Incidence and Patterns of Overuse and Traumatic Injuries among Adolescent Elite Athletes in Canoe Sprint, Handball, and Triathlon

Michael Cassel; Anne Schomöller; Lucie Risch; Tilman Engel; Theresa Joost; Josefine Stoll; Claudia Beckendorf; Frank Mayer

doi:10.1055/a-2518-8985

Sportverletzung · Sportschaden, Table of Contents

Sportverletz Sportschaden 2025; 39(01): 33-42
DOI: 10.1055/a-2518-8985

Original Article

Incidence and Patterns of Overuse and Traumatic Injuries among Adolescent Elite Athletes in Canoe Sprint, Handball, and Triathlon

Verletzungs- und Überlastungsinzidenzen und -muster bei Nachwuchsathlet/-innen aus dem Kanurennsport, Handball und Triathlon

Authors

Michael Cassel

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Anne Schomöller

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Lucie Risch

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Tilman Engel

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Theresa Joost

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Josefine Stoll

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Claudia Beckendorf

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)
Frank Mayer

¹University Outpatient Clinic; Hochschulambulanz, University of Potsdam Faculty of Human Sciences: Universitat Potsdam Humanwissenschaftliche Fakultat, Potsdam, GERMANY (Ringgold ID: RIN232716)

Abstract

Background

Adolescent elite athletes in Olympic sports often specialise at an early age, which increases the risk of overuse and traumatic injuries. The knowledge of injury patterns is a key aspect for prevention strategies. However, little is known about adolescent athlete’s injury patterns in most Olympic sports. This study aimed to analyse the incidence and pattern of traumatic and overuse injuries in adolescent elite athletes from three Olympic sports with various physical demands.

Methods

A retrospective data analysis was performed, including 348 initial orthopaedic consultations of adolescent elite athletes (m/f: 267/81, 15.9±1.7 years, 179±9 cm, 71±11 kg, 648±107 training hours/year). Athletes from handball (n=185), canoe sprint (n=112) and triathlon (n=51) presented at the local sports medicine centre. All consultations included a medical history obtained by a physician, an orthopaedic examination, and a documentation of anthropometric and training-related data. Injury patterns were classified for traumatic and overuse ratio, type, area, structure, and cause of injury. Incidence per 1000 hours (h) of exposure and injury ratio were analysed in the entire cohort and compared between sports.

Results

The mean injury incidence was 3.3/1000 h, while overuse injuries occurred approximately twice as often as traumatic injuries (2.0 versus 1.2/1000 h). Sport-specific total injury incidence was lowest in canoe sprint (1.6/1000 h) and highest in handball (4.7/1000 h). The traumatic versus overuse injury ratio was lowest in canoe sprint (0.13) and highest in handball (0.54). Injury incidence increased with age and training hours from 1.0/1000 h in young athletes (12–13 years) to 5.1/1000 h in older athletes (16–17 years). Type, area, structure and cause of injuries differed significantly between athletes of the three sports. Handball players presented with various traumatic and overuse pathologies, mostly located in the lower extremity. Canoeists and triathletes mainly suffered from tendon overload and muscle injuries of the extremities and the lower back.

Conclusion

Both the total incidence and the ratio of traumatic versus overuse injuries differ between athletes participating in handball, canoe sprint, and triathlon. Overuse injuries occurred approximately twice as often as traumatic injuries in the present cohort. Further investigation is required to evaluate whether the variety of injuries seen in individual and team sports is to be taken into consideration in the development of prevention strategies.

Zusammenfassung

Hintergrund

Nachwuchsathlet/-innen in olympischen Sportarten spezialisieren sich häufig frühzeitig, was das Risiko für Verletzungen und Überlastungen erhöht. Die Kenntnis von Verletzungs- und Überlastungsmustern ist ein wesentlicher Schlüssel für Präventionsstrategien. In den meisten olympischen Sportarten ist diesbezüglich jedoch wenig bekannt. Ziel der Studie war es, Häufigkeit und Muster von Verletzungen und Überlastungen bei Nachwuchsathlet/-innen aus 3 olympischen Sportarten mit unterschiedlichen körperlichen Belastungsformen zu analysieren.

Methoden

In einer retrospektiven Analyse wurden 348 orthopädische Erstvorstellungen von Nachwuchsathlet/-innen (m/w: 267/81, 15,9±1,7 Jahre, 179±9cm, 71±11kg, 648±107h/Jahr) aus Handball (n=185), Kanurennsport (n=112) und Triathlon (n=51) im Untersuchungszentrum ausgewertet. Es erfolgten ärztliche Anamnese, orthopädische Untersuchung und Erfassung anthropometrischer und trainingsbezogener Daten. Verletzungsmuster wurden nach Verletzung und Überlastung, Art, Lokalisation, Struktur und Ursache klassifiziert. Das Verhältnis von Verletzungen zu Überlastungen (Ratio) sowie deren Inzidenzen pro 1000 Stunden (h) Exposition wurden für die gesamte Kohorte analysiert und zwischen den Sportarten verglichen.

Ergebnisse

Die durchschnittliche Inzidenz der Ereignisse betrug 3,3/1000h, während Überlastungen etwa doppelt so häufig waren wie Verletzungen (2,0 versus 1,2/1000h). Verletzungen und Überlastungen waren im Kanurennsport am niedrigsten (1,6/1000h) und im Handball am höchsten (4,7/1000h). Die Verletzungs-zu-Überlastungs-Ratio war im Kanurennsport am geringsten (0,13) und im Handball am höchsten (0,54). Die Inzidenz stieg durch höheres Alter und mehr Trainingsstunden von 1,0/1000h bei jungen (12–13 Jahre) auf 5,1/1000h bei älteren Athlet/-innen (16–17 Jahre). Im Handball waren Verletzungen der unteren Extremität vorrangig. Im Kanurennsport und Triathlon traten häufig Überlastungen sehniger und muskulärer Strukturen der Extremitäten bzw. des unteren Rückens auf.

Schlussfolgerung

Sowohl die Gesamtinzidenz als auch das Verhältnis von Verletzungen und Überlastungen sind bereits bei Nachwuchsathlet/-innen aus Handball, Kanurennsport und Triathlon verschieden, wobei in der Gesamtkohorte Überlastungen verglichen zu Verletzungen doppelt so häufig auftraten. Inwiefern die unterschiedlichen Verletzungs- und Überlastungsmuster in Individual- und Mannschaftssportarten in der Entwicklung von Präventionsstrategien zu berücksichtigen sind, ist zu überprüfen.

Keywords

Musculoskeletal - injury profiles - epidemiology - Olympic sports

Schlüsselwörter

Muskuloskelettale Beschwerden - Verletzungsprofile - Epidemiologie - Olympische Sportarten

Full Text

References

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