Content uploaded by Nicola Maffulli
Author content
All content in this area was uploaded by Nicola Maffulli
Content may be subject to copyright.
TITLE PAGE
Title of Article
Sports Injuries at the Olympics: A review of the evidence
Corresponding Author
Name: Mr Christopher Watura
Postal address: The Centre for Sports and Exercise Medicine, Barts and The London, School of
Medicine and Dentistry, The Royal London Hospital (Mile End), London, E1 4DG
Email: chris.watura@googlemail.com
Telephone: 07909221877
Co-authors
MeSH terms
Olympic
Paralympic
Sport
Injuries
Word Count
3000 words (including headings)
ABSTRACT
Background
The Olympics are a major international event including a Summer, Winter and Paralympic Games
each held separately every four years. Surprisingly, few Games have been reported on regarding
injury occurrence. The paucity of this type of evidence is surprising as it must be considered when
planning the best medical services and injury prevention strategies for future Olympic events. There
are no previous articles that collate the available evidence into a complete review of injuries at the
Olympic Games.
Methods
Eight databases were systematically searched in January 2012 to identify publications regarding
injuries during the Olympic Games. Articles were considered for review if they fulfilled a set
inclusion criteria.
Conclusion
This review discusses trends in the literature to reveal which athletes will be at highest risk of injury
at future Games and other multisport events, and the areas where improvements in injury prevention
strategies and where further investigations are most urgently needed. The limitations of past studies
are exposed and suggestions made which will improve the quality and usefulness of future studies.
MAIN TEXT
INTRODUCTION
The Olympics are a major international event and include a Summer, Winter and Paralympic Games
each held separately every four years. The next Summer Olympics will be hosted by London, UK on
July 27th – August 12th 2012. Over 10, 000 athletes from at least 205 countries will participate in a
total of 400 events covering 26 sports and 39 disciplines within them.
In the published literature, few Olympic Games have been reported on regarding injury occurrence.
The paucity of this type of evidence is surprising as it must be considered when planning the optimum
medical care for competitors and is fundamental to the protection of athlete’s health and the
prevention of injuries – a duty which the International Olympic Committee (IOC) has been
increasingly emphasising the importance of fulfilling.[1] A survey of athletic injuries during the 2002
Salt Lake Winter Paralympics was the first to be inclusive of all sports at any Olympic event.[2]
Similar surveillance was later carried out at the 2008 Beijing Summer Olympics[1] and the 2010
Vancouver Winter Olympics.[3] These are the three “core” studies to be discussed in this review,
alongside other literature that has been identified by a systematic search. There are no previous
articles that collate the literature into a complete review of injuries at Olympic Games. The purpose of
this is to recognise trends that are useful predictors for future Games and other multi-sport events
regarding the injury frequencies, characteristics, causes, and levels of risk in each sport. Suggestions
can then be made for the development of injury prevention policies, the best use of medical resources
and where further research is needed most.
METHODS
Eight databases [Medline, Cumulative Index to Nursing & Allied Health (CINAHL), Web of
Knowledge, Excerpta Medica database (EMBASE), SPORTDiscuss, Applied Social Sciences Index
and Abstracts (ASSIA), Google Scholar, SciVerse ScienceDirect] were searched in January 2012 to
identify publications regarding injuries during the Olympic Games. The Medical Subject Heading
(MeSH) terms “injuries”, “trauma”, “musculoskeletal”, “soft tissue” were used in combination with
“olympic”, “games”, “paralympic”, “disabled sport”, “sport”, “multi-sport”, “championship”,
“world”, “athletes”, “athletics”. This list of terms is deliberately broad to ensure the initial search is
highly sensitive. Full-texts were retrieved and their reference lists manually searched for other
relevant literature. The following inclusion criteria was applied: Publications (i) considering any
Olympic or Paralympic Games period from 1984 to the present day, and (ii) documenting any sports
related injuries, that (iii) occurred in the participating Olympic athletes. The most useful articles
were those that included all of the athletes, countries, sports and injury types at the Olympic event
being assessed. These were selected to be the “core” articles for this review [Figure 1]. Articles were
excluded if they reported on an unofficial “Olympic” event. The grey literature was also noticed.
RESULTS
Table 1
Sports injuries and
illnesses during the
Winter Olympic
Games 2010[3]
Sports injuries during
the Summer Olympic
Games 2008[1]
Injuries among
Disabled Athletes
during the 2002
Winter Paralympic
Games[2]
Total number
athletes in study
n=2567
(1552 Male, 1045
Female)
n=9672
(4100 Male, 5571
Female)
n=416
(328 Male, 88 Female)
Number of injuries n=287 n=1055
(549 Male, 464 Female) n=39
Incidence of injury
(per 1000 athletes in
the study)
111.8
(Male 93.3, Female
131.1)
96.1
Authors unable to
collect accurate
exposure data and
report limited ability
to calculate incidences
Sports with highest
rate of injury (%
athletes registered in
the event)
Snowboard cross
(35%)
Bobsleigh (20%)
Freestyle cross (19%)
Freestyle aerial (19%)
Ice hockey (18%)
Short-track speed
skating (18%)
Alpine (15%)
Football (31.5%)
Taekwondo (27.0%)
Hockey (20.4%)
Handball (17.4%)
Weightlifting (16.9%)
Boxing (14.9%)
Sledge Hockey (14%)
Alpine Skiing (12%)
Sports with lowest
rate of injury (%
athletes registered in
the event)
Luge (2%)
Freestyle moguls (2%)
Nordic skiing events
(mean av. 2.6%)
Speed skating (3%)
Sailing (0.8%)
Canoeing/kayaking
(1.2%)
Rowing (1.8%)
Synchronized swimming
Nordic Skiing (2%)
Curling (4%)
(1.9%)
Diving (2.1%)
Fencing (2.4%)
Swimming (3.4%)
Distribution between
training (t) and
competition (c)
t 54.0%
c 46.0%
t 26.2%
c 73.8%
t 50%
c 50%
Injuries resulting in
time loss (% of all
injuries)
n=65 (22.6%) n=419 (49.6%) n=8 (21%)
Commonest injury
type (% of all
injuries)
Contusion,
haematoma (27.8%) -
Sprains (32%)
Fractures (21%)
Strains (14%)
Lacerations (14%)
Commonest injury
location (% of all
injuries)
Knee (13.7%) Thigh (13.3%)
Knee (21.1%) -
Commonest injury
causes (% of all
injuries)
Non-contact trauma
(23.0%)
Contact with a
stagnant object
(21.8%)
Contact with another
athlete (14.5%)
Contact with another
athlete (32.9%)
Non-contact trauma
(20.0%)
Overuse with gradual
(9.1%) or sudden
(12.8%) onset
Traumatic (77%)
Overuse (15%)
Unknown (8%)
In the study of the 2010 Winter Olympics,[3] 270 (11%) of the athletes sustained at least one injury,
nine athletes had two injuries and four had three injuries. The incidence was higher in females than
males [Table 1]. There was no difference between the ages of the injured and non-injured athletes.
Information on gender and age was missing in 8 and 100 cases respectively. 1055 injuries were
reported in the study of the 2008 Summer Olympics[1] [Table 1]. The ages of injured athletes ranged
between 15 – 53 years (mean 25.7 years, SD 4.75) with no significant difference between the ages of
men and women. The injured group reflected the age and gender distribution of the total study group
((mean 25.9 years, SD 5.48) (male 57.6%, female 42.4%)). Data was published on 39 injured athletes
from 20 of the 40 countries competing in the 2002 Winter Paralympics.[2] The age of the injured
Paralympians ranged between 17 – 58 years (mean 33 years). The injury rates in any sport did not
differ significantly by gender.
Table 1 presents the Olympic sports that are associated with the highest and lowest risk of injury, and
the distribution of injuries between competition and training. At the 2010 Winter Olympics,[3] about
20% of females in snowboard cross, bobsleigh, ice hockey, freestyle cross and aerials were injured;
while the highest risk sports for male athletes were short-track speed skating, bobsleigh and ice
hockey (27.8%, 17.1% and 15% injured respectively). Information on injury circumstances was
available for 272 (94.8%) of injuries at this Winter Games and showed no significant difference
(p=0.18) in the distribution of injuries between training and competition overall. However there were
3 times more injuries in training than competition for freestyle ski cross, short-track speed skating,
figure skating, skeleton, biathlon and the snowboard events. Contrastingly, in the 2008 Summer
Olympics[1] there was a higher distribution of injuries during competition than training overall [Table
1]. A particularly high proportion of competition injuries were in boxing, water polo, hockey,
handball, weightlifting, baseball and judo. No competition injuries, yet interestingly a small number
of training injuries were reported in archery, canoeing/kayaking, diving, shooting and synchronised
swimming. The proportion of training injuries was also high in table tennis, tennis, swimming,
gymnastics, beach volleyball, equestrian, modern pentathlon, and athletics.
Table 1 presents the number of injuries that resulted in time lost from sports participation. 11 (16.9%)
of the time loss injuries in the 2010 Winter Olympics[3] were for longer than one week indicating a
greater severity. These injuries were one death (in luge), three fractures (lower leg, ribs), two sprains
(knee, ankle), two strains (abdomen, groin) two concussions and one contusion (knee). Information on
time loss was missing for 100 (34.8%) injuries. At the 2008 Summer Olympics,[1] physicians
estimated that 275 (33.0%) injuries would result in an absence from sports of up to 1 week, 93
(11.2%) in an absence for more than a week but less than a month, 41 (4.9%) for more than a month
and in 10 cases the duration was unspecified. The injuries with time loss greater than a month
comprised 13 fractures (foot n=4, clavicle n=3, knee n=2, arm, wrist, hand and pelvis), 8 ligament
ruptures (knee n=6, ankle n=2), 5 dislocations (shoulder n=2, knee, elbow, wrist), 3 ruptures of
Achilles tendon, 3 sprains (ankle, knee and shoulder), 6 muscle injuries (thigh n=4, hip and lower
leg), 2 complex lesions of the joints (shoulder, knee), and 1 concussion. Information on time loss was
missing for 221 injuries, at least 22 of which were suspected to be severe (10 fractures, 8 ligament
ruptures, 4 complex injuries with ligament ruptures). The risk of incurring a time loss injury was
highest in football, taekwondo, handball, weightlifting, boxing, triathlon and athletics. Time loss
injuries were reported from all sports except flat-water canoeing, diving, sailing, and synchronised
swimming. During the 2002 Winter Paralympics,[4] only traumatic injuries resulted in time loss.
Most of these 8 time loss injuries were incurred by alpine skiers who were unable to compete for the
remainder of competition. Their injuries were two torn cruciate ligaments, two distal radius fractures
and a concussion. Information was missing for 6 other injured athletes, two of which had intraarticular
knee pathology that would have made continued participation unlikely.
The most common injury types for both males and females in the 2010 Winter Olympics[3] were in
the order of contusions, ligament sprains then muscular strains. The most common locations were the
face, head and cervical spine combined, the knee followed by wrist for females and thigh for males.
Twenty concussions were reported from the snowboard cross and half pipe, alpine skiing, freestyle ski
cross and aerial, bobsleigh, short-track speed skating and ice hockey events. Shoulder, knee and ankle
ligament injuries were common in alpine skiing, ski jumping, speed skating and all freestyle skiing
events. Hand, wrist, lower leg and ankle fractures and other bone injuries mostly occurred in ice
hockey, alpine and freestyle skiing, and snowboard disciplines. At the 2008 Summer Olympics,[1]
fractures were commonest in taekwondo, boxing, track and field, football and handball. The
dislocations and tendon or ligament ruptures were commonest in taekwondo, judoka, handball,
hockey, weightlifting, track and field, wrestling and basketball. Concussions were reported from
boxing, football, baseball, basketball, hockey, judo, taekwondo, road cycling, and slalom
canoeing/kayaking. Regarding the data from the 2002 Winter Paralympics[4] [Table 1], five of the six
overuse injuries involved the upper limb. Sledge hockey injuries usually affected the upper limbs and
all Nordic skiing injuries involved the upper limb. Whereas of the alpine skiing injuries 33% affected
the upper limb and 38% the lower limb.
The causality of injuries is detailed in Table 1. In the 2010 Winter Olympics,[3] 60% of the non-
contact injuries were suffered by alpine and freestyle skiers and snowboarders. 57% of contact
injuries with a stagnant object were in bobsleigh, skiing and snowboarding. 81% of contact injuries
with another player occurred in ice hockey. In the 2008 Summer Olympics,[1] contact with another
athlete caused more than 50% of the injures in boxing, judo, water polo, handball, taekwondo,
wrestling, and football. Non-contact traumas were frequent in cycling, riding, shooting, tennis, and
volleyball. Overuse caused more than 40% of injuries in rowing, modern pentathlon, sailing, shooting,
tennis, beach volleyball, triathlon, athletics, weightlifting, swimming, and badminton. Some injuries
were due to contact with an object (13.4%) and recurrence of a previous injury (5.5%). In baseball
and hockey, contact with a moving object (ball, stick) was the cause of more than half the injuries.
Rarer causes of injury were playing field conditions, weather conditions and equipment failure. In the
2002 Winter Paralympics[2] equipment was believed to have more commonly had a role, in almost
twenty per cent of injuries. One injured alpine skier reported failure of their binding to release and the
mechanisms of two others’ injuries indicated involvement of their outrigger skis. Two injured sledge
hockey players were struck by sticks and four were involved in collisions.
DISCUSSION
Table 2
Sports injuries and illnesses
during the Winter Olympic
Games 2010[3]
Sports injuries during the
Summer Olympic Games
2008[1]
Injuries among Disabled
Athletes during the 2002
Winter Paralympic Games
Data collection method Head physicians of every
National Olympic Committee
(NOC) were asked to report
daily the occurrence (or non-
occurrence) of newly
sustained injuries on a
standardised reporting form.
In addition, the medical
centres at the Vancouver and
Whistler Olympic clinics
reported daily on all athletes
treated.
The chief physicians and/or
chief medical officers of the
NOCs were asked to report
daily newly incurred injuries
(or non-occurrence) on a
standardized form. Injuries
were additionally reported by
the Local Organizing
Committee (LOC) physicians
at different venue medical
stations and the polyclinic.
The authors collected data on
injuries presenting to the
polyclinic or different venue
medical outposts. In addition,
team physicians and other
medical personnel were
contacted to secure their
participation. Attempts were
made to distribute forms to
team medical personnel so
that injuries that were not seen
by venue or polyclinic
physicians were recorded.
Definition of injury An athlete was defined as
injured if they received
medical attention (not only
time loss injuries) and the
IOC surveillance method
applied the following criteria:
[1] musculoskeletal complaint
or concussion, [2] newly
incurred (pre-existing, not
fully rehabilitated should not
be reported) or reinjuries (if
the athlete has returned to full
participation after the
previous injury), [3] incurred
An injury was defined as any
musculoskeletal complaint
(traumatic and overuse) and
the IOC surveillance method
applied the following criteria:
[1] all injuries that received
medical attention (not only
time loss injuries), [2] newly
incurred (pre-existing, not
fully rehabilitated injuries
should not be reported) and
reinjuries (should be reported
only if the athlete has returned
to full participation after the
No definition of injury
outlined.
in competition or training and
[4] during the 2010 Winter
Olympics.
If multiple body parts were
injured or multiple types of
injury incurred in the same
body part in one incident,
only the most severe injury
was registered but with
several diagnoses.
previous injury), [3] in-
competition and training
injuries, [4] during the 2008
Summer Olympics, and [5]
excluding illnesses and
diseases.
If multiple body parts were
injured or multiple types of
injury incurred in the same
body part in one incident, this
was counted as one injury
with 2 diagnoses.
Response / Participation
rate
All 33 NOCs with more than
10 athletes, representing 2417
(94.2%) of the total 2567
athletes, were included in the
analysis of response rates.
These NOCs returned 461 out
of a maximum of 561 forms.
The response rates decreased
with the sizes of the NOCs.
42 injuries were missed by
NOCs but recorded from the
clinic databases. The highest
proportions of missed injuries
were in the smallest NOCs.
The physicians or therapists
of 92 national teams with
9672 (88%) athletes took part
in the study and returned 1314
forms. In addition, 264 forms
from venue medical stations
and all daily reports from the
polyclinic were received.
No information given on the
response rate of medical
personnel to whom forms
were distributed, however this
is less important as most data
was recorded by the authors
themselves.
The studies of the 2010 Winter Olympics[3] and 2008 Summer Olympics[1] both had involvement
from the IOC Medical Commission. They utilised the current IOC injury reporting system which is an
adaption of a system established for team sport tournaments. It was proven suitable for non-team
sports in a pilot study during the 2007 International Association of Athletics Federation (IAAF)
World Championship in Athletics.[5] Standardised reporting forms outlining a definition of injury
were distributed to chief physicians of the NOC. The forms requested an injury report from the
physician responsible for any injured athlete and a daily report whether or not an injury occurred.[6]
The study of the 2002 Winter Paralympics[2] was different however as the data was mainly collected
by the authors themselves who accessed medical records. [Table 2]
Shadgan B et al.[7] recorded exclusively the injuries incurred by wrestling athletes at the 2008
Summer Olympics. Three physicians directly observed and recorded all injuries during wrestling
matches, but found it impractical to also be present at all training sessions and so disregarded training
injuries in their study. The study of the 2008 Summer Olympics[1] in Table 2 also included injuries in
wrestlers, and successfully recorded those incurred during training. This highlights an advantage of
the IOC’s injury surveillance system which does not require researchers to be at the scene to record
every injury. However a disadvantage remains that that the system relies on excellent compliance of
the participating NOCs in order for complete data to be entered into the study. Missing information
was a problem, with time loss information missing for over a third of injuries in the 2010 Winter
Olympics[3] and gender unspecified for 42 of the injuries in the 2008 Summer Olympics.[1] A lack of
exposure data obtained by the method of data collection at the 2002 Winter Paralympics[2] meant the
authors were unable to calculate incidence rates. The limitations in these data collection methods are
important to overcome in future studies to improve accuracy. To maximise the sample size and
thereby increase the reliability, studies should gather data from as many athletes as possible, including
those who do not incur any injury to confirm they are uninjured. One optimal injury surveillance
system should be established for all Olympic and other multinational and multisport events with a
standardised definition of injury, the same reporting form and the same protocols. This would allow
results from all the events to be more comparable and conclusions to be made from a more robust
bank of evidence.
Contact with another athlete was the commonest cause of injury in the 2010 Summer Olympics,[3]
whereas in the 2008 Winter Olympics[1] it was non-contact trauma closely followed by contact with
another athlete [Table 1]. This suggests a difference in the nature of Summer and Winter sports in
general. More sophisticated analysis of the mechanisms of injury in future studies, for example using
video playback, would provide a better understanding of causality to advise injury prevention
measures. The Summer Olympics is about 8 times larger than the Winter Olympics.[8] Accordingly,
many more injuries were reported from the 2008 Summer Olympics[1] than the 2010 Winter
Olympics.[3] However Table 1 presents an incidence of injury at the 2010 Winter Olympics[3] that
works out as 16.3% higher than at the 2008 Summer Olympics.[1] This suggests a higher risk of
injury associated with winter sports compared to summer sports in general. During both the 2002
Winter Paralympics[2] and the 2010 Winter Olympics[3] there was an even distribution of injuries
between training and competition, and about one quarter resulted in time loss [Table 1]. In contrast
the distribution of injuries was three times higher in competition than in training during the 2008
Summer Olympics[1] and about one half of these injuries resulted in time loss. This comparison
suggests that although more injuries occur in winter athletics, those in summer athletics are usually
more severe as they twice as often result in time loss. However, the duration of absence from sport in
each case is only an estimate because there was no follow-up of injured athletes.
The 10 publications identified in the literature search that met the 3-part inclusion criteria [Figure 1]
are now to be discussed. Only 2 of the 10 were studies of Paralympic athletes, one during the 2002
Winter Paralympics[2] which has been discussed in detail and the other comparing differences in the
soft tissue injuries sustained by members of the four different disabled sport organisations in the USA
team at the 1996 Summer Paralympics.[9] Despite the growing awareness and popularity of disabled
sports, there remains a lack of research regarding injuries among elite disabled athletes.[2]
A study of polyclinic services during the 2002 Winter Olympics[8] comments on a rise in the number
of athletes that visited the polyclinic from the 1994 to the 1998 Winter Olympics, and then again
during the 2002 Winter Olympics. This suggests a continually increasing demand for polyclinic
services. This study claims that alpine skiers made the most visits to the polyclinic (though the
authors recognise this observation appears to be inconsistent with results from published
epidemiological studies investigating winter sport injuries) and goes against evidence that instead
snowboard cross was associated with the the highest rate of injury in the 2010 Winter Olympics[3]
[Table 1]. Of all polyclinic services, general medicine had the highest patient encounters at the 2002
Winter Olympics,[8] and it is assumed that most of these were for illnesses as opposed to injuries.
Contrastingly, it works out that 2244 (87.5%) more athletes were affected by injury than illness in the
study of the 2002 Winter Paralympics[2] which reported an incidence of 72.1 ilnesses per 1000.
Muskuloskeletal and physical therapy services were the second and third most visited at the 2002
Winter Games.[8] Of the 466 patients who consulted musculoskeletal services, upper limb injuries
represented 25% of the diagnoses, 55% were lower limb, 13% were spine related and there were
seven concussions. These statistics are in agreement with the those from the study of the 2010 Winter
Olympics.[3] Another article by Crim JR[4] reports that out of all the winter sports the highest rate of
injuries resulting in positive MR imaging or plain radigraphs was in snowboarders (28/1000 races)
and the most commonly injured joint was the knee (37 injuries). This is also in agreement with the
study of the 2010 Winter Olympics[3] [Table 1]. These correlations in the literature suggest a
predictable trend for future Winter Olympics.
In a study of patients presenting to the Foot and Ankle Department during the 2004 Olympics,[10]
64% of the patients were athletes and interestingly the most common soft tissue injury was achilles
tendonitis (n=153) closely followed by ankle sprains (n=138) then peroneal tendinitis (n=64). A study
of the 8 team sport tournaments during the 2004 Summer Olympics[11] found the lowest rate of
injury was in softball, however this sport had the 4th highest injury rate in the 2008 Summer
Olympics[1] [Table 1]. During both the 2004 Summer Olympics[11] the 2008 Summer Olympics[1],
football was associsted with the highest relative risk of injury and hockey, handball and basketball
were among the other top five highest risk team sports. Recognition of these trends is important to
make suggestions for which events will have the highest demand for medical resources at future
Olympic Games.
CONCLUSION
This review has found trends in the evidence regarding injuries at Olympic Games. From this it is
shown the areas where athletes are at risk of injury during future Games and other multisport events,
and where improvements in injury prevention strategies are most urgently needed. This review has
also brought to light several areas of conflict where further research is required to produce conclusive
evidence. None of the data collection methods in the studies reviewed were without limitations. All
had valuable data missing. More work should be done to establish one injury surveillance system for
all Olympic and other multinational, multisport events. This would produce more valid evidence when
making implications for future events. Researchers could also improve on past studies by using video
playback for the analysis of injury mechanisms and following up injured athletes to record their actual
duration of absence from sport. Data collection should also be increased to include information on the
investigations injured athletes are referred for and the treatments they receive. This would provide
additional evidence for what medical resources will be in particular demand at future events.
Acknowledgements, Competing interests,
Funding
I would like to acknowledge the support of the The Centre for Sports and Exercise Medicine at Barts
and The London School of Medicine and Dentistry where I am currently completing a BSc in Sport
and Exercise medicine.
There are no competing interests to declare.
There was no funding for this work.
REFERENCE LIST
1. Junge A, Engebretsen L, Mountjoy ML et al. Sports injuries during the Summer Olympic
Games 2008. Am J Sports Med. 2009;37[11]:2165-72.
2. Webborn N, Willick S, Reeser JC. Injuries among disabled athletes during the 2002 Winter
Paralympic Games. Med Sci Sports Exerc. 2006;38[5]:811-5.
3. Engebretsen L, Steffen K, Alonso JM et al. Sports injuries and illnesses during the Winter
Olympic Games 2010. Br J Sports Med. 2010;44[11]:772-80.
4. Crim JR. Winter sports injuries. The 2002 Winter Olympics experience and a review of the
literature. Magn Reson Imaging Clin N Am. 2003;11[2]:311-21.
5. Alonso JM, Junge A, Renström P et al. Sports injuries surveillance during the 2007 IAAF
World Athletics Championships. Clin J Sport Med. 2009;19[1]:26-32.
6. Junge A, Engebretsen L, Alonso JM et al. Injury surveillance in multi-sport events: the
International Olympic Committee approach. Br J Sports Med. 2008;42[6]:413-21.
7. Shadgan B, Feldman BJ, Jafari S. Wrestling injuries during the 2008 Beijing Olympic Games.
Am J Sports Med. 2010;38[9]:1870-6.
8. Reeser JC, Willick S, Elstad M. Medical services provided at the Olympic Village polyclinic
during the 2002 Salt Lake City Winter Games. WMJ. 2003;102[4]:20-5.
9. Nyland J, Snouse SL, Anderson M et al. Soft tissue injuries to USA paralympians at the 1996
summer games. Arch Phys Med Rehabil. 2000;81[3]:368-73.
10. Badekas T, Papadakis SA, Vergados N et al. Foot and ankle injuries during the Athens 2004
Olympic Games. J Foot Ankle Res. 2009;2:9.
11. Junge A, Langevoort G, Pipe A et al. Injuries in team sport tournaments during the 2004
Olympic Games. Am J Sports Med. 2006;34[4]:565-76.
Figure Legends
Figure 1: a flow diagram of the literature identified for review in accordance to the inclusion criteria.
Key: (i) considering any past Summer/Winter/Junior Olympic or Paralympic Games period,
and (ii) documenting any sports related injuries from 1984 to the present day, that (iii)
occurred in the participating Olympic athletes.
