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The Journal of Sports Medicine and Physical Fitness 2014 February;54(1):78-87

language: English

Training-related risk factors in the etiology of overuse injuries in endurance sports

Ristolainen L. 1, Kettunen Ja. 2, Waller B. 3, Heinonen A. 3, Kujala Um. 3

1 ORTON Orthopaedic Hospital ORTON Foundation, Helsinki, Finland;
2 Arcada, University of Applied Sciences Helsinki, Finland;
3 Department of Health Sciences University of Jyväskylä, Jyväskylä, Finland


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Aim: The purpose of this study was to clarify training-related risk factors for overuse injuries.
Methods: This was twelve-month retrospective study which was done by self-reported postal questionnaire. The study group consisted of 446 men and women top-level Finnish athletes representing three different endurance sports (cross-country skiing, swimming, long-distance running) between the ages of 15-35. Self-reported anthropometric and training-related variables (such as starting age of training, years of active training, hours trained yearly, competition hours and weekly resting days) and occurrence of overuse injuries.
Results: Athletes with less than 2 rest days per week during the training season had 5.2-fold risk (95% confidence intervals [CI] 1.89-14.06, P=0.001) for an overuse injury, and athletes who trained more than 700 hours during a year had 2.1-fold risk (95% CI 1.21-3.61, P=0.008) for an overuse injury compared to the others. Athletes who reported a tendon injury were on average two years older than athletes without such an injury (P<0.001).
Conclusion: We found that low number of recovery days and a high amount of training are training-related risk factors for overuse injuries in top-level endurance athletes. The higher number of tendon overuse injuries in older than younger athletes may indicate that age-related degeneration plays an important role in the etiology of tendon injuries. These findings should be taken into account when planning exercise programs for endurance athletes.

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leena.ristolainen@orton.fi