Mental Health Effects of COVID-19 on Youth Athletes

Youth athletes who played a single sport experienced higher depression and anxiety scores during the COVID-19 pandemic, according to a study presented at the 2021 annual American Academy of Orthopaedic Surgeons meeting.

Based on the results of a survey, “Sidelined due to COVID-19: Youth Athletes Sleep More, Practice Less, and May Lose Interest in Playing Sports Due to Social Distancing Mandates,” youth athletes who play just one sport are at greater risk of depression during the ongoing COVID-19 pandemic.

The researchers also found that female athletes who had only been playing a few years at the onset of the pandemic were at the greatest risk of anxiety during shutdowns.

On a more positive side though, they found that youth athletes had better sleep quality and spent more time outdoors.

“Mental health needs to be at the forefront for orthopaedic surgeons, primary care physicians, and any health professionals working with youth athletes,” said Henry B. Ellis, M.D., pediatric orthopedic surgeon and associate director of clinical research at Scottish Rite for Children in Dallas, the Frisco campus.

“When athletes sustain an injury, they lose their ability to participate in sports. For some of those youth athletes, their identity is wrapped up in being a player for that sport (like a soccer player or a dancer). If they are out for a long period of time or have a sudden change in events, like they did during the pandemic, it can be challenging for them to cope.”

The self-reported questionnaire included 60 questions in six areas: demographics, sport participation/training before and during COVID-19, changes in sport-related goals and aspirations, changes in sleep habits, and Patient-Reported Outcomes Measurement System (PROMIS) Emotional Distress depression and PROMIS anxiety.

Data was collected on 575 U.S. athletes between the ages 6 to 19 from April 24, 2020 through May 12, 2020 when social distancing measures were lessening.

Most of the survey responders were high-level athletes who played sports for multiple years. More than 60% of the athletes played a single sport, including many elementary and middle school athletes. Most experts, however, recommend that athletes don’t specialize until at least the age of 14.

The survey also revealed that athletes’ training decreased from 9.75 hours per week to 6.52 hours per week. Overall, 86.2% continued to train while social distancing and 76% maintained communication with their sports teams.

The athletes also reported that their average hours of sleep per night increased overall from 7.86 hours pre-COVID to 9.12 hours during the pandemic. The older athletes reported the biggest increase in sleep.

The data showed that approximately one-fourth of the athletes reported increased depression scores during the pandemic. Overall, 28.3% identified as mild, moderate, or severe, while 22.2% experienced some degree of anxiety.

Higher depression scores were associated with increasing age, fewer years played, decreased hours of sleep, and sport specialization.

About 13.3% of the athletes had a change in their goals and aspirations regarding sports. About 52.8% said they felt they lost opportunities to compete at a higher level. And 41.7% lost interest in intense training. The older youth athletes were more likely to report changes in sport-related goals and aspirations.

“We were really surprised by how many single sport athletes responded and their increase in depression scores,” said Dr. Ellis. “We had not seen that in our own practice, but we’ve since used these results to implement a stronger look at the mental health of athletes. They may not have the adaptability when a disruption keeps them out of sports for a long period of time.”