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At a time when there is an abundance of medical meetings, journals and papers, some might argue that the last thing we need is even more material. What would justify an emphasis on a new and developing research field in medicine such as the prevention of injuries and diseases in high level athletes?1 First, it must ask important questions not answered by others. Second, the new research field should have the potential to create truly new knowledge; lead to new ways of thinking; and lay the foundation for improved health for our patients. And finally, research results from the new field should be publishable in respected journals, recognised and cited by peers, presentable at high-quality meetings and fundable on competitive grant review.
First, is injury prevention important? Epidemiological studies show that of injuries seen by a physician in Scandinavia, every sixth is sustained during sporting activity.2 Among children, every third hospital-treated injury is the result of sports participation. A research group within the English Football Association found that the overall risk to professional athletes is unacceptably high—approximately 1000 times higher among professional football players than for high-risk industrial occupations.3
The second issue relates to the potential for new ideas and improved health. In May 2000, a PubMed search revealed that out of 10 691 papers on athletic injury, there were only six randomised controlled trials on sports injury prevention. However, a similar search of the literature now reveals that sports injury prevention research is emerging as a new field in medicine. While the number of papers on athletic injuries has increased by 26% over the last 5 years, clinical studies and RCTs related to sports injury prevention have doubled.
Sports participation is also important from a public health perspective. There is no longer any doubt that regular physical activity reduces the risk of premature mortality in general, and of coronary heart disease, hypertension, colon cancer, obesity and diabetes mellitus in particular. The question is whether the health benefits of sports participation outweigh the risk of injury and long-term disability, especially in high-level athletes. Sarna et al4 have studied the incidence of chronic disease and life expectancy of former male world-class athletes from Finland in endurance sports, power sports and team sports. The overall life expectancy was longer in the high-level athlete compared with a reference group (75.6 vs 69.9 years). The same group also showed that the rate of hospitalisation was lower for endurance sports and power sports compared with the reference group.5 6 This resulted from a lower rate of hospital care for heart disease, respiratory disease and cancer. However, the athletes were more likely to have been hospitalised for musculoskeletal disorders. Thus, the evidence suggests that, although sports participation is beneficial, injuries are a significant side effect. To promote physical activity effectively, we have to deal professionally with the health problems of the active patient. This involves not only providing effective care for the injured patient but also developing and promoting injury prevention measures actively.
Since 2007, the International Olympic Committee (IOC) has been developing various programmes for the prevention of injuries and diseases in high level and recreational sports. This development is taking place with the cooperation of International Federations (IFs) such as the Fédération Internationale de Football Association (FIFA), the International Ice Hockey Federation (IIHF), the International Association of Athletics Federations (IAAF) and the International Swimming Federation (FINA), as well as with renowned research institutions worldwide. The IOC’s Medical and Scientific Department is currently developing research in the prevention field with several major institutions to focus on research, education and implementation of the new knowledge to all NOCs around the world. This strategy is highlighted by the IOC’s support of special issues of BJSM. The Injury Prevention and Health Protection addendum to the BJSM under IOC leadership will disseminate new knowledge to the scientific community, which again will help IFs and NOCs to implement new knowledge for the practising athlete. The IOC will have yearly Advanced Team Physician Meetings to educate our colleagues, and a major conference every third year where researchers from around the world will meet to discuss challenges and new results in the field of prevention of injuries and diseases. The IOC will continue the extensive publication of the Olympic Encyclopaedia and the more practical and very popular Olympic Handbook in Sports Medicine. Every year there will be at least two consensus conferences; 2009 focused on Pre-Participation Exams and on Age Determination in Young Athletes. The results from these conferences will be passed on to all NOCs and IFs. Finally, the IOC will further develop an injury and disease surveillance system for the Olympic Games—following on from the success of that conducted in Beijing.
Through these initiatives, the IOC will increasingly emphasise protection of the athletes’ health and the prevention of injuries.
Competing interests None.
Provenance and peer review Commissioned; not externally peer reviewed.