New insights into preventing injuries and illnesses among elite athletics athletes

Epidemiology of bone injuries in elite athletics: A prospective 9-year cohort study

OBJECTIVES

To describe bone injury patterns in elite track and field athletes. To investigate relationships between bone injury and athlete characteristics to inform future injury prevention strategies.

DESIGN

Descriptive epidemiology study.

SETTING

Elite athletics training centres across the United Kingdom and internationally, observed between 2012 and 2020.

PARTICIPANTS

207 Olympic programme senior track and field athletes.

MAIN OUTCOME MEASURES

Injury number, Incidence, Severity, Burden, Time Loss.

RESULTS

There were 78 fractures during the study period. Gradual repetitive bone injuries were the most common type of injury mode. The foot, pelvis and the lumbar spine were the regions with the highest number of bone stress injuries. Stress fractures had a higher burden overall compared to stress reactions. Average return to full training was 67.4 days (±73.1) for stress reactions and 199 (±205.2) days for stress fractures. There was no relationship between bone injury type and age, sex, ethnicity, side dominance or event group.

CONCLUSION

Bone stress injuries in athletics have a high severity and burden warranting continued efforts to prevent their occurrence and optimize management. Age, sex, ethnicity, side dominance and event region do not have any relationship with bone injury occurrence and are therefore unlikely to increase risk in this cohort.

Injury and Illness in Elite Athletics: A Prospective Cohort Study Over Three Seasons

Background

Athletics (also known as track and field) is one of the most popular sports in the world and is the centrepiece of the Summer Olympic Games. Participation in athletics training and competition involves a risk of illness and injury.

Purpose

To describe injury and illness in British Olympic track and field athletes over three full training and competition seasons.

Study Design

Descriptive Epidemiology Study.

Methods

A total of 111 athletes on the British national program were followed prospectively for three consecutive seasons between 2015-2018. Team medical personnel recorded all injuries and illnesses during this time, following current consensus-based methods. All data pertaining to these records were reviewed and analyzed for sports injury and illness epidemiological descriptive statistics.

Results

The average age of the athletes was 24 years for both males and females (24 years, +/- 4). Total exposure for the three seasons was 79 205 athlete days (217 athlete years). Overuse injuries (56.4%) were more frequent than acute injuries (43.6%). The thigh was the most common injury location (0.6 per athlete year), followed by the lower leg (0.4 per athlete year) and foot (0.3 per athlete year). Muscle and tendon were the most commonly injured tissues, while strains and tears were the most common pathology type. Hamstring muscle strain was the most common diagnosis causing time loss, followed by Achilles tendinopathy and soleus muscle strain. Respiratory illness was the most common illness type (0.3 per athlete year).

Conclusion

Hamstring strains, Achilles tendinopathy, and soleus strains are the most common injuries in athletics and have highest burden. Respiratory illness is the most common illness and has the highest burden. Knowledge of this injury and illness profile within athletics could be utilised for the development of targeted prevention measures within the sport at the elite level.

Level of Evidence

3.

Injuries and Illnesses Observed in Athletes from Beginner to Elite Levels at the 18th National Sports Festival for Persons with Disabilities in Japan

Objectives

: This study aimed to describe the injuries and illnesses that occurred at the 18th National Sports Festival for Persons with Disabilities in Japan, which was attended by more than 3000 athletes from beginner to elite levels.

Methods

: Records from medical stations set up at the venues for each sport were reviewed. The incidence rates (IRs) were calculated as the number of medical station visits per 1000 athlete-days. The backgrounds of injuries and illnesses were investigated.

Results

: In total, 3277 athletes attended the festival, and 134 eligible medical station visits were analyzed. Overall, 102 athletes complained of injuries. For the whole schedule of the festival, IRs were 15.5 for injuries and illnesses and 11.8 for injuries alone. For injuries and illnesses, high IRs were seen in soccer (39.8), basketball (25.6), and foot baseball (22.4); for injuries alone, high IRs were also seen in soccer (33.6), basketball (25.6), and foot baseball (16.8). The most frequent symptoms were internal symptoms (n=32), contusions (n=30), and wounds (n=24). Joint sprains occurred in various sports, whereas muscle strains happened mainly in disciplines demanding sprinting or high agility. Of the 55 cases that occurred during events or public rehearsals, 45 were traumatic, whereas the relation to sports activities was not described in 51 cases. Of participants with internal symptoms, 11 were suggested to have viral infections. We identified 21 injuries caused by falls.

Conclusions

: Minor trauma and viral infection were the most frequently observed symptoms among injuries and illnesses, respectively. Structured medical records and organized surveillance systems should be utilized to improve data collection and understand the onset of injury and illness.

Ten Tips to Hurdle the Injuries and Illnesses During Major Athletics Championships: Practical Recommendations and Resources

Participating or winning a medal in major track and field (athletics) competitions is the goal of every athlete. However, health problems can impair sports performance and affect this dream. Therefore, we present ten tips to help hurdle the challenges of illness/injury at major athletics championships: (1) Prepare for travel (medical checking, vaccine, time-zone, jet lag, culture, food habits…), (2) Respect athlete characteristics and discipline specificity (sex, endurance/explosive), (3) Educate athletes and their entourages regarding prevention, (4) Vigilance of painful symptoms and subclinical illness markers, (5) Avoid infection risk (washing hands, safe food and drink, avoid contact with sick people…), (6) Train appropriately and optimally (physical conditioning, technical training, load management, and psychological preparation), (7) Health status (history of previous injuries, well-being in the month before championships), (8) Lifestyle (good sleep, regular hydration and nutrition with safe water/food, regular fruits and vegetables, improve recovery strategies…), (9) Environmental considerations (heat, cold, air cleaning, changes or climatic conditions…), (10) Safety (equipment, rules, own-practice in athletics, and extra-sport activities). These ten tips “PREVATHLES” are based on our field experience in addition to existing epidemiological and experimental literature in athletics and other sports. Although there is currently no scientific evidence for their efficacy, sound judgement, and logical practice provide a strong basis, and given the low risk of using them in the benefit/risk balance, we suggest athletes and those around them follow these ten tips to limit the impact of injury/illness on championship performance.

Relation of Team Size and Success With Injuries and Illnesses During Eight International Outdoor Athletics Championships

Introduction: The number of injuries and illnesses during major athletics championships vary according to sex and discipline. They may also differ between countries (national teams) given the differences in training, medical care, nutrition, lifestyle habits, and in travel to the championships. In addition, injuries and illnesses may influence the performance during the championships. Therefore, the aim was to analyse the differences in the injury and illness occurrence during international outdoor athletics championships with regards to the athlete's country, as well as establishing the potential relationships with the success of the country during the respective championships. Method: The national medical teams and the local organizing committee physicians reported all injuries and illnesses daily on a standardized injury and illness report form during 4 World and 4 European outdoor championships from 2007 to 2018. Results were presented as number of registered athletes, injuries, illnesses and medals (absolute and per 1000 registered athletes), and for countries of different team size. Results: During these 8 championships, a total of 219 different countries participated with a total of 13059 registered athletes who incurred 1315 injuries and 550 illnesses. The number of injuries and illnesses per championships varied between countries. Countries with higher numbers of registered athletes had a higher number of injuries and illnesses, as well as a higher number of medals and gold medals. There were significant positive correlations between number of injuries/illnesses and number of registered athletes, medals, gold medals. Injury and illness numbers per 1,000 registered athletes differed between countries and team sizes. Analyzing country participation grouped according to the number of registered athletes, there were significant negative correlations between injury/illness and medals/gold medals per 1,000 registered athletes. Conclusions: Given the correlation between health problems and country size, we suggest that medical services provision and staff should be adapted to the team size. In groups of different country team sizes, lower number of injuries and illnesses per registered athletes were correlated with higher number of medals and gold medals per registered athletes, which can support that injury and illness prevention should be recognized as a win-win performance-prevention strategy.