Effect of Physical and Academic Stress on Illness and Injury in Division 1 College Football Players

J. Bryan Mann, Kirk R. Bryant, Brick Johnstone, Patrick A. Ivey, Stephen P. Sayers

Stress-injury models of health suggest that athletes experience more physical injuries during times of high stress. The purpose of the current study was to evaluate the effect of increased physical and academic stress on injury restrictions for athletes (n=101) on a Division I college football team. Weeks of the season were categorized into three levels: high physical stress (i.e., preseason), high academic stress (i.e., weeks with regularly scheduled examinations such as midterms, finals, and week before Thanksgiving break), and low academic stress (i.e., regular season without regularly scheduled academic examinations). During each week, we recorded whether a player had an injury restriction or not, thereby creating a longitudinal binary outcome. The data was analyzed using a hierarchical logistic regression model to properly account for the dependency induced by the repeated observations over time within each subject. Significance for regression models was accepted at p<0.05. We found that the odds of an injury restriction during training camp (high physical stress) were greatest compared to weeks of high academic stress (OR=2.05, p=0.0003) and low academic stress (OR=3.65, p<0.001). However, the odds of an injury restriction during weeks of high academic stress were nearly twice as high than during weeks of low academic stress (OR=1.78, p=0.0088). Moreover, the difference in injury rates reported in all athletes during weeks of high physical stress and weeks of high academic stress disappeared when considering only athletes that regularly played in games (OR=1.13, p=0.75), suggesting that high academic stress may affect athletes that play to an even greater extent than high physical stress. Coaches should be aware of both types of stressors and consider carefully the types of training methods imposed during times of high academic stress, when injuries are most likely.