Research Reviews

An analysis of injuries & illnesses at the 2011 IAAF World Championships

7/30/2013

Study Title: Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance
Authors: J-M Alonso, P Edouard, G Fischetto et al.
Journal: British Journal of Sports Medicine
Date: 2012
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Summary:

There's no question that any attempt at implementing injury prevention strategies in sport must first be preceded by the identification and exploration of such injuries. This epidemiological study was a summary of the results from the injury and illness surveillance program implemented at the 2011 IAAF World Championships in Daegu. Modified and improved from the previous two programs in 2007 and 2009, the aim of this program was to identify the incidence and characteristics of injuries and illnesses sustained at the event with the intention of gaining insight into future prevention strategies.
In addition to injury report forms, the study's authors also joined forces with volunteers from the local organizing staff to conduct daily interviews of participating team physicians to ensure data quality. Countries with more than 15 registered athletes participated in this study, totalling 1512 (81.7% of athletes). The number of injuries reported by national teams was significantly higher than that reported by organizing committee physicians, and this was no surprise as athletes injured are often looked after by their own staff, especially if they are relatively minor. 249 injuries in total were reported with the lower extremity affected in 74.3% of cases. Again, no surprise. Interestingly, the hamstring was the most frequent body part injured (23% of all injuries), followed by strains and muscle cramps (I do wonder though, if any of these cramps were from the hamstring). Most of the injuries were "sustained" during competition and half of which during the finals. Although it was concluded that injury risk was therefore significantly higher in the finals than qualifying rounds, I think this can be somewhat misleading as I don't think "the finals" itself as an independent variable are concrete predictors. To me, "the finals" are just the straw that broke the camel's back. Males and athletes greater than 30 years of age sustained more injuries than their counterparts, and combined-events and distance athletes had higher rates as well.
An incidence of 39.5 illnesses per 1000 athlete participations (126 illnesses in total) were reported with greater than a third of illnesses affected by the upper respiratory tract. Infection was also commonly reported. As stated in the discussion, I believe the combined stress and intensity of competition played a significant role in this. Only two episodes of heat exhaustion and no episodes of cardiovascular-system collapses were reported.
As mentioned above, the aim of this study was to use surveillance in order to identify, and subsequently prevent, injuries. Overuse injuries dominated the classification of injury, as did combined-events and distance events. Although the volume of competition that athletes in these events participate in is greater - from an epidemiological viewpoint - I personally would like to see more "high definition" in injury-density such as injuries per minute of competition. I know this would be quite a challenge to implement, but my concern is that those not familiar with track and field may fail to recognize the importance of surveillance and prevention in the jumps and sprints.
It was interesting to see hamstring strains being most prevalent not because this was a surprise to me, but more so because there is still plenty of room for investigative research. We still have more theories than answers in this subject matter and frankly, I believe research in this area should be increased to at least to being on par with the common jogging/treadmill-based research that's prevalent today. Note: if anyone reading this is interested in this subject matter, I'd be happy to chat with you.
Finally, it was stated that more than 75% of hamstring strains were overuse injuries. It was also stated that "this rate is unexpectedly high for this pathology which is most often reported as acute". In my opinion, no hamstring injury is acute. Sure, the diagnosis of a "strain" may be acute, but if the concept and thought process of muscle injury terminology is combined with the concept and thought processes of performance engineering and a guided framework, then I think we would be better positioned to improve injury prevention.
Ultimately, preventing injury is next to impossible. And I both like and appreciate the implemented surveillance at these World Championships. Now it's up to us on the front lines and those doing research to do our job to help try and get the rates down even further.

Alonso, J-M et al. Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance. British Journal of Sports Medicine, 2012; 46: 505-514
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