International Athletics Championships Research Articles

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

ObjectiveTo 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...

Bone stress injuries in athletics (track and field) championships: findings from a prospective injury surveillance conducted across 24 international championships with 29,147 registered athletes

BackgroundAthletics (track and field) athletes are prone to develop bone stress injuries (BSIs) but epidemiological data on BSIs from top-level sports events are scarce.ObjectiveTo describe the incidence and characteristics of BSIs during 24 international athletics championships held from 2007 to 2023.MethodsBSI-related data were prospectively collected during 24 international athletics championships, including the Olympic Games (n = 3), World Outdoor Championships (n = 4), European Outdoor Championships (n = 6), World Indoor Championships (n = 3) and European Indoor Championships (n = 8). Descriptive and comparative statistics were used to assess the epidemiological characteristics of BSIs.ResultsBSIs accounted for 1.5% of all reported injuries (n = 36; 1.2 per 1000 registered athletes (95%CI 0.8 to 1.6)). No significant difference of BSI incidence was detected between female (2.0 per 1000 athletes (95%CI: 0.9 to 2.3)) and male athletes (0.9 per 1000 athletes (95%CI: 0.4 to 1.4)) (relative risk (RR) = 1.73, 95%CI: 0.88 to 3.40). BSI incidence was significantly higher during outdoor championships (1.6 per 1000 registered athletes (95%CI: 1.0 to 2.1)) as compared to indoor championships (0.2 per 1000 registered athletes (95%CI: 0.0 to 0.5)) (RR = 10.4, 95%CI: 1.43 to 76.0). Most BSIs were sustained in the foot (n = 50%) or leg (n = 33%). BSIs were reported in athletes participating in endurance disciplines (52.8%) or in explosive disciplines (47.2%).ConclusionsBSIs represent a small portion of injuries sustained during international athletics championships. Collective results suggest that injury rates are higher in outdoor competitions as compared to indoor competitions. The most common injury locations comprise the foot and leg.Clinical Trial NumberNot applicable.

Is the risk of muscle injuries higher in the finals than in previous rounds of the 100 m, 200 m and 400 m sprints of international athletics championships?

ObjectivesTo compare incidence rates of lower limb muscle injuries (LLMIs) and hamstring muscle injuries (HMIs) in 100 m, 200 m and 400 m sprints disciplines between finals, semi-finals and heats of international athletics championships. DesignProspective total population study. MethodsWe analysed in-competition LLMIs and HMIs of female and male athletes during eight championships between 2009 and 2022. ResultsLLMI and HMI incidence rates in 100 m finals were significantly higher than in heats and semi-finals for female and male athletes. HMI incidence rates were significantly higher in 200 m finals than heats and semi-finals for male athletes. ConclusionsLLMI and HMI risk was higher in finals compared to previous rounds during international athletics championships.

Having an injury complaint during the four weeks before an international athletics ('track and field') championship more than doubles the risk of sustaining an injury during the respective championship: a cohort study on 1095 athletes during 7 international championships.

To analyse the association between pre-participation health status and in-championships injuries in a large dataset from seven international athletics championships, and to determine the health status of athletes during the four weeks before the start of international athletics championships. Prospective cohort study. We used data collected from athletes of national teams with medical staff who participated i) in a pre-participation health survey (retrospective data collection) and ii) in an in-championships injury surveillance (prospective data collection) during seven international athletics championships (2013-2018). We performed a binomial logistic regression with in-championship injury (yes/no) as the dependent variable and sex, age, discipline (explosive/endurance), type of championships (outdoor/indoor) and pre-participation injury complaint (yes/no) and pre-participation illness complaint (yes/no) as independent variables, with odds ratios (OR) and 95% confidence intervals (95% CI). Out of the 1095 athletes included 31.2% reported an injury complaint during the 4 weeks before the championships and 21.6% an illness complaint. The univariate model showed that discipline, type of championships and pre-participation injury complaints (OR = 2.57, 95%CI: 1.66 to 3.97) were significantly associated with in-championships injuries, and the multivariable model showed that type of championships and pre-participation injury complaints (OR = 2.64, 95%CI: 1.60 to 4.36) remained significantly associated with in-championships injuries. Our present study shows that an injury complaint during the four weeks before an international athletics championship significantly increased risk of sustaining an injury during the following championship, which was reported by about one third of athletes with differences between sex and disciplines.

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℃, 132heat-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 (0.12more 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.

High Risk Of Heat-related Illnesses For Endurance Athletes During Athletics Championships In Hot Climate

PURPOSE: To analyze the relationship between climatic conditions and the occurrence of heat-related illnesses during international athletics championships. METHODS: In this population-based study, all heat-related illnesses were selected from prospectively collected illness data from seven international outdoor World and European athletics championships between 2009 and 2018. The Universal Thermal Climate Index (UTCI) of each championship day was calculated as a model of thermoregulation for climatic conditions. The incidence rates of heat-related illnesses were analyzed in relation to the daily maximum UTCI temperature by fitting linear models. In addition, the relative risk (RR) was calculated for athletes from endurance and explosive disciplines, and for women and men. RESULTS: Overall, 132 heat-related illnesses occurred during the 50 championship days with UTCI temperatures between 15° and 37°Celsius (C). The average incidence rate of heat-related illness was 11.7 (95%CI 9.7 to 13.7) per 1000 registered athletes. The expected daily incidence rate of heat-related illness increased significantly with UTCI temperature (0.14 more illnesses per 1000 registered athletes per °C; 95%CI 0.10 to 0.18), doubling from 25 to 35 °C UTCI. No severe heat illness was observed below a UTCI temperature of 28 °C. Athletes in endurance disciplines had higher incidence rates than in explosive disciplines (RR = 21.7, 95% CI 12.0 to 39.2), while female and male athletes did not differ. CONCLUSION: More heat-related illness occurred on championship days with higher UTCI temperatures. There was a 20-fold increased risk in endurance disciplines compared with explosive disciplines. Strategies to prevent heat-related illness should focus on endurance disciplines in athletics competitions that occur in warm and humid climates with UTCI above 28 °C.

Injury patterns among national-level athletes in Lebanon: a retrospective study

ABSTRACT Objectives:This study aims to assess the annual prevalence, associated factors, and characteristics of musculoskeletal disorders among Lebanese national-level athletes. Methods: Lebanese athletes aged 18 and over and who competed in a top-level national championship during an entire athletics season were invited to participate in the study. Data were collected through questionnaire assessing self-reported injury during the past year. Injury, dependent variable of the study, was defined as a musculoskeletal condition that made the athlete partially or completely abstains from training or competition for a 1-week minimum injury period. Results: Among the 250 eligible athletes, 210 (84.0%) (25.5±6.7 years) completed the questionnaire. The 1-year retrospective injury prevalence was 51.9% (95% confidence interval, 45.1%-58.7%). Injured athletes reported 150 injuries: 128 (85.3%) affected the lower extremities, and 111 (74.0%) occurred during training. The most common type was muscle cramps/spasm (n=53; 35.3%); and overuse (n=121; 80.7%) was the predominant cause. Athletes who mainly practiced endurance disciplines (-p-value=0.042), who participated in international athletics championships (-p-value=0.047), and who were taking chronic medications (-p-value=0.049) had more injuries in the past year. Conclusion: These findings may help inform potential injury prevention programs, which should target injuries affecting the lower extremities, and consider the factors associated with injury risk among Lebanese athletes.

Lower limb muscle injury location shift from posterior lower leg to hamstring muscles with increasing discipline-related running velocity in international athletics championships

ObjectiveTo analyse the rates of lower limb muscle injuries in athletics disciplines requiring different running velocities during international athletics championships. DesignProspective total population study. MethodsDuring 13 international athletics championships (2009–2019) national medical teams and local organizing committee physicians daily reported all newly incurred injuries using the same study design, injury definition and data collection procedures. In-competition lower limb muscle injuries of athletes participating in disciplines involving running (i.e. sprints, hurdles, jumps, combined events, middle distances, long distances, and marathon) were analysed. ResultsAmong the 12,233 registered athletes, 344 in-competition lower limb muscle injuries were reported (36% of all in-competition injuries). The proportion, incidence rates and injury burden of lower limb muscles injuries differed between disciplines for female and male athletes. The most frequently injured muscle group was hamstring in sprints, hurdles, jumps, combined events and male middle distances runners (43–75%), and posterior lower leg in female middle distances, male long distances, and female marathon runners (44–60%). Hamstring muscles injuries led to the highest burden in all disciplines, except for female middle distance and marathon and male long distance runners. Hamstring muscles injury burden was generally higher in disciplines requiring higher running velocities, and posterior lower leg muscle injuries higher in disciplines requiring lower running velocities. ConclusionsThe present study shows discipline-specific injury location in competition context. Our findings suggest that the running velocity could be one of the factors that play a role in the occurrence/location of muscle injuries.

In-competition injuries and performance success in combined events during major international athletics championships

ObjectivesTo analyse the potential association between in-competition injuries and performance success (determined as “winning a medal”) in combined events during international athletics championships. MethodsNewly incurred injuries were prospectively reported daily by the national medical teams and/or by the local organising committee physicians during 18 international athletics championships. Participation, climatic conditions and performance (medals) were collected retrospectively from the internet. Potential association between injury and performance success (win a medal) were analysed using an adjusted stepwise multiple regression and risk indicators presented as Odd Ratios (OR) (95%CI). Then, the proportions of injured competing athletes were descriptively presented among ranked and dropped-out, and medallist and non-medallist athletes. ResultsA total of 799 athletes competed in combined events during the included 18 championships, of these 134 (16.8%) had at least one injury. An adjusted stepwise multiple regression analysis revealed that in-competition injury was significantly associated with lower odds of winning a medal (OR=0.45 (95% CI 0.20–0.88)). The proportion of injured athletes was higher among the dropped-out than among the ranked athletes, and among non-medallists than medallists. DesignThis was a total population design. ConclusionsDuring international athletics championships, being injured during a combined events competition was associated with lower odds of winning a medal. Injury prevention could contribute to improve performance success.

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

ObjectiveTo analyse differences between athletic disciplines in the frequency and characteristics of injuries during international athletics championships.MethodsStudy design, injury definition and data collection procedures were similar during the 14 international...

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

BackgroundIllnesses impair athletes’ participation and performance. The epidemiology of illness in athletics is limited.ObjectiveTo describe the occurrence and characteristics of illnesses during international athletics championships (indoor and outdoor), and to...

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.

Sex differences in thigh muscles characteristics: a systematic review

Objective: To determine differences between male and female subjects in the thigh muscles characteristics, separated into architectural (pennation, thickness, and/or fascicle length), mechanical (mass, strength, power, and/or stiffness), neuromuscular (activity) and fatigue aspects, in order to better understand the sex-related differences in the risk of muscle injuries. Methods: A systematic literature search on Pubmed was performed with different keywords: skeletal muscle AND sex characteristics AND muscle contraction, with the following limits: humans and adults (19–44 years old). Studies dealing with hamstring and quadriceps muscles, in physiological condition, and comparison between male and female healthy adult subjects were included. Studies dealing with other skeletal muscles, injuries or physiopathology situation were excluded. Thigh muscular architectural, mechanical, neuromuscular and fatigue characteristics have been analysed to determine differences between male and female subjects. Results: Seventeen studies were included, reporting significant sex-related differences for thigh muscles architecture and mechanical characteristics and muscle fatigue, and especially quadriceps, while for thigh muscles neuromuscular characteristics the results were not consensual, and few information was available regarding hamstring muscles. Conclusions: Sex-related differences in thigh muscles characteristics, and especially quadriceps, have been reported for mechanical characteristics and muscle fatigue, while for neuromuscular characteristics sex-related differences were found to be moderate. Although several macroscopic muscle characteristics have been reported to be different between male and female healthy adult subjects, it is difficult to conclude on its exact relationship with higher muscle injury rates reported in male athletes during international athletics championships.

Interrater reliability of the injury reporting of the injury surveillance system used in international athletics championships

ObjectivesThe quality of epidemiological injury data depends on the reliability of reporting to an injury surveillance system. Ascertaining whether all physicians/physiotherapists report the same information for the same injury case is of major interest to determine data validity. The aim of this study was therefore to analyse the data collection reliability through the analysis of the interrater reliability. DesignCross-sectional survey. MethodsDuring the 2016 European Athletics Advanced Athletics Medicine Course in Amsterdam, all national medical teams were asked to complete seven virtual case reports on a standardised injury report form using the same definitions and classifications of injuries as the international athletics championships injury surveillance protocol. The completeness of data and the Fleiss’ kappa coefficients for the inter-rater reliability were calculated for: sex, age, event, circumstance, location, type, assumed cause and estimated time-loss. ResultsForty-one team physicians and physiotherapists of national medical teams participated in the study (response rate 89.1%). Data completeness was 96.9%. The Fleiss’ kappa coefficients were: almost perfect for sex (k=1), injury location (k=0.991), event (k=0.953), circumstance (k=0.942), and age (k=0.870), moderate for type (k=0.507), fair for assumed cause (k=0.394), and poor for estimated time-loss (k=0.155). ConclusionsThe injury surveillance system used during international athletics championships provided reliable data for “sex”, “location”, “event”, “circumstance”, and “age”. More caution should be taken for “assumed cause” and “type”, and even more for “estimated time-loss”. This injury surveillance system displays satisfactory data quality (reliable data and high data completeness), and thus, can be recommended as tool to collect epidemiology information on injuries during international athletics championships.

INJURY RISK IS DIFFERENT BETWEEN MALE AND FEMALE ATHLETES DURING 14 INTERNATIONAL ATHLETICS CHAMPIONSHIPS

BackgroundDuring top-level international Athletics championships, injury risk was about 100 injuries per 1000 athletes for outdoor championships, and about 63 injuries per 1000 athletes for indoors championships. However, it is...

EPIDEMIOLOGICAL INJURY SURVEILLANCE SYSTEM DURING MAJOR ATHLETICS CHAMPIONSHIPS: WHAT IS THE METHODOLOGICAL QUALITY?

BackgroundEpidemiological studies with injury surveillance during major athletics championships are of interest to improve the knowledge on injury incidence and prevalence in this context. However, the quality of the injury...

HAMSTRING MUSCLE INJURY IS THE FIRST INJURY DIAGNOSIS DURING MAJOR ATHLETICS CHAMPIONSHIPS

BackgroundDuring top-level international athletics championships, thigh muscle tear (hamstring muscle tear in particular) was the most commonly reported injury diagnosis. However, there has been no detailed characterisation of hamstring muscle...

Muscle injuries and hamstring muscle injuries during the international athletics championships between 2007 and 2015

The purpose of this study was to analyse the incidence and characteristics of muscle injuries and hamstring muscle injuries occurred during the international athletics championships from 2007 to 2015. National medical teams and local organizing committee physicians have collected every day all newly occurred injury whenever international championship from 2007 to 2015. Only the muscle injuries and hamstring muscle injuries, whatever gravity (cramp, contracture, rupture, avulsion), were analysed. A total of 720 muscle injuries have been reported on the total of 1762 recorded injuries, 40.9% of injuries; 57.5% ( n = 414) have resulted in time loss of sport. The overall incidence of muscle injuries was significantly higher among male athletes than female athletes (49.1 ± 4.4 vs. 28.7 ± 3.7 injuries per 1000 registered athletes, respectively; RR = 1.71; 95% CI: 1.46 to 2.00). A total of 185 hamstring muscle injuries were reported on the total of 1082 recorded injuries (9 championships included). This represented 17.1% of total injuries; 61.1% lead to time loss of sport. Hamstring muscle injuries represented 39.8% of all muscle damage, and 74.6% of all thigh muscle injuries. The overall incidence of hamstring muscle injuries was significantly higher in athletes than female athletes men (22.4 ± 3.4 vs. 11.5 ± 2.6 injuries per 1000 registered athletes, respectively; RR = 1 94; 95% CI: 1.42 to 2.66). The impacts of hamstring muscle injuries were significantly higher in male than female athletes for the sprints, hurdles and jumps. There was no difference between male and female athletes in the frequency of hamstring muscle injuries between outdoor and indoor championships, the type, cause, severity, discipline and age categories. During international athletics championships, muscle injury is the principal type of injury, and among those, the hamstring is the most commonly affected, with a two times higher risk in male than female athletes. Athletes in explosive power events, male athletes and older male athletes, in specific were more at risk of muscle injuries and hamstring injuries. Injury prevention strategies should be sex-specific.

An injury complaints in the months before the championships is a risk factor for injury during athletics championships

During international athletics championships, the incidence and characteristics of new injuries have been well described: about 10% of registered athletes have a new injury. It seemed also important to understand the complaints of athletes in terms of injuries in the period before and at the start of the championships and potential association with potential new injuries for identification of possible risk factors. The objective of this study was to determine the health of athletes before the start of an international athletics championship and to identify risk factors for new injuries. In the 2013 World Athletics Championships in Moscow, all athletes enrolled ( n = 1784) were asked to complete a pre-participation health questionnaire (PHQ) collecting data on the health status during the months preceding the championships. During the period of the Championships, all new injuries were prospectively recorded. The PHQ was completed by 698 (39%) of the athletes; 204 (29.2%) reported suffering such injury complaint during the month before the championships. The most common mode of onset of pain before championships was gradual (43.6%). Forty-nine athletes reported at least one new injury during the championships. Athletes who reported suffering injuries before championships had an increased risk of having a new injury during the championship [odds ratio (OR) = 2.09; 95% confidence interval (95% CI): 1.16–3.77; P = 0.014] and those who reported suffering injuries championships before a gradual fashion appearance were at increased risk of almost four times to re-injury with sport stop in the championship (OR = 3.92; 95% CI: 1.69–9.08; P = 0.001). Approximately one third of athletes participating in an international athletics championship and involved in this study reported an injury complaint during the month before the championships. This represented a risk factor to suffer a new injury during the championship. This study highlights the potential importance of a pre-participation health questionnaire as a screening tool to identify athletes at risk of injury before international athletics championships.

Athletic injury prevention: Epidemiology of injuries during the French Elite championships

The epidemiology of injuries is the first step in the sports injuries prevention. In this context, the IAAF and EA have implemented a prospective injury follow-up during their international athletics championships since 2007, and the FFA initiated since the French championships in 2014. The aim of the study was to determine the incidence and characteristics of injuries during the French Elite championships. During the period of the outdoor and indoor French Elite championships, all newly occurring injuries were recorded by the local medical team. During the outdoor French Elite championships (2014 and 2015), an incidence of 40 to 60 injuries per 1000 registered athletes has been reported. The main diagnoses were: muscle injury hamstring and leg cramps. The injuries occurred mainly in combined events disciplines (20–50%), hurdles (37%), sprint (23–29%) and jumps (19%). It is also interesting to note that 50 athletes (9%) contested the championships and mentioned already present injury (occurred the previous day, weeks or months before the championships and/or recurrent during the championships). At the indoor French Elite championships (2014 and 2015), an incidence of 45–48 injuries per 1000 registered athletes has been reported. The main diagnosis was muscle hamstring injury, followed by knee injuries and ankle sprains. The injuries occurred primarily in jumps (29%), combined events (24%), sprint (17–24%) and hurdles (18%). It is emphasized that this is the first epidemiological data during the French Elite Athletics championships. This information is fundamental to understanding the risk of injury among Elite athletes at the French national level to develop well-adapted prevention measures to their own problems. The injury is multifactorial, its prevention requires the consideration and management of several parameters such as physical fitness, technical mastery of gesture, lifestyle, psychological aspects, a good course of treatment, equipment and sporting rules.