Background Athletics is one of the most popular sports in the world and is the centrepiece of the Summer Olympic Games. Participation in athletics training and competition involves a risk of illness and injury.

Objective This paper reports and summarises injury and illness in British Olympic track and field athletes over three full training and competition seasons.

Study Design Descriptive epidemiological study

Setting Elite athletics training centres

Participants Elite track and field athletes from the British national programme

Main outcome measures Exposure, incidence, severity, burden, mechanism- acute vs overdue

Methods A total of 111 athletes on the British national programme were followed prospectively for three consecutive seasons between 2015–2018. Team medical personnel recorded all injuries and illnesses during this time, following current consensus-based methods.

Results The average age of the athletes was 24 years for both males and females (24 years, SD: 4). Total exposure for the three seasons was 79 205 athlete days (217 athlete years). Overuse injuries (56.4%) were more frequent than acute injuries (43.6%). The thigh was the most common injury location (0.6 per athlete year), followed by the lower leg (0.4 per athlete year) and foot (0.3 per athlete year). Muscle and tendon were the most commonly injured tissues, while strains and tears were the most common pathology type. Respiratory illness was the most common illness type (0.3 per athlete year). Hamstring muscle strain was the most common diagnosis causing time loss, followed by Achilles tendinopathy and soleus muscle strain.

Conclusion Our findings indicate that future injury prevention efforts within elite athletics need to focus specifically on hamstring strains, Achilles tendinopathy, and soleus strains. Improved knowledge of the aetiology and risk profile of these problems in elite athletes is needed.