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High incidence of injuries at the Pyeongchang 2018 Paralympic Winter Games: a prospective cohort study of 6804 athlete days
  1. Wayne Derman1,2,
  2. Phoebe Runciman1,2,
  3. Esme Jordaan3,4,
  4. Martin Schwellnus5,6,
  5. Cheri Blauwet7,
  6. Nick Webborn8,
  7. Jan Lexell9,
  8. Peter van de Vliet10,
  9. James Kissick11,
  10. Jaap Stomphorst12,
  11. Young-Hee Lee13,
  12. Keun-Suh Kim14
  1. 1 Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa
  2. 2 International Olympic Committee Research Centre, Cape Town, South Africa
  3. 3 Biostatistics Unit, Medical Research Council, Parow, South Africa
  4. 4 Statistics and Population Studies Department, University of the Western Cape, Bellville, South Africa
  5. 5 Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  6. 6 IOC Research Centre, South Africa, Pretoria, South Africa
  7. 7 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
  8. 8 Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Eastbourne, UK
  9. 9 Department of Neuroscience, Rehabilitation Medicine, Uppsala Universitet, Uppsala, Sweden
  10. 10 Medical and Scientific Department, International Paralympic Committee, Bonn, Germany
  11. 11 Carleton University Sport Medicine Clinic, Department of Family Medicine, University of Ottowa, Ottowa, Canada
  12. 12 Department of Sports Medicine, Isala Klinieken, Zwolle, The Netherlands
  13. 13 Rehabilitation Medicine, Wonju College of Medicine, Yonsei University, Wonju, Seoul, The Republic of Korea
  14. 14 Yonsei Institute of Sports Science and Exercise Medicine, Yonsei University, Seodaemun-gu, Seoul, The Republic of Korea
  1. Correspondence to Professor Wayne Derman, Institute of Sport and Exercise Medicine, Department of Surgical Sciences, Stellenbosch University, Cape Town, South Africa; ewderman{at}


Objective To describe the epidemiology of sports injury at the Pyeongchang 2018 Paralympic Winter Games.

Methods 567 athletes from 49 countries were monitored daily for 12 days over the Pyeongchang 2018 Paralympic Winter Games (6804 athlete days). Injury data were obtained daily from teams with their own medical support (41 teams and 557 athletes) and teams without their own medical support (8 teams and 10 athletes) through two electronic data capturing systems.

Results 112 of 567 athletes (19.8%) reported a total of 142 injuries, with an injury incidence rate (IR) of 20.9 per 1000 athlete days (95% CI 17.4 to 25.0). The highest IR was reported for para snowboard (IR of 40.5 per 1000 athlete days [95% CI 28.5 to 57.5]; p<0.02), particularly in the lower limb and head/face/neck anatomical areas. Across all sports at the Games, acute traumatic injuries (IR of 16.2 per 1000 athlete days [95% CI 13.2 to 19.8]) and injuries to the shoulder/arm/elbow complex (IR of 5.7 per 1000 athlete days [95% CI 4.2 to 7.8]) were most common. However, most injuries (78.9%) did not require time loss.

Conclusion The new Paralympic Winter Games sport of Para snowboard requires attention to implement actions that will reduce injury risk. The shoulder was the most injured single joint—a consistent finding in elite para sport.

  • paralympic
  • impairment
  • disability
  • injury
  • international sporting events
  • athletes
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  • Contributors All authors have contributed to the development, application and write up of the current study. Each author has completed a Conflicts of Interest form.

  • Funding Funding for this study was provided by the IOC Research Centre South Africa grant and International Paralympic Committee research support.

  • Competing interests All authors have declared competing interests.

  • Ethics approval Ethics board approval for this study was granted by the Research Ethics Committees of the University of Brighton (FREGS/ES/12/11) and Stellenbosch University (N16/05/067).

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

  • Data sharing statement No data are available.

  • Patient consent for publication Not required.

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