Balancing Act: An Occupational Lens on the Process of Becoming an Elite Athlete

Abstract

Background

In 2023, the International Olympic Committee identified youth elite athletes as a ‘neglected population’ and called for further research into their wellbeing. To date, limited research has explored the experiences of youth athletes, and existing studies predominantly utilise psychological perspectives.

Aim

To use an occupational perspective to explore the process of becoming an elite athlete, drawing on the current experiences of youth athletes and retrospective accounts from experienced athletes.

Methods

A convergent mixed-method design, combining data from a cross-sectional questionnaire (N = 39), and semistructured individual interviews (N = 8) with athletes.

Results

Quantitatively, gender and sport type (individual vs team) were associated with mental health outcomes across the sample, with females and athletes competing in individual sports reporting poorer mental health outcomes. Enthusiastic commitment was positively correlated with grit and negatively correlated with depression. Qualitative data identified six key factors impacting occupational balance, including elite as a time commitment, relocation for recognition, athletes as a commodity, meaningful relationships supporting life balance, access to formal support and superhuman barriers to help-seeking.

Conclusion

These findings highlight the intricate and complex nature of athlete wellbeing during the transition process and promote occupational balance and occupational science as a nuanced perspective for identifying and addressing opportunities for imbalance for the athlete population.

Significance

This study used an occupational lens to shine a light on the process of becoming an elite athlete and why it is important to support youth athletes, not just in sport but in life. The findings emphasise opportunities for occupational therapy to contribute to sport as an emerging practice domain.

Introduction

The health and wellbeing of athletes is a growing area of interest. Research shows that the physical and emotional demands of training, pressure to perform and potential for injury can all contribute to the development of mental health issues including anxiety, depression and burnout among athletes [1–3]. Across the athlete lifespan, an area of increased vulnerability has been identified during the transition into elite sport [4]. This transition commonly occurs as a young adult, between 17 and 24 years of age [5].

Youth athletes on an elite pathway may experience increased mental health risks in relation to navigating complex interpersonal relationships, engaging with social media and formation of identity [6, 7]. In addition, youth athletes report increased stigma in relation to mental health and negative attitudes towards help-seeking [8]. As a result, youth athletes may be at high risk of using maladaptive coping strategies [9], alcohol and substance misuse [2, 10–12] and disordered eating behaviours [13–15]. Alongside all these pressures, youth athletes have significant time demands in relation to sport that can negatively impact wellbeing [16].

In accordance with the International Olympic Committee’s Mentally Fit Continuum, optimisation of life balance and quality of life are required for elite athletes to achieve peak performance [17]. This continuum acknowledges that mental health and physical health contribute equally to optimising the elite athlete’s overall wellbeing in conjunction with performance excellence [17]. To gain a holistic understanding of mental health and life balance of elite athletes, a multidisciplinary approach is required. The current study adopts an occupational perspective, supported by psychological concepts, to explore factors influencing the transition into elite sport. An occupational perspective considers how occupations impact our sense of self through connectedness and engagement in meaningful and purposeful occupations [18]. To maintain an occupational perspective within the current research, occupation-based theories and frameworks including the Occupational Therapy Practice Framework 4th Edition (OTPF-4) [19] and Backman’s occupational balance curve [20] were utilised.

Within the study of occupational science and occupational therapy, occupations refer to everyday activities including ‘things people need to do, want to do and are expected to do’ [21]. The OTPF-4 states that ‘occupations are central to a client’s (person’s, group’s or population’s) health, identity and sense of competence and have particular meaning and value to the client’ [19]. This framework considers occupations to be classified into one of nine categories: activities of daily living (ADL), instrumental activities of daily living (IADL), health management, rest and sleep, education, work, play, leisure and social participation [19]. These categories allow occupational therapists to conceptualise time use and provide a framework to understand and evaluate occupational performance and participation. For elite athletes, time use primarily comprises sports participation, studies and sleep [22]. In line with the OTPF-4, this results in the majority of elite athlete time use falling under the categories of work, education, health management and rest and sleep.

To understand the concept of occupational balance, the Occupational Balance Curve developed by Backman [20] was used to provide a framework exploring the key factors that may impact an individual or community, enabling or impeding them from achieving optimal health and wellbeing. The five key factors identified in the occupational balance curve are individual occupational factors, social support and community, socioeconomic changes and policies, home and family factors and workplace factors [20]. The spectrum of occupational balance represented by the curve ranges from health-enhancing behaviours (greater satisfaction with life, happiness and quality of life) to increased risk to health (infections and cardiovascular diseases, anxiety, depression and substance abuse).

Over the lifespan athletes may experience times when they have an increased risk of occupational balance resulting in poor health and decreased quality of life. To date, research has established that injury [8], performance failure [23] and retirement [24, 25] are key risk factors. Research also acknowledges that individual psychological factors such as resilience and perseverance (or grit) are protective factors [26]. For example, athletes with higher levels of grit are more likely to compete in higher levels of sport and outperform competitors [26, 27].

To date, little research has formally examined the mental health and wellbeing of athletes as they become elite, with the mental health of youth elite athletes recognised as a ‘neglected population’ [4, 7]. Purcell, Henderson [4] have further noted the need for early intervention as critical in promoting mental health among youth elite athletes. This gap is essential to consider, as the behaviours a young person develops while entering into elite sport may shape the way they respond to future sport transitions across the athlete lifespan. To assist in developing the depth of research in the area, the current study aimed to explore the impact of becoming an elite athlete on athlete wellbeing, utilising a multidisciplinary approach including occupational and psychological perspectives.

Methods

Study Design

A convergent mixed-methods design was used, in which quantitative and qualitative data were collected during the same recruitment phase and given equal priority [28]. Survey participants were invited to indicate interest in a follow-up interview through a separate, anonymised expression of interest link provided at the end of the survey. Those who consented were contacted and formed part of the qualitative sample. Additional participants for the qualitative component were also recruited via sporting associations. Each dataset was analysed separately and then integrated during interpretation to enable comparison, convergence and contextualisation of the findings [29]. Due to the anonymous design of the quantitative questionnaire, data were not linked for participants who completed both survey and interview components. Shared occupational concepts (occupational balance, health and wellbeing) guided both studies to support meaningful integration (Fig. 1). Study 1 used a quantitative online survey to examine patterns in relation to the occupational concepts, while Study 2 used semistructured qualitative interviews to generate deeper, contextualised insights into athletes’ experiences of becoming elite.

Fig. 1.

Study protocol

Together, the two studies formed an integrated mixed-methods design that enabled quantitative patterns and qualitative insights to be interpreted in relation to one another. This approach provided a more comprehensive understanding of athletes’ transition into elite sport than either method could offer alone, while ensuring that the shared occupational concepts of occupational balance, health and wellbeing remained central to the interpretation of the combined findings. This design aligns with contemporary guidance on convergent mixed-methods approaches, which emphasises equal weighting, independent analysis and intentional integration to produce a more comprehensive understanding than either method alone [30].

Study 1

Study 1 utilised an online survey (via the Qualtrics platform) to assess athlete-specific time use and identity development from occupational and psychological perspectives.

Participants

Athletes were deemed ‘elite’ if they met the criteria defined by Swann, Moran [31]. This definition considers elite athlete characteristics including training, competition, experience and remuneration. As such, Australian youth athletes (17–24 years of age) representing their sport at a state, national or international level were eligible to participate in this study. Initially, only youth athletes (aged 17–24 years old) [5] were encouraged to participate as per the eligibility criteria. However, due to poor uptake, age restriction was removed and experienced athletes (over 24 years old) reflecting retrospectively on their transition into elite sport were invited to participate. Incomplete surveys and those that did not meet ‘elite’ criteria [31] were removed (< 50% completion), and data from 39 participants were included in the final sample (youth athletes 17–24 years n = 25, experienced athletes > 24 years n = 14).

Measures

Demographic Information

Demographic information was collected relating to age, gender, ethnicity, relationship status (i.e., single, in a relationship, engaged and married), living situation and displacement.

Sport Participation

Participants completed items relating to ‘elite’ athlete criteria [31] including level of competition (current and highest), sport-based remuneration, training (duration and frequency) and commitment to sport (years played). Athletes also indicated whether the sport that they were primarily involved in was an individual or a team-based sport.

Time Use

Time use was explored in reference to the OTPF-4, categories of occupation including work (participation in sport and employment outside of sport), rest and sleep (two items from the Pittsburgh Sleep Quality Index [32]), education (study) and health management (participation in sport) [19].

Mental Health

Participants completed the 21-item Depression, Anxiety and Stress Scale (DASS-21) developed by Lovibond and Lovibond [33]. The scale comprises three subscales (each containing 7 items), measuring symptoms of depression, anxiety and stress experienced during the prior 7 days. Participants rated the items on a four-point Likert scale from 0 (did not apply to me at all) to 3 (applied to me very much, or most of the time). Higher scores in each subscale indicated greater likelihood of experiencing stress, anxiety or depression and higher overall scores indicated poorer mental health, which is an outcome associated with occupational imbalance [20]. The Cronbach’s alpha for DASS-21 subscales has been high in previous research (Depression α = 0.91, DASS-Anxiety α = 0.80 and DASS-Stress α = 0.84 [34]. For this study, reliability for the subscales was similar for depression α = 0.80 and anxiety α = 0.71 and lower for stress α = 0.30.

Resilience

The study used the GRIT-S (as a proxy measure of resilience; 35), an eight-item self-reported outcome measure that consists of two subscales: consistency of interest and perseverance of effort. The scale uses a five-point Likert scale ranging from 1 (not like me) to 5 (very much like me). Higher mean scores reflect higher levels of grit. The GRIT-S is reported to have acceptable internal reliability, with Cronbach’s alpha ranging from 0.73 to 0.83 [35]. In the current study, the Cronbach alpha coefficient was 0.77.

Sports Commitment

To assess commitment to sport, two subscales from the Sports Commitment Questionnaire (SCQ-2) [36] were used. The enthusiastic commitment subscale (6 items) assessed desire and resolve to persist in a sport over time and the constrained commitment subscale (5 items) assessed perceptions of obligation to persist in a sport over time. The questionnaire uses a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The SCQ-2 has displayed acceptable internal reliability for the selected subscales (enthusiastic commitment α = 0.87 and constrained commitment α = 0.61) [37]. For this study, reliability for the subscales was 0.88 for enthusiastic commitment and 0.80 for constrained commitment.

Procedure and Data Analysis

Ethics approval was obtained from the Flinders University Human Research Ethics Committee (Project ID 5509). Participants provided informed consent electronically, and those aged over 18 years (over 17 years of age for university students) were eligible to participate. The online survey was disseminated to athletes across Australia through university based ‘Elite Athlete’ programmes and to Sporting Organisations via email, social media and/or newsletters. The survey took approximately 15–20 min to complete. All participants were entered into a raffle to win a $25 gift card to reimburse them for their time and were offered an opportunity to express interest in participating in semi-structured interviews (Study 2; see below).

IBM SPSS Statistics software package (Version 29) was used to analyse the survey data. Descriptive statistics were generated for all variables (mean, standard deviations, frequencies). Independent sample t-tests were used to determine differences between demographic information (age, gender and relationship status) and athletes’ competition type (individual or team sports) in relation to the mental health outcomes of depression, anxiety, stress and grit. ANOVAs were used to determine differences between mental health outcome measures and level of competition (state/national/international). These analyses were conducted for the entire sample and then repeated to examine the subgroup of youth athletes. A p-value of < 0.05 was considered significant.

Results

Characteristics of the Sample

The overall sample included 13 males and 26 females ranging from 17 to 51 years of age (M = 25.08 years, SD = 7.88). Of these 39 athletes, 25 met the age criteria for classification as a youth athlete (aged 17–24). There were no significant differences between youth athletes (M = 20.44, SD = 1.96) and experienced athletes (M = 33.36, SD = 7.68) in relation to depression, anxiety, stress, grit or motivation (all p > 0.05). Within the sample, approximately 75% of the athletes identified as Australian. Overall, 15 athletes reported competing in individual sports, while 24 reported competing in team sports. Sporting codes represented included: rugby union (n = 14), swimming (n = 4), judo (n = 3), volleyball (n = 2), rowing (n = 2), cycling (n = 1), Australian rules football (n = 1), golf (n = 1), field hockey (n = 1), netball (n = 1), rugby league (n = 1), touch football (n = 1) sailing (n = 1), archery (n = 1), athletics (n = 1), equestrian (n = 1), triathlon (n = 1), ballet (n = 1) and other individual sport not named (n = 1).

The highest level of competition reported by the athletes was state (n = 9), national (n = 15) and international (n = 17). Twenty-one athletes were currently competing at national (n = 12) or international level (n = 9). Twelve of the athletes were required to relocate to pursue their chosen sport (intra-state n = 6, interstate n = 4 and international n = 2). In relation to key time use factors of work and education, the athletes reported training between 2 and 7 days per week (M = 5.60, SD = 1.75), for a total duration of 5–45 h per week (M = 12.94, SD = 9.20). They also competed between 1 and 6 times per month (M = 3.89, SD = 1.50). Overall, 84.6% of the participating athletes reported having employment outside of sport (18 casually, 5 part-time and 10 full-time). In addition, 61.5% reported undertaking studies alongside sporting commitments (1 part-time online diploma, 8 part-time university, 14 full-time university and 1 college). The majority of athletes lived with others (19 with family, 10 in shared housing, 7 with significant other and 3 alone).

Examining Between-Group Differences in Mental Health Outcomes and Sports Commitment

The results have been analysed and presented for the overall athlete sample (Table 1) and for the youth athlete subsample (Table 2). Comparisons between the two samples are also provided.

Table 1.

Mental health outcomes and sports commitment by demographic and sport participation variables for entire sample (athletes 17 + years)

N		Depression		Anxiety		Stress		Grit		Enthusiastic commitment		Constrained commitment
		M	SD	M	SD	M	SD	M	SD	M	SD	M	SD
Gender
Male	13	4.15	2.73	2.69**	2.29	6.30*	2.21	3.86	0.76	4.44	0.59	2.03	0.63
Female	26	5.73	3.91	5.69**	3.65	8.27*	2.99	3.46	0.62	4.30	0.80	2.23	1.09
Relationship status
Single	26	6.08*	3.92	5.50*	3.55	8.08	2.73	3.58	0.65	4.33	0.79	2.26	1.05
In a relationship	13	3.46*	2.03	3.08*	3.01	6.69	3.07	3.61	0.76	4.38	0.65	2.00	0.77
Sport type
Individual	15	5.33	3.66	6.60**	3.58	9.53***	2.53	3.68	0.46	4.56	0.44	2.03	0.87
Team	24	5.13	3.65	3.50**	2.99	6.42***	2.43	3.53	0.16	4.24	0.83	2.23	1.00
Level of competition
State	18	4.72	3.84	4.17	3.24	7.33	2.30	3.40	0.68	4.28	0.91	2.24	1.06
National	12	5.08	3.00	5.75	3.98	7.33	3.55	3.79	0.71	4.45	0.52	2.30	0.92
International	9	6.33	4.00	4.33	3.57	8.56	3.09	3.69	0.61	4.36	0.60	1.89	0.81

Note: Stress subscale demonstrated low internal consistency in this sample (α = 0.30). Stress-related comparisons are therefore exploratory and should be interpreted with caution

^*p < 0.05, ^**p < 0.01 and ^***p < 0.001

Table 2.

Mental health outcomes and sports commitment by demographic and sport participation variables for youth athletes (aged from 17 to 24)

N		Depression			Anxiety			Stress			Grit			Enthusiastic commitment			Constrained commitment
		M	SD	M		SD	M		SD	M		SD	M		SD	M		SD
Gender
Male	5	5.40	2.70	2.20*		2.17	7.00		2.00	3.90		0.36	4.40		0.77	2.04		0.82
Female	20	5.65	3.90	6.20*		3.53	8.50		2.30	3.43		0.13	4.27		0.79	2.40		1.12
Relationship status
Single	20	5.95	3.91	5.95		3.76	8.30		2.39	3.54		0.60	4.24		0.84	2.53		1.07
In a relationship	5	4.20	1.92	3.20		2.28	7.80		2.05	3.45		0.79	4.53		0.46	2.20		1.22
Sport type
Individual	10	5.40	2.84	7.20*		3.71	9.30*		2.63	3.96		0.15	4.42		0.46	2.13		0.86
Team	15	5.73	4.18	4.20*		3.19	7.4*		1.77	3.42		0.18	4.24		0.91	2.43		1.17
Level of competition
State	10	5.50	3.20	4.40		3.20	7.60		1.71	3.30		0.66	4.22		1.02	2.58		1.27
National	9	5.89	2.89	7.00		3.81	8.67		2.87	3.64		0.53	4.43		0.58	2.31		1.06
International	6	5.33	3.50	4.67		3.88	8.50		2.35	3.73		0.69	4.28		0.61	1.93		0.68

Note: Stress subscale demonstrated low internal consistency in this sample (α = 0.30). Stress-related comparisons are therefore exploratory and should be interpreted with caution

^*p < 0.05, ^**p < 0.01 and ^***p < 0.001

Gender

Overall, females reported significantly higher anxiety, and preliminary trends indicate higher stress than their male counterparts (see Table 1). Among the youth athletes (17–24 years), females also reported significantly higher anxiety, t(23) =  − 2.40, p = 0.03.

Relationship Status

For the overall sample of athletes, those who identified as single reported significantly higher scores for depression (t(37) = 2.25, p = 0.03) and anxiety (t(37) = 2.11, p = 0.04), compared to athletes currently in a relationship (Table 1). However, among youth athletes, no significant differences were observed based on relationship status (Table 2).

Sport Type

As shown in Table 1, athletes (entire sample) who competed in individual sports reported significantly higher anxiety (t(37) = 2.92, p = 0.006) and preliminary trends indicate higher stress (t(37) = 3.83, p < 0.001), compared to athletes who participated in team sports. Similarly, for youth athletes (17–24 years old), those competing individually experienced higher anxiety (t(23) = 2.16, p = 0.04) and preliminary trends indicate higher stress (t(23) = 2.09, p = 0.05) compared to those competing in team sports (Table 2).

Level of Competition

Across the overall sample (Table 1) and among the youth athletes (Table 2) level of competition did not significantly impact any of the mental health outcomes.

Table 3 presents the correlations between variables. Across all athletes, preliminary trends indicate time spent training (hrs/week) was positively associated with stress, although this was not observed in the youth subpopulation. There were no significant associations between time spent competing (hrs/month) and the mental health outcomes or commitment types, across the entire sample or among youth. Enthusiastic commitment was positively correlated with grit and negatively correlated with depression. While constrained commitment was positively correlated with depression.

Table 3.

Pearson correlation matrix for athletes stratified by age

	1	2	3	4	5	6	7	8	9
(1) Time spent competing (hrs/month)	-a	0.37*	0.19	−0.01	0.02	0.00	0.18	− 0.40	0.14
(2) Time spent training (hrs/week)	0.43*	−	0.23	0.04	0.07	0.30	0.43**	0.06	− 0.12
(3) Sleep (hrs/night)	0.12	0.40	−	0.28	− 0.30	− 0.19	− 0.15	0.10	− 0.29
(4) Grit	0.03	0.24	0.25	−	− 0.31	− 0.37*	− 0.27	0.37*	− 0.26
(5) Depression	0.02	0.04	− 0.03	− 0.26	−	0.45***	0.34*	− 0.44**	0.55**
(6) Anxiety	− 0.07	0.15	− 0.14	− 0.44*	0.41*	−	0.68**	− 0.01	0.21
(7) Stress	0.19	0.39	− 0.04	− 0.38	0.25	0.62**	−	0.11	0.16
(8) Enthusiastic commitment	− 0.07	− 0.01	0.14	0.31	− 0.70***	− 0.18	0.01	−	0.55***
(9) Constrained commitment	0.10	0.002	− 0.24	0.35	0.61**	0.21	0.14	− 0.68***	−

Stress subscale demonstrated low internal consistency in this sample (α = 30). Stress-related comparisons are therefore exploratory and should be interpreted with caution

^a Entire sample (n = 39) is above the diagonal and youth subsample (n = 24) are below

^*p < 0.05, ^**p < 0.01 and ^***p < 0.001.

Summary

Study 1 highlights several key factors that influenced the mental health and wellbeing of athletes transitioning to elite sport, including gender and sport type. Gender and sport type (individual vs. team) were associated with mental health outcomes across the sample, with females and athletes competing in individual sports tending to report higher anxiety and appear more vulnerable to poorer mental health outcomes. These findings are consistent with research conducted by Correia and Rosado [38], who reported that female athletes and those participating in individual sports were more vulnerable to anxiety. The preliminary results from Study 1 reinforce the need to better understand the distinct experiences of youth elite athletes to better support wellbeing and address challenges across different sporting contexts.

Interestingly, enthusiastic commitment (underpinned by intrinsic motivation) was positively correlated with grit and negatively correlated with depression. While constrained commitment (associated with extrinsic motivation) was positively correlated with depression. These patterns suggest that different forms of motivation may shape athlete wellbeing and resilience across the lifespan. Notably, intrinsic motivation was associated with positive wellbeing outcomes for athletes within this study, consistent with previous research on athlete motivation [39].

Study 2

Methods

Semistructured individual interviews were conducted with athletes. Interview guides were developed using concepts from the occupational balance curve and OTPF-4 [19, 20] to explore the experiences of athletes during the transition to elite sport, both from the perspective of youth athletes currently on elite pathways and experienced athletes’ retrospective reflections.

Positionality Statement

The research team included both male and female researchers, all based in Australia. All members of the research team have allied health backgrounds, including two occupational therapists and two research psychologists. Three of the authors have previous publications in the area of sport and/or mental health.

Participants

Fourteen individuals from Study 1 expressed an interest in participating in a follow-up interview, and all were contacted by the researcher via email. Overall, 6 responded to this invitation and completed a semi-structured interview. Additional participants (n = 2) were recruited for interviews through sporting associations across South Australia and Queensland. The interviewees ranged in age from 22 to 51 years (M = 30.63, SD = 11.24), and 75% of participants were female (n = 6). Participants included youth athletes, 17–24 years (n = 5), and experienced athletes, over 24 years of age (n = 3) who reflected retrospectively on their experience of becoming an elite athlete. Of the athletes who accepted an invitation for follow-up interview, all represented athletes who participated in team sports (rugby n = 7, sailing-paired n = 1).

Procedure and Data Analysis

Ethics approval was obtained from Flinders University Human Research Ethics Committee (Project ID 5509) and participants provided written consent. The lead author conducted the interviews via Microsoft Teams in July–October 2023. Interviews lasted between 13.5 min and 48 min (M = 29.01; SD = 12.24), with the initial questions being used to build rapport and develop a historical understanding of the participant’s relationship to sport. All participants received a $25 gift card to thank them for their time. The interviews were transcribed verbatim and checked for accuracy prior to commencing analysis. In line with the aims of this study, quality and depth of information gathered during interviews and the demographics of the sample, the number of participants was deemed to be sufficient to provide saturation and satisfactory information power [40, 41]. Preliminary analysis involved inductive thematic analysis using procedures outlined by Braun and Clarke [42]. The first author led the analysis process; to ensure the process was rigorous the wider research team supported discussions, review and refinement throughout steps 3–6. (1) Following a process of familiarisation with the dataset (2) initial coding was completed and code labels identified for key segments of the data (e.g. moving to pursue sport, lack of access to opportunities and impact of new environments). (3) Initial generation of themes was completed by identifying shared patterns across the data set and clustering codes that shared core concepts and/or ideas (e.g. need for geographical relocation). (4) These initial themes were checked for accuracy and suitability to ensure they highlighted the key pattern across the dataset, and revision of themes occurred as required. (5) Themes were refined and defined, with a brief summary of each theme developed to ensure that they were clearly defined. In this phase names were developed to capture the theme and summary (e.g. relocation for recognition). (6) Alongside the development of the themes was a process of informal writing up and reflecting on the data set and themes, which was used to inform both the process and final write up (42).

Results

Six overarching themes were generated from the data: (1) elite as a time commitment, (2) relocation for recognition, (3) athletes as a commodity, (4) meaningful relationships support life balance, (5) access to formal supports and (6) superhuman barriers to help seeking.

Theme 1: Elite as a Time Commitment

All the athletes reported that being an elite athlete required a dedication to sport through time commitment to promote opportunities to compete at higher levels.

Someone that’s extremely dedicated and committed to their sport. They put all their lives into it, so that’s their number one, number one goal. Extremely dedicated, committed to training as much as they possibly can. (Rugby – 5 F Experienced athlete).

An elite athlete is someone who’s putting in massive hours to their training and competition and competing at international level…trying to reach the peak of the sport. (Sailing – 6 F Youth athlete).

Although the key attributes of an elite athlete remained consistent in various responses, female athletes frequently expressed challenges in fulfilling the criteria. Barriers to meeting the criteria included type of sport, gender or (lack of) financial compensation.

I’d say an elite athlete does get either sponsoring or some money through their sport. They might even do their sport full-time, but then it depends on the sports. Because I know for a fact that some women’s sports are just very hard to make it as a professional athlete. So they sometimes have to have jobs on the side as well, but I’d say a lot of their time goes into that sport. (Rugby – 8 F Youth athlete).

Despite discrepancies across sports and gender, consistency in time commitment and dedication to sport continued to be considered a valid way to define elite athletes.

Theme 2: Relocation for Recognition

Additional stresses exist for youth athletes in relation to relocation requirements to pursue sport at the elite level. For all the participants involved in the current study, relocation was required to be recognised and pursue their chosen sport to the highest level. This included interstate and overseas relocation. It was also noted that different sports have different physical resource requirements and environmental features that may require an athlete to geographically relocate.

Since I was eighteen I haven’t lived in the same city as my family and I’m 34 now, so that unfortunately affects, I guess, the family dynamic in that, you know, you could be a lot closer if you’d been around. (Rugby – 4 M Experienced athlete).

The challenges associated with relocating or having to travel for one’s sport were reported by numerous participants. This was consistent with the idea that to be recognised or progress in your sport, relocation was an expectation not an option.

After my time over interstate competing, I was told that I needed to make the move. I am being looked at for national. They’re looking to like elevate that a little bit more. So to do that I would need to move. (Rugby – 1 F Youth athlete).

Theme 3: Athletes as a Commodity

As youth athletes become elite, they find themselves in new social and physical environments that challenge their sense of self. They may go from being highly regarded within their communities to feeling like an outsider and out of their depth, with some discussing feelings of imposter syndrome. This can result in feeling threatened by those within the team:

It is also like hard coming into a team where it is so competitive and the girl is being like, well, you’ve been brought in. Why have you been brought in? Whose spot are you taking kind of thing. (Rugby – 1 F Youth athlete).

For some, this resulted in youth athletes fixating on the need to do more, work harder and earn a right to supports that may be available to the team:

I prioritised my training above study and above work because yeah, that was my goal. (Rugby – 2 F Youth athlete)

Rugby’s a very old, traditional sport and with that comes sort of that seniority experience sort of scenario where you’ve gotta earn your spot in the team in terms of playing but you’ve gotta earn your spot in the team sort of socially too. Whereby you can’t just rock up as a new fella and you know, start talking in huddles or, you know, yeah, have too much to offer until you’ve sort of, sort of proved yourself or been there for a while. (Rugby – 4 M Experienced athlete).

In addition to the requirement of increased physical effort, athletes shared common characteristics that empowered them to overcome barriers and setbacks encountered on their path to elite. These characteristics encompassed traits, qualities and attributes such as stubbornness, resilience, selfishness, obsessiveness and hardworking:

Professional sport is sort of all-encompassing, whereby with a short window and a very, I guess, obsessive personality, which is typically the dude that plays professional sport, you tend to just drop everything for whatever you have got to do for sport and you become selfish and selfish usually, has like a lot of negative connotations about it. But selfish in a way that you have just got to look after your body, your career, and your goal because you have only got such a small window and such a small opportunity to make the most of it. (Rugby – 4 M Experienced athlete).

As youth athletes dedicate their maximum effort into their sport, they often reported finding themselves with limited influence over crucial decisions in their lives (e.g., ‘We are pieces of meat at the end of the day, but you know the quality of those pieces of meat obviously affect how things go’; Rugby – 4 M Experienced athlete; ‘My “market value” trebled’; Rugby – 3 M Experienced athlete). These statements indicate a diminished sense of autonomy and perceptions of having limited control over their own worth or value within the sporting context. Rather than viewing themselves as athletes with potential, they may express sentiments of being regarded as commodities, as objects to be traded and contracted across the world based on financial value. This dehumanising experience can contribute to athletes feeling more like commodities than respected individuals.

Theme 4: Meaningful Relationships Support Life Balance

For athletes across the lifespan, meaningful relationships can promote life balance. Among the participants, life balance varied significantly based on social connection, gender and financial support from sport. The athletes discussed differing experiences based on the quality of their relationships. Financially supported athletes described spending the sporting season (9–10 months per year) surrounded by teammates, reserving the off-season for reconnecting with family and friends. The paid athletes highlighted the importance of assistance in establishing and sustaining meaningful relationships during the transition to elite. This was identified as an area that sporting organisation could enhance their support for youth athletes in the future.

The relationship you have, the partner, can be a really, really difficult one to manage… that’s been interesting one for me. Like realising the I guess where I was at that time and where I put my partner… professional sport is obviously such a short window. You're looking at a partner who's hopefully lifelong and a family that’s gonna last for longer than you, that you know, those priorities could potentially be or certainly with me they should have been shifted a bit. (Rugby – 4 M Experienced athlete).

I had family and I was sacrificing time from family to, you know, to chase this, this opportunity and dream. (Rugby – 3 M Experienced athlete)

For the unpaid athletes, life balance looked significantly different. The structure of the sport programmes was designed to accommodate education and/or work responsibilities. This was evident in the scheduling of training sessions outside of the standard 9 am to 5 pm workday.

Sometimes when I have a rough shift, I might end up not being able to fit in a workout just because of time or energy levels. (Rugby – 8 F Youth athlete)

For the unpaid athletes, the offseason was utilised as a time for picking up more hours at work to financially support themselves during the on-season:

Having to have to juggle things around and make time and make sacrifices for all these sporting commitments… During the off season…It’s mainly work. I still try and go to the gym like twice a week, but that’s the point where I tend to pick up like a bit of overtime, just so I can supplement that income. (Rugby – 7 F Youth athlete).

While the unpaid athletes were required to work or study in addition to pursuing elite sport, they discussed generally positive and meaningful relationships with family and friends outside of sport.

It can strain relationships, but I think I’m lucky most people in my life pretty understanding and kind of respect what I’m doing. (Sailing – 6 F Youth athlete)

My partner is really supportive in terms of… you know whether I choose to play footy, they’re here and he’s been great and even things like my team and my coaches like all around, like they’ve been really supportive. (Rugby – 7 F Youth athlete).

Irrespective of athletes’ income levels, participants emphasised the challenges associated with achieving life balance during the pursuit of being elite and noted that it would not be sustainable long-term.

I don’t know whether it was balance per se, but I think it definitely worked for me at the time. I’m looking back. It was. It was only a short period of time, so I think it was easy to maintain, but I think if I was, UM, trying to keep that then it wouldn’t be very sustainable. (Rugby – 2 F Youth athlete).

It’s hard because finding the time when I was in a position of pursuing an athletic career and working at the same time and balancing family. I don't know if I could have got any more hours in the day. (Rugby – 3 M Experienced athlete).

Theme 5: Access to Formal Supports

During the transition to elite, athletes require greater support than they can receive from the informal networks of family and friends. At these times access to formal support can be vital in promoting positive outcomes for athletes in sport and in life. Athletes reported they gained access to resources and formal supports in relation to diet and nutrition, medical/injury prevention and management, psychology, training and fitness plans, access to physical facilities and equipment for training and recovery and financial support (through income and/or coverage of travel expenses). For most athletes, these resources included an expectation of increased dedication and performance outcomes compared to what they had previously experienced in community or lower-level sporting programs.

I suppose, as a resource, access to nutritionist, diet. All this type of stuff because apparently, I was too small. But I was contracted on the basis of my size and capabilities, but within six months of being in their program, I went from 85 to 98 kilos, still working on speed, strength through the roof, lost my neck. You know all these types of things that I just simply would never have had that opportunity to implement anything like that with the work rugby balance life balance. (Rugby – 3 M Experienced athlete).

Repeatedly it was reported that access to these supports was directly linked to athletic output and performance. When athletes did not meet the requirement to maintain access to resources, they reported finding themselves in difficult situations with no access to supports.

It’s pretty much results based, so you have to be keeping top results to maintain your scholarship. And because I didn’t have a partner to campaign with, I wasn’t racing internationally. So I didn’t have any results to keep me on. (Sailing – 6 F Youth athlete).

This type of pressure was also associated with mental distress (e.g., ‘There was a, there was a really it was a really dark kind of time where I was left to my own devices to try and deal with that stuff’; Rugby – 3 M Experienced athlete).

These ties between performance output and resources were reported by all athletes with similar sentiments expressed by both paid and unpaid athletes. Across the board, athletes expressed the importance of formal resources in regard to achieving and maintaining elite athlete status and in promoting positive mental health during this time.

Team psychologists would be really good. I’ve heard of teams getting those and that would be really good, obviously that requires money. (Rugby – 5 F Experienced athlete)

But I guess it’s one thing to tell your team manager that you’re not feeling too good today and there’s another thing to actually speak to a sport psychologist or another support system about. (Rugby – 1 F Youth athlete).

Theme 6: Superhuman Barriers to Help Seeking

The elite athlete identity is one made up of time spent training, competing or otherwise surrounded by sport. Living a life that others are unable to comprehend, that is full of invisible barriers, can create a skewed perspective for the general population. One experienced athlete discussed their experiences as another world, describing:

It’s a super unique environment. It’s not the real world to the point where we sort of refer to people who don’t play rugby as Muggles, just ‘cause they just sort of live a different life and run a different race… a lot of the stuff you deem as normal and fun and all in rugby’s just not common practice in the real world.’ (Rugby – 4 M Experienced athlete).

While athletes discussed the concept of feeling as though they live in another world, this mindset also impacted their potential for help-seeking within the elite athlete population. With reference to how athletes are perceived by the general population, a youth participant stated:

They’re just humans as well, and we just expect them to be superhuman because maybe their physical performance is in a way superhuman to what the average person knows, but that doesn’t mean that they’re immune to all the other strains of life. (Rugby – 8 F Youth athlete).

Due to the nature of the lived experience of athletes and the expectations they perceive to be placed on them by the general public, they may struggle to find support outside of the athlete space. Discussing the perception of athlete privilege and its impact on help-seeking and mental health, a youth participant acknowledged:

I think that support network is there if I need it, but I’m probably not super comfortable using it… Other people don’t always recognise the difficulties of being an athlete and it's like ohh you just get to travel the world and you’re living your dream and you get to do what you love every single day. So there might not be that understanding that there can be a lot of challenges. (Sailing – 6 F Youth athlete).

Without the informal supports of friends and family who may not understand the athlete experience, athletes are limited to seeking support within the environment that they live in. Additional barriers within this space were identified, including stigma and performance culture.

There’s definitely like a stigma within sport or just the culture…. Do I want to disclose all these things? Will these affect my performance?… I guess there is a fear that like if I do have to get that extra help. That my spot on the team might be compromised because you know, they might not think that I’m psychologically ready. (Rugby – 7 F Youth athlete).

An individual barrier as to being perceived as weak (Rugby – 3 M Experienced athlete)

With regards to youth athletes, specific barriers to help-seeking may be experienced during the transitional phase as they feel they have not yet earned the right to have difficulties or minimise their own wellbeing struggles. This can be due to feelings of self-doubt, fear of being perceived as inadequate and a reduction in self-confidence.

I find it really hard to go to team managers… Primarily because, like at the moment, especially because I am new to like this team… So not having a platform to stand on as such. And then that doubt. I’m not gonna annoy you with my problems because they have so many more things to worry about. That’s just like kind of what goes on in my head a little bit. (Rugby – 1 F Youth athlete).

With some youth participants who have reported significant setbacks noting the need for preventative mental health support:

I just try and keep up my own mental health strategies. Gratitude. Mindfulness, that kind of stuff to make sure I keep up my mental fitness. (Sailing – 6 F Youth athlete)

Discussion

The aim of the current research was to examine the experiences of athletes’ transitioning into elite sport and to highlight factors that contribute to the mental health and wellbeing outcomes of these athletes from an occupational perspective. Across the two studies, the findings emphasise the importance of a holistic, individualised understanding of youth athletes within the framework of the occupational balance curve [20], and illustrate the complex, interconnected factors that shape wellbeing during the pursuit of elite sport.

Occupational Balance

Occupational imbalance occurs when there is a prolonged pattern of occupation that is unsustainable. This imbalance can be characterised by too much or too little time allocated to one or more occupational domains, resulting in negative impacts on health and wellbeing [43, 44]. In Study 1, athletes who identified as female or participated in individual sports reported higher levels of anxiety and preliminary trends indicate higher levels of stress, which may indicate greater vulnerability to conditions that disrupt occupational balance. The qualitative findings help explain one potential factor underpinning the elevated anxiety scores. The theme ‘Elite as a time commitment’ illustrates how team-sport athletes experience pathways to elite sport as requiring an excessive allocation of time to sport-related occupations, often at the expense of other occupational domains and limiting opportunities to engage in other meaningful roles and activities. These insights illustrate how time-use pressures can narrow an athlete’s occupational repertoire and contribute to occupational imbalance and the associated reduced wellbeing outcomes. When considered together, the quantitative patterns and qualitative insights suggest that the demands of elite sport may create conditions that increase athletes’ vulnerability to mental ill health, reinforcing the value of occupational balance as a lens for understanding athlete wellbeing.

Individual Occupational Factors

In Study 1, intrinsic motivation (reflecting an athlete’s sense of meaning, competence and personal value) correlated positively with grit (measured as passion and persistence over time), indicating that sustained enjoyment in sport was tied to feelings of mastery and purpose. The semistructured accounts in Study 2 provide an opportunity to expand on the quantitative relationship between intrinsic motivation and grit. Specifically, team-sport athletes described sporting environments that generated fluctuating self-worth, obligation and perceived inadequacy (Theme 3: ‘Athlete as a commodity’ and Theme 6: ‘Superhuman barrier to help seeking’), revealing how external pressure can destabilise the individual occupational factors that support motivation and persistence. When merged, these findings illustrate how occupational transitions [45], such as becoming elite, can reshape athletes’ time use, identity and perceived competence, increasing vulnerability to occupational imbalance and identity foreclosure. With identity foreclosure being characterised by roles and values becoming narrowly centred on sport [46]. This interpretation aligns with existing research linking strong athletic identity to identity foreclosure [47–53] and the impact of new sporting environments on an athlete’s perceived competence and feelings of adequacy [54–57]. Athletes who maintain a broader sense of self—identifying as ‘more than an athlete’–experiencing more positive health and wellbeing across the athlete lifespan [51]. Taken together, the current findings align with established psychology literature [57–59] while extending it by highlighting the importance of supporting diverse and balanced occupational identities during the transition into elite sport.

Social Support and Community

Study 2 revealed that despite being embedded in a team environment, athletes described relationships that were often superficial, transactional, or workplace-based (Theme 4: meaningful relationships and life balance). Primary social networks were often tied to sporting workplaces, which created connections that were contingent on performance, selection or role status. As a result, when these athletes experienced injury, non-selection or performance decline, these relationships were challenged or disappeared. These qualitative insights show how sport-centred occupational participation and time use can erode social support, even in contexts where support may be assumed to be strong. Time-use demands, such as long training hours and travel, further restrict an athlete’s ability to maintain relationships outside of sport. Participants described limited opportunities to invest in friendships, romantic relationships or community roles, leading to a narrowing of their social environments around sport. When considered in relation to Study 1, the link between individual-sports athletes reporting poorer health outcomes can be considered with an occupational lens. This pattern should be interpreted cautiously given the absence of qualitative perspectives from individual-sport athletes within Study 2. It may be hypothesised that individual-sport athletes encounter similar concerns to team-based sport athletes, with the addition of reduced access to social support reflected in the solitary and less socially embedded nature of many individual-sport occupations. This highlights the fragility of sport-centred social networks and aligns with previous research that highlights the benefits of positive support and social networks as protective factors of athlete mental health and wellbeing [49, 60–64].

Home and Family Factors

While Study 1 provided preliminary indications that athletes experiencing higher overall occupational demands may also experience poor wellbeing, these findings were not strong enough to draw definitive conclusions about the specific contribution of home and family factors. Instead, findings suggest that multiple life domains, including sport, school, work and family, may interact in ways that place pressure on an athlete’s capacity to maintain occupational balance and wellbeing, an idea that is supported by existing literature [54, 57, 65–67]. Study 2 offered richer insight into how these pressures unfold in the context of team-sport athletes (mainly within rugby) and how these disruptions shaped daily occupations. ‘Relocation for recognition’ (Theme 2) highlighted how many athletes moved away from home to pursue elite opportunities. This relocation often required the athletes to take on new household responsibilities, manage living arrangements independently and adjust to unfamiliar environments. During these periods of occupational transitions, athletes described disrupted routines, financial difficulties, extended periods away from home and the emotional demands of balancing sport with family expectations that negatively impact wellbeing [51, 68]. Training and competition schedules limited their ability to participate in family roles, maintain relationships, or engage in restorative occupations outside of sport. These experiences demonstrate how conflicting occupational demands, including household tasks, social isolation, financial obligations, meeting family expectations and fulfilling sport-related obligations, can create strain and reduce opportunities for engagement in restorative and meaningful occupations. These findings reinforce existing evidence that conflicting occupational demands within the home and family context can lead to exhaustion, reduced wellbeing and increased risk of burnout [65–70], with romantic relations suggested to improve wellbeing outcomes for athletes [60].

Workplace Factors

Although many team-based athletes in Study 2 reported having access to formal support (including physiotherapy, nutrition, training plans, rehabilitation, wellbeing services), they described strong cultural barriers to help-seeking and limited autonomy within the sporting environments (Theme 5: ‘Access to formal supports’ and Theme 6: ‘Superhuman barrier to help-seeking’). These findings suggest that organisational culture and workload demands may shape an athlete’s capacity to maintain occupational balance during the transition into elite sport environments. These qualitative findings from Study 2 assist in contextualising the reduced mental health outcomes observed in Study 1 by identifying potential workplace barriers that may occur in a wider sporting context and may impact athlete wellbeing. Future research is needed to confirm whether individual-sport athletes encounter similar workplace concerns. The findings from Study 2 and outcomes from Study 1 are supported by previous research into athlete wellbeing that emphasises barriers to help-seeking including stigma, lack of available time, fear of repercussions, accessibility, perceptions of weakness and more [63, 64, 71]. Research in this space also highlights that barriers to help-seeking in relation to mental wellbeing extend beyond the elite space and can be observed from grassroots levels. This indicates that understanding this issue will require consideration of and focus on broader systemic and cultural issues within sporting environments [72].

Socioeconomic Changes and Policies

Participants in Study 2 described relocation requirements, financial instability and precarious work conditions (Theme 2: ‘Relocation for recognition’ and Theme 3: ‘Athlete as a commodity’), highlighting how broad socioeconomic pressures shape occupational opportunities for athletes. These themes demonstrate the direct impact of socioeconomic changes and policies on the identity, autonomy and wellbeing of athletes. While explored with reference to team-based sports (predominantly rugby), athletes in Study 1 may have experienced similar challenges based on relocation requirements (30.7% of the athletes reported relocating), financial instability and work conditions (61.4% reported studying and working; 84.6% reported working and sport). This hypothesis warrants further investigation, as the qualitative sample did not include individual-sport athletes. These preliminary findings underscore factors that can promote occupational imbalance and associated decline in mental health, indicating the need to further explore the socioeconomic impact across sport types and settings. This has been identified within the literature as a growing area of interest relating to social policy and work conditions, notably in the context of legitimising women’s professional sport [73].

Strengths and Limitations

This is the first known study investigating the elite athlete experience from an occupational perspective. The research focused on a select few occupational categories from the OTPF-4. Future research should consider a broader range of occupational categories and consider additional methods of measuring time use to assist in capturing the complex nature of occupational engagement and performance for athletes.

The study defined youth athletes as those aged 17–24 years [5]; however, the transition to elite pathways for sport can be observed at younger ages depending on the sport. As suggested by Walton and Purcell [67] expanding the age range to include younger athletes may provide a more comprehensive understanding of early elite athlete development and its occupational implications, particularly in relation to developmental milestones.

Recruitment challenges resulted in small sample sizes across both studies. For the quantitative sample this reduced statistical power and reliability for certain results (notably the DASS-21 stress subscale). As a result, some of the findings represent exploratory trends rather than definitive conclusions. Similarly, while the integrated findings were intended to include a diverse variety of sports, the convenience sampling used in Study 2 resulted in a qualitative sample comprising only team-sport athletes, predominantly rugby. This limits the breadth of perspectives captured and may reduce the transferability of the qualitative insights to athletes in other sporting contexts, particularly those from individual sports.

Future studies should consider more diverse sampling strategies, include athletes across sporting contexts and developmental stages, and employ longitudinal and mixed-methods designs to better understand the mechanisms that promote or impede occupational balance and identify protective factors that support healthy, multidimensional athlete identities.

Implications

The current research considers athletes as occupational beings embedded within complex environments. Viewing the wellbeing of athletes during the transition to elite sport through an occupational lens highlights how occupational balance and its associated factors operate as both risk and protective factors for the previously ‘neglected population’ [7]. The findings demonstrate the dynamic interaction between individual capacities and the relational, organisational and sociocultural systems surrounding athletes. Applying insights from the occupational balance curve within the context of athlete development offers a pathway for designing strategies that support sustainable routines, identity development and meaningful participation across the athlete lifespan. This includes recognising how time demands, relocation, commodification pressures, access to support and ‘superhuman’ expectations can disrupt occupational patterns and constrain opportunities to achieve optimal occupational balance. Expanding the scope of occupational science and occupational therapy into the elite sport and athlete context highlights an opportunity for alternative professional perspectives and input into the foundational research relating to the previously underrepresented population.

Conclusion

Athlete wellbeing fluctuates across the lifespan due to numerous factors relating to the individual, their environments and the occupations they engage in. The direction of influence between occupational balance and wellbeing is not yet known and the nuance of the youth athlete experience reinforces the need for research that traces these intertwined concepts and explores how these evolve across the athlete lifespan. The complex nature of the occupational choices that athletes make can shape both performance and health outcomes. When taken together, the findings from the current studies relating to athletes’ experiences as they become elite provide support in identifying who may be at increased risk of occupational imbalance (Study 1), while also illuminating how occupational imbalance may contribute to these outcomes (Study 2). Study 2 sheds important light on mechanisms for promoting or impeding occupational balance (e.g., intense time use pressures, capacity to form sustainable and meaningful relationships and disrupted perceptions of self) that may be relevant across sporting contexts and should be considered in future research. This occupational approach highlights that wellbeing challenges in elite pathways are not solely a psychological phenomenon but are deeply connected to how athletes’ daily occupations are structured, constrained and distributed. Supporting athletes to maintain a sustainable distribution of occupations is therefore essential as they navigate complex transitions across elite sport.

Author contributions

J.W. (Occupational Therapist), I.P. and J.P. contributed to the study conception and design. Data collection, data analysis and manuscript writing were performed by J.W. I.P., J.P., B.S. provided supervisory support, manuscript editing/revision and content supervision. B.S. provided discipline specific guidance in maintaining an occupational focus during manuscript drafting and editing. All authors approved the final manuscript.

Funding

Open Access funding enabled and organized by CAUL and its Member Institutions.

Data Availability

The research data generated during the current studies is not publicly available due to participant privacy or ethical restrictions.

Declarations

Competing interests

The authors declare no competing interests.