RICHMOND, Va. (November 26, 2025) - The ECNL Center for Athlete Health and Performance, led by ECNL Chief Medical Advisor Dr. Drew Watson, recently presented research regarding the relationship between mental health and injuries at the annual meeting of the American Medical Society for Sports Medicine.
Examining more than 650 athletes from the 2024 season, the Center for Athlete Health and Performance found athletes that suffered injuries during the prior six months reported higher levels of anxiety and depression compared to those who remained healthy, even after they returned to play. The study also found more severe injuries, and a greater number of injuries,was associated with more severe levels of anxiety of depression.
"While sports have wide ranging and profound physical and mental health benefits, we also continue to recognize that injuries have impacts for young athletes beyond just physical symptoms," Dr. Watson said. "We also found that these impacts may persist even after the physical symptoms have resolved and players have returned to sports, suggesting that we should not only be considering these impacts while players are sidelined from their injury, but also addressing any lingering issues after they return to play."
Overall, the CAHP found that athletes were reporting improved mental health compared to during and after the COVID-19 pandemic, further emphasizing the beneficial role of sports participation. Youth soccer players injured in the previous six months, however, reported significantly worse mental health than uninjured athletes, even after returning to play. The study also found those who had two or more injuries had higher levels of anxiety and depression than athletes who reported zero or one injuries during the course of the season, and that injuries that lasted longer than three months were associated with the highest levels of anxiety.
In addition to the relationships with mental health, injuries were associated with negative impacts on quality of life, including school function, emotional function and psychosocial function. Similar to mental health, athletes who had returned to play after an injury reported improvements in these areas, but remained worse than uninjured athletes. And higher numbers of injuries and more severe injuries were similarly associated with greater impairments in these various facets of quality of life.
"This current work shows that the loss of sport that results from prolonged and recurrent injuries, in particular, can impact a range of psychosocial outcomes for players," Dr. Watson said. "Injuries don't just have physical consequences, they can impact all areas of a young athlete's life, whether emotional, social, or academic."
This work represents an important step in the ongoing efforts within the ECNL to recognize and address the mental health of its athletes. By prioritizing mental health research and understanding the different factors that influence these psychosocial outcomes, we can identify the individuals at greatest risk, undermine the stigma associated with mental health, and equip stakeholders across youth soccer with information to help these young athletes.
The ECNL Center for Athlete Health and Performance launched in March 2025 to identify, develop and share best practices in long-term youth athlete health, development and performance. The ECNL Center for Athlete Health and Performance provides compilations of the most applicable research from around the world on topics relevant to youth athletes, as well as evidence derived from research projects within the ECNL conducted in collaboration with Dr. Watson's Human Performance Laboratory at the University of Wisconsin.
The CAHP will continue to conduct research, disseminate evidence, and offer recommendations on a wide range of high-yield topics relevant to youth athletes, coaches, and families, including mental health, injury and illness risk and prevention, load management, pediatric exercise physiology, sport nutrition, and more.
For more information regarding the ECNL Center for Athlete Health and Performance, click here.
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About the ECNL:
The ECNL is the nation's leading youth soccer development platform for America's top soccer players. The ECNL mission to provide the best youth sports experience in the world drives constant innovations in competitions and experiences for players, parents, families, coaches, referees, and partners. The ECNL has questioned convention and challenged the status quo of youth sport since 2009, pushing boundaries and striving for unmatched excellence. Together with its clubs and club leaders, the ECNL creates unforgettable memories and supports the development of youth players into college stars, professionals, world champions, and leaders.
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