Search

Objective: To analyse associations between feels-like temperatures measured with the universal thermal climate index (UTCI) and injury rates during international athletic championships., Methods: During 10 international outdoor athletic championships from 2007 to 2022, in-competition injuries were collected by medical teams and local organising committees. UTCI was extracted hourly from a global reanalysis of observed atmospheric conditions during each championship. We performed Poisson regressions with incidence rates (number of injuries per 1000 athlete starts) as outcomes and UTCI as a predictive variable adjusted for sex, for all and time-loss injuries, for different injured tissue types (ie, muscle, tendon, ligament, articular, bone and skin) and specific discipline (ie, sprints, hurdles, jumps, throws, middle distance, long distance, marathon and race walking)., Results: A total of 1203 in-competition injuries were reported for 29 579 athlete starts. For all in-competition injuries (ie, all injured tissue types and all disciplines), higher UTCI was associated with lower incidence rates for time-loss injuries (IRR=0.98, 95% CI 0.97 to 0.98) but not for all injuries (IRR=1.00, 95% CI 1.00 to 1.01). Based on injured tissue type with all disciplines included, higher UTCI was associated with lower incidence rates for all (IRR=0.97, 95% CI 0.97 to 0.98) and time-loss (IRR=0.96, 95% CI 0.96 to 0.96) muscle injuries. Based on the specific discipline, higher UTCI was associated with lower incidence rates for all and time-loss muscle injuries for sprints (IRR=0.95, 95% CI 0.95 to 0.96, and IRR=0.94, 95% CI 0.93 to 0.94, respectively), hurdles (IRR=0.97, 95% CI 0.96 to 97, and IRR=0.95, 95% CI 0.94 to 0.96, respectively) and throws (IRR=0.97, 95% CI 0.97 to 0.98)., Conclusions: Higher feels-like temperatures were associated with a decreased risk of time-loss and muscle injuries, particularly in sprints, hurdles and throws. Although the precise mechanism for lower injury rates with higher feels-like temperatures requires further investigation, adapting preparations such as warm-up or clothing to forecasted weather conditions may be of benefit., Competing Interests: Competing interests: None declared. PE and SR are Associate Editors for the British Journal of Sports Medicine. KH is an Editor for the German Journal of Sports Medicine. PE and KH are Associate Editors for the BMJ Open Sports and Exercise Medicine., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

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., Competing Interests: None declared. PE is an associate editor for the British Journal of Sports Medicine and the Scandinavian Journal of Medicine & Science in Sports. KH is an editor for the German Journal of Sports Medicine. PE and KH are associate editors for the BMJ Open Sports and Exercise Medicine. KH is the head team physician of the German Athletics Federation., (Copyright © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Athletics (track and field) athletes are prone to develop bone stress injuries (BSIs) but epidemiological data on BSIs from top-level sports events are scarce., Objective: To describe the incidence and characteristics of BSIs during 24 international athletics championships held from 2007 to 2023., Methods: BSI-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., Results: BSIs 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%)., Conclusions: BSIs 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 Number: Not applicable., (© 2024. The Author(s).)

Background: The aim of this study was to analyze muscle injuries and their related risk factors during the Athletics events of the 2020 Tokyo Olympic Games including the differences in muscle injury rates between heats and finals., Methods: We included and analyzed in this study muscle injuries diagnosed by either magnetic resonance imaging, ultrasound, or physical examinations by at least two physicians, from Athletics athletes participating at the 2020 Tokyo Olympic Games. Data from electronic medical records, including sex, nationality, event, and the round (heat vs. final) during which the muscle injury occurred and the air temperature in the stadium, measured every five minutes during the competition were extracted., Results: Among the 1631 athletes who competed, a total of 36 athletes (20 males and 16 females) were diagnosed with a muscle injury during the 2020 Tokyo Olympic Games. Among them, 24 occurred during heats (1.47 per 100 athletes) and 12 during finals (2.20 per 100 athletes) (P=0.25). Logistic regression analysis revealed that the geographic region of athletes' origin was a factor associated with muscle injury, with the highest muscle injury rate being in athletes from Africa (odds ratio [OR]=4.74, 95% confidence interval [CI]) = 1.75 to 12.82) and North America (OR=3.02, 95%CI=1.27 to 7.20). For male athletes, competing in finals was a risk factor to sustain a muscle injury (OR=2.55, 95%CI=1.01 to 6.45)., Conclusions: During the 2020 Olympic Games, muscle injury rate was higher in finals than in heats, reaching statistical significance in male athletes.

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., Competing Interests: Declaration of interest statement OO is Deputy Editor for the British Journal of Sports Medicine. PE is Associate Editor for the British Journal of Sports Medicine, for the BMJ Open Sports and Exercise Medicine, and for the Scandinavian Journal of Medicine & Science in Sports., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To 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., Design: Prospective total population study., Methods: We analysed in-competition LLMIs and HMIs of female and male athletes during eight championships between 2009 and 2022., Results: LLMI 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., Conclusions: LLMI and HMI risk was higher in finals compared to previous rounds during international athletics championships., Competing Interests: Declaration of interest statement None declared. PE is an Associate Editor for the British Journal of Sports Medicine. KH is an Editor for the German Journal of Sports Medicine. PE and KH are Associate Editors for the BMJ Open Sports and Exercise Medicine., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Warm-up is commonly performed by track-and-field athletes before performing maximal sprinting activities. Whilst some warm-up strategies may enhance athletes' physical and mental readiness, less is known about the current athletes' behaviors and warm-up practices in track and field. Therefore, this study aimed to identify the warm-up practices in a population of athletes performing in sprinting disciplines., Methods: A cross-sectional exploratory study was performed in which track-and-field athletes, performing in athletics at a competitive level in disciplines requiring maximal acceleration and sprinting were recruited. We collected, using an online survey, information about 1) "General and Anthropometric data;" 2) "Athletics training practices" questioning the level of practices and the training frequency; and 3) "Athletics warm-up practices before maximal sprinting" questioning warm-up structure, duration and specific content., Results: A total of 114 athletes replied to the survey. They reported a mean weekly training duration of 10.5 (±4.0) hours and a pre-maximal sprint warm-up duration of 40.5 (±13.5) minutes. During warm-up, they were engaged in five principal activities: predominantly moderate jogging (95% participation, 8±3.3 minutes), succeeded by dynamic and/or ballistic stretching (78% participation, 9±4.3 minutes), followed by athletic drills (96% participation, 15±5.4 minutes), culminating in accelerations (100% participation) along with high-speed running (77% participation). Warm-up duration and composition differed across athletes' levels of practice and disciplines., Conclusions: Most of the participants' warm-up practices were typically structured in a three-phase manner, comprising jogging, stretching, and specific training (athletic drills and accelerations). Most athletes followed scientific-based warm-up recommendations there are some areas where the evidence is limited, and more research is needed to determine the optimal warm-up routine for athletes.

Objectives: To explore perceptions and beliefs of elite athletics (track and field) athletes, coaches, and health professionals, towards the use of injury prediction as an injury risk reduction strategy., Design: Cross-sectional study., Method: During the 2022 European Athletics Championships in Munich, registered athletes, coaches, and health professionals were asked to complete an online questionnaire on their perceptions and beliefs of injury prediction use as an injury risk reduction strategy. The perceived level of interest, intent to use, help, potential stress (psychological impact) and dissemination were assessed by a score from 0 to 100., Results: We collected 54 responses from 17 countries. Elite athletics stakeholders expressed a perceived level of interest, intent to use, and help of injury prediction of (mean ± SD) 85 ± 16, 84 ± 16, and 85 ± 15, respectively. The perceived level of potential stress was 41 ± 33 (range from 0 to 100), with an important inter-individual variability in each elite athletics stakeholder's category., Conclusions: This was the first study investigating the perceptions and beliefs of elite athletics stakeholders regarding the use of injury prediction as an injury risk reduction strategy. Regardless of the stakeholders, there was a high perceived level of interest, intent to use and help reported in this potential strategy., Competing Interests: Declaration of competing interest No conflict of interest. PE is Associate Editor for the BJSM and the BMJ Open Sports and Exercise Medicine. KH is Editor for the German Journal of Sports Medicine, and Associate Editor for the BMJ Open Sports and Exercise Medicine., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To explore how sports injury epidemiological outcomes (i.e., prevalence, average prevalence, incidence, burden, and time to first injury) vary depending on the response rates to a weekly online self-reported questionnaire for athletes., Methods: Weekly information on athletics injuries and exposure from 391 athletics (track and field) athletes was prospectively collected over 39 weeks (control group of the PREVATHLE randomized controlled trial) using an online self-reported questionnaire. The data were used to calculate sports injury epidemiological outcomes (i.e., prevalence, average prevalence, incidence, burden, and time to first injury) for sub-groups with different minimum individual athletes' response rates (i.e., from at least 100%, at least 97%, at least 95%, … to at least 0% response rate). We then calculated the relative variation between each sub-group and the sub-group with a 100% response rate as a reference. A substantial variation was considered when the relative variation was greater than one SD or 95% CI of the respective epidemiological outcome calculated in the sub-group with a 100% response rate., Results: Of 15 249 expected weekly questionnaires, 7209 were completed and returned, resulting in an overall response rate of 47.3%. The individual athletes' response rates ranged from 0% (n = 51) to 100% (n = 100). The prevalence, average weekly prevalence, and time to first injury only varied substantially for the sub-groups below a 5%, 10% and 18% minimum individual response rate, respectively. The incidence and injury burden showed substantial variations for all sub-groups with a response rate below 100%., Conclusions: Epidemiological outcomes varied depending on the minimum individual athletes' response rate, with injury prevalence, average weekly prevalence, and time to first injury varying less than injury incidence and injury burden. This highlights the need to take into account the individual response rate when calculating epidemiological outcomes, and determining the optimal study-specific cut-offs of the minimum individual response rate needed., (© 2024 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

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., Competing Interests: Competing interests: None declared. PE is Associate Editor for the British Journal of Sports Medicine. KH is Editor for the German Journal of Sports Medicine. PE and KH are Associate Editors for the BMJ Open Sports and Exercise Medicine., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To compare the perception towards injury risk reduction approach between athletes who have already experienced an injury and those who have not., Methods: We conducted a cross-sectional study using a one-time online survey asking athletics athletes licensed at the French Federation of Athletics (http://www.athle.fr) about their perceptions regarding injuries and injury risk reduction behaviours. We statistically compared athletes who already experienced an injury and those who did not., Results: A total of 7870 athletes were included. 90% of athletes declared having experienced at least one injury. They (1) were proportionally more men than women, (2) had significantly more years of experience in athletics, (3) had a significant difference in disciplines (more hurdles, jumps and combined events and fewer sprint athletes), (4) had a significant difference in competition levels (more national and less departmental levels) and (5) reported significantly higher values or agreements in favour of injury risk reduction approach, compared with uninjured athletes. There were significantly more athletes declaring following injury risk reduction programmes among athletes who experienced at least one injury than those who did not., Conclusions: Athletes who experienced at least one injury during their lifetime were more prone to adhere to injury risk reduction strategies than athletes who have never experienced an injury. Their entourage (coaches and health professionals) should use this fertile ground to implement injury risk reduction strategies. In addition, their experience should be disseminated to uninjured athletes to help them adhere to injury risk reduction without injury experience., Competing Interests: Competing interests: EV and PE are associate editors of the BJSM. EV is the editor-in-chief of BMJ Open Sports and Exercise Medicine. PE is the associate editor of the BMJ Open Sports and Exercise Medicine., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To investigate if several potential risk factors were associated with time to injury complaints leading to participation restriction in Athletics (ICPR)., Methods: We performed a secondary analysis of data collected during 39 weeks of the 2017-2018 Athletics season in a cluster-randomised controlled trial ('PREVATHLE'). Univariate and multivariable analyses using Cox regression models were performed to analyse the association between the time to first ICPR and potential risk factors collected (1) at baseline: sex, age, height, body mass, discipline, the usual duration of Athletics training and non-specific sports training, ICPR in the preceding season (yes/no), ICPR at baseline (yes/no); (2) weekly during the season: duration and intensity of Athletics training and competition, and non-specific sports training, fitness subjective state, sleep duration and illness (yes/no); and (3) combined., Results: Data from 320 athletes were included; 138 (43.1%) athletes reported at least one ICPR during the study follow-up. The combined multivariable analyses revealed that the risk of ICPR at any given time was significantly higher in athletes with a pre-existing ICPR (hazard rate ratio, HRR 1.90, 95% CI 1.15 to 3.15; p=0.012) and lower in athletes with a higher fitness subjective state (HRR 0.63, 95% CI 0.55 to 0.73; p<0.001) and who had had at least one illness during the season (HRR 0.42, 95% CI 0.29 to 0.62; p<0.001)., Conclusions: Our results provide new insights into injury risk factors in Athletics that could help with potential injury risk reduction strategies. These could be to explore the pre-existing injury presence at the season's beginning and to monitor the fitness subjective state and illnesses occurrence during the season., Trial Registration: ClinicalTrials.gov Identifier: NCT03307434., Competing Interests: Competing interests: None declared. PE and KH are Associate Editors for the BMJ Open Sports and Exercise Medicine. PE is an Associate Editors for the Brit J Sports Med., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In competitive events, athletes' performances can be affected by their food choices. In addition, nutrition labels are essential to sustain informed decisions and to allow athletes to comply with their dietary planning. Knowing what influences athletes' food choices will help to improve the food provision in future championships. Therefore, we aimed to study the factors influencing athletes' choices, their knowledge on nutrition labels, and their opinion on the food service at two European Athletics Championships. Questionnaires were completed by 339 athletes (57% males, 19.6 ± 1.3 years) competing at the 2019 European Athletics Under 20 and Under 23 Championships. Factors that may impact performance (time of the day and nutrient composition) were rated as important and very important by a higher percentage of athletes (78% and 74%, respectively) compared to the presence of teammates (32%) and the coach (23%). Among the athletes who knew what nutrition labels are (49%), 72% would like to have additional nutritional information in future championships. Furthermore, our study revealed that for most athletes (72%), food temperature is important or very important for food choices. Overall, food provision had positive results, but further research is needed to help organizers better tailor food provision to athletes' needs.

Context: Hamstring muscle injury location using magnetic resonance imaging (MRI) is not so well described in the literature., Objective: To describe the location of hamstring injuries using MRI., Data Sources: PubMed, Web of Science, Scopus, SPORTDiscus, Cochrane Library., Study Selection: The full text of studies, in English, had to be available. Case reports and reviews were excluded. Included studies must report the location of hamstring injuries using MRI within 8 days of the acute injury., Study Design: Systematic review., Level of Evidence: Level 4., Data Extraction: A first screening was conducted based on title and abstract of the articles. In the second screening, the full text of the remaining articles was evaluated for the fulfillment of the inclusion criteria., Results: From the 2788 references initially found in 5 databases, we included 34 studies, reporting a total of 2761 acute hamstring injuries. The most frequent muscle head involved was the long head of the biceps femoris (BFLH) (70%), followed by the semitendinosus (ST) (15%), generally associated with BFLH. The most frequent tissue affected was the myotendinous junction (MTJ) accounting for half the cases (52%). Among all lesions, the distribution between proximal, central, and distal lesions looked homogenous, with 34.0%, 33.4% and 32.6%, respectively. The stretching mechanism, while only reported in 2 articles, represented 3% of all reported mechanisms, appears responsible for a specific lesion involving the proximal tendon of the semimembranosus (SM), and leading to a longer time out from sport., Conclusion: BFLH was the most often affected hamstring injuries and MTJ was the most affected tissue. In addition, the distal, central, and proximal locations were homogeneously distributed. We also noted that MRI descriptions of hamstring injuries are often poor and did not take full advantage of the MRI strengths., Systematic Review Registration: Before study initiation, the study was registered in the PROSPERO International prospective register of systematic reviews (registration number CRD42018107580).

Objectives: 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., Design: Prospective cohort study., Methods: 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)., Results: 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., Conclusions: 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., Competing Interests: Declaration of Interest Statement None declared. PE is Associate Editor for the British Journal of Sports Medicine. KH is Editor for the German Journal of Sports Medicine. PE and KH are Associate Editors for the BMJ Open Sports and Exercise Medicine. TT is Deputy Editor for the Journal of Science and Medicine in Sport., (Copyright © 2022 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

This study aimed to explore how stakeholders in athletics perceive the relevance of injury prevention, determine their communication preferences, and describe their expectations regarding injury prevention. We conducted a cross-sectional study using an exploratory online survey with high-level athletes (i. e. listed by the French ministry of sports), non-high-level athletes (i. e. all competitive level except high-level athletes), coaches, and health professionals licensed with the French Federation of Athletics. The survey was composed of three parts regarding stakeholder's characteristics (4 questions), perceived relevance (2 questions), communication preferences and expectations (3 questions) towards injury prevention. There were 2,864 responders to the survey. Almost all responders found that injury prevention is relevant (97.7% [95% CI 97.0% to 98.2%]), without any significant differences in the distribution between stakeholders' age, experience and sex ( p >0.05). About three-quarters of the stakeholders preferred to find injury prevention information on a website (77.4%) without significant differences between stakeholders' categories ( p >0.05); other media to find injury prevention information was chosen by less than 50% of responders. Expectations about injury prevention were mainly explanations, advice and tips about injury knowledge, management and prevention, based on expert opinion and/or scientific research. In conclusion, these results confirm that injury prevention is a challenge shared by numerous stakeholders in athletics, within France, and provide some orientation on how and what information to disseminate to these stakeholders., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: We aimed to describe hamstring muscle injury (HMI) history and hamstring specific training (HST) in elite athletes. A secondary aim was to analyse the potential factors associated with in-championships HMI., Methods: We conducted a prospective cohort study to collect data before and during the 2018 European Athletics Championships. Injury and illness complaints during the month before the championship, HMI history during the entire career and the 2017-18 season, HST (strengthening, stretching, core stability, sprinting), and in-championship HMI were recorded. We calculated proportions of athletes with HMI history, we compared HST according to sex and disciplines with Chi2 tests or ANOVA, and analysed factors associated with in-championship HMI using simple model logistic regression., Results: Among the 357 included athletes, 48% reported at least one HMI during their career and 24% during the 2017-18 season. Of this latter group, 30.6% reported reduced or no participation in athletics' training or competition at the start of the championship due to the hamstring injury. For HST, higher volumes of hamstring stretching and sprinting were reported for disciplines requiring higher running velocities (i.e., sprints, hurdles, jumps, combined events and middle distances). Five in-championship HMIs were recorded. The simple model analysis showed a lower risk of sustaining an in-championships HMI for athletes who performed more core (lumbo-pelvic) stability training (OR = 0.49 (95% CI: 0.25 to 0.89), p = 0.021)., Conclusions: Our present study reports that HMI is a characteristic of the athletics athletes' career, especially in disciplines involving sprinting. In these disciplines, athletes were performing higher volumes of hamstring stretching and sprinting than in other disciplines. Further studies should be conducted to better understand if and how HST are protective approaches for HMI in order to improve HMI risk reduction strategies.

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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

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., (© 2021 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

Objective: To analyse the rates of lower limb muscle injuries in athletics disciplines requiring different running velocities during international athletics championships., Design: Prospective total population study., Methods: During 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., Results: Among 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., Conclusions: The 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., (Copyright © 2021 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Low energy availability (LEA) causes impaired physiological functioning. Cross-country running is a weight-sensitive sport, making athletes more prone to LEA. We aimed to estimate the prevalence of elite European cross-country athletes at risk of LEA using the LEA in Females Questionnaire (LEAF-Q) and to analyze demographic and physical characteristics that are associated with LEA. Athletes ≥ 18 years competing at the 26th European Cross-Country Championships ( n = 602) were invited to complete a questionnaire (sociodemographic, training, anthropometric characteristics, and LEAF-Q). A total of 207 valid surveys were collected (83 females, 22.1 (4.0) years, and 124 males, 22.3 (4.1) years), and 16 surveys were excluded. A high prevalence of athletes at risk of LEA (64.3%) was observed, being higher in females than in males (79.5 and 54.0% respectively, p < 0.001). More than half of athletes (54.1%, n = 112) reported bowel movements once a week or more rarely, while 33 female athletes (41.3%) did not report normal menstruation. Overall, cross-country athletes are at high risk of LEA. Moreover, a high prevalence of gastrointestinal and menstrual impairments was reported. Hence, athletes should be followed by multidisciplinary teams to inform, prevent, and treat LEA and its effects.

Objectives: To analyse the potential association between in-competition injuries and performance success (determined as "winning a medal") in combined events during international athletics championships., Methods: Newly 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., Results: A 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., Design: This was a total population design., Conclusions: During 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., (Copyright © 2020 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

We aimed to determine whether an Athletics Injury Prevention Programme (AIPP), targeting the most common athletics injuries, can reduce the occurrence of injury complaints that lead to restrictions in athletics participation (participation restriction injury complaints) in the short (12 weeks) and long (40 weeks) terms. For our 40-week prospective cohort study (level of evidence 2), we invited inter-regional and national-level athletes to regularly perform the AIPP, which included 8 exercises addressing core stability, hamstring, leg and pelvic muscles strengthening and stretching, and balance exercises. A Cox regression was used to analyse the influence of AIPP on the occurrence of participation restriction injury complaint, adjusted to sex, age, height, body mass, discipline, and history of injury complaints during the preceding season, individual response rate, mean weekly training time, mean weekly number of competition, presented by hazard ratio (HR) with 95% confidence interval (95% CI). At 12 weeks (n = 62 athletes), the AIPP was significantly associated with a lower risk of participation restriction injury complaint HR = 0.36 (95%CI: 0.15 to 0.86), p = 0.02 and HR = 0.29 (95%CI: 0.12 to 0.73), p = 0.009, with cumulative weeks and cumulative training time as time scale, respectively, while at 40 weeks (n = 53 athletes) there was no significant association. An 8-exercise injury prevention programme can effectively help to reduce occurrence of injury complaints that would restrict an athlete's participation in athletics in the short term.

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., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Competing Interests: Competing interests: No, there are no competing interests for any author.

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)., (Copyright © 2019 Carragher, Rankin and Edouard.)

Background: Pole vault is a highly demanding sport where many physical and technical requirements are engaged in performance process. Considering level of energy transferred from athlete's horizontal speed to the pole during pole bending, we can imagine that associated musculoskeletal tensions, in addition to trials accumulation, can increase the risk of (specific) injuries. Given the multiple morphological, physical and technical characteristics of vaulters and ways of pole vaulting, we can hypothesis that some patterns of pole vaults can lead to higher injury risk than others. Aim: To analyze the potential association between the biomechanical patterns of pole vault and the history of injuries. Method: We conducted a study over national-level pole vaulters including the prospective collection of pole vault biomechanical data during competition at the national elite indoor championship and youth national indoor championship (U17 and U20), associated with the retrospective collection of their injuries during the 12 preceding months through an online questionnaire. Results: Among the 88 pole vaulters participating in these championships, 62 (70.5%) accepted to participated in this study, and their pole vault biomechanical and injury data were collected. 77.4% reported having presented at least one injury during the 12 preceding months. One biomechanical parameter related to the take-off phase (lower H2, i.e., height of the grip (superior) hand from the ground when the athlete subsequently took off from the ground) and some biomechanical parameters related to the terminal phase of the run-up phase (higher Spd [i.e., speed between 10 and 5 meters to the box), SL adj (last stride adjustment), SL var (stride length variation), t c (contact time)] were significantly associated with higher proportions of all injuries. Conclusion: Biomechanical pole vault patterns during the competition day were associated with a higher proportion of history of all injuries. Although the injury data collection was retrospective leading to recall bias risk, and do not allow determining cause-consequence relationships regarding biomechanical patterns and injury occurrence, this present study is the first to analyze potential association between the biomechanical pole vault patterns and injury occurrence, which is of great help to provide hypotheses/ideas to design future studies and to move forward into prevention measures., (Copyright © 2019 Edouard, Sanchez, Bourrilhon, Homo, Frère and Cassirame.)

Background: Illnesses impair athletes' participation and performance. The epidemiology of illness in athletics is limited., Objective: To describe the occurrence and characteristics of illnesses during international athletics championships (indoor and outdoor), and to analyse differences with regards to athletes' sex and participation in explosive and endurance disciplines., Methods: During 11 international championships held between 2009 and 2017, physicians from both national medical teams and the local organising committees reported daily on all athlete illnesses using a standardised report form. Illness frequencies, incidence proportions (IPs) and rates (IRs), and relative risks (RR) with 95% CIs were calculated., Results: During the 59 days of the 11 athletics championships, 546 illnesses were recorded in the 12 594 registered athletes equivalent to IP of 43.4 illnesses per 1000 registered athletes (95% CI 39.8 to 46.9) or IR of 1.2 per 1000 registered athlete days (95% CI 1.1 to 1.2). The most frequently reported illnesses were upper respiratory tract infections (18.7%), exercise-induced fatigue/hypotension/collapse (15.4%) and gastroenteritis (13.2%). No myocardial infarction was recorded. A total of 28.8% of illnesses were expected to lead to time loss from sport. The illness IP was similar in male and female athletes, with few differences in illness characteristics. During outdoor championships, the illness IP was higher in endurance than explosive disciplines (RR=1.87; 95% CI 1.58 to 2.23), with a considerably higher IP of exercise-induced illness in endurance disciplines, but a similar upper respiratory tract infection IP in both discipline groups., Conclusions: Illness prevention strategies during international athletics championships should be focused on the most frequent diagnoses in each discipline group., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

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., (Copyright © 2019 Edouard, Richardson, Murray, Duncan, Glover, Kiss, Depiesse and Branco.)

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., (Copyright © 2019 Edouard, Richardson, Navarro, Gremeaux, Branco and Junge.)

Objectives: The 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., Design: Cross-sectional survey., Methods: During 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., Results: Forty-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)., Conclusions: The 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., (Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objectives: Incidence and prevalence data obtained from injury surveillance studies could be biased by the response rate as well as by the completeness and quality of the reports. It therefore appears crucial to analyse the quality of the injury surveillance system itself and thereby validate the quality of the data. This study aimed to analyse the quality of and compliance with the injury surveillance system implemented during international athletics championships., Design: Prospective, epidemiological study., Methods: The national medical teams and the local organising committee physicians daily reported all injuries on a standardised injury report form during 14 international athletics championships from 2007 to 2015. The quality of the injury surveillance system was analysed following the guidelines laid down by the Centre for Disease Control and Prevention., Results: On average 41.7±17.4% (mean±standard deviation) of all registered countries participated in the injury surveillance project, accounting for a coverage of athletes of 79.5±10.2% of all registered athletes. Their medical staff returned 89.2±8.4% of the expected injury report forms (information is missing for one championship). The completeness of injury data provided by medical teams and local organising committee physicians averaged 95.8±6.5%. National medical teams reported 60.6±16.6% of all injuries, and local organising committee physicians 28.7±15.0% whereas 10.6±6.5% of injuries were reported by both., Conclusions: The injury surveillance system used during international athletics championships provided good national medical team participation, coverage of athletes, response rate, and completeness of reports. These parameters should be systematically reported for injury surveillance studies to show the quality of the study., (Copyright © 2016 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Background: During top-level international athletics championships, muscle injuries are frequent., Objective: To analyse the incidence and characteristics of muscle injuries and hamstring muscle injuries (hamstring injuries) occurring during top-level international athletics championships., Methods: During 16 international championships held between 2007 and 2015, national medical team and local organising committee physicians reported daily all injuries on a standardised injury report form. Only muscle injuries (muscle tears and muscle cramps) and hamstring injuries have been analysed., Results: 40.9% of all recorded injuries (n=720) were muscle injuries, with 57.5% of them resulting in time loss. The overall incidence of muscle injuries was higher in male athletes than female athletes (51.9±6.0 vs 30.3±5.0 injuries per 1000 registered athletes, respectively; RR=1.71; 95% CI 1.45 to 2.01). Muscle injuries mainly affected the thigh (52.9%) and lower leg (20.1%), and were mostly caused by overuse with sudden onset (38.2%) and non-contact trauma (24.6%). Muscle injury risk varied according to the event groups. Hamstring injuries represented 17.1% of all injuries, with a higher risk in male compared to female athletes (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)., Conclusions: 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., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objectives: Consistency in routines for reporting injury has been a focus of development efforts in sports epidemiology for a long time. To gain an improved understanding of current reporting practices, we applied the Injury Definitions Concept Framework (IDCF) in a review of injury reporting in a subset of the field., Design: Meta-narrative review., Methods: An analysis of injury definitions reported in consensus statements for different sports and studies of injury epidemiology in athletics (track and field) published in PubMed between 1980 and 2013 was performed. Separate narratives for each of the three reporting contexts in the IDCF were constructed from the data., Results: Six consensus statements and 14 studies reporting on athletics injury epidemiology fulfilled the selection criteria. The narratives on sports performance, clinical examination, and athlete self-report contexts were evenly represented in the eligible studies. The sports performance and athlete self-report narratives covered both professional and community athletes as well as training and competition settings. In the clinical examination narrative, data collection by health service professionals was linked to studies of professional athletes at international championships., Conclusions: From an application of the IDCF in a review of injury reporting in sports epidemiology we observed a parallel usage of reporting contexts in this field of research. The co-existence of reporting methodologies does not necessarily reflect a problematic situation, but only provided that firm precautions are taken when comparing studies performed in the different contexts., (Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Objectives: To explore the performance of retrospective health data collected from athletes before Athletics championships for the analysis of risk factors for in-competition injury and illness (I&I)., Methods: For the 2013 European Athletics Indoor Championships, a self-report questionnaire (PHQ) was developed to record the health status of 127 athletes during the 4 weeks prior to the championship. Physician-based surveillance of in-competition I&I among all 577 athletes registered to compete was pursued during the championships., Results: 74 athletes (58.3%) from the sample submitted a complete PHQ. 21 (28%) of these athletes sustained at least one injury and/or illness during the championships. Training more than 12 h/week predisposed for sustaining an in-competition injury, and a recent health problem for in-competition illness. Among the 577 registered athletes, 60 injuries (104/1000 registered athletes) were reported. 31% of injuries were caused by the track, and 29% by overuse. 29 illnesses were reported (50/1000 registered athletes); upper respiratory tract infection and gastro-enteritis/diarrhoea were the most reported diagnoses., Conclusions: Pre-participation screening using athletes' self-report PHQ showed promising results with regard to identification of individuals at risk. Indoor injury types could be attributed to extrinsic factors, such as small track size, track inclination, and race tactics., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: Injury incidence has been reported for international athletics championships from 2007 to 2012. However, it is unclear whether male or female athletes differ in risk and/or characteristics of injuries., Objective: To compare the incidences and characteristics of injuries that occurred during international athletics championships between female and male athletes., Methods: The national medical team and the local organising committee physicians reported all injuries daily on a standardised injury report form during 14 international championships from 2007 to 2014. Relative risks (RR) of injury, 95% CI and magnitude thresholds were calculated., Results: The rate of injuries per 1000 registered athletes was significantly higher in male (110.3±6.8) than in female (88.5±6.7) athletes (RR=1.25; 95% CI 1.13 to 1.37, small effect size). Male athletes incurred significantly more injuries in the thigh (RR=1.64; 95% CI 1.32 to 2.05, small), lower leg (RR=1.36; 95% CI 1.05 to 1.75, small) and hip/groin injuries (RR=2.26; 95% CI 1.31 to 3.88, moderate), more muscle strains (RR=1.64; 95% CI 1.33 to 2.04, small), cramps (RR=1.81; 95% CI 1.35 to 2.43, small), and especially more thigh strains (RR=1.66; 95% CI 1.25 to 2.19, small), but fewer stress fractures (RR=0.32; 95% CI 0.12 to 0.81, moderate) than female athletes. A higher injury risk of male than of female athletes was observed in sprints (RR=1.32; 95% CI 1.06 to 1.66, small), middle distance runs (RR=1.48; 95% CI 1.06 to 2.06, small), race walks (RR=2.55; 95% CI 1.27 to 5.10, moderate) and jumps (RR=2.13; 95% CI 1.53 to 2.97, moderate). No sex difference was found for cause and severity of injury., Conclusions: Injury risk during international athletics championships differed between female and male athletes for location, type and event groups. Injury prevention strategies should be sex-specific, regarding the differences in injury location and type., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Objective: To further analyze newly incurred injuries and illnesses (I&Is) during Athletics International Championships to discuss risk factors., Design: Prospective recording of newly occurred injuries and illnesses., Setting: The 2012 European Athletics (EA) Championships in Helsinki, Finland., Participants: National team and local organizing committee physicians and physiotherapists and 1342 registered athletes., Main Outcome Measures: Incidence and characteristics of new injuries and illnesses., Results: Ninety-three percent of athletes were covered by medical teams, with a response rate of 91%. One hundred thirty-three injuries were reported (incidence of 98.4 injuries per 1000 registered athletes). Sixty-two injuries (47%) resulted in time loss from sport. The most common diagnosis was hamstring strain (11.4% of injuries and 21% of time-loss injuries). Injury risk was higher in males and increased with age. The highest incidences of injuries were found in combined events and middle- and long-distance events. Twenty-seven illnesses were reported (4.0 illnesses per 1000 athlete days). The most common diagnoses were upper respiratory tract infection (33.3%) and gastroenteritis/diarrhea (25.9%)., Conclusions: During outdoor EA Championships, injury and illness incidences were slightly lower and injury characteristics were comparable with those during outdoor World Athletics Championships. During elite athletics Championships, gender (male), age (older than 30 years), finals, and some events (combined events and middle- and long-distance races) seem to be injury risk factors. Illness risk factors remain unclear. As in previous recommendations, preventive interventions should focus on overuse injuries, hamstring strains, and adequate rehabilitation of previous injuries, decreasing risk of infectious diseases transmission, appropriate event scheduling, sports clothes, and heat acclimatization.