Predictive Indicators of Overuse Injuries in Adolescent Endurance Athletes

Abstract

Purpose:To analyze the influence of training exposure and the utility of self-report questionnaires on predicting overuse injuries in adolescent endurance athletes. Methods: Five adolescent male endurance athletes (15.7 ± 1.4 y) from a full-time sports academy answered 2 questionnaires (Recovery Cue; RC-q and Oslo Sports Trauma Research questionnaire; OSTRC-q) on a weekly basis for 1 season (37 wk) to detect signs of overtraining and underrecovery (RC-q) and early symptoms of lower-limb injuries (OSTRC-q). All overuse injuries were retrospectively analyzed to detect which variations in the questionnaires in the weeks preceding injury were best associated. Overuse incidence rates were calculated based on training exposure. Results: Lower-limb overuse injuries accounted for 73% of total injuries. The incidence rate for overuse training-related injuries was 10 injuries/1000 h. Strong correlations were observed between individual running exposure and overuse injury incidence (r 2 = .66), number of overuse injuries (r 2 = .69), and days lost (r 2 = .66). A change of 20% or more in the RC-q score in the preceding week was associated with 67% of the lower-limb overuse injuries. Musculoskeletal symptoms were only detected in advance by the OSTRC-q in 27% of the episodes. Conclusion: Training exposure (especially running exposure) was shown to be related to overuse injuries, suggesting that monitoring training load is a key factor for injury prevention. Worsening scores in the RC-q (but not the OSTRC) may be an indicator of overuse injury in adolescent endurance runners when used longitudinally.Keywords: injury management, endurance training, sport medicine.The ability to detect and prevent injuries early remains one of the big challenges in sport. Although some injuries may be unpredictable and therefore difficult to prevent, most of the injuries related to long-distance running have an origin in excessive loads and a history of overuse. 1 This suggests that training-load monitoring and early detection may be effective in aiding injury prevention.The literature on injury epidemiology in adolescent track and field athletes is scarce, but runners seem to account for the majority of injuries (up to 80% 2 ) with the majority of these injuries (more than two-thirds 3 ), occurring in the lower extremity and being of an overuse nature. 1 Although incidence rates in senior athletics has been reported as 3.9 injuries/1000 h of practice, 4 specific injury incidence in youth track and field varies among disciplines; whereas an overall incidence of 0.89 injuries/1000 h has been reported for high school track and field athletes, long-distance runners have showed a 19 times larger incidence (17 injuries/1000 h) 5 than disciplines. Due to the gradual onset of most overuse injuries new methods, by means of self-reported questionnaires, have been suggested for registering overuse injuries in epidemiological studies in athletics, which may currently be underestimated. 6 The purpose of this study is to establish the relationship between s...

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