Background Triathlons increasing popularity has not been matched by an increase in the quantity and quality of triathlon injury research.
Objective To summarise current knowledge of the distribution and determinants of injury, and the efficacy of preventive measures implemented by the International Triathlon Union (ITU), in the sport.
Design English language computer search of the ‘Medline’, ‘PubMed’, and ‘PsychLit’ databases, from 1986 to 2009, using the headings: ‘triathlon’, ‘triathlete’, ‘swimming’, ‘cycling’, ‘running’, ‘runner’, ‘injury’/’injuries’, and ‘epidemiology’. Articles currently in press and unpublished, postgraduate theses were also used.
Setting Novice, competitive/age-group to National Squad level athletes over the sprint to Ironman distances.
Participants Less than 50, mostly retrospective, peer reviewed publications were obtained. No data were available for youth or junior athletes, different senior age-groups, or athletes with a disability.
Assessment of risk factors Only risk factor data that had been tested for correlation or predictive value were included.
Main outcome measurements Injury type, time loss, clinical outcome and economic cost.
Results Although the long term implications for pulmonary, musculoskeletal or cardiac health are unknown, triathlon ‘appears to be relatively safe for persons of all ages assuming that high risk individuals undertake health screening’. Most injuries appear to be gradual onset or overuse, training related, lower limb injuries, occurring during running. Catastrophic injuries occur, usually ‘as a result of failure to adjust pace within safe limits for specific environmental conditions’ or inadequate implementation of safety guidelines, but are largely unreported. Triathlon cross-training may engender an increase in injury risk over that faced in swimming, cycling and running in isolation. Injury recurrence is significant.
Conclusion It is recommended that a longitudinal prospective survey of injury in ITU events be carried out, after a consensus statement on definition and recording of triathlon injuries has been developed.
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