Insights from the first IOC Olympian Health Cohort: injury and illness in Olympians preparing for the Tokyo 2020 Summer and Beijing 2022 Winter Olympic Games

Debbie Palmer; Torbjorn Soligard; Gwen Fernandes; Dave Collins; Niall Elliott; Paul Kelly; Iain R Murray; Lars Engbretsen

doi:10.1136/bmjsem-2025-002545

Insights from the first IOC Olympian Health Cohort: injury and illness in Olympians preparing for the Tokyo 2020 Summer and Beijing 2022 Winter Olympic Games

BMJ Open Sport Exerc Med. 2025 Sep 21;11(3):e002545. doi: 10.1136/bmjsem-2025-002545. eCollection 2025.

Authors

Debbie Palmer^{1

2}, Torbjorn Soligard³, Gwen Fernandes⁴, Dave Collins^{1

2}, Niall Elliott^{2

5}, Paul Kelly^{2

6}, Iain R Murray^{2

7}, Lars Engbretsen⁸

Affiliations

¹ Edinburgh Sports Medicine Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK.
² UK Collaborating Centre on Injury and Illness Prevention in Sport, University of Edinburgh, Edinburgh, UK.
³ Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland.
⁴ Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
⁵ Sports Medicine, Sport Scotland Institute of Sport, Stirling, UK.
⁶ Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK.
⁷ Department of Trauma and Orthopaedics, The University of Edinburgh, Edinburgh, UK.
⁸ Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.

Abstract

Objective: To describe the prevalence and nature of Olympic-career related injuries and illnesses, and behaviours during injury/illness, in Olympians in the 4 years prior to their participation at the Tokyo 2020 and Beijing 2022 Olympic Games.

Methods: 315 current Olympians from 70 countries completed a cross-sectional online survey, distributed by direct email through National Olympian Associations and World Olympians Association databases. Questions included Olympic sport exposure, significant training and competition injury and illness history (lasting >2 weeks) and athlete behaviours during injury/illness.

Results: 65% of Olympians were women (35% men), representing 51 sports (37 summer, 14 winter), aged 28.6 years (4.6). Overall, 58.5% (95% CI 52.2% to 64.9%) of summer and 55.6% (95% CI 44.7% to 66.4%) of winter Olympians were injured, with knee injuries most frequent (19.6% summer, 27.8% winter Olympians). Injury rates were similar between males and females. 17.1% (95% CI 12.3% to 21.9%) of summer and 23.5% (95% CI 13.1% to 31.3%) of winter Olympians were ill, with respiratory illness most frequent. Illness rates were (non-significantly) higher for female versus male winter Olympians (adjusted relative risk 2.04 (95% CI 0.73 to 5.76)) but similar between male and female summer Olympians. 78% of Olympians said they put the most pressure on themselves to return from injury/illness quickly. Almost half reported using painkillers during injury, while one-quarter continued full training/competition during injury/illness. Injury and illness prevalence followed similar bimodal and trimodal seasonal patterns for summer and winter Olympians, respectively.

Conclusions: Olympians report a significant history of injury and illness across the 4 years before the Olympic Games. A biopsychosocial approach that supports athletes during injury/illness absences is needed. Concurrent injury/illness prevention strategies should be considered to reduce the burden of both injuries and illnesses at key times in an athlete's season.

Keywords: Health promotion; Illness; Injury; Olympics.