Epidemiology of Injury Complaints in Elite Sprinting Athletes in Athletics (Track and Field)

: To describe the epidemiology of injury complaints related to the athletics activity in elite athletics (track and eld) athletes practicing disciplines with sprints (i.e., sprints, hurdles, combined events, long jump, and triple jump). Methods: We conducted a cross-sectional study on elite sprinting athletes licensed with the French Federation of Athletics with retrospective data collection of injury complaints related to the athletics activity that occurred during their lifetime athletics activity, allowing the reporting of the

athletics (track and eld) athletes practicing disciplines with sprints (i.e., sprints, hurdles, combined events, long jump, and triple jump). Methods: We conducted a cross-sectional study on elite sprinting athletes licensed with the French Federation of Athletics with retrospective data collection of injury complaints related to the athletics activity that occurred during their lifetime athletics activity, allowing the reporting of the injury complaints during the one-year period before the survey and at the time of the survey, using a self-reported online survey system. We calculated the (i) lifetime, (ii) 1 year, and (iii) point (at the time of the survey) prevalence proportion, and we descriptively analyzed the injury complaint characteristics. Results: A total of 302 injury complaints related to the athletics activity were reported by 64 athletes of the 68 included athletes. The lifetime prevalence proportion was 95.6% (95% CI: 90.7 to 100.5%). The 1-year prevalence proportion was 61.8% (95% CI: 50.2 to 73.3%). The point prevalence proportion (at the time of the survey) was 16.2% (95% CI: 7.4 to 24.9%). Almost all injury complaints were located in the lower limb (92.7%) and especially involved the hamstrings (33.4%); the main type involved was the muscle (49.0%), and injury complaints mainly occurred during training and with a sudden mode of onset. The most frequent diagnosis was hamstring muscle injury (31.1%). Conclusions: This study provides new insights speci cally in elite sprinting athletes, con rming the injury risk in this population and that the main injury diagnosis was the hamstring muscle injury. Efforts should thus continue to monitor injuries in this population and to develop athletics- and sprinting-speci c injury risk reduction strategies. Keywords: track and eld; epidemiology; sports injuries; musculoskeletal pathologies; prevention; injury surveillance 1. Introduction Athletics (also known as track and eld) is an Olympic sport, which invariably leads to a risk of injuries [1]. Consequently, reducing the risk of injuries related to athletics activity is fundamental to promote performance and to allow a healthy and sustainable athletics Appl. Sci.2023,13, 8105.

eld) is an Olympic sport, which invariably leads to a risk of injuries [1]. Consequently, reducing the risk of injuries related to athletics activity is fundamental to promote performance and to allow a healthy and sustainable athletics Appl. Sci.2023,13, 8105.

Appl. Sci.2023,13, 8105 2 of 12 activity for competitive athletes. With this aim, the rst step in the injury prevention sequence is to understand the extent of the injury problem [2]. This can be achieved by clear and detailed knowledge on epidemiology of injuries in athletics, which is a crucial step in the view of developing injury risk reduction strategies [2]. Among the athletes participating in athletics, the population of elite athletes compet- ing (or with the goal of competing) at an international level represents a population of interest when dealing with injury risk. Indeed, elite athletes are exposed to high training volume and/or intensity as well as to regular competitions [3,4], which can increase their injury risk [5]. There is, thus, a need to have clear and detailed knowledge of their injury epidemiology to develop injury risk reduction strategies appropriate to their speci cities [2]. In addition, athletes participating in explosive disciplines requiring sprints (i.e., sprints, hurdles, combined events, and jumps), named “sprinting athletes”, comprise a signi cant proportion of elite athletes, representing about 50% of the athletes engaged in international championships [6]. The injury epidemiology in elite sprinting athletes does not represent, currently and to our knowledge, several publications. The extent of their injury problem is well described during the context of international athletics championships [6,7]; however, it only represents 3 to 9 days in the athletics season. During the whole athletics season, there are few studies in elite athletics [8–14]. However, detailed injury epidemiology was not always available for sprinting athletes only [8–14], and/or did not include international- level athletes (or it was not speci ed) [9,10,12–14], and/or were youth and junior elite athletes [13,14]. In this context, the aim of this study was to describe the epidemiology of injury complaints related to the athletics activity in elite sprinting athletes. 2. Methods 2.1. Study Design and Overall Procedure We conducted a cross-sectional study, with retrospective data collection of injury complaints related to the athletics activity, using a self-reported online survey system (LimeSurvey), asking elite sprinting athletes in explosive disciplines requiring sprints (i.e., sprints, hurdles, combined events, and

epidemiology of injury complaints related to the athletics activity in elite sprinting athletes. 2. Methods 2.1. Study Design and Overall Procedure We conducted a cross-sectional study, with retrospective data collection of injury complaints related to the athletics activity, using a self-reported online survey system (LimeSurvey), asking elite sprinting athletes in explosive disciplines requiring sprints (i.e., sprints, hurdles, combined events, and jumps), to report their injury complaints during their lifetime athletics activity, allowing them also to report the injury complaints during the one-year period before the survey and at the time of the survey. The present study was approved by the Committee for the Protection of Persons (CPP Ouest I—Tours, number: 2021-A02523-38). 2.2. Population The eligible population consisted of athletes (i) licensed with the French Federation of Athletics (FFA), for (ii) competitive athletics activity in explosive disciplines requir- ing sprints (i.e., sprints, hurdles, combined events, and jumps), and (iii) listed in the Sport Ministry repository of “elite athletes” or being elite athletes sparring partners, and (iv) competing at least at the international or national level. Eligible athletes were contacted to participate in this study(i)by the research team directly or indirectly via their coaches or (ii) by the technical national director of the FFA directly or indirectly via their coaches. They were informed about the study aim and procedure and that their data would be used for research, as well as about their rights. Eligible athletes interested in participating in this study were included if they agreed to participate, signed the informed consent, and completed the online survey. Informed consent was obtained from all participants involved in the study, as well as their parents for those under 18 years old. 2.3. Primary Outcome The primary outcome was theinjury complaint related to the athletics activity, de ned as “a pain, discomfort, or lesion of the musculoskeletal system, occurring during athletics practice (training or competition), and having had a negative impact on sports practice (reduction of practice, adaptation and incomplete practice, or stopping the practice) regard-

athletics activity, de ned as “a pain, discomfort, or lesion of the musculoskeletal system, occurring during athletics practice (training or competition), and having had a negative impact on sports practice (reduction of practice, adaptation and incomplete practice, or stopping the practice) regard-

Appl. Sci.2023,13, 8105 3 of 12 less of whether or not the athlete consulted a healthcare professional” [15]. We chose the term “injury complaint”, as in previous studies, since it refers to self-reported information without medical diagnosis [15]. 2.4. Data Collection Data were collected using an online survey (LimeSurvey). This online survey was developed by one sports medicine physician with experience in injury epidemiology in athletics (P.E.), two researchers in sport psychology (B.C. and A.R.), and three researchers in sport biomechanics (C.G., C.H., and G.G.). This online survey was developed with the goal of exhaustively collecting injury complaints related to the athletics activity of the included athletes based on the “International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport” [16]. The survey was divided into two parts (Supplementary Materials): (1) information on anthro- pometrics and athletics activity: age, sex, body mass, height, main athletics discipline (i.e., sprints, hurdles, jumps, or combined events), level of athletics (international or national), number of years of athletics activity, average number of athletics sessions per week, average number of hours of athletics activity per week, and average number of hours of sports outside of athletics per week; and (2) injury complaints related to the athletics activity: each athlete was asked to report for each location (i.e., the foot, the ankle, the lower leg, the knee, the thigh (hamstrings, quadriceps and adductors), the hip and groin, the trunk, the upper limbs and the head/neck), how many injury complaints he/she had during their lifetime (i.e., from the start of their athletics activity), and then for each reported injury complaints: the date of occurrence, the type of injury (i.e., muscle, tendon, ligament, bone, articular, nerve, skin, others [6]), the circumstance of occurrence (training or competition), the mode of onset (sudden or gradual), the injury mechanisms (clearly identi able injury with contact, clearly identi able without contact, or not clearly identi able), and the severity (i.e., the duration of absence in sports due to the injury complaint (none, less than 7 days, between 7 and 28 days, or more

the circumstance of occurrence (training or competition), the mode of onset (sudden or gradual), the injury mechanisms (clearly identi able injury with contact, clearly identi able without contact, or not clearly identi able), and the severity (i.e., the duration of absence in sports due to the injury complaint (none, less than 7 days, between 7 and 28 days, or more than 28 days) [16]. The survey was tested by two sports medicine physicians and four sports scientists, until the nal version was validated by the group of the six initial developers; it was not tested on the targeted population. Data were collected using the survey from 31 August 2021 to 10 November 2022. Athletes who agreed to participate in this study were asked to complete the online survey. A member of the research team (B.C.) was available to answer any question the athletes may have had about the survey. 2.5. Statistical Analyses We performed a descriptive analysis using frequency and percentages for categorical data, means, and standard deviations (SD) for continuous variables. We also calculated the prevalence proportion (% and 95% con dence interval (95% CI)) [17]: (1) the percentage of athletes with at least one injury complaint related to the athletics activity during the time period from the start of their athletics activity and the time of the study (lifetime prevalence proportion), (2) the percentage of athletes with at least one injury complaint related to the athletics activity during the one-year time period before the survey (1-year prevalence proportion), and (3) the percentage of athletes with at least one injury complaint related to the athletics activity at the time of the survey (point prevalence proportion). 3. Results 3.1. Population A total of 68 elite sprinting athletes, 34 female and 34 male athletes, licensed with the French Federation of Athletics, were included in the present study (Table). The average number of years from the start of their athletics activity was 7.8 4.1 years (Table). They were training in athletics an average 6.8 1.7 times per week for 13.9 4.7 h, and were practicing an average of 2.2 5.1 h of

34 male athletes, licensed with the French Federation of Athletics, were included in the present study (Table). The average number of years from the start of their athletics activity was 7.8 4.1 years (Table). They were training in athletics an average 6.8 1.7 times per week for 13.9 4.7 h, and were practicing an average of 2.2 5.1 h of sports outside of athletics (Table).

Appl. Sci.2023,13, 8105 4 of 12 Table 1.Characteristics of included elite athletes practicing explosive disciplines requiring sprints. Total Female Athletes Male Athletes Number of athletes (n (%)) 68 (100.0%) 34 (50.0%) 34 (50.0%) Anthropometrics Age (years) (mean SD) 23.3 3.8 23.1 4.3 23.6 3.3 Body mass (kg) (mean SD) 68.5 10.7 60.7 5.9 76.3 8.7 Height (cm) (mean SD) 175.4 8.5 169.3 5.2 181.5 6.5 Athletics activity Disciplines of athletics (n (%)): Sprints 37 (54.4%) 18 (52.9%) 19 (52.8%) Hurdles 23 (33.8%) 10 (29.4%) 13 (36.1%) Jumps 2 (2.9%) 2 (5.9%) 0 (0.0%) Combined events 6 (8.8%) 4 (11.8%) 2 (5.9%) Level of athletics activity (n (%)): International 28 (41.2%) 18 (52.9%) 10 (29.4%) National 40 (58.8%) 16 (47.1%) 24 (70.6%) Number of years of athletics activity (mean SD) 7.8 4.1 7.1 4.5 8.4 3.7 Mean number of athletics sessions per week (mean SD) 6.8 1.7 6.9 1.8 6.6 1.5 Mean hours of athletics per week (mean SD) 13.9 4.7 14.3 4.2 13.5 5.3 Mean hours of sports outside athletics per week (mean SD)2.2 5.1 1.9 5.6 2.5 4.7 History of injury complaints related to athletics activity Lifetime injury complaints (n (%)) 65 (95.6%) 33 (97.1%) 32 (94.1%) Lifetime prevalence proportion (% (95% CI)) 95.6(90.7 to 100.5)97.1(91.4 to 102.7)94.1(86.2 to 102.0) Injury complaints during the one-year period (n (%)) 42 (61.8%) 19 (55.9%) 23 (67.6%) 1-year prevalence proportion (% (95% CI)) 61.8(50.2 to 73.3)55.9(39.2 to 72.6)67.6(51.9 to 83.4) Injury complaints at the time of the survey (n (%)) 11 (16.2%) 6 (17.6%) 5 (14.7%) Point prevalence proportion (% (95% CI)) 16.2(7.4 to 24.9)17.6(4.8 to 30.5)14.7(2.8 to 26.6) 95% CI: 95% con dence interval. 3.2. Injury Number and Prevalence A total of 302 injury complaints related to athletics activity were reported by 65 athletes of the 68 included athletes. The lifetime prevalence proportion was 95.6% (95% CI: 90.7 to 100.5%) (Table). Six athletes reported 1 injury, 10 athletes reported 2 injuries, 11 reported 3 injuries, 8 reported 4 injuries, 9 reported 5 injuries, 7 reported 6 injuries, 5 reported 7 injuries, 1 reported 8 injuries, 4 reported 9 injuries, 2 reported

by 65 athletes of the 68 included athletes. The lifetime prevalence proportion was 95.6% (95% CI: 90.7 to 100.5%) (Table). Six athletes reported 1 injury, 10 athletes reported 2 injuries, 11 reported 3 injuries, 8 reported 4 injuries, 9 reported 5 injuries, 7 reported 6 injuries, 5 reported 7 injuries, 1 reported 8 injuries, 4 reported 9 injuries, 2 reported 10 injuries, 1 reported 11 injuries, and 1 reported 14 injuries (Figure). During the one-year period before the survey, 42 athletes reported having at least one injury complaint occurring during athletics. The 1-year prevalence proportion was 61.8% (95% CI: 50.2 to 73.3%) (Table). Eighteen athletes reported 1 injury, 14 athletes reported 2 injuries, 6 reported 3 injuries, 1 reported 4 injuries, 2 reported 5 injuries, and 1 reported 6 injuries (Figure). Eleven athletes reported having at least one injury complaint related to the athletics activity when lling out the survey. The point prevalence proportion was 16.2% (95% CI: 7.4 to 24.9%) (Table). Nine athletes reported one injury, one reported two injuries, and one reported six injuries (Figure).

Appl. Sci.2023,13, 8105 5 of 12Appl. Sci. 2023, 13, x FOR PEER REVIEW 5 of 12 7.4 to 24.9%) (Table 1). Nine athletes reported one injury, one reported two injuries, and one reported six injuries (Figure 1). Figure 1. Numbers of injury complaints related to the athletics activity reported by elite sprinting athletes over their lifetime, during the one-year period before the survey, and at the time of the survey. 3.3. Injury Characteristics The characteristics of the injury complaints related to the athletics activity are pre- sented in Tables 2–4 and in Figure 2. These characteristics were, in general, similar be- tween female and male athletes as well as between lifetime, one-year, and point observa- tions. Over the lifetime, the main injury complaint location was the hamstrings (33.4%), the main type was the muscle (49.0%), the main circumstance was training (69.5%), the main mode of onset was sudden (67.2%), the main injury mechanism was “not a clearly identifiable mode of onset” (50.3%), and the main severity was time loss between 7 and 28 days (Table 2). The hamstring muscle injury complaints were the most frequent injury diag- nosis (31.1%), with comparable proportion between female and male athletes (Table 3). Table 2. Characteristics of injury complaints related to the athletics activity in elite sprinting athletes, regarding location, type, circumstance, mode of onset, mechanism, and severity, according to sex, over the lifetime, over the one-year period before the survey, and at the time of the survey. Values are presented in numbers, and percentages in brackets. Lifetime Injury Complaints Injury Complaints during the One-Year Period before the Survey Injury Complaints at the Time of the Survey Total Female Athletes Male Athletes Total Female Athletes Male Athletes Total Female Athletes Male Athletes Total (n (%)) 302 (100.0) 142 (100.0) 160 (100.0) 84 (100.0) 37 (100.0) 47 (100.0) 17 (100.0) 11 (100.0) 6 (100.0) Location Head and neck 2 (0.6) 1 (0.7) 1 (0.6) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) Upper extremity 9 (3.0) 3 (2.1) 6 (3.8) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0

This study provides insights into injury risks in elite sprinting athletes.