQoL analyses, only participants aged ≥30 years (n=2,071) were included in osteoarthritis/pain analyses.Results: Of the 2,233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally; median PCS: 51.4 IQR 9.0; MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. People who had played sport injured reported worse adjusted PCS (Effect(95% CI): -1.78(-2.62, -0.93) and MCS (-1.40(-2.25, -0.54), had greater odds of osteoarthritis (adjusted OR(95% CI): 1.86(1.39, 2.51) and persistent joint pain (2.34(1.85, 2.96)), compared to people who had not played sport injured. Similar relationships were observed regarding PCS, osteoarthritis and pain in elite and recreational subgroups. Playing injured was only related to worse MCS scores for elite cricketers (-2.07(-3.52, -0.63)); no relationship was observed in recreational cricketers (-0.70(-1.79, 0.39)).Conclusion: Athletes that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite athletes. Recreational and elite athletes should be informed of the potential long-term health implications of playing sport

Health Conditions, Substance Use, Physical Activity, and Quality of Life in Current and Former Baseball Players

“…22 Baseball is a noncollision sport, which might explain why the prevalence of injuries was similar to that in cricket 31,60,61 and why HRQoL in current and former baseball players was comparable to that in current and former recreational and elite cricketers. 9,11 After controlling for confounders, we observed former pitchers to have a clinically meaningful decrease in mental components of HRQoL as compared with former position players. 29 Furthermore, the similarities in physical components of HRQoL between pitchers and position players, after controlling for previous injury, suggest that these mental components of HRQoL disparities are not explained by impaired physical function.…”

“…Health conditions were assessed using the following question, developed from the cricket health and well-being study: "Have you ever been told you have any of the following by a doctor?" 9,11 Participants were also asked, "Do you currently have any of the following, diagnosed by a doctor?" The assessed health conditions included asthma, depression, diabetes, hypertension, and hypercholesterolemia.…”

“…Participants were categorized as currently playing baseball, no longer playing baseball, or planning to return to baseball. 9,11 Only 1 participant planned to return to baseball, with the last game age noted as 23 years and current age as >30 years. The participant was categorized as no longer playing baseball for analyses.…”

“…Confounders were identified via clinical reasoning and literature search. In relation to HRQoL and flourishing, confounders included BMI, 23 competition level, 8 baseball seasons played, 74 injury history, 9 and education level. 87 Competition Level and Seasons Played.…”

“…17,78 People with high flourishing have been shown to have positive individual and societal influences and overall life satisfaction. 34,35,40,73 Few studies have investigated flourishing in athletes; professional current and former cricketers have reported high flourishing as compared with lower playing standards, 9 demonstrating potential disparities between different playing standards. Within baseball, 1 investigation of HRQoL and flourishing in retired professional baseball players found that 51% indicated moderate life satisfaction and 15% indicated low life satisfaction.…”