The Effect of Music Listening on Athletes' Anxiety, Depression, and Pain: A Mini Review

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Abstract

Introduction

Music is a type of art that combines melody, harmony, and rhythm. These elements combine to make one feel romantic, joyful, or sad, and sometimes initiate a bodily reaction in the listener [1]. Some studies have shown that music can trigger various parts of the brain, including the cingulate, amygdala, and hippocampus [2-4]. Other musical activities, such as imagined performance, can also improve connectivity between supplementary motor areas and widespread brain regions such as the posterior temporal cortex, sensorimotor cortex, and occipital cortex [5].

Historically, music has been an important tool of health and healing that promotes people’s well-being and quality of life [6]. According to recent meta-analysis research, listening to music while engaging in a wide range of sports can improve an athlete’s mood and physical performance (the ergogenic effect), decrease perceived stress, and enhance their physiological efficiency [7]. There are various types of music depending on the activities and the purpose it is being used for [8], such as special music designed for pain management [9], group music for treating chronic mental health conditions [10], hip-hop music for the promotion of sexual health [11], and some musical dance for patients with Parkinson’s disease [12]. Hence, musical activities serve a different purpose concerning the social, physical, and psychological processes to promote people’s health and quality of life.

Researchers have shown that music can improve submaximal endurance performance for athletes, and the majority of them claimed that music makes athletes feel better about their effort and performance [13-15]. This may be connected to theories that contend that music’s rhythm enhances exercise performance. Rhythmic musical signals promote symmetry, balance, and motor coordination by reducing variability in muscle recruitment [16, 17]. Using synchronous music does, in fact, require the purposeful synchronization of repetitive motions with musical rhythmic aspects like beat or tempo [15]. However, the athletes can use music, mostly during warm-up or resting times [13]. Studies looking at how music during the warm-up process affected athletes’ short-term maximal performances discovered considerable ergogenic effects. The motivating benefits of music have been associated with improvements in self-confidence, increased physiological arousal, and enhanced motor coordination [7, 18, 19].

The first conceptual framework to predict the effects of music in sport and exercise stated that both internal and external factors, such as relationships and cultural relevance, improve music’s motivational qualities, which act as an ergogenic aid to improve athletes’ physical and mental condition during sport-related activities and physical exercise [20, 21]. Athletes may be more vulnerable to developing certain mental conditions due to a variety of characteristics that are unique to sports. They include traveling for sports (particularly for younger elite athletes) [22], being exposed to stress associated with sports, and sustaining an injury [23].

Athletes’ anxiety and depression have been demonstrated to be related to injuries in particular [24-26]. Athletes who suffered from psychological conditions such as anxiety and depression also reported more pain interfering with their sports activities [27]. Evidence suggests that athletes may also be more likely to commit suicide, with possible risk factors including accidents, competitive pressure, and substance abuse [28, 29]. It is still debatable, though, how prevalent mental disorders are among athletes [30, 31]. Hence, in this study, we give a brief overview of the mental health issues that athletes may experience, such as anxiety, depression, and pain related to sports, as well as how music can help the athletes overcome these symptoms.

Method

The goal of this mini-review is to give the readers a brief summary of current theoretical ideas about sports and how listening to music can help deal with sports-related anxiety, depression, and pain. We review studies through a database search on the Web of Science, PubMed, Scopus, and Google Scholar. Search terms included the following, individually and in combination: ‘athletes’, ‘sports’, ‘music’, ‘anxiety’, “depression, and ‘pain’. No date constraints were employed, and review articles were limited to those published in English. Furthermore, we applied no restrictions to the types of music, sports, or stages of sports performance.

Music and Anxiety

Anxiety is a prevalent emotional condition felt by athletes at all levels of performance and is typically described as an unpleasant psychological state in reaction to perceived stress regarding the completion of a task under pressure [32]. Anxiety typically consists of a somatic component (e.g., level of physical arousal) and a cognitive component (e.g., troubling thoughts and uncertainties). Anxiety can appear as a persistent trait of one’s personality known as state anxiety or as a transient, more unstable state of anxiety that is situation specific [33]. Additionally, anxiety associated with sports can have a severe negative effect on the athlete’s performance [32]. Sport-related anxiety can, in short, have a negative effect on an athlete’s performance during training and competition, raise the likelihood of an injury occurring, prolong the process of getting back in shape, and raise the chances of a potential injury during training and competition after a period of rehabilitation [32, 34].

The theoretical conceptions under consideration are all based on the association between cognitive and physiological arousal, characterized as the stress reaction to potentially stressful events, emphasizing the significance of comprehending anxiety as a psychophysical entity [34-36]. According to Särkämö, Altenmüller [37], music has a variety of effects on cognitive, sensory-motor, and psycho-emotional processes that promote coordination of recurrent movement patterns during sport activities. Other studies proved that muscles naturally relax and contract in response to tension, resolution, and rhythm as an inherent kind of musical cognition [38, 39].

Sport is viewed as being fundamentally reliant on the athletes’ ability to manage competitive anxiety [40]. Pre-task music is frequently used in sports to manage certain mindsets, such as pre-competition anxiety [41]. Researchers found that both relaxing and non-relaxing types of music worked to lower signs of competitive state anxiety, like somatic and cognitive anxiety, subjective relaxation, and heart rate [42]. A previous interventional study by Kuan, Morris [4] has indicated that music has a direct physiological and behavioural effect on an athlete’s induced state of anxiety. For example, unfamiliar relaxing music (“Near The Plantation”) and unfamiliar arousing music (“Attila The Hu”) reduce the power spectral density of the occipital lobe and elevate brain functional connectivity between the frontal lobe and occipital lobe. Furthermore, in an interventional investigation, the results of repeated measures MANOVA showed that relaxing music (from classical, chilled-pop, and ambient sources) significantly decreased competitive state anxiety and enhanced perceptions of relaxation [40]. Nonetheless, there are currently a few studies being conducted on how music affects anxiety levels during athletic activities.

Music and Depression

The most common psychological disorder is depression, and 6.7% of the adult population will experience it at some point in their lives [43]. The prevalence of depression among college athletes was found to vary widely, from as low as 15.6% to as high as 21% [43]. Nonetheless, the majority of research on elite athletes reveals that depression affects them as frequently as the general population [44]. The symptoms of depression present as loss of interest or pleasure, insomnia, low appetite, undesirable mood, grief, poor concentration, low self-worth, or suicidal tendencies, and without clinical treatment, could lead to various psycho-social problems such as abnormal eating behaviour, school dropout, substance abuse, hysteria, delinquency, and suicide [45].

Failure in competition is the type of common stressor that seems to make athletes more vulnerable to depressive disorders and adverse impacts. [46, 47]. Not only does losing in competition make one more vulnerable to depression, but thinking back on earlier failures in sports can also make one depressed [48]. Depressive symptoms based on failure have also been related to game outcome (winning or losing). When an athlete lost, their levels of depression, vigour, and anger significantly increased; yet, when they won, their moods stayed more joyful [49]. Maintaining good health, recovering from injuries, thinking about retirement, adjusting to success, managing performance expectations and anxiety are other significant factors associated with depressive disorders in sports [50].

Previous studies have demonstrated that listening to music while exercising or participating in sports can have ergogenic (i.e., increased work output), psychological (i.e., improved positive emotional states), psychophysical (i.e., lower perceived exhaustion), and psychophysiological (i.e., enhanced oxygen uptake) effects [20, 51]. The sort of music and the level of exercise intensity (low, moderate, or high) are both crucial for bringing out the best in athletes [52]. Earlier research has shown that music’s motivational elements can influence participants’ psychophysiological elements, such as depression and mood [53]. In addition, previous study discovered that using music therapy greatly reduced the level of depression in badminton players [54].

Athletes that listen to music upregulate their energy and downregulate negative emotions such as depression [55]. For instance, in a case study of an endurance runner, Lane (2008) [56] outlined how the runner’s choice of musical selections correlated with the emotional states felt during a successful performance. While the major objective in terms of emotion control was to feel relaxed, the runners listened to slow relaxing music one hour before the competition. As an alternative, the runner increased the rhythm and picked songs with motivational lyrics when he needed to feel motivated before a race. The runner always picks tunes that fit his pacing technique. In order to remember not to start the race too fast, this involved listening to music with a moderate tempo before the race. Hence, the emotional states and pacing techniques needed at certain moments of the race were established with the aid of music.

Music and Pain Management

Athletes frequently suffer from sports injuries [57, 58], and pain is frequently present [59, 60]. However, pain can also arise without an injury or continue after one has recovered [61]. Pain is defined as a distressing sensory or emotional feeling that is connected to or indicative of a real or potential tissue injury [60]. A range of factors, such as neurological, immunological, behavioural, psychological, sociocultural, and others, have an impact on how an individual experiences pain [62, 63]. The longer the duration of the pain, the more likely it is that behavioural and psychological factors will have an impact on the pain and related issues, including functional impairment [63].

A scientific approach to pain management in sports looks at the source(s) and nature of pain and creates a treatment plan that takes into account the biological, physical, and psychological factors that contribute to pain [63]. In recent years, few studies have looked into the application of music as a stimulus that aids athletes in avoiding pain and fatigue-related symptoms [63]. Many kinds of music in sporting contexts are assumed to influence how exertion is perceived through the neural systems. The afferent neural system has a constrained channel capacity and conveys signals to the spinal column and brain. As a result, sensory inputs like music may block the physiological feedback signals connected to physical effort [64, 65].

Moreover, it has been shown that music’s ability to slow down theta waves (4–7 Hz) affects different parts of the brain. The reduction of fatigue-related symptoms has been directly linked to this process [66]. For example, during intense physical exertion, motivational music has an impact on athletes’ experiences and how they perceive their physical exertion and fatigue [67]. Using EEG, recent research has shown that music reduces brain connections in the central and frontal regions of the brain (also known as the sensorimotor regions), a feature that is related to decreased exercise fatigue [68]. Thus, when athletes practice while listening to music, they frequently put up more effort and for a longer period of time [7]. In another study, it was discovered that, as compared to a no-music control, the time-to-exhaustion was 18.1% and 19.7% longer when athletes ran in time to neutral and motivational music, respectively [69].

Conclusion and Recommendations

Overall, this review shows that athletes appear to experience higher rates of psychological and physical distress, including anxiety, depression, and pain, and that using music as a treatment is a simple, effective, non-pharmacological, non-invasive, and inexpensive intervention that has no negative side effects. According to the review’s findings, there is growing evidence that listening to music reduces athletes’ anxiety, depression, and pain in both clinical and non-clinical settings. Motivational and relaxing types of music were the most frequently employed and most successful, but other forms of music were used concurrently to serve various purposes. This shows that, for the majority of us, music is a form of expression that is very personal and that it follows us as we navigate through life. More research is needed to fully figure out how listening to music affects sports at different stages.

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