Balancing act: incidence and prevalence of triathlon injuries

2022 European Championships – Triathlon - General view of athletes in action at the start of the Men’s Triathlon Elite Final REUTERS/Andreas Gebert

Triathlon comprises three different sports disciplines: swimming, cycling, and running. It has recently found a place in the spotlight globally and is a relatively young sport. The complex interplay between the three disciplines means that the risk factors predisposing triathletes to injury are not the same as the risk factors for each discipline in isolation. Understanding the intrinsic and extrinsic risk factors will aid coaches, athletes, and practitioners in creating individualized training, and injury management and prevention strategies for triathletes. 

Triathletes train on average 10-14 hours a week. This comprises 8-10 training, which is higher than single-sport athletes and increases the injury risk. Therefore, having an injury prevention strategy aimed at triathletes could prove vital in the sport’s progression for amateurs, age-groupers, and elites. In addition, the popularity of the triathlon has created multiple competition formats. A triathlon can be completed over any distance, but the more common events are the Ironman, Half Ironman, and Olympic distances (see table 1). 

Table 1: the most common triathlon distances

Researchers in the United Kingdom conducted a systematic review of long-distance (Ironman) triathletes to determine the epidemiology of musculoskeletal injuries. The study results showed that elite athletes have a lower incidence of overuse and acute injuries than non-elite⁽¹⁾. The overuse injury incidence ranges between 37% and 91%, with elite athletes on the lower end of the range. When comparing the short (Olympic) and long (Ironman) distance athletes, the injury incidence is similar, with the knee being the most commonly affected area in both populations⁽²⁾. Regarding the injury incidence within each discipline, running and cycling were the most frequently affected (see figure 1)⁽¹⁾.