Br J Sports Med 46:769 doi:10.1136/bjsports-2012-091457
  • Warm up

Protecting elite athletes in extreme and challenging environments: advancing the dialogue

  1. Lars Engebretsen3
  1. 1National Youth Sports Health & Safety Institute, USA
  2. 2Department of Paediatrics, Sanford School of Medicine of The University of South Dakota, Sanford Children’s Health Research Center, Sioux Falls, SD, USA
  3. 3Department of Orthopeadic Surgery, University of Oslo/IOC Medical & Scientific Department, Oslo, Norway
  1. Correspondence to Professor Lars Engebretsen, Department of Orthopeadic Surgery, University of Oslo/IOC Medical & Scientific Department, Kirkeveien 111, Oslo 0407, Norway; lars.engebretsen{at}
  • Accepted 21 June 2012

Watching the Olympic athlete powering through the water or down a mountain, sprinting on the track with unimaginable speed and efficiency or demonstrating any number of other seemingly super-human feats, it is hard for some to imagine the challenges these elite athletes face that threaten their performance and health and safety. Even at the Olympic or world championship level, environmental conditions can readily erase years of training and preparation when these circumstances beyond the control of the athlete are unexpectedly more than the athlete is accustomed to and can tolerate.

The International Olympic Committee (IOC) Medical Commission recognises this, as do the International Sport Federations. New guidelines to minimise clinical risk and injury surveillance tracking systems have been developed and incorporated.1 But more needs to be done, as evidenced by periodic reports …