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Letting the cat out of the bag: athletes, coaches and physiotherapists share their perspectives on injury prevention in elite sports
  1. Caroline Bolling1,
  2. Saulo Delfino Barboza1,
  3. Willem van Mechelen1,2,3,4,
  4. H Roeline Pasman1
  1. 1 Amsterdam Collaboration on Health & Safety in Sports, Department of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, The Netherlands
  2. 2 Department of Human Biology, Faculty of Health Sciences, Research Unit for Exercise Science and Sports Medicine (ESSM),University of Cape Town, Cape Town, South Africa
  3. 3 School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
  4. 4 School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Qld, Australia
  1. Correspondence to Caroline Bolling, Department of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam 1081 HV, The Netherlands; carolbolling{at}


Objectives To explore how sports injury prevention takes place in elite sport practice and to describe the perspectives of athletes, coaches and physiotherapists regarding the most critical factors that help prevent injury in the elite sports context.

Methods Qualitative study. Semistructured interviews with 19 international level athletes, coaches and physiotherapists, from different Olympic sports. Interviews were transcribed verbatim and analysed using comparative data analysis based on Grounded Theory.

Results The participants perceived injury risk as an inherent part of elite sports, because athletes try to enhance performance by pushing their limits. Participants described injury prevention as a learning process that changed over time, based on their sports experience and the injuries that they had sustained along their career. Communication among the athletes, coaches and physiotherapists was described as a key component of the injury prevention process. Study participants emphasised the relevance of teamwork and shared responsibility. Performance was presented as the core of the athlete’s daily practice, indicating that injury prevention can be a means to that end but is not a goal in itself for this community.

Conclusion Participants perceive injury prevention as part of elite sports and thus embrace the need for injury prevention. Injury prevention strategies in elite sports were described as a learning process, following the dynamic nature of training for maximal performance. Performance is the participants’ main goal.

  • injury prevention
  • sports medicine
  • elite performance

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  • Contributors CB, the main coder and interviewer, developed the reasoning for this paper and drafted the first version. SDB, WvM and RP contributed intellectually and provided feedback on various drafts.

  • Funding CB is supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, Brazil, grant number 202242/2015-3. No other sources of funding were used to assist in the preparation of this article.

  • Competing interests None declared.

  • Ethics approval This study was approved by the Vrije University Medical Center Ethics Committee, Amsterdam, the Netherlands; protocol METc FWA00017598.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.