The Relationship Between Flourishing, Pain, And Injury In Collegiate Athletes

Abstract

Flourishing encompasses a holistic representation of physical, psychological, and social health. However, pain and injury can negatively affect health. Currently, there is little research on flourishing within collegiate athletes. PURPOSE: To evaluate the relationship of pain and injury with flourishing in NCAA athletes and to compare by division. METHODS: NCAA division 1 (D1), 2 (D2), and 3 (D3) athletes were given a questionnaire incorporating the flourishing scale and the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC). Athletes were further classified by OSTRC scores into overuse and substantial overuse injuries. Multivariable regressions with logarithmic transformations and ANCOVAs were performed to investigate the relationship between flourishing and OSTRC pain and flourishing, overuse and substantial overuse injury. Confounders controlled for included age, gender, history of orthopaedic surgery and major injury, hours of sleep, and non-steroidal anti-inflammatory use. Unadjusted and adjusted effect size and 95% confidence intervals (95% CI) were reported. RESULTS: 253 athletes (Age: 19.43 (1.18) years; Male: 70; D1: 102, D2: 74, D3: 77; 7-8 hours of sleep: 157) participated. Mean flourishing scores were D1: 48.59 (10.43), D2: 50.08 (5.31), and D3: 48.58 (8.09). The median OSTRC score was 0 (0-22). 124 reported an overuse injury and 47 a substantial overuse injury. There was a unadjusted negative relationship between OSTRC total score and flourishing (-5.2% (95% CI: -10%, 1%), p=0.037); however there was no relationship after controlling for confounders (0.1% (95% CI: -2.6%, 2.7%), p=0.989). There was no relationship between overuse injury and flourishing (-0.23 (95% CI: -2.57, 2.11), p= 0.848). There was an unadjusted negative relationship between substantial overuse injuries and flourishing (-2.77 (95% CI: -5.43, -0.12), p=0.042), but there was no relationship after controlling for confounders (1.97 (95% CI: -4.95, 1.01), p=0.196). These relationships were similar by division. CONCLUSION: College athletes have high flourishing, and have similar flourishing between all NCAA divisions. Pain and injury have a negative relationship to flourishing; however, these relationships are confounded by surgical and injury history, and lifestyle.