Table 2

Main codes and related quotes on the theme ‘sports injury is an inherent part of elite sport’

When you are on the edge you may get injured ‘Elite athletes are performing on the edge and the injury is part of the process when you are always in this limit’. Athlete 10
‘Elite sports are sometimes on the edge of what is possible. Basically, if you function on that edge, even with all the precautions that you take, sometimes it happens that you get injured. We try to avoid this as much as possible, by creating a very well-balanced, very well- built programme, and by all the other prevention measures.’ Coach 4
Balance between pushing hard and respecting the limits ‘When we are talking about sports at an international level, giving the right load - physically and mentally - and the recovery time in-between. And, you always think: ‘Did I load enough?’, in order to create a type of what we call overload: the stimulus to get better physically. But also, giving rest to athletes, because by giving rest you avoid injuries, specially overuse injuries. So, the balance between load and rest makes the athlete perform better, but it might bring fatigue and eventually an injury. It’s difficult: under-load is not good because you don’t get better, overload is not good because you create injuries.’ Physiotherapist 5
‘As a top-level athlete, you are always trying to get all out of your training. So, you always want to gain more, more and more. And you also have to balance between training harder and taking rest and recovery.’ Athlete 5
Sometimes you need to take the risk ‘It was before the Olympics in Beijing. She(athlete) was injured for 5 months. She was doing her rehabilitation with me and I called the coach: ‘she is starting next week with me and in one and half week she will start on the field and I think in about 2 weeks she can start to join the team again’. He (coach) called her on the same evening: ‘I want you to start next week on the field, otherwise I will not select you for the Olympic team’. I contacted her orthopaedic surgeon, I went to her surgeon with her and also the surgeon said: ‘we are not the ones selecting the athletes, we can try to convince the coach. But he is the one who makes the decision’. Eventually, we decided to take a risk. So, she joined 2 weeks later the team and eventually it went well. But it’s a risk. And eventually she has an Olympic gold (medal). (…) it also depends on what the athlete wants. The opinion of the athlete is also important. This was her first Olympics, she was just afraid to lose her position as she was already training for 4 years for this.’ Physiotherapist 1
‘Yes, it’s possible to prevent injuries but not really if you want an athlete to win a world championship or an Olympic medal. Maybe is possible to prevent the injuries. But it is also necessary to take some chances and sometimes, have a small injury, to find the boundaries.’ Coach 2
Injury prevention is part of training ’I choose to do my sport and injury prevention is just a part of it. It’s just included in the hours that you are training.’ Athlete 3
’I think I do a lot of things to prevent injuries, and I feel is part of being a better athlete and get the best of my performance. And I think for the sport that I do, requires a lot of training and you have to be very careful to not get injured and if I know that if I get injured for a week, 2 weeks or even longer, it influences my training for the whole year. I think it’s just necessary.’ Athlete 8
’What I notice is that if you approach a player from an injury prevention point they are less interested than when I say about performance
What do I do? I call preparation, and actually it is their warming up. The preparation is everything that after testing them, I think they should do for injury prevention.’ Physiotherapist 1