Injury epidemiology in olympic triathletes: a 5-year prospective study

Melissa Crunkhorn, Liam Toohey, Naroa Etxebarria, Michael K. Drew, Kate Watson, Paula Charlton

Research output: Contribution to conference (non-published works)Abstractpeer-review


Background There is limited evidence describing the injury profile of short-course triathletes, and detail regarding differences between male and females. Comprehensive and reliable longitudinal epidemiological information is required to inform athlete healthcare and preventative practices.

Objectives To characterise the prevalence, incidence rate (IR) and burden of injuries in elite short-course triathletes over a five-year training and competition period.

Design Descriptive epidemiological study.

Setting Olympic elite national triathlon squad.

Participants Fifty-eight triathletes were prospectively monitored over five consecutive seasons (2018–2022).

Interventions/Assessment of Risk Factors Athlete sex was the independent variable analysed in this study.

Main Outcome Measurements Injuries requiring medical attention were prospectively recorded and further sub-categorised according to time-loss. The IR and burden (injury IR x mean injury severity) were calculated per 365 athlete-days, with sex differences compared using incidence rate ratios (IRR) from negative binomial regression models.

Results Three hundred and nine injuries were reported in 48 (82.7%) athletes, with 68.3% resulting in time-loss. The injury IR was 1.80 injuries per 365 athlete-days (95%CI=1.61–2.01), with no significant difference observed between sexes (IRR=0.85, 95%CI=0.68–1.06, p=0.147). Overuse injuries (n=146, 47.2%) were the most frequently reported, with 105 (49.8%) resulting in time-loss. Most injuries (71.8%) occurred during training. The most frequently injured body sites were the ankle (16.5%), foot (12.3%), and lower leg (12.3%). Bone stress injuries (BSI) were the most burdensome injury type with 35.5 days of time-loss per 365 days (95%CI=25.37–49.68). Twenty-two athletes (45.8%), reported at least one BSI (range 0–3), with 2-fold greater rate of BSI in females compared to males (IRR=2.19, 95%CI=1.07–4.50, p=0.032).

Conclusion Two thirds of injuries reported resulted in time-loss. Foot, ankle and other lower leg injuries had the highest incidence, with BSI having the highest burden. The considerably higher rate of BSI observed in females warrants consideration for future prevention strategies targeted to female triathletes.
Original languageEnglish
Number of pages1
Publication statusPublished - 1 Mar 2024


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