Injury rates in Short Course Triathlon

by Doug Stewart

A recent systematic review exploring injury rates in triathletes revealed some interesting findings. The triathletes studied were deemed ‘short course,’ which meant they included triathletes racing up to the Olympic distance (1.5km swim, 40km bike, 10km run).

A systematic review involves searching for previous published data and reviewing their findings to provide an overall summary of the best data available.

In this current review, the number of studies that met their inclusion criteria were 23 investigating injury, 24 exploring illness, and 5 studying both. Twenty of the studies investigated both male and female triathletes, but there were substantially more males in the cohorts. 7 studies focussed exclusively on female triathletes and 2 papers focussed on para triathletes (with an equal split of male and female athletes included).
 
With respect to injury rates, running saw the highest number of injuries reported, followed by cycling and then swimming. Swimming injuries accounted for the largest percentage of upper limb injuries. Overuse injuries were the most commonly reported. These were linked to running, with the lower leg (knee, calf and ankle/feet) being the most common place to get injured. This is perhaps not surprising, given the impact forces of running compared to cycling or swimming. It may also provide guidance on areas to focus on for strength and conditioning to try and help reduce the likelihood of injuries occurring.
 
Illness was also reviewed, with gastrointestinal issues the most commonly cited. The main cause of this was swimming in contaminated water, but – interestingly – the most often cited discipline for the symptoms to occur was on the run, then swimming and finally, least common was on the bike. With contaminated water (the single biggest cause), then consideration should be given when training around your breathing and if you find yourself swallowing water when swimming.

Additionally, with gastrointestinal symptoms most often cited on the run, then working on your race day fuelling strategies in training will be crucial. This will help train your gut to handle the demands of race day. Hopefully, by addressing these areas in training, you will reduce the likelihood of experiencing the same challenges on race day.
 
The authors do acknowledge a lack of high quality studies exploring the health problems of short course triathlon. So, although water quality is highlighted as a cause for illness, or overuse injuries are reported, it is hard to drill down further to draw more in-depth conclusions. But this serves as a good starting point and food for thought around how to train for race day.


References:

Guevara, S. A., Crunkhorn, M. L., Drew, M., Waddington, G., Périard, J. D., Etxebarria, N., ... & Charlton, P. (2023). Injury and illness in short-course triathletes: A systematic review. Journal of Sport and Health Science.

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