Ironman-distance triathlons are multisport endurance events with rigorous demands and injury risk. Although injury profiles of triathletes have been reported, studies investigating injuries related to traumatic events are few and limited by self-reported injuries, small sample sizes, and inconsistent injury definitions. PURPOSE: To determine and characterize musculoskeletal and dermatological trauma-related injuries among world championship Ironman-distance triathletes. METHODS: A retrospective study of 3,646 standardized medical tent records from 2008-2019 was performed. Medical records were documented by nurses and physicians at a single Ironman-distance championship competition and descriptive statistics were utilized to evaluate demographics, injury frequency, and injury type. Chi-Squared analyses were used to compare the frequency of non-trauma and trauma-related injuries during different race segments. RESULTS: In total, 217 athletes presented to the medical tent with trauma-related injuries, an incidence of 59.5 per 1000 athletes. Musculoskeletal (n = 51), dermatologic (n = 119), or a combination of both injuries (n = 47) were common among trauma-related injuries. The most common musculoskeletal pathologies were musculoskeletal pain (37.3%), joint injuries (24.1%), and fractures (14.5%). The most common dermatologic injuries were abrasions (53.3%), lacerations (10.1%), and contusions (9.2%). Trauma-related injuries were predominantly localized to the shoulder (23.5%), head (18.0%), and hip/groin (13.8%). The cycling segment of the race had significantly more trauma-related injuries than the running and swimming segments (χ 2 (2) = 116; 18.15 p < .001). Within our analytic sample, 79 athletes did not finish the race, of which 17 (4.7 per 1000 medical encounters) were transferred to the hospital. No statistical significance was observed among sex and age as risk factors for trauma-related injuries. CONCLUSION: Though most trauma-related incidents are often unavoidable during ultra-endurance competition, increased awareness of specific musculoskeletal and dermatological injuries is crucial. These injuries are somewhat common and occur most commonly during the cycling segment of triathlon races.
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