Most of the 480,000 student-athletes who compete in National Collegiate Athletic Association (NCAA)–sponsored college sports each year will matriculate out of highly competitive sports participation on the conclusion of their collegiate career, with less than 2% of men's and women's basketball, football, and men's soccer players advancing to major professional leagues.1 Given that cardiovascular disease risk is more strongly related to current physical activity levels than a history of sport participation, student-athletes must maintain an active lifestyle beyond their competitive sport careers to sustain health benefits.2–5
Common perceptions are that athletes value physical activity and will continue to be active throughout their lives. However, former student-athletes may find it difficult to maintain their physical activity participation once they transition out of the competitive college sport environment due to a variety of physical and psychosocial challenges. Tracey and Elcombe6 noted that athletes have been left out of physical activity promotion research, even though former athletes face unique challenges in maintaining their physical activity beyond competitive athletics. Some of these challenges may include a narrow focus on an athlete identity that does not necessarily translate to broader exercise participation, a utilitarian attitude toward physical activity with a lack of intrinsic motivation for exercise outside of sport training, and chronic injuries that may limit future physical activity.6–9 Therefore, past competitive sport experiences do not automatically prepare former student-athletes to transition to a physically active lifestyle beyond the structure of college athletics.10 A severe drop in physical activity following years of high-intensity, high-volume training may increase their risk of developing chronic diseases related to inactivity.11
Although former student-athletes are unlikely to maintain the exceptionally high levels of training required for collegiate athletic participation, how physically active they are in their post-college lives remains a key question. Research examining physical activity behaviors of former athletes has often been conducted outside of the United States and typically within samples of elite (eg, world-class, Olympic, and professional), white, male athletes.12–15 Collectively, these findings have suggested that former elite athletes, particularly those classified as endurance sport athletes, were more physically active, lived longer, and had lower risk for chronic diseases compared to the general population. However, modern student-athletes and the unique environment of the U.S. collegiate sport system are markedly different from other athlete populations and contexts; thus, additional research is needed to clarify physical activity patterns of former student-athletes.
A few recent studies have investigated physical activity and health outcomes of former U.S. collegiate student-athletes specifically. Sorenson et al.5 found that although current student-athletes were substantially more active than other college students, former student-athletes were no more active or healthier than their non–student-athlete counterparts. However, conclusions drawn from this study were limited by the inclusion of participants from only one institution and a small subsample of former student-athletes (n = 44). A larger study by Gallup,16 which compared former NCAA student-athletes (n = 1,670) with non–student-athlete college alumni on various measures of well-being, found that former student-athletes were more likely than non–student-athlete alumni to report that they were thriving in their physical well-being after college, as defined by good physical health, feeling active, and having enough daily energy to be productive. Two exceptions to this finding were former football and men's basketball players, with only 28% classified as thriving in their physical well-being compared to 33% of non–student-athletes and 47% of former student-athletes from sports other than football or men's basketball.
Other researchers have found that former student-athletes report similar physical and mental health as non–student-athlete alumni17 but lower health-related quality of life, possibly due to limitations resulting from chronic injuries sustained during their participation in collegiate sports.9 Russell et al.18 suggested that the physical and psychological effects of injuries sustained during sport present unique long-term barriers to physical activity in former athletes. Wiese-Bjornstal19 posited that these injuries could result in negative consequences for the lifespan health of student-athletes, including potential barriers to continued physical activity after college such as functional limitations, osteoarthritis, and chronic pain. A recent study by Simon and Docherty20 demonstrated that former Division I student-athletes (n = 100) between the ages of 40 and 65 years were less physically active and performed worse on assessments of physical fitness compared to similarly aged non–student-athlete alumni (n = 100) who had been recreationally active in college. These differences might be attributed to chronic pain or injuries because 57% of the former varsity student-athletes reported current physical limitations during exercise compared to only 6% of those who were not former student-athletes.
Taken together, findings have been mixed, with some evidence suggesting that student-athletes' physical activity patterns and fitness levels may shift significantly after transitioning out of college sports. Research including larger, more representative samples is needed to clarify the physical activity patterns of former student-athletes. Such evidence will support further exploration into potential chronic disease risks for former athletes who become inactive after sport11 and inform sports medicine initiatives that promote lifetime health and well-being of student-athletes. Thus, the purpose of this descriptive study was to investigate self-reported physical activity patterns among a large sample of former NCAA student-athletes and to identify demographic and sport-related differences (eg, gender, sport, and division) within this cohort.
The current study employed a descriptive survey design to explore patterns of self-reported physical activity participation among former student-athletes who competed in a varsity college sport at an NCAA member school.
Participants were recruited through the NCAA “Former Student-Athlete Research Panel,” which is an ongoing project of the NCAA Research Panel and the NCAA “After the Game” initiative. Through this panel, student-athletes who have completed their athletic eligibility are invited by the NCAA to register to participate in research and provide demographic variables to enable the creation of appropriate research pools. A total of 1,987 individuals who were registered in the Research Panel responded to the survey analyzed in this study, with a final sample of 1,606 former student-athletes who provided complete physical activity data for inclusion in analyses (estimated age = 42.75 ± 16.58 years; male = 56.66%, female = 39.42%, not reported = 3.92%; white = 81.45%, non-white or multiple races/ethnicities = 16.31%, not reported = 2.24%). A range of sports (N = 33) from the three NCAA divisions (DI = 67.25%, DII = 6.97%, DIII = 22.04%, not reported = 3.74%) were represented in the sample, with football (n = 374), baseball (n = 114), and men's track and field (n = 91) being the most predominant.
International Physical Activity Questionnaire Short-Form (IPAQ-SF)
The widely used IPAQ is an extensively validated physical activity self-report questionnaire for adults.21,22 The short-form version (IPAQ-SF) includes seven items that assess perceived physical activity participation over the past 7 days by asking respondents to report the number of times per week they engaged in various types of physical activities, as well as the number of hours and minutes spent doing the activities on each day. For this study, the total combined amount (measured in minutes) of self-reported moderate-to-vigorous physical activity (MVPA) performed each week was used as the primary outcome variable. We chose to focus our analyses on MVPA minutes given that health-related physical activity guidelines are based on accumulating minimum amounts of weekly physical activity at these intensities.23 Further details on the IPAQ-SF can be accessed online.24
Demographic information collected from the panel and analyzed in the current study included: age (estimated from high school graduation year), gender, race/ethnicity, sport played, NCAA Division (Division I, II, or III based on each institution's 2015 classification), scholarship status, and playing status (starter, regular substitute, competed infrequently, or practice player).
Former student-athletes registered in the NCAA Research Panel, which houses demographic information of all panel members, were invited by e-mail to complete the IPAQ-SF online via Qualtrics survey software (Qualtrics, Provo, UT). The research protocol was approved by the NCAA Research Review Board and by the institutional review board of the research team's university. No incentives were offered for participation, and participants provided their informed consent online within the Qualtrics survey.
Data were downloaded from Qualtrics to SPSS (version 25.0; IBM, Armonk, NY) software for initial data scoring and cleaning. Of the 1,606 participants, total MVPA scores for 30 participants were reduced to 2,100 minutes per week prior to data analysis to limit the effects of extreme, highly unrealistic scores (ie, > 5 hours of reported activity per day). Data were prescreened for normality by examining histogram and Q-Q plots, which suggested the distribution of self-reported MVPA scores was positively skewed. Therefore, analyses were performed using a nonparametric bootstrapping procedure with 5,000 replications to conduct significance testing. Bias-corrected 95% bootstrapped confidence intervals were examined in conjunction with P values to determine statistical significance. Independent samples t tests and analysis of variance with post-hoc comparisons were used in SPSS version 25 to analyze significant group differences in MVPA across several of the demographic variables. For t tests, the equality of variances assumption was checked using Levene's test; degrees of freedom and t values were adjusted if appropriate. Given the continuous nature of the age variable, a linear regression analysis was performed to examine the association of estimated age with MVPA participation. Finally, we analyzed all covariates together in a multiple regression model in MPlus version 8 (Indiana University, Indianapolis, IN), dummy coding categorical variables and treating football as the reference group for sport.
The average number of self-reported minutes spent in MVPA per week across the entire sample was 482.18 ± 444.08 minutes. As shown in Figure 1, self-reported MVPA was skewed by extreme scores, with 10% of the sample reporting greater than 17 hours of MVPA per week. On the other end of the continuum, close to 21% of the sample reported 2.5 hours of weekly physical activity or less, with 6.5% of the sample reporting no MVPA.
Sample distribution of self-reported weekly moderate-to-vigorous physical activity (MVPA).
Across the demographic and sport-related variables (Table 1), significant differences in reported weekly MVPA minutes were only observed for race/ethnicity. On average, participants who identified only as white reported significantly lower levels of weekly MVPA than other participants in the sample, t(331.12) = 2.80, P < .01. The omnibus test also indicated an overall difference based on division status, F(2,1543) = 3.40, P = .03, but bootstrapped confidence intervals for the pairwise comparisons did not, suggesting the omnibus test may be a result of bias due to nonnormality. There were no significant differences between men and women, t(1,472.64) = 1.06, P = .30, or between individuals who received an athletic scholarship and those who did not, t(1,574) = 1.10, P = 0.27. There were also no significant differences for playing time status, F(3,1570) = 0.82, P = .48. Self-reported MVPA levels for the 12 most represented sports (n > 45 per sport) in the sample are depicted in Figure 2. No significant differences were observed across these sports, F(1,1,1175) = 0.81, P = .63. Finally, estimated age was a weak negative predictor of reported weekly MVPA (P < .01, B = −3.32, bootstrapped 95% confidence interval: −3.33 to 3.30, R2 = 0.015).
Demographic and Sport-Related Differences in Self-Reported Weekly Minutes of MVPA
Comparison of weekly minutes of self-reported moderate-to-vigorous physical activity (MVPA) by college sport. Note: the upper whisker represents quartile 3 + 1.5 × interquartile range. The top 12 sports are presented by participation: (> 45 student-athletes/sport [baseball, n = 114; men's basketball, n = 74; women's basketball, n = 83; football, n = 374; men's soccer, n = 48; women's soccer, n = 74; softball, n = 66; men's swimming and diving, n = 59); women's swimming and diving, n = 57; men's track and field, n = 91; women's track and field, n = 79; and women's volleyball, n = 68]).
Results from the multiple regression model examining all covariates together indicated that age (P < .01; standardized coefficient = −.13) and race/ethnicity (P = .03; standardized coefficient = −.07) were the only significant predictors after controlling for the effect of all other predictors in the model. The overall model explained only 3.4% of the variance in self-reported MVPA (R2 = 0.034, P < .01). Table 2 shows parameter estimates, standard errors, and bias-corrected confidence intervals.
Self-Reported Weekly Minutes of MVPA Combined Model
In this exploratory, descriptive study, we examined self-reported physical activity patterns and differences across demographic and sport-related variables. There were no significant differences in total reported MVPA based on athletic scholarship status, playing status, or sport played. Former Division I student-athletes reported lower mean levels of physical activity than Division II and III student-athletes, but these observed differences did not reach statistical significance based on examination of the bootstrapped confidence intervals. Even when all predictors were included in the same model, only a small amount of variance in self-reported MVPA was explained. Lack of significant sport-related effects in the current study may suggest that other factors related to physical activity adoption and maintenance may be more important than specific characteristics of college sport participation in predicting continued physical activity engagement within this population. For example, other research has suggested that chronic injuries or psychosocial factors such as identity and motivation may play key roles in individuals' exercise participation after concluding their college athletic careers.7,8,18
Most former student-athlete participants in this study reported physical activity levels that meet or exceed minimum guidelines for health promotion. Interestingly, gender- and age-related correlates of physical activity found in the general population were minimized in this sample of former student-athletes. In contrast to patterns typically observed in research with the general population,25 there were no significant gender differences in reported MVPA in this former student-athlete sample and non-white participants reported significantly more weekly MVPA than white participants. Similarly, the typical documented age-related decrease in physical activity was not as evident in this cohort, with age only accounting for approximately 1.5% of the variance in self-reported MVPA. This finding could suggest that former student-athletes are more likely than non–student-athletes to maintain their physical activity with age. More recent societal and cultural changes (eg, increased professionalism and accessibility of intercollegiate athletics) have altered the demographics of college sport participants over time, thus potentially confounding cross-sectional comparisons within this cohort.
In general, self-reported physical activity was high with respect to current national guidelines23; average weekly MVPA reported in this sample exceeded the 150 to 300 minutes recommended for achieving substantial health benefits. The overall mean level of MVPA reported was positively skewed by extreme scores in the sample. Further inspection of the data revealed that approximately 1 in 5 former student-athletes reported engaging in 150 minutes or less of MVPA per week. Even so, this still appears to be a positive finding given that national trends show approximately 60% of college graduates meet minimum physical activity guidelines (eg, 75 to 150 minutes) and only 35% achieve at least 150 to 300 minutes of vigorous or moderate intensity aerobic leisure-time activity.26
Despite high self-reported physical activity, these reports likely represent a substantial decrease in physical activity from what many of these individuals performed during their collegiate years as student-athletes. For instance, Division I student-athletes report spending more than 30 hours per week in sport-related commitments,27 with a substantial portion of that time likely spent in practice, training, and competition. In comparison, half (52.12%) of the former student-athletes in the current sample reported 6 or fewer hours of weekly MVPA. Similar patterns were observed in the study conducted by Sorenson et al.,5 who found that former student-athlete and non–student-athlete alumni reported approximately 4 to 5 hours of weekly exercise in comparison to the 15 hours of exercise reported by current student-athletes. Given the anticipated decrease in physical activity following the transition out of the collegiate sport environment, student-athletes may benefit from receiving educational programming and advice from the sports medicine team during college that is specifically tailored to address the unique challenges associated with transitioning from highly structured, competitive athletics to lifestyle physical activity.28 Plateau et al.7 found that even though former student-athletes report exercising in line with physical activity guidelines, they may still feel frustrated by their inability to maintain the high intensity exercise and fitness levels previously required for their collegiate sport training. Thus, former student-athletes may need assistance in redefining appropriate thresholds for health-related physical activity as they transition out of competitive college sports.7
Limitations and Future Directions
The current study is limited in several ways, including the self-report nature of the data and cross-sectional study design. Although widely used, the validity of the IPAQ has been questioned by some researchers, with studies showing that people overestimate their physical activity participation when completing the IPAQSF.29,30 Additionally, the IPAQ-SF accounts for all forms of daily physical activity, so total amounts may be further inflated when drawing comparisons with nationally recommended guidelines that focus mainly on aerobic, leisure-time activity.
Although not a focus of the current study, future research could assess the potential barriers and facilitators of physical activity in former student-athletes, which may be similar to or different from non–student-athlete college alumni and the general population. Comparisons of physical activity and health data from student-athlete and non–student-athlete alumni could help identify potentially unique risk or protective factors for former student-athletes to help inform sports medicine and health care professionals providing care to this population. Findings from this study, which included a relatively large sample of former NCAA student-athletes, can inform future research investigating physical activity and health outcomes in this unique population. Given the emerging but limited evidence available, longitudinal approaches should be incorporated in the future to track changes in physical activity and health status of current and former student-athletes over time to better understand how participation in college athletics contributes to long-term health outcomes.
Implications for Clinical Practice
Given the relatively high level of MVPA reported in this sample, sports medicine professionals should consider the ideal range of MVPA recommended for the former student-athlete population to support optimal health while minimizing injury risk. Evidence indicates that former competitive athletes may suffer from long-term joint problems and chronic injuries,9,31,32 which might be exacerbated by continued engagement in high-intensity/high-volume exercise. In most collegiate sport environments, the primary goal of the sports medicine team is to help student-athletes return to sport. With a greater focus on promoting holistic health and well-being, athletic trainers, team physicians, and other health care professionals working with this population should also consider providing guidelines for realistic goals for returning to a healthy lifestyle beyond competitive sport participation.
Shifting focus from return-to-play to return-to-healthy living may be particularly important for transitioning student-athletes who are injured in their final year of eligibility, as well as for student-athletes who sustain career-ending injuries earlier in their college sport career. Additionally, sports medicine teams at many institutions may be responsible for conducting exit interviews with all student-athletes regardless of injury status. This space provides a natural opportunity for sports medicine professionals to discuss future lifestyle physical activity goals as part of other health-related exit counseling provided to student-athletes during this time. By considering holistic lifespan health outcomes such as lifetime physical activity participation, sports medicine professionals will be better prepared to work as a part of an interdisciplinary team to support lifetime health and well-being of student-athletes.
- National Collegiate Athletic Association. Estimated probability of competing in professional athletics. http://www.ncaa.org/about/resources/research/estimated-probability-competing-professional-athletics. Updated April 20, 2018. Accessed June 29, 2018.
- Paffenbarger RS Jr, Lee IM. A natural history of athleticism, health and longevity. J Sport Sci. 1998;16suppl:S31–S45. doi:10.1080/026404198366957 [CrossRef]
- Pihl E, Jürimäe T, Kaasik T. Coronary heart disease risk factors in middle-aged former top-level athletes. Scand J Med Sci Sport. 1998;8:229–235. doi:10.1111/j.1600-0838.1998.tb00197.x [CrossRef]
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- Sorenson SC, Romano R, Azen SP, Schroeder ET, Salem GJ. Life span exercise among elite intercollegiate student athletes. Sports Health. 2015;7:80–86. doi:10.1177/1941738114534813 [CrossRef]
- Tracey J, Elcombe TA. A lifetime of healthy meaningful movement: have we forgotten the athletes?Quest. 2004;56:241–260. doi:10.1080/00336297.2004.10491825 [CrossRef]
- Plateau CR, Petrie TA, Papathomas A. Exercise attitudes and behaviours among retired female collegiate athletes. Psychol Sport Exerc. 2017;29:111–115. doi:10.1016/j.psychsport.2017.01.001 [CrossRef]
- Reifsteck EJ, Gill DL, Labban JD. “Athletes” and “exercisers”: understanding identity, motivation, and physical activity participation in former college athletes. Sport Exerc Perform Psychol. 2016;5:25–38. doi:10.1037/spy0000046 [CrossRef]
- Simon JE, Docherty CL. Current health-related quality of life is lower in former Division I collegiate athletes than in non-collegiate athletes. Am J Sport Med. 2014;42:423–429. doi:10.1177/0363546513510393 [CrossRef]
- Smith M, Reifsteck E, Gill D. Moving into an active future: supporting lifetime physical activity for student-athletes. ACSMs Health Fit J. 2018;22:1–5.
- Witkowski S, Spangenburg EE. Reduced physical activity and the retired athlete: a dangerous combination?Br J Sport Med. 2008;42:952–953. doi:10.1136/bjsm.2008.054353 [CrossRef]
- Garatachea N, Santos-Lozano A, Sanchis-Gomar F, et al. Elite athletes live longer than the general population: a meta-analysis. Mayo Clin Proc. 2014;89:1195–1200. doi:10.1016/j.mayocp.2014.06.004 [CrossRef]
- Kujala UM, Sarna S, Kaprio J, Tikkanen HO, Koskenvuo M. Natural selection to sports, later physical activity habits, and coronary heart disease. Br J Sport Med. 2000;34:445–449. doi:10.1136/bjsm.34.6.445 [CrossRef]
- Laine MK, Eriksson JG, Kujala UM, et al. A former career as a male elite athlete--does it protect against type 2 diabetes in later life?Diabetologia. 2014;57:270–274. doi:10.1007/s00125-013-3105-8 [CrossRef]
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- Gallup. Understanding life outcomes of former NCAA student-athletes: The Gallup-Purdue Index Report. 2016. http://www.ncaa.org/sites/default/files/2016_Gallup_NCAA_StudentAthlete_Report_20160503.pdf. Accessed June 29, 2018.
- Kerr ZY, DeFreese JD, Marshall SW. Current physical and mental health of former collegiate athletes. Orthop J Sport Med. 2014;2:2325967114544107. doi:10.1177/2325967114544107 [CrossRef]
- Russell HC, Tracey J, Wiese-Bjornstal DM, Canzi E. Physical activity in former competitive athletes: the physical and psychological impact of musculoskeletal injury. Quest. 2017;70:1–17.
- Wiese-Bjornstal DM. Sport injury and college athlete health across the lifespan. Journal of Intercollegiate Sports. 2009; 2:64–80. doi:10.1123/jis.2.1.64 [CrossRef]
- Simon JE, Docherty CL. The impact of previous athletic experience on current physical fitness in former collegiate athletes and noncollegiate athletes. Sports Health. 2017;9:462–468. doi:10.1177/1941738117705311 [CrossRef]
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- International Physical Activity Questionnaire. Available at: https://sites.google.com/site/theipaq/home. Accessed June 29, 2018.
- Centers for Disease Control and Prevention. Facts about physical activity. https://www.cdc.gov/physicalactivity/data/facts.htm. Updated May 23, 2014. Accessed June 29, 2018.
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Demographic and Sport-Related Differences in Self-Reported Weekly Minutes of MVPA
|Characteristic||MVPA Minutes (Observed Mean ± SD)||Bootstrapped Bias-Corrected 95% CIs for Mean Differences (Lower to Upper)a|
| Male (n = 910)||487.81 ± 462.46||−21.52 to 68.23|
| Female (n = 633)||464.47 ± 398.32|
| White (n = 1,308)||461.06 ± 416.47||−165.66 to −28.69|
| Non-white (n = 262)||556.60 ± 520.60|
| Division I (n = 1,080)||457.36 ± 417.77||I & II: −185.26 to 10.42|
| Division II (n = 112)||542.42 ± 486.81||I & III: −107.07 to 1.66|
| Division III (n = 354)||510.35 ± 469.22||II & III: −68.73 to 133.59|
| Scholarship (n = 920)||486.06 ± 446.10||−19.26 to 67.59|
| Non-scholarship (n = 656)||461.63 ± 420.72|
| Starter (A; n = 1,184)||477.56 ± 432.56||A & B: −83.51 to 50.63|
|A & C: −27.94 to 129.52|
| Regular substitute (B; n = 224)||493.73 ± 456.70||A & D: −182.93 to 100.76|
| Competed infrequently (C; n = 109)||421.67 ± 396.02||B & C: −24.35 to 163.32|
|B & D: −174.30 to 125.89|
| Practice player only (D; n = 57)||513.09 ± 526.35||C & D: −251.36 to 67.52|
Self-Reported Weekly Minutes of MVPA Combined Model
|Variable||Unstandardized Estimate||Standard Error||Bootstrapped Bias-Corrected 95% CIa|
|Men's swimming & diving||−29.82||63.44||−147.84||102.92|
|Women's swimming & diving||57.06||57.34||−49.35||175.76|
|Men's track & field||35.40||61.21||−77.70||159.86|
|Women's track & field||−32.74||56.10||−137.17||78.92|