The Associations Between Wellbeing and Injury Differ by Time Loss in Collegiate Athletes

Background: Self-reported wellbeing measures such as mood and soreness have been identified as predictors of injury risk. However, most research has focused on investigating time-loss injuries even though nontime-loss injuries are more prevalent. Hypothesis: Impairments in sleep and subjective wellbeing would be associated with increased injury for both time-loss and nontime-loss injuries. Study Design: Prospective longitudinal study. Level of Evidence: Level 3. Methods: During 2022, 127 athletes completed a daily survey that inquired about training load and sleep from the previous day along with mood, stress, and soreness on the current day. Incidence of injury was also monitored using documentation provided by athletes’ respective athletic trainers. Mixed effect models were used to analyze the relationship between wellbeing and sleep measures with injury. Results: Self-reported wellbeing, based most closely on soreness the day of injury, by National Collegiate Athletic Association Division 1 collegiate athletes was predictive of time-loss injuries, whereas no significant relationship was identified for nontime-loss injuries. Specifically, 1 unit increase in soreness was associated with a 39% increase in odds of sustaining a time-loss injury. Conclusion: This study found that subjective wellbeing and sleep have a different relationship with injury dependent upon whether the resulting injury leads to time loss. Clinical Relevance: Self-reported wellbeing appears to be a relevant predictor of injury among collegiate athletes for time-loss injuries.