Despite a high daily training availability, a quarter of Academy athletes start the season with an injury and three quarters finish with one

      Introduction: The development (or academy) phase of an athlete forms the foundation for a successful athletic career. Injuries affect an athlete’s availability to train, compete, and perform. Context-specific understanding of the injury burden and risk factors can enable prevention strategies to be prioritised, developed, and implemented to positively impact academy athlete longevity and trajectory towards elite levels. Medical servicing is a key component of the health system around an athletic population. Currently there are no data pertaining to the delivery of medical services in Australian academy athletes. We aim to investigate the incidence, prevalence, burden and characteristics of injuries; and to describe the frequency and type of medical servicing for elite sports academy athletes over a 12-month season.
      Methods: Medical attention and time-loss injuries were prospectively recorded for 94 athletes (72.3% females) during the 2019-2020 scholarship season. The number and type of linked medical treatments was also recorded. Injury incidence rates (IIR), point and period prevalence, and injury burden were calculated and compared by athlete sex, sport, and categorisation using incidence rate ratios (IRR).
      Results: 193 injuries were reported in 71 (75.5%) athletes. The IIR was 2.08 (95%CI=1.80-2.40) injuries per 365 days, with no sex difference observed (IRR=1.05, 95%CI=0.77-1.43, p=0.761). The injury burden was 43.52 (95%CI=37.79-50.11) days absence per 365 days. More than one-quarter (point prevalence, 26.6%) of athletes commenced the season with an injury. In-season injury risk was 2.5 times higher in athletes commencing the season with an injury (IRR=2.49, 95%CI=1.85-3.35, p<0.0001). 75.5% of athletes sustained a medical-attention injury within the 12 month period, medical servicing was not uniform across sports, and despite this, a mean daily athlete availability rate of 87% was observed which fluctuated significantly across the period between 79% and 92%. 81.2% of the 1164 treatments recorded were physiotherapy, with an overall 4.3:1.0 physiotherapy to medicine treatment ratio.
      Discussion: This is the first study to report the incidence, prevalence, burden, and characteristics of injuries, and the frequency and type of medical servicing delivered to athletes across multiple sports at a State Academy of Sport in Australia. One in four athletes began the elite pathway season with a pre-existing injury, while also demonstrating a 2.5 increased risk of subsequent injury in the scholarship period. Injury profiles and medical servicing varied across sports highlighting the need for service delivery models, prevention programs, and scholarship selection processes to be flexible and supportive of athlete health requirements.
      Conflict of interest statement: My co-authors and I acknowledge that a conflict of interest may exist as author DS works at ACTAS, and authors LT, NP, and MK work at the AIS, which could potentially bias this research.