The Effect Of Injuries And Pain On Athletic Identity Across NCAA Divisions

Abstract

There is a high prevalence of pain and injury in collegiate athletes, which can affect playing time and performance. Previous studies have observed that surgery and concussions can affect athletic identity. Currently, there is a paucity of research investigating how current pain and injury affect athletic identity. PURPOSE: To determine how current collegiate athlete pain and injury affect athletic identity and how these relationships differ across NCAA divisions. METHODS: NCAA division 1 (D1), 2 (D2), and 3 (D3) athletes were administered a questionnaire through an encrypted database. The Athletic Identity Questionnaire (AIM) and Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC) were used within the survey. AIM estimates self-perceived athletic identity while OSTRC measures level of participation, training volume, performance, and pain. Athletes were further classified by OSTRC scores into overuse and substantial overuse injuries. Multivariable and logistic regressions assessed the relationship between Aim, OSTRC scores, and overuse injury. Models were adjusted for age, gender, NCAA division, history of orthopedic surgery, and history of major injury, with unadjusted and adjusted coefficients and Odds Ratios (OR) with 95% confidence intervals (95% CI). RESULTS: 252 athletes (age of 19.4 years (1.2); female: 181, male: 70; D1: 101, D2: 74, D3: 77) participated. Mean AIM scores were D1: 37.98 (7.61), D2: 37.03 (37.03), and D3: 38.86 (6.98). The OSTRC median score was 0 (IQR: 0-22). 127 (50%) athletes had an overuse injury while 47 (19%) had a substantial overuse injury. Adjusted total OSTRC score was -0.67 (95% CI: -2.4, 1.1; p=0.474). Adjusted OR for OSTRC overuse injury was 1.00 (95% CI: 0.97, 1.04; p=0.589) and substantial overuse injury was 0.95 (95% CI: 0.91, 0.99; p=0.036). Similar results were observed between gender and division subgroups. CONCLUSION: After adjusting for confounding variables, it was determined that substantial overuse injuries negatively affected athletic identity, regardless of gender or NCAA division. Sports medicine professionals need to consider the possibility of lost athletic identity when an athlete sustains an injury. Measures should be taken to ensure that athletes continue to have meaningful contribution to sport following pain or injury.