Several main strengths of our study can be acknowledged. First, the topic being studied, namely the long-term consequences of an elite sports career, is exponentially under scrutiny in medical sciences. Second, a large group of former elite athletes retired from rugby, football, ice hockey, Gaelic sports and cricket was secured, which provided a unique and innovative insight in this special population. Third, the assessment of patient-reported outcomes measures (PROMs) by validated questionnaires gives us real-time information about each participant having symptoms of CMD. If PROMS would be systematically used during and after a career in elite sports, it could be of great additional help for clinicians to easily identify relevant information, about the condition of the mental health of the elite athlete and for elite athletes themselves this could empower the clinicians in their clinical decisions and the athlete in seeking help .