Abstract
<title>Abstract</title> <p>Background Long-term musculoskeletal sequelae following elite sport participation are increasingly recognized; however, epidemiological data on severity-stratified musculoskeletal disorders (MSDs) in retired athletes remain limited. Understanding sport-specific degenerative patterns may inform long-term joint preservation strategies. Methods This cross-sectional study included 503 male retired elite athletes aged 45–60 years from six sport disciplines. MSDs were assessed using the Persian version of the Oslo Sports Trauma Research Center questionnaire, and health-related quality of life (HRQoL) was measured using the SF-36 Health Survey. Incidence rates were calculated per 1,000 training hours. Severity-dependent analyses and between-sport comparisons were performed using appropriate non-parametric statistical tests. Results The incidence and distribution of MSDs varied according to sport discipline and severity level. At severe and moderate levels, persistent musculoskeletal pain was the most prevalent condition across disciplines, whereas knee osteoarthritis predominated among retired football players. The knee and shoulder were the most frequently affected anatomical regions, reflecting cumulative mechanical loading and sport-specific demands. Despite differences in MSD burden, no significant between-sport differences were observed in Physical or Mental Component Summary scores of HRQoL. Conclusions Retired elite athletes demonstrate sport-specific and severity-dependent patterns of musculoskeletal disorders, particularly involving the knee joint in high-impact sports. These findings highlight the need for long-term orthopedic surveillance and targeted preventive strategies extending beyond athletes’ competitive careers to mitigate degenerative joint disease and preserve functional health.</p>