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In his new blog, Dr. Vincent Gouttebarge discusses mental health conditions in football and how they are related to injury occurrence.


Dr. Vincent Gouttebarge, PhD:


During their career, professional football players are exposed to long periods of high energical and physical load, leading now and then to injuries of the musculoskeletal system (muscles, bones, ligaments). Recently, as professional football aims to achieve not only sporting success but also business and financial profits, organisational and environmental pressure on professional players has been growing. In addition, players have been exponentially in the spotlight of public interest, with their moves on and off the field being closely examined and analysed by the media.


Because of the combination of all these potential sources of pressure, professional football players are likely to suffer during their career from mental and psychosocial health problems. Even in the long term after their career, former players might encounter mental and psychosocial health problems, especially the ones who did not quit football voluntarily or those who did not adequately prepare for their post-sport life. With regard to the aforementioned, it appears rather strange that hardly any scientific studies about the mental and psychosocial state of current and former professional football players have been carried out.


Mental health conditions and injury occurrence
Junge and colleagues (2000) studied the influence of psychological aspects (worry, anxiety, anger etc.) on the occurrence of injuries among 588 football players from both professional and recreational leagues in Germany, France and the Czech Republic. This study revealed that players with fewer injuries had less worries about their performance, less competitive anxiety, less peaking under pressure and less outward expression of anger. Recently, Ivarsson and colleagues (2013) recruited 56 Swedish Premiere League football players (both male and female) in order to study personality traits and stress as a predictor of injury. The results suggested that anxiety, negative life-events, stress and daily hassle were related to injury occurrence among professional players.


On the other side, professional players are likely to experience adverse emotional and psychological reactions upon being injured (Evans 2012). For instance, unhappiness, feelings of isolation (no group training sessions any more), frustration, anger and/or appetite and sleep disturbance might occur as a consequence of severe injuries. Even more, the rehabilitation of such severe injuries might be affected by adverse emotional responses such as loss of identity, fear, anxiety and loss of confidence, playing a negative role in the process of regaining playing fitness.






Mental health conditions in football
In the past decade, the counselling and support of professional football players regarding their mental approach has undergone significant development, sport psychologists are seen nowadays in many clubs as full members of the training / medical staffs. However, while they are quite open about their physical fitness, professional football players remain really quiet when it comes to their mental state. Hamstring, knee or ankle injuries can be discussed within the dressing room or with the media; in contrast, discussing mental well-being is a kind of taboo, being a kind of vulnerability or weakness that does not fit professional football.


Consequently, reliable data about mental health problems during a footballer's career is lacking. Even more, despite well-known examples with tragic consequences, the mental and psychosocial problems that occur after retirement from professional football have been the subject of even less study among large groups of former professional football players. The occurrence of adverse mental and psychosocial problems among both current and former professional football players is currently having my attention, ongoing study being is conducted in collaboration with the FIFPro and its related national players’ associations.





Lately, the Professional Footballers’ Association (PFA) and the French National Union of Professional Footballers (UNFP) have introduced a mental health service open to any current and former players who are experiencing mental health issues. Therefore, a network of qualified counsellors has been recruited, which includes a team of former players who have overcome mental health issues and addiction in the past. The service offers counselling courses to deal with mental conditions such as stress, anxiety, behavioural problems and even adverse addictions.


Because of an increasing awareness of the relevance of mental and psychosocial issues in professional football, it appears most desirable that scientific studies related to the topic are conducted, both in current and former players. With this knowledge, a thorough information and counselling system based on proper treatment could be developed and implemented in order to protect and promote the sustainable health of current and former professional football players.





Mental health conditions in other professional athletes
In a French study (Schaal 2011), more than 2000 young and adult elite athletes from various Olympic sport disciplines were asked whether they had encountered mental and psychosocial problems in the past. This study showed that 17 % of these athletes did have recent or ongoing mental problems, including anxiety and depressive disorders. Also, more than 20 % of the elite athletes reported they were having or had had sleeping problems. Athletes mainly from the aesthetic disciplines (gymnastics, figure skating and synchronized swimming) reported more psychological problems, especially anxiety disorders. A small difference between male and female athletes was found in the occurrence of mental problems: female athletes were prone to report more mental health problems (sleeping, eating, anxiety and depressive disorders) than male athletes.


Key points

  • Scientific data about the mental and psychosocial consequences of a professional football career are scarce.
  • Professional football players suffering from mental issues (worry, anxiety, stress ,anger) are more likely to suffer from injury.
  • Up to 20 % of young and adult elite athletes from various Olympic sport disciplines reported suffering from mental problems, including anxiety, depression and sleeping problems.
  • A mental health service is proposed by the Professional Footballers’ Association and the French National Union of Professional Footballers for current and former players who are experiencing mental health issues.
  • Research into mental and psychosocial issues as a consequence of a professional football career is needed in order to develop and implement a thorough information and counselling system, striving to protect and promote the sustainable mental well-being of current and former players.





Former professional football player Dr. Vincent Gouttebarge is senior researcher at the Coronel Institute of Occupational Health from the Academic Medical Centre in Amsterdam (the Netherlands), and is co-owner of Vintta, a research and consultancy unit for sports health.