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Factors influencing injury risk in adolescent elite athletes

Summary of an observational study looking at risk factors influencing injury risk in adolescent elite athletes.

Who

496 adolescent athletes (females: 226, males: 270) aged 15-19 years from 16 sports including American football, skiing, water skiing, canoe, rowing, wrestling, bowling, triathlon, golf, cycling, orienteering, handball, and athletics (Sweden).

Design

Prospective observational study: e-mail survey sent weekly or bi-weekly for 52 weeks

Outcome measures/tests

  • injury: Swedish version of the Oslo Sports Trauma Reseach Centre (OSTRC) Overuse Injury Questionnaire + additional questions
  • training days, competition days, average training intensity
  • stress, nutrition, sleep volume
  • competence-based self-esteem

Main results

  • 215 athletes (out of 496) reported a new injury over the 52 weeks.
  • Foot was the most injured region (20%). Injuries from the foot to the hip accounted for 65% of injuries.
  • Five risk factors for first injury were identified (univariate):
    • competence-based self-esteem
    • increased training intensity
    • increased training load
    • decreased sleep volume
    • Risk Index (if 3 risk factors were present compared to no risk factors)
  • Athlete with increased training intensity, increased training load and decreased sleep had 2.25-2.37 times higher risk of sustaining an injury than the athlete with no changes in these variables (2.37 - univariate analysis; 2.25 - multiple cox regression analysis).
  • Athletes with higher competence-based self-esteem were at higher risk of sustaining an injury (for every point increased the hazard increased by 1.02).
  • unhealthier diet (HR 1.32) and sleeping for less than 8 hours (HR 1.31) increased hazard of sustaining an injury.
  • There were NO differences between female and male adolescent athletes for any variables.

Take home message

For a clinician
Increasing training load and training intensity with decreasing sleep at the same time, doubled their risk of sustaining an injury. The more confident the adolescent athlete was with their competence, the more likely they were to get injured.
For a parent
Increasing training load and training intensity with decreasing sleep at the same time, doubled their risk of sustaining an injury. The more confident the adolescent athlete was with their competence, the more likely they were to get injured.
For an athlete
Increasing training load and training intensity with decreasing sleep at the same time, doubled their risk of sustaining an injury. The more confident the adolescent athlete was with their competence, the more likely they were to get injured.

Original article

von Rosen P, Frohm A, Kottorp A, Fridén C, Heijne A. Multiple factors explain injury risk in adolescent elite athletes: Applying a biopsychosocial perspective. Scandinavian Journal of Medicine & Science in Sports. 2017 Dec;27(12):2059-69.

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