Injury incidence and prevalence in elite short-course triathletes: a 4-year prospective study

Crunkhorn, Melissa Leith; Toohey, Liam Anthony; Charlton, Paula; Drew, Michael; Watson, Kate; Etxebarria, Naroa

doi:10.1136/bjsports-2023-107327

Cited by 5 publications

References 43 publications

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Deciphering Risk of Recurrent Bone Stress Injury in Female Runners Using Serum Proteomics Analysis and Predictive Models

Romanowicz,

Popp,

Dinh

et al. 2024

Preprint

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Up to 40% of elite athletes experience bone stress injuries (BSIs), with 20-30% facing reinjury. Early identification of runners at high risk of subsequent BSI could improve prevention strategies. However, the complex etiology and multifactorial risk factors of BSIs makes identifying predictive risk factors challenging. In a study of 30 female recreational athletes with tibial BSIs, 10 experienced additional BSIs over a 1-year period, prompting investigation of systemic biomarkers of subsequent BSIs using aptamer-based proteomic technology. We hypothesized that early proteomic signatures could discriminate runners who experienced subsequent BSIs. 1,500 proteins related to metabolic, immune, and bone healing pathways were examined. Using supervised machine learning and genetic programming methods, we analyzed serum protein signatures over the 1-year monitoring period. Models were also created with clinical metrics, including standard-of-care blood analysis, bone density measures, and health histories. Protein signatures collected within three weeks of BSI diagnosis achieved the greatest separation by sparse partial least squares discriminant analysis (sPLS-DA), clustering single and recurrent BSI individuals with a mean accuracy of 96 +/- 0.02%. Genetic programming models independently verified the presence of candidate biomarkers, including fumarylacetoacetase, osteopontin, and trypsin-2, which significantly outperformed clinical metrics. Time-course differential expression analysis highlighted 112 differentially expressed proteins in individuals with additional BSIs. Gene set enrichment analysis mapped these proteins to pathways indicating increased fibrin clot formation and decreased immune signaling in recurrent BSI individuals. These findings provide new insights into biomarkers and dysregulated protein pathways associated with recurrent BSI and may lead to new preventative or therapeutic intervention strategies.

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Deciphering Risk of Recurrent Bone Stress Injury in Female Runners Using Serum Proteomics Analysis and Predictive Models

Romanowicz,

Popp,

Dinh

et al. 2024

Preprint

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‘Downhill race for a rainbow jersey’: the epidemiology of injuries in downhill mountain biking at the 2023 UCI cycling world championships—a prospective cohort study of 230 elite cyclists

Fallon,

Palmer,

Bigard

et al. 2024

BMJ Open Sport Exerc Med

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ObjectivesThis study aims to understand the prevalence, incidence rate, anatomical sites, injury severity and main medical actions carried out during official training and racing by elite downhill mountain biking (DHMTB) riders during the 2023 Union Cycliste Internationale (UCI) Cycling World Championships.MethodsThe participants of this prospective, observational study were elite male and female cyclists competing at the UCI DHMTB World Championships located in the Nevis range in Fort William, Scotland, in 2023. This study followed the injury reporting guidelines established by the International Olympic Committee, which include the Strengthening the Reporting of Observational Studies in Epidemiology—Sports Injury and Illness Surveillance (SIIS) and the cycling-specific extension. Injuries were defined as ‘tissue damage or other derangement of normal physical function due to participation in sports, resulting from rapid or repetitive transfer of kinetic energy requiring medical attention’. All epidemiological data were collected by the local organising committee medical professionals working at the event through an online survey. All data inputted were screened daily by the lead event physician and UCI medical delegate.ResultsThroughout 5 days of the championships, 10.4% of the 230 cyclists sustained at least one injury. The overall injury incidence rate was 3.3 (95% CI 3.1 to 3.5) per 100 rides. The incidence rates were higher in the training 4.3 (95% CI 4.0 to 4.6)/100 rides than in the racing 2.2 (95% CI 2.1 to 2.3)/100 rides. There was a greater incidence of injury in female cyclists in the training 5.8 (95% CI 5.0 to 6.6)/100 rides and racing 4.5 (95% CI 3.9 to 4.9)/100 rides compared with male cyclists. Female cyclists experienced more severe injuries, with an average of 12.6 (±14, 95% CI 5.66 to 19.54) days lost to injury compared with 5.5 (±1.6 95% CI 1.89 to 9.11) seen in male cyclists. The main event medical actions were lifting, immobilisation and helmet removal.ConclusionThis study provides insights into the risk of injury to athletes within DHMTB. Our findings suggest more focus should be placed on the female DHMTB athlete. Additionally, this study provides unique information about common medical actions required of medical professionals working at DHMTB events and the importance of pre-event scenario training.

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Accuracy of self-reported foot strike pattern detection among endurance runners

Vincent,

Coffey,

Villasuso

et al. 2024

Front. Sports Act. Living

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IntroductionFoot strike pattern is often associated with running related injury and the focus of training and rehabilitation for athletes. The ability to modify foot strike pattern depends on awareness of foot strike pattern before being able to attempt change the pattern. Accurate foot strike pattern detection may help prevent running related injury (RRI) and facilitate gait modifications and shoe transitions. The purposes of this study were to determine the accuracy of self-reported foot strike pattern among endurance runners, to identify what factors were predictive of accurate foot strike detection and recent RRI.MethodsThis was a retrospective, cross-sectional study which included endurance runners (N = 710; 51.5% female; 35.4 ± 15.5 years; 51.6% were training competitively at the time of testing) with different running injury histories. Runners self-reported foot strike pattern [rearfoot, non-rearfoot (mid or forefoot), or “don't know”] and information about shoewear specifics. All runners performed a single session of running at self-selected speed on an instrumented treadmill with 3D motion capture and high-speed filming that verified actual foot strike. Logistic regression was used to predict accuracy of foot strike detection and RRI.ResultsOverall accuracy of foot strike detection was low (42.7%; p < 0.01). Self-reported foot strike was 28.3% for rearfoot, 47.0% for nonrearfoot forefoot strike and 24.6% did not know. Biomechanical analyses actually showed that 34% of rearfoot strikers accurately detected rearfoot strike, while 69.5% of non-rearfoot strikers self-reported accurate non-rearfoot strike (p < 0.05). Runners who “did not know” their strike had the highest prevalence of RRI compared to runners who self-reported nonrearfoot or rearfoot strike (73% vs. 56% and 58%; p < .001). After accounting for several variables, shoe heel-to-toe drop was a consistent predictor of accurate strike detection [OR = 0.93 (0.88–0.99); p = 0.026] and RRI in last six months [OR = 1. 1 (1.01–1.17); p = 0.018]. RRI were also predicted by recent shoe change [OR = 2.8 (1.7–4.6); p < 0.001].DiscussionAccurate detection of actual foot strike by endurance runners varies by the actual foot strike type determined during testing and is associated shoe characteristics. These findings demonstrate the importance of accurately identifying foot strike pattern and recommending footwear as a factor if planning to use retraining to alter foot strike pattern.

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Injury incidence and prevalence in elite short-course triathletes: a 4-year prospective study

Cited by 5 publications

References 43 publications

Deciphering Risk of Recurrent Bone Stress Injury in Female Runners Using Serum Proteomics Analysis and Predictive Models

Deciphering Risk of Recurrent Bone Stress Injury in Female Runners Using Serum Proteomics Analysis and Predictive Models

‘Downhill race for a rainbow jersey’: the epidemiology of injuries in downhill mountain biking at the 2023 UCI cycling world championships—a prospective cohort study of 230 elite cyclists

Accuracy of self-reported foot strike pattern detection among endurance runners

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