Exercise addiction is characterized by compulsive and excessive exercise patterns that eventually can lead to musculoskeletal injury. While exercise leads to increased self-esteem and is a useful tool for emotional regulation, the level of psychosocial distress may be negatively affected by such injuries.

The prevalence proportions of post-injury depression and emotional stress in athletes with exercise addiction have not previously been explored and compared to non-addicted athletes.

We wanted to test the hypothesis that athletes with addiction profiles react to injury with higher levels of emotional and social distress compared to athletes without addiction.

A cross-sectional survey was employed and a total of 1167 athletes (673 with diagnosed musculoskeletal injuries and 494 without present injury) responded to the following questionnaires: The Exercise Addiction Inventory, The Major Depression Inventory, The Perceived Stress Scale and EQ-5D to assess quality of life.

We found that 26% of the injured athletes with exercise addiction had symptoms of major depression and 53% reported emotional distress. These proportions were significantly greater compared with the injured non-addicted athletes where 11% had symptoms of major depression and 28% reported stress. Quality of life was also significantly reduced in the addiction group.

Injured athletes with exercise addiction report more post-injury psychosocial distress compared with injured non-addicted exercisers. Future trials need to investigate the effect of emotional assessment and support as a complement intervention to somatic injury treatment. Injured athletes should be examined for exercise addiction as they are at risk of depression.

The authors have not supplied their declaration of competing interest.