The impact of triathlon training and racing on athletes’ general health.
Veronica Vleck1, Gregoire P Millet2, and Francisco Bessone Alves1
1 CIPER. FMH-UL. Portugal.
2 ISSUL, UNIL, Lausanne. Switzerland.
Corresponding author’s email address:
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Table S6. Percent comparison of anatomical location of injury in triathletes (updated from Vleck V. Triathlon. In: Caine DJ, Harmer P, Schiff M, editors. Epidemiology of injury in Olympic sports. International Olympic Committee Encyclopaedia of Sports Medicine Series. West Sussex: Wiley-Blackwell. 2009; 294-320, [202], with permission).
Number of injuries / Ireland and Micheli [206]a / Massimino et al. [209] / Williams et al [210] / Collins et al. [211] (All) / Collins et al. [211] Elite / Collins et al. [211] F / Collins et al. [211] >40 years old / Hiller et al. in o’Toole et al.[237] / O’Toole et al. [203] / Migliorini [213] / Korkia et al. [214] / Manninen and Kallinen [216] / Cipriani, Swartz and Hodgson [217] / Vleck and Garbutt [14] EM OD / Vleck and Garbutt [14] SE M ODDesign / Retros / Retros / Retros / Retros / Retros? / Retros / - / Pros / Retros / Retros / Retros / Retros
Discipline attributed to overall / 7 S, 17 B, 71 R 5 O / 5 S,20 B 58R / (11 S, 5.0 B 53 R) / 11 S, 12.5 B, 62 R, 8 R+O, 6.5 O / - / - / 3, 29 10 B+R B64RS / 12S, 16B, 65R / LB (14)B(43)R / Most R / 34.5B 62.1R / 25.0B, 64.3R
Head/neck/ cervical region / - / - / 6 / - / - / - / - / - / - / - / 1.3 / 3.8 / 16.7 / 0
Upper back / (2.8) / - / - / - / - / - / - / - / 6.5 / 15.7 (14)
- / - / - / -
Lower back (LB) /back (B)/spine (Sp) / (3.7) / LB 10 / LB 17.2 / LB 4 (28.6 B, 42.9 R+O 14.3 Oth) / 4.2 LB / LB (7.5) / LB (0) / (72)b / - / - / LB 8 (15.4) / LB (17.9) / LB (29.4)OU
Shoulder (Sh) /Bicep / (7.5) / - / 7.2 (Sh) / 13.8 (82.6 S, 13 B, 4.3 R+ 0th) / (4.2) Sh / (15) Sh / (11.4) Sh / - / - / 3.2a / 1.3 Sh / 8.6 All S / 7 (13.5) / 8.3 / (14.2) 23.5 OU
Elbow / - / - / - / - / - / - / - / - / - / - / 1.3 / - / - / - / -
Hand (H) / fingers (F) / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Forearm / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Chest/ribs / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Abdomen (Ab)/ rest of trunk (T) / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Hip / - / 5 / 6 / 3.6 (All R) / (4.2) / (5) / 6 / - / - / - / 4.2 / 11 (11.5 H, 9.6 G) / - / -
Buttocks / Gluteals / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Groin (G)/ pelvic area (PA) / - / 7 / - / G 2.4 (7.5 R, 25 R+0 / G (0) / G (0) / 0 / - / - / - / 3.75 G / - / - / - / -
Anterior thigh/ Quads / (2.8) AT / - / - / 1.2 (100 C anterior and posterior thigh) / 0 Thigh / 0 Thigh
- / 0 Thigh / 17.5 Thigh
- / (5.8) Thigh / AT (9.3) / AT (0)
1.9
Posterior thigh/ Hamstrings / (3.7) PT / HS 8 / - / 1.8 H (66.7 R, 33.3 Oth) / - / - / - / - / - / -
Inner thigh / - / - / - / -
Knees / 29.9 / 22 / 22 / 25.1 (0 S, 14.3 B, 66.7 R, 11.9 R+O, 7.1 0th) / 29.2 / (22.5) / (22.9) / 19 / (63) / 51.6 / 16.3 (19) / 33.3 / 25 (46.2) / 14.2 / 17.9
Hamstrings / 8 / - / 1.8 66.7 R, 33.3 O / (0) / (2.5) / (0) / - / - / - / - / (17.3 H, 5.8 Thigh/H) / 25 / 11.8
Upper Leg/ tibia / - / - / - / - / - / - / 5 / Leg 22.6 / - / 5.7 / - / - / -
Calf / (7.5) / - / - / 5.4 (0 S, 33.3 B, 44.4 R, 2.2 R+O) / (8.3) / 3 / (8.6) / - / - / 4.8 / - / 25 / 11.8
Lower leg / - / - / - / 6.6 (90.9 R, 9.1 R+O) / (12.5) / (12.5) / (2.9) / 11 / 17.5 (16) / 12 (23.1) / - / -
Achilles tendon / (7.5) / 4 / - / 10.2 (11.8 B, 88.2 R) / (12.5) / (5) / (22.9) / 17 / - / - / - / 2.9 / (11.5) / 14.3 (50) / 17.9 (17.6)
Ankle (A)/foot (F) / - / 21 / 13.8 / A 6.6 (R) / (0) A / (7.5) / (8.6) / A (6) / (61) / F 16.1 / 26.3 (27) / A 7.6 / (A 17.3, F 15.4) / A (16.7) / A 11.8
Foot (F) /toes (T) / (11.2) F / - / - / PF 5.9 (90 R, 10 R+O) / 0 PF / PF (5) / PF (8.6) / 7 / - / - / 4.8 / F (15.4) / - / -
Systemic (Sy), (SF) / - / - / - / (5) SF (All R) / SF (8) / SF (5) / SF (5.7) / - / - / - / - / 16.7 / 11.8
ITB / - / - / - / 3.0 (80.0R, 20.0 R+O) / (12.5) / (2.5) / 0 / - / - / - / - / - / - / - / -
Other / (23.3) / 23 / - / 4.8 (37.5 B, 12.5 R, 50.0 O) / (4.2) / (7.5) / (2.9) / - / - / - / - / 2 / - / 16.7 / 11.8
Skin / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Head / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Ear / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Collarbone / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Upper arm / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Shin / - / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Lower Limb / - / - / - / - / 13 / 3 / 0 / - / - / - / - / - / - / - / -
Number of injuries / Vleck and Garbutt [14] Ag M OD / Burns et al. [221, 225] / Egermann et al. [222] / Vleck [12] Squad / Vleck [12] Elite F OD / Vleck [12] SE F OD / Vleck [12] E F IM / Vleck [12] OD MF / Vleck [12] P /1000 hours / Villavicencio et al. [226] / Gosling et al. [238] / Andersen et al. [94] / Zwingenberger et al. [232] / Zwingenberger et al. [232]
Design / Retros / Retros / Retros / Retros / Retros / Retros / Retros / Pros / Pros / Race / Retros / Pros / Retros / Pros
Discipline attributed to overall / 15.9B, 58.7R / PS: 2.1 S, 5.3 B, 71 R, 22.1 Oth, C: 1.7, 8.3 B, 73.3 R / 5.8 S, 54.8 B, 33.7 R, 5.7 Oth / - / - / - / - / - / - / LB 81.4 SR of which 4.2, 22.9, 35.4 and 39.6 weights, R, B and Oth respectively / 11.9 S, 18.4 B, 54.6 R / 78 S, B or R. 22 to other training. Acute 24/41 B, 3/41 from R, 0 from S / 7 S, 43 B, 50 R / -
Head/neck/ cervical region / - / - / - / (4.2) OU33S, 33B, 33O / 0 / 0 / 0 / 4.2 NI / [0.85] / 61.9 SR of which 65.4 B / - / H 2.0 / H 0.0
Upper back / - / 13PS / 31.2 cc, 26.8 OU / - / 14.3 / 10 / 16.7 / - / - / - / - / Sp 5.6
Lower back (LB) /back (B)/Spine (Sp) / LB (15.8) / 15C / (23.9)56B,17R / 0 / 0 / 0 / 11.5 / [2.33] / 67.8 73.1SR / - / 17.8 / Sp 1.0
Shoulder /Bicep / - / - / 19.1 cc, 57.6 OU / (14.1) 64.6S, 28o / 14.3 / 100 / 0 / 17.4 / [0.85] / - / - / 18.6 / 6.0 S / 1.85 S
Elbow / - / - / 4.0 cc, 34.6 OU / - / - / - / - / 1 / [0.21] / - / - / - / 3.0 / 0.0
Hand (H) / fingers (F)/Wrist (W) / - / - / - / - / - / - / - / F1.0 / [0.21] / - / - / - / H 5.0, W 0.0 / H 3.7, W 0.0
Forearm / - / - / - / - / - / - / - / - / - / - / 7 / 0
Chest/ribs / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Abdomen (Ab)/ rest of trunk (T) / - / - / - / - / - / - / - / 3.1 / [0.63] / - / - / 4.0 T / 3.70 T
Hip / - / 5PS, 5C / - / - / - / - / - / 0.63 / [0.63] / - / - / - / 1.0 / 0
Buttocks / Gluteals / - / - / - / - / - / - / - / 4.2 / [1.85] / - / - / - / - / -
Groin (G)/ Pelvic area (PA) / - / - / - / - / - / - / - / 2.1 / [0.42] / - / - / - / PA 3.0 / Pa 0.0
Anterior thigh/ Quads / - / - / - / AT (4.2), 33 R 33 O / AT (0) / AT (0) / AT (16.7) / AT (8.3) / [1.69] / - / - / - / - / -
-
Posterior thigh/ Hamstrings / - / - / - / - / - / - / - / 11.5 / [2.33] / - / - / - / - / -
Inner thigh / - / - / - / - / - / - / [0.21] / - / - / - / - / -
Knees / 21.9 / 15 PS, 17 C / 42.7 cc, 66.6 OU / (39.4) 34 B, 56 R, 17 O / 8.6 / 20 / 50) / 14.5 / [3.00] / MC 32 / - / 22.5 / 20.0 / 33.3
Hamstrings / - / - / - / (15.5) 17 B, 66 R, 17O / 14.3 / 10 / 16.7 / 13 / - / - / - / - / - / -
Upper leg (UL)/ tibia / - / UL: 11 PS, 3 C / - / - / - / - / - / - / - / - / - / Thigh 18.6 / UL 10.0 / UL 7.41
Calf / - / - / - / (21.1) (7S, 80R, 13O) / 42.9 / 30 / 16.7 / (8.3 ) NI / [1.48] / - / - / - / - / -
Lower leg / - / 19PS, 17C / - / - / - / - / - / - / - / - / - / 22.5 / 21.0 / 24.07
Achilles tendon / 10.3 / 27.4cc77.7ou / 226 B, 81 R, 11O / 0 / 30 / 16.7 / 0 / - / - / - / - / -
Ankle (A)/foot (F) / - / A 16 PS, 12 C / A 22.4 cc 59.2 OU / A 8.56 R, 33 O / A (14.3) / A (10) / A (0) / 26.9 / [0.42] / - / - / - / A 4.0 / A 9.26
Foot (F) /toes (T) / - / F14 PS, 23C / - / - / - / - / - / - / [0.42] / - / - / - / Fo 9.0 / Fo 11.11
Systemic (Sy), (SF) / - / - / - / 18.3 / 28.6 / 20 / 16.7 / 26.9 / - / - / - / - / - / -
ITB / - / - / - / - / - / - / - / - / - / - / - / - / - / -
Other / - / 7 PS, 8 C / (18.3) 7 B, 53 R, 40 O / 28.6 / 20 / 8 / 19.6 / - / - / - / - / - / -
Skin / - / - / - / - / - / - / - / - / [0.21] / - / - / - / - / -
Head / - / - / - / - / - / - / - / 1 / [0.21 / - / - / - / - / -
Ear / - / - / - / - / - / - / - / 1 / [0.21] / - / - / - / - / -
Collarbone / - / - / - / - / - / - / - / [0.85] / - / - / - / - / -
Upper arm / - / - / - / - / - / - / - / [1.06] / - / - / - / 4.0 / 0. 0
Shin / - / - / - / - / - / - / - / [1.27] / - / - / - / 7.0 / 0.0
Lower Limb / - / 72 PS
75 C / - / - / - / - / - / - / - / - / - / - / -
- (dash) = no information, A = ankle, B (‘bike’) cycle, C = competitive season, cc = chronic complaint, F = female, Fo = foot, Fi = fingers, IA = injured athletes, IM = Ironman distance (i.e. 3.8 km swim, 180 km cycle, 42.2 km run), LB = lower back, M = male, MC = most common, N = neck, O = other, OD = Olympic distance (i.e. 1.5 km swim, 40 km cycle, 10 km run), P = prospective study, Pa = pelvic area, PF = plantar fasciitis, PS = pre-season, Quads = quadriceps, Retros = retrospective study, R = run, R+O = run +Other, R/P retrospective study with prospective aspects, S = swim, SF = stress fracture, Sy = systemic, UL = upper leg, T = toes.
a worst injuries
b LB pain or sciatica
*Values in () parentheses are for % respondents affected. Values in square [] brackets are rates/1000 training hrs. All other values are for % of total number of injuries.
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