Is there a strong association between substantial injuries and previous injuries in adolescent elite athletes? A 1-year prospective cohort study

Adolescent elite athletes have a high injury risk and many risk factors for injury have been suggested, where the most conclusive risk factor is a previous injury. However, there is a lack of longitudinal data on a complete season in adolescent elite athletes. The aim of the study was to explore the relationship between substantial injuries and previous injuries in adolescent elite athletes. A secondary aim was to explore sex differences in terms of this relationship. Injury problems and substantial injury was monitored in adolescent elite athletes (n = 320) using the validated the Oslo Sports Trauma Research Center Questionnaire over 52 weeks. In total, 74% (n = 237) athletes reported at least one substantial injury during the study period. Previous injury problems were reported by 82% (n = 195), where 48% (n = 183) of all substantial injuries occurred within the same body location as a previous injury. Forty-four percent (n = 83) of the substantial injuries occurred within 2 weeks after occurrence of an injury problem. There was no association between sex and number of substantial injuries (p = .956, χ2 = 1.7). Poisson regression analysis demonstrated that 16-year-old athletes had a significantly (p = .034) increased risk of reporting substantial injuries (IRR 1.19, 95% CI: 1.01-1.39), compared to 18-year-old athletes. A high prevalence of substantial injuries occurred closely followed a previous injury in the same body location. Exploring rehabilitation following injuries in this age, addressing injury risk behavior when an injury problem has occurred and increasing awareness of the relationship between injury problems and substantial injuries are suggested to be important strategies to reduce substantial injuries in adolescent elite athletes.