Self-reported sports injuries and later-life health status in 3357 retired Olympians from 131 countries: a cross-sectional survey among those competing in the games between London 1948 abd PyeongChang 2018.

Palmer D, Cooper DJ, Emery C, Batt ME, Engebretsen L, Scammell BE, Schamasch P, Shroff M, Soligard T, Steffen K, Whittaker JL, Budgett R. Br J Sports Med. 2021;55:46-53. doi: 10.1136/bjsports-2019-101772. PMID: 33168580.

Full Text Freely Available

Take-Home Message

More than a third of former Olympic athletes reported pain or functional limitations related to a significant injury during their career.


Elite athletes experience high training loads, which may explain their increased risk of acute and overuse injury. A better understanding of these injuries’ long-term consequences may help inform strategies to mitigate the risk of injury and optimize long-term outcomes.

Study Goal

Palmer and colleagues completed a cross-sectional study to describe the prevalence and nature of Olympic career-related injuries. They also assessed athletes’ injury-related symptoms and general health status.


The researchers collected self-reported data from 3357 retired Olympic athletes (1488 females) from 131 countries using an online web-based survey. Respondents answered questions about 1) demographics, 2) Olympic-career sports participation (e.g., sport, years internationally competing), self-reported history of injury (e.g., anatomical location, injury type), 3) self-reported current musculoskeletal health, and 4) Olympic career and current general health and quality of life. The authors focused on significant injuries that caused significant pain or dysfunction for at least 1 month that disrupted sport participation.


Overall, 63% of respondents reported at least 1 significant injury. The sports with the highest injury prevalence was handball (82%), alpine skiing (82%), freestyle skiing (82%), badminton (78%), judo (77%), and snowboarding (77%).   The sport with the lowest injury prevalence was shooting and biathlon (40%). The most affected location reported was the knee (21% of all injuries). Almost 1 in 4 athletes reported continuing to train or compete with performance decline while injured. In contrast, 1 in 5 athletes indicated they stopped all training/competition and allowed the injury to heal fully. Interestingly, almost 1 in 15 athletes reported depression during their career, and among them, 84% also reported an injury. Finally, about 1 in 3 respondents reported current pain or functional limitations attributed to significant injuries sustained during their Olympic careers.


Overall, the injuries have a significant impact on elite athletes during their careers and after. An athlete who reported depression during their career may be more likely to report an injury (84% vs. 63% among all athletes). One-third of respondents reported currently experiencing pain or functional limitations due to career-related injuries. While the authors provided insight into how the overall health outcomes differed by sex, it would have been interesting to understand better how anatomical location, injury type, playing with an injury, and other career choices impacted long-term outcomes.

Clinical Implications

Clinicians should recognize how an injury may impact a patient’s mental and physical wellbeing in the short- and long-term. Hence, clinicians should monitor these outcomes during recovery. Furthermore, clinicians should educate patients about their risk of pain and functional limitations later in life, the importance of reporting these symptoms to healthcare providers, and how to prevent or manage these symptoms. These findings also highlight the importance of adopting injury prevention programs to avoid a significant injury and their long-term consequences.

Questions for Discussion

How do you counsel your athletes on their long-term health relating injury? Do you have any specific psychological resources for your injured athletes?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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