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New sports, COVID-19 and the heat: sports injuries and illnesses in the Tokyo 2020 Summer Olympics
  1. Torbjørn Soligard1,
  2. Debbie Palmer2,3,
  3. Kathrin Steffen4,
  4. Alexandre Dias Lopes5,
  5. Natalia Grek6,
  6. Kentaro Onishi7,
  7. Tomoyuki Shimakawa8,
  8. Marie-Elaine Grant9,
  9. Margo Mountjoy10,
  10. Richard Budgett1,
  11. Lars Engebretsen1,4
  1. 1 Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  2. 2 Edinburgh Sports Medicine Research Network, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
  3. 3 Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
  4. 4 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  5. 5 Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, Massachusetts, USA
  6. 6 Moscow, Russian Federation
  7. 7 Department of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  8. 8 Department of Orthopaedic Surgery, Yaesekai Doujin Hospital, Okinawa, Japan
  9. 9 Institute of Sport and Health, University College Dublin, Dublin, Ireland
  10. 10 Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Torbjørn Soligard, Medical and Scientific Department, International Olympic Committee, Lausanne, Vaud, Switzerland; torbjorn.soligard{at}


Objective To describe the incidence of injuries and illnesses sustained during the Tokyo Summer Olympic Games from 23 July to 8 August 2021.

Methods We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the Tokyo 2020 medical staff.

Results In total, 11 315 athletes (5423 women, 48%; 5892 men, 52%) from 206 NOCs were followed up prospectively for the occurrence of injury and illness. NOC and Tokyo 2020 medical staff reported 1035 injuries and 438 illnesses, equalling 9.1 injuries and 3.9 illnesses per 100 athletes over the 17-day period. Altogether, 9% of the athletes incurred at least one injury and 4% at least one illness. The incidence of injury was highest in boxing (27%), BMX racing (27%), BMX freestyle (22%), skateboarding (21%), karate (19%) and handball (18%), of which both BMX freestyle and skateboarding were new events, and lowest in diving, road cycling, rowing, marathon swimming and shooting (1–2%). Marathon and artistic swimming presented the highest illness incidences (both 8%), followed by skateboarding and karate (both 7%). In the study period, COVID-19 affected 18 athletes, accounting for 4% of all illnesses and 0.16% of all athletes. Exertional heat illness affected 78 athletes (18% of all illnesses, 0.7% of all athletes), the majority (88%) resulting in no time lost from sport.

Conclusion Overall, 9% of the athletes incurred an injury and 4% an illness during the Games. Comprehensive countermeasures helped mitigate both COVID-19 and exertional heat illnesses.

  • Surveillance
  • Illness
  • Covid-19
  • Sporting injuries

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  • Twitter @DebbiePalmerOLY, @margomountjoy, @larsengebretsen

  • Contributors All authors contributed to the study conception and design, data collection and interpretation. TSo analysed the data and drafted the paper. All authors provided revisions and contributed to the final manuscript. TSo is the guarantor.

  • Funding The International Olympic Committee funded the data collection of the study.

  • Competing interests TSo works as scientific manager in the Medical and Scientific Department of the International Olympic Committee. KS is co-editor of the British Journal of Sports Medicine – Injury Prevention & Health Protection. MM is deputy editor of the British Journal of Sports Medicine. RB is director of the Medical and Scientific Department of the International Olympic Committee. LE is head of scientific activities in the Medical and Scientific Department of the International Olympic Committee, and editor of the British Journal of Sports Medicine and associate editor of the Journal of Bone and Joint Surgery.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.