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Sex differences in injury during top-level international athletics championships: surveillance data from 14 championships between 2007 and 2014
  1. Pascal Edouard1,2,3,
  2. Nina Feddermann-Demont4,5,
  3. Juan Manuel Alonso6,7,
  4. Pedro Branco6,8,
  5. Astrid Junge4,9,10
  1. 1Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint-Etienne, Saint-Etienne, France
  2. 2Laboratory of Exercise Physiology (LPE EA 4338), University of Lyon, Saint Etienne, France
  3. 3Medical Commission, French Athletics Federation (FFA), Paris, France
  4. 4FIFA Medical Assessment and Research Centre (F-MARC), Zurich, Switzerland
  5. 5Department of Neurology, University Hospital Zurich, Zurich, Switzerland
  6. 6Medical & Anti Doping Commission, International Association of Athletics Federations (IAAF), Monaco, Monaco
  7. 7Department of Sports Medicine, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  8. 8European Athletics Medical & Anti Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland
  9. 9Medical School Hamburg, Hamburg, Germany
  10. 10Schulthess Clinic Zürich, Zurich, Switzerland
  1. Correspondence to Dr Pascal Edouard, Department of Clinical and Exercise Physiology, Sports Medicine Unity, Bellevue Hospital, University Hospital of Saint-Etienne, Saint-Etienne Cedex 2 42 055, France; Pascal.Edouard42{at}


Background Injury incidence has been reported for international athletics championships from 2007 to 2012. However, it is unclear whether male or female athletes differ in risk and/or characteristics of injuries.

Objective To compare the incidences and characteristics of injuries that occurred during international athletics championships between female and male athletes.

Methods The national medical team and the local organising committee physicians reported all injuries daily on a standardised injury report form during 14 international championships from 2007 to 2014. Relative risks (RR) of injury, 95% CI and magnitude thresholds were calculated.

Results The rate of injuries per 1000 registered athletes was significantly higher in male (110.3±6.8) than in female (88.5±6.7) athletes (RR=1.25; 95% CI 1.13 to 1.37, small effect size). Male athletes incurred significantly more injuries in the thigh (RR=1.64; 95% CI 1.32 to 2.05, small), lower leg (RR=1.36; 95% CI 1.05 to 1.75, small) and hip/groin injuries (RR=2.26; 95% CI 1.31 to 3.88, moderate), more muscle strains (RR=1.64; 95% CI 1.33 to 2.04, small), cramps (RR=1.81; 95% CI 1.35 to 2.43, small), and especially more thigh strains (RR=1.66; 95% CI 1.25 to 2.19, small), but fewer stress fractures (RR=0.32; 95% CI 0.12 to 0.81, moderate) than female athletes. A higher injury risk of male than of female athletes was observed in sprints (RR=1.32; 95% CI 1.06 to 1.66, small), middle distance runs (RR=1.48; 95% CI 1.06 to 2.06, small), race walks (RR=2.55; 95% CI 1.27 to 5.10, moderate) and jumps (RR=2.13; 95% CI 1.53 to 2.97, moderate). No sex difference was found for cause and severity of injury.

Conclusions Injury risk during international athletics championships differed between female and male athletes for location, type and event groups. Injury prevention strategies should be sex-specific, regarding the differences in injury location and type.

  • Epidemiology
  • Injury
  • Athletics
  • Prevention

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