Illnesses during 11 international athletics championships between 2009 and 2017: incidence, characteristics and sex-specific and discipline-specific differences

Educating and promoting athletes' health protection through infographics on injury and illness prevention during an international competition: a prospective study during the 2024 European Athletics Championships

Objective

To investigate the feasibility, perceived relevance and usefulness of providing injury and illness prevention information through infographics to athletes and medical teams before and during an international athletics championship, and its potential impact on injury and illness risk during the same championship.

Methods

We conducted a prospective cohort study during the 2024 European Athletics Championships in Roma with (1) dissemination of infographics, (2) data collection on perceived relevance (yes/no) and perceived usefulness (score from 0 to 100) of infographics among athletes and medical teams using an online questionnaire and (3) data collection by medical teams of newly incurred injuries and illnesses among athletes during the championship.

Results

Among the 124 athletes who completed the questionnaire, 35.5% had access to the infographics, of which 86.4% found the information relevant, and their perceived usefulness scores to reduce their risk were 51.8±23.9 (range: 2.9-100.0) for injuries and 50.6±23.0 (range: 0.0-100.0) for illnesses. Among the registered physicians and physiotherapists, 44 replied to the survey, 70.5% had access to the infographics, of which 83.9% found it relevant, and their perceived usefulness scores to reduce risk were 55.6±28.0 (range: 6.0-100.0) for injuries and 52.9±28.0 (range: 0.0-100.0) for illnesses. The logistic regression showed that a higher perceived usefulness score was associated with a lower risk of in-championship injury (OR 0.950; 95% CI 0.877 to 0.996).

Conclusions

Promoting the health protection of athletes through infographics on injury and illness prevention in the context of international athletics championships was feasible and may represent an additional prevention approach.

Coverage from medical teams and injury/illness epidemiology within youth athletics in Africa: A prospective study during the 2023 African Youth Under 18/20 Athletics Championships

OBJECTIVES

To describe athletes' coverage by national medical teams, and injuries and illnesses occurring during the four weeks before and during the 2023 African Youth Under 18/20 Athletics Championships.

DESIGN

Cross-sectional and prospective cohort study design.

METHODS

We conducted a study with data collection of: 1) national medical teams, 2) injury and illness complaints during the four weeks preceding the championships using an online pre-participation health questionnaire, and 3) newly incurred in-championship injuries and illnesses collected by national medical teams and the local organising committee using daily standardised online report forms, for all registered athletes at the championships.

RESULTS

Among the 43 countries participating at the championships, 15 (34.9 %) countries had a medical team with at least one medical personnel. Of the 15 countries, 6 (40.0 %) countries had at least one physiotherapist and one physician, 4 (26.7 %) countries had only physiotherapist(s), and 5 (33.3 %) countries had only physician(s). Nine (60 %) countries participated in the injury surveillance study, including 397 athletes: 61 (15.4 %) completed the pre-participation health questionnaire and 11 athletes (18.0 %) reported an injury complaint and 6 (9.8 %) an illness complaint during the four weeks before the championships. During the championships, there were 52.9 injuries and 50.4 illnesses per 1000 registered athletes. The main injury location was the thigh (33.3 %), and the main injury type was the muscle (47.6 %). The most common system affected by illness was the upper respiratory tract (55.0 %), and the main illness cause was idiopathic (50.0 %).

CONCLUSIONS

This preliminary study provides foundational information to improve medical coverage and services during international championships, and orient injury/illness prevention in youth athletics across Africa.

Injuries and illnesses at the Munich 2022 European Championships: a prospective study of 5419 athletes from 52 countries involved in 9 sports

Objective

To describe the incidence and characteristics of the sports injuries and illnesses that occurred during the 2022 European Championships.

Methods

We conducted a prospective study on newly incurred injuries and illnesses collected by the national medical teams and the local organising committee physicians using a standardised online report form on a daily basis, in all athletes registered at the 2022 European Championships from 11 August 2022 to 21 August 2022 in Munich (Germany).

Results

In total, 5419 athletes were registered at the 2022 European Championships in 9 sports. A total of 181 in-competition injuries were reported, representing an overall incidence of 33.4 injuries per 1000 registered athletes, with higher values in triathlon, cycling and athletics. More injuries located at the lower limb and involving the muscles and skin were reported in athletics, at the lower limb and involving the skin in triathlon, at the head and trunk and upper limb and involving head and skin in cycling. A total of 65 illnesses were reported, representing an overall incidence of 12.0 illnesses per 1000 registered athletes, with higher values in athletics and rowing. The most affected common system was the cardiovascular system (24.6%), followed by the gastrointestinal (18.5%) and upper respiratory tracts (16.9%). The most frequent causes were exercise (36.9%), infections (30.8%) and 'others' (10.8%).

Conclusion

This was the first injury and illness surveillance during multisports European Championships providing relevant results to help anticipate medical services and athletes' health protection, and highlighting the need for special attention for triathlon and cycling.

Nasal Injuries and Issues in Athletes

ABSTRACT

Nasal injuries and issues are widespread in athletic populations and can adversely affect training, performance, and overall well-being. Causes can typically be understood as cellular (allergic, nonallergic, and infectious rhinitis) or structural (static vs dynamic obstruction, trauma), and diagnosis and management differ accordingly. Upper respiratory tract infections, a subtype of infectious rhinitis, remain the most common illnesses among athletes. Here, the authors review the research surrounding the complex relationship between exercise, immunology, and susceptibility to infection. Furthermore, the authors provide an updated understanding of the current literature surrounding rhinitis and nasal trauma management and synthesize practical treatment considerations for providers caring for athletes at all levels.

Glutamine metabolism and optimal immune and CNS function

Nutrients can impact and regulate cellular metabolism and cell function which is particularly important for the activation and function of diverse immune subsets. Among the critical nutrients for immune cell function and fate, glutamine is possibly the most widely recognised immunonutrient, playing key roles in TCA cycle, heat shock protein responses and antioxidant systems. In addition, glutamine is also involved with inter-organ ammonia transport, and this is particularly important for not only immune cells, but also to the brain, especially in catabolic situations such as critical care and extenuating exercise. The well characterised fall in blood glutamine availability has been the main reason for studies to investigate the possible effects of glutamine replacement via supplementation but many of the results are in poor agreement. At the same time, a range of complex pathways involved in glutamine metabolism have been revealed via supplementation studies. This article will briefly review the function of glutamine in the immune system, with emphasis on metabolic mechanisms, and the emerging role of glutamine in the brain glutamate/gamma-amino butyric acid cycle. In addition, relevant aspects of glutamine supplementation are discussed.

Risks, Epidemics, and Prevention Measures of Infectious Diseases in Major Sports Events: Scoping Review

BACKGROUND

Major sports events are the focus of the world. However, the gathering of crowds during these events creates huge risks of infectious diseases transmission, posing a significant public health threat.

OBJECTIVE

The aim of this study was to systematically review the epidemiological characteristics and prevention measures of infectious diseases at major sports events.

METHODS

The procedure of this scoping review followed Arksey and O'Malley's five-step methodological framework. Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched systematically. The general information (ie, publication year, study type) of each study, sports events' features (ie, date and host location), infectious diseases' epidemiological characteristics (ie, epidemics, risk factors), prevention measures, and surveillance paradigm were extracted, categorized, and summarized.

RESULTS

A total of 24,460 articles were retrieved from the databases and 358 studies were included in the final data synthesis based on selection criteria. A rapid growth of studies was found over recent years. The number of studies investigating epidemics and risk factors for sports events increased from 16/254 (6.3%) before 2000 to 201/254 (79.1%) after 2010. Studies focusing on prevention measures of infectious diseases accounted for 85.0% (238/280) of the articles published after 2010. A variety of infectious diseases have been reported, including respiratory tract infection, gastrointestinal infection, vector-borne infection, blood-borne infection, and water-contact infection. Among them, respiratory tract infections were the most concerning diseases (250/358, 69.8%). Besides some routine prevention measures targeted at risk factors of different diseases, strengthening surveillance was highlighted in the literature. The surveillance system appeared to have gone through three stages of development, including manual archiving, network-based systems, and automated intelligent platforms.

CONCLUSIONS

This critical summary and collation of previous empirical evidence is meaningful to provide references for holding major sports events. It is essential to improve the surveillance techniques for timely detection of the emergence of epidemics and to improve risk perception in future practice.

Injuries and Illnesses Across 10 Years of Canada Games Competitions: 2009 - 2019

Background

The Canada Games are a national level competition held every two years alternating between Summer and Winter Games. Participation in elite level athletics, like the Canada Games, have an inherent risk of injury and illness.

Purpose

To analyze the incidence and characteristics of injuries and illnesses during Canada Games competitions from 2009-2019 (primarily) and to understand sex differences in odds of musculoskeletal injury for Summer and Winter Canada Games athletes (secondarily).

Study Design

Descriptive Epidemiology Study.

Methods

Using a retrospective cohort, data were abstracted from medical incident reports generated during Canada Games from 2009 - 2019. Data were coded for body part injured and injury type or illness system; injuries were also categorized as acute or chronic.

Results

Across all 10 years of competition, 3160 injuries reported in 8710 male athletes and 3272 injuries reported in 8391 female athletes. Injury incidence was 362.8 and 389.9 and illness incidence was 47.8 and 64.5 per 1000 male and female athletes, respectively. Female athletes had a 1.12 (95% CI: 1.06; 1.19) greater odds of injury and 1.37 (95% CI: 1.20; 1.57) greater odds of illness compared to male athletes. Overall, injury (399.31 vs. 360.31; p < 0.001) and illness (68.67 vs. 47.30; p < 0.001) incidences were higher in Winter Games, compared to Summer Games, per 1000 athletes. When comparing male and female athletes participating in similar sports, sex specific differences exist in odds of both injury and illness.

Conclusions

Male and female athletes competing in Canada Games competitions demonstrate differences in injury and illness incidence and odds of injury. This suggests a need to examine if additional modifiable risk factors may exist, which could contribute to prevention strategies to reduce injury and illness during Canada Games competition.

Level of Evidence

3.

The epidemiology of injury and illness at the Vitality Netball World Cup 2019: an observational study

BACKGROUND

Netball is a physical game with sudden direction changes, decelerations, jumping and landing, stop/start maneuvers and restrictive footwork rules exposing players to injury. Close contact play and shared facilities during tournaments, increase illness risk.Objective: To describe incidence, period prevalence, types and severity of injuries and illnesses during the 10-day Vitality Netball World Cup 2019 (NWC).Methods: All players from 16 teams consented (n = 192). Medical staff recorded injuries (840 exposure hours), illnesses (1440 player-days) and time-loss. Main outcome measures included incidence (I) calculated as injury/1000 player-hours and illness/1000 player-days, period prevalence (PP) and severity (time-loss) of all match injuries and illnesses.

RESULTS

39 players sustained 46 match injuries (I = 54.76; PP = 20.31%). Lower limb injuries (I = 29.76), specifically the ankle (I = 13.10) were most common with lateral ankle ligament sprains the highest (I = 17.39). Contact injuries (I = 40.48) significantly exceeded non-contact injuries (I = 14.29; p = 0.0124). Center players sustained most injuries (n = 12; 26%; I = 14.29), followed by goalkeepers (n = 10; 22%; I = 11.90) and goal defenders (n = 8; 17%; I = 9.52). Injuries occurred in almost 50% of matches, and 67% did not result in time-loss. Time-loss injuries (n = 14; 33%) were most frequent in the lower limb (n = 10; 71%) specifically involved lateral ankle ligaments (n = 4; 29%), attributable to contact (n = 11; 79%) and mostly implicated center players and goal defenders (n = 4 each; 29% each). 11 players contracted 11 illnesses (I = 7.64; PP = 5.72%) with respiratory tract illness contributing 36%. Most illnesses did not result in time-loss (91%).

CONCLUSION

This is the first study reporting injury and illness during an NWC. Contact was the main mechanism of injury, and 2/3 of injuries did not result in time-loss. The ankle is most commonly injured and center players sustain most injuries. Non-respiratory system disease was most frequent, but upper respiratory tract infection remains the most common diagnosis. Targeted surveillance studies using similar methodology are required to develop injury and illness preventative strategies in elite netball.

International Olympic Committee (IOC) consensus statement on acute respiratory illness in athletes part 1: acute respiratory infections

Acute illnesses affecting the respiratory tract are common and form a significant component of the work of Sport and Exercise Medicine (SEM) clinicians. Acute respiratory illness (ARill) can broadly be classified as non-infective ARill and acute respiratory infections (ARinf). The aim of this consensus is to provide the SEM clinician with an overview and practical clinical approach to ARinf in athletes. The International Olympic Committee (IOC) Medical and Scientific Commission appointed an international consensus group to review ARill (non-infective ARill and ARinf) in athletes. Six subgroups of the IOC Consensus group were initially established to review the following key areas of ARill in athletes: (1) epidemiology/risk factors for ARill, (2) ARinf, (3) non-infective ARill including ARill due to environmental exposure, (4) acute asthma and related conditions, (5) effects of ARill on exercise/sports performance, medical complications/return-to-sport and (6) acute nasal/vocal cord dysfunction presenting as ARill. Several systematic and narrative reviews were conducted by IOC consensus subgroups, and these then formed the basis of sections in the consensus documents. Drafting and internal review of sections were allocated to 'core' members of the consensus group, and an advanced draft of the consensus document was discussed during a meeting of the main consensus core group in Lausanne, Switzerland on 11 to 12 October 2021. Final edits were completed after the meeting. This consensus document (part 1) focusses on ARinf, which accounts for the majority of ARill in athletes. The first section of this consensus proposes a set of definitions and classifications of ARinf in athletes to standardise future data collection and reporting. The remainder of the consensus paper examines a wide range of clinical considerations related to ARinf in athletes: epidemiology, risk factors, pathology/pathophysiology, clinical presentation and diagnosis, management, prevention, medical considerations, risks of infection during exercise, effects of infection on exercise/sports performance and return-to-sport guidelines.

Risk factors associated with acute respiratory illnesses in athletes: a systematic review by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’

Objective

To review risk factors associated with acute respiratory illness (ARill) in athletes, including non-infectious ARill and suspected or confirmed acute respiratory infections (ARinf).

Design

Systematic review.

Data sources

Electronic databases: PubMed-Medline, EbscoHost and Web of Science.

Eligibility criteria

Original research articles published between January 1990 and July 2020 in English were searched for prospective and retrospective full text studies that reported quantitative data on risk factors associated with ARill/ARinf in athletes, at any level of performance (elite/non-elite), aged 15–65 years.

Results

48 studies (n=19 390 athletes) were included in the study. Risk factors associated with ARill/ARinf were: increased training monotony, endurance training programmes, lack of tapering, training during winter or at altitude, international travel and vitamin D deficits. Low tear-(SIgA) and salivary-(IgA) were immune biomarkers associated with ARill/ARinf.

Conclusions

Modifiable training and environmental risk factors could be considered by sports coaches and athletes to reduce the risk of ARill/ARinf. Clinicians working with athletes can consider assessing and treating specific nutritional deficiencies such as vitamin D. More research regarding the role and clinical application of measuring immune biomarkers in athletes at high risk of ARill/ARinf is warranted.

PROSPERO registration number

CRD42020160928.

Incidence of acute respiratory illnesses in athletes: a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE

To determine the incidence of acute respiratory illness (ARill) in athletes and by method of diagnosis, anatomical classification, ages, levels of performance and seasons.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

Electronic databases: PubMed-Medline, EbscoHost and Web of Science.

ELIGIBILITY CRITERIA

Original research articles published between January 1990 and July 2020 in English reporting the incidence of ARill in athletes, at any level of performance (elite/non-elite), aged 15-65 years.

RESULTS

Across all 124 studies (n=1 28 360 athletes), the incidence of ARill, estimated by dividing the number of cases by the total number of athlete days, was 4.7 (95% CI 3.9 to 5.7) per 1000 athlete days. In studies reporting acute respiratory infections (ARinf; suspected and confirmed) the incidence was 4.9 (95% CI 4.0 to 6.0), which was similar in studies reporting undiagnosed ARill (3.7; 95% CI 2.1 to 6.7). Incidences of 5.9 (95% CI 4.8 to 7.2) and 2.8 (95% CI 1.8 to 4.5) were found for studies reporting upper ARinf and general ARinf (upper or lower), respectively. The incidence of ARinf was similar across the different methods to diagnose ARinf. A higher incidence of ARinf was found in non-elite (8.7; 95% CI 6.1 to 12.5) vs elite athletes (4.2; 95% CI 3.3 to 5.3).

SUMMARY/CONCLUSIONS

These findings suggest: (1) the incidence of ARill equates to approximately 4.7 per athlete per year; (2) the incidence of upper ARinf was significantly higher than general (upper/lower) ARinf; (3) elite athletes have a lower incidence of ARinf than non-elite athletes; (4) if pathogen identification is not available, physicians can confidently use validated questionnaires and checklists to screen athletes for suspected ARinf. For future studies, we recommend that a clear diagnosis of ARill is reported.

PROSPERO REGISTRATION NUMBER

CRD42020160472.

Traditional Chinese medicine Jianpi therapy in exercise-induced fatigue: A protocol for systematic review and meta-analysis

BACKGROUND

Exercise-induced fatigue (EIF) is a common occurrence in sports competition and training. It may cause trouble to athletes' motor skill execution and cognition. Although traditional Chinese medicine Jianpi therapy has been commonly used for EIF management, relevant evidence on the effectiveness and safety of Jianpi therapy is still unclear.

METHODS

Databases including PubMed, Embase, Web of Science, the Cochrane Library, SinoMed, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI), and Wanfang will be searched for relevant randomized controlled trials from databases from 2000 to 2021. Randomized controlled trials related to traditional Chinese medicine Jianpi therapy in the treatment and management of EIF will be included. Systematic review and meta-analysis of the data will be performed in RevMan 5.3 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Two authors independently performed the literature searching, data extraction, and quality evaluation. Risk of bias was assessed using the Cochrane Risk of Bias Tool for randomized clinical trials.

RESULTS

This systematic review and meta-analysis will summarize the latest evidence for traditional Chinese medicine Jianpi therapy in EIF. The results will be submitted to a peer-reviewed journal once completed.

CONCLUSION

The conclusion of our research will provide evidence to support traditional Chinese medicine Jianpi therapy as an effective intervention for patients with EIF.OSF Registration DOI: 10.17605/OSF.IO/NRKX4.

Determinants of the adoption of injury risk reduction programmes in athletics (track and field): an online survey of 7715 French athletes

OBJECTIVES

To identify individual characteristics associated with the adoption of injury risk reduction programmes (IRRP) and to investigate the variations in sociocognitive determinants (ie, attitudes, subjective norms, perceived behavioural control and intentions) of IRRP adoption in athletics (track and field) athletes.

METHODS

We conducted a cross-sectional study using an online survey sent to athletes licensed with the French Federation of Athletics to investigate their habits and sociocognitive determinants of IRRP adoption. Sociodemographic characteristics, sports practice and history of previous injuries were also recorded. Logistic regression analyses and group comparisons were performed.

RESULTS

The final sample was composed of 7715 athletes. From the multivariable analysis, competing at the highest level was positively associated with IRRP adoption (adjusted OR (AOR)=1.66; 99.9% CI 1.39 to 1.99 and AOR=1.48; 99.9% CI 1.22 to 1.80) and presenting a low number of past injuries was negatively associated with IRRP adoption (AOR=0.48; 99.9% CI 0.35 to 0.65 and AOR=0.61; 99.9% CI 0.44 to 0.84), both during their lifetime and the current season, respectively. These results were supported by higher scores of sociocognitive determinants among athletes who reported IRRP adoption compared with other athletes.

CONCLUSION

Some characteristics of athletes seem to be associated with IRRP adoption either positively (competing at the highest level) or negatively (presenting a lower number of past injuries), whereas all the sociocognitive determinants tested appear to be linked to IRRP adoption. Since many athlete characteristics are difficult or impossible to change, IRRP promotion may be enhanced by targeting athletes' beliefs and intentions to adopt an IRRP.

Apparent temperature and heat-related illnesses during international athletic championships: A prospective cohort study

International outdoor athletics championships are typically hosted during the summer season, frequently in hot and humid climatic conditions. Therefore, we analyzed the association between apparent temperature and heat-related illnesses occurrence during international outdoor athletics championships and compared its incidence rates between athletics disciplines. Heat-related illnesses were selected from illness data prospectively collected at seven international outdoor athletics championships between 2009 and 2018 using a standardized methodology. The Universal Thermal Climate Index (UTCI) was calculated as a measure of the apparent temperature based on weather data for each day of the championships. Heat-related illness numbers and (daily) incidence rates were calculated and analyzed in relation to the daily maximum UTCI temperature and between disciplines. During 50 championships days with UTCI temperatures between 15℃ and 37℃, 132 heat-related illnesses were recorded. Average incidence rate of heat-related illnesses was 11.7 (95%CI 9.7 to 13.7) per 1000 registered athletes. The expected daily incidence rate of heat-related illnesses increased significantly with UTCI temperature (0.12 more illnesses per 1000 registered athletes/°C; 95%CI 0.08-0.16) and was found to double from 25 to 35°C UTCI. Race walkers (RR = 45.5, 95%CI 21.6-96.0) and marathon runners (RR = 47.7, 95%CI 23.0-98.8) had higher heat-related illness rates than athletes competing in short-duration disciplines. Higher UTCI temperatures were associated with more heat-related illnesses, with marathon and race walking athletes having higher risk than athletes competing in short-duration disciplines. Heat-related illness prevention strategies should predominantly focus on marathon and race walking events of outdoor athletics championships when high temperatures are forecast.

Days until return-to-play differ for sub-categories of acute respiratory tract illness in Super Rugby players: A cross-sectional study over 5 seasons (102,738 player-days)

OBJECTIVES

To document incidence rate and severity of specific sub-categories of respiratory tract illness (RTill) in rugby players during the Super Rugby tournament.

DESIGN

Cross-sectional study.

METHODS

Team physicians completed daily illness logs in 537 professional male rugby players from South African teams participating in the Super Rugby Union tournaments (2013-2017) (1141 player-seasons, 102,738 player-days). The incidence rate (IR: illness episodes/1000 player-days) and severity [%RTill resulting in time-loss, illness burden (IB: days lost to illness/1000 player-days) and days until return-to-play (DRTP)/single illness (mean: 95% Confidence Intervals)] are reported for the following specific sub-categories of RTill: non-infective respiratory tract illness (RTnon-inf), respiratory tract infections (RTinf), influenza-like illness, infective sinusitis, upper respiratory tract infections (URTinf), lower respiratory tract infections (LRTinf).

RESULTS

The overall IR of RTill was 2.9 (2.6-3.3). IR was higher for RTinf (2.5; 2.2-2.9) vs. RTnon-inf (0.4; 0.3-0.6) (p < 0.001). For sub-categories the highest IR was in URTinf (1.9; 1.7-2.2), while the % illness causing time-loss was influenza-like illness (100%), LRTinf (91.7%), infective sinusitis (55.6%), and URTinf (49.0%). IB was highest for URTinf (2.0; 1.6-2.5), and the DRTP/single illness was highest for LRTinf (3.2; 2.3-4.4), and influenza-like illness (2.1; 1.6-2.8).

CONCLUSIONS

RTinf accounted for >57% of all illness during the Super Rugby tournament, and mostly URTinf. Influenza-like illness. LRTinf caused time-loss in >90% cases. URTinf, LRTinf and influenza-like illness resulted in the highest burden of illness and LRTinf caused the highest DRTP. Prevention strategies should focus on mitigating the risk of RTinf, specifically URTinf, LRTinf and influenza-like illness.

How do the new Olympic sports compare with the traditional Olympic sports? Injury and illness at the 2018 Youth Olympic Summer Games in Buenos Aires, Argentina

OBJECTIVE

To describe injuries and illnesses across traditional and new sports among the participating athletes of the Buenos Aires 2018 Youth Olympic Summer Games (BA YOG) (6-18 October 2018).

METHODS

We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues manned by the BA YOG 2018 medical staff.

RESULTS

In total, 3.984 athletes from 206 NOCs were observed. NOCs and BA YOG 2018 medical staff reported 619 injuries and 334 illnesses, equalling 15.5 injuries and 8.4 illnesses per 100 athletes over the 13-day period. The eight new sports on the Youth Olympic programme (futsal, beach handball, karate, roller speed skating, kitesurfing, BMX freestyle, climbing and break dancing) fell in between the other sports with respect to injury and illness risk. Injury incidence was highest in rugby (43% of all rugby players), followed by boxing (33%) and badminton (24%), and lowest in swimming, archery, roller speed skating, equestrian, climbing and rowing (<5%). The highest incidences of illness were recorded in golf (20%), followed by triathlon (16%), beach volleyball and diving (both 14%). Of the illnesses, 50% affected the respiratory system and 15% the gastrointestinal system. Injury and illness incidences varied between continents with athletes representing Europe having significantly fewer injuries and illnesses compared with other continents, apart from a similar illness incidence to Asian athletes.

CONCLUSION

The overall injury incidence of 15.5 injuries per 100 athletes was higher, while the overall illness incidence of 8.4 illnesses per 100 athletes was similar to previous youth and Olympic Games. The new sports did not differ significantly compared with the other sports with respect to injury and illness risk.

Injury frequency and characteristics (location, type, cause and severity) differed significantly among athletics ('track and field') disciplines during 14 international championships (2007-2018): implications for medical service planning

OBJECTIVE

To analyse differences between athletic disciplines in the frequency and characteristics of injuries during international athletics championships.

METHODS

Study design, injury definition and data collection procedures were similar during the 14 international championships (2007-2018). National medical teams and local organising committee physicians reported all newly incurred injuries daily on a standardised injury report form. Results were presented as number of injuries and number of injuries per 1000 registered athletes, separately for male and female athletes, and for each discipline.

RESULTS

From a total of 8925 male and 7614 female registered athletes, 928 injuries were reported in male and 597 in female athletes. The discipline accounting for the highest proportion of injuries was sprints, for both men (24%) and women (26%). The number of injuries per 1000 registered athletes varied between disciplines for men and women: highest in combined events for male athletes (235 (95% CI 189 to 281)) and female athletes (212 (95% CI 166 to 257)), and lowest for male throwers (47 (95% CI 35 to 59)) and female throwers (32 (95% CI 21 to 43)) and for female race walkers (42 (95% CI 19 to 66)). Injury characteristics varied significantly between disciplines for location, type, cause and severity in male and female athletes. Thigh muscle injuries were the main diagnoses in the disciplines sprints, hurdles, jumps, combined events and race walking, lower leg muscle injuries in marathon running, lower leg skin injury in middle and long distance running, and trunk muscle and lower leg muscle injuries in throws.

CONCLUSIONS

Injury characteristics differed substantially between disciplines during international athletics championships. Strategies for medical service provision (eg, staff, facilities) during athletics championships should be discipline specific and be prepared for targeting the main injuries in each discipline.

A One-Season Prospective Study of Illnesses, Acute, and Overuse Injuries in Elite Youth and Junior Track and Field Athletes

Background: In high-level adult athletes, injury incidences and characteristics have been reported during international championships and during one season. Youth track and field athletes are also exposed to injury risk, although less information is available on this specific population, as well as on illness risk.

Aim: To determine the prevalence of health problems (i.e., illnesses, acute, and overuse injuries) in high level Youth and Junior Track & Field athletes.

Method: During the 2015–16 athletics season (30 weeks from December 2015 to July 2016), we conducted a prospective cohort study on a population of Youth and Junior Irish national level athletes, during which athletes were asked to complete a weekly web-based questionnaire (Oslo Sports Trauma Research Center questionnaire on health problems) regarding their health problems.

Results: A total of 70 athletes participated (37 male and 33 female athletes), with an average weekly response rate of 71%. The average weekly prevalence for all athletes was 27% (95%CI 17 to 38%) for all health problems, and 11% (95%CI 3 to 18%) for substantial health problems. Average prevalence varied significantly between endurance and explosive disciplines: a higher prevalence of all and substantial health problems and all and substantial overuse injuries was found in endurance disciplines. A higher prevalence of acute injuries was found in explosive disciplines. Characteristics of acute and overuse injuries differed according to sex and discipline: hamstring strain/cramps/spasms was the main injuries in explosive disciplines, and knee tendinopathy and lower leg strain/cramp/spasms in endurance disciplines, trunk cramps/spasms being frequent in both disciplines. Upper respiratory tract problems were the most commonly reported illnesses regardless of sex and disciplines.

Conclusion: This study provides important information regarding the extent of health problem in Youth and Junior track and field athletes. This could help orient injury prevention measures. For injuries, it should be focused on muscle injuries, especially located on the hamstring, calf, and trunk. For illness, prevention measures could include: screening tests for airway problems, but also general illness prevention measures (e.g., drinking regularly, eating “safe” food, regular hand washing, decreasing contact with sick people, avoiding dehydration).

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.