Injury rates among elite young female athletes may be higher than what’s been reported, new data suggest.

“Most studies define injury as time loss from participation, whereas many athletes with overuse injuries continue to participate despite pain and reduced performance. When time-loss definitions are used, about 90 percent of overuse injuries appear to be missed,” the researchers said online April 23 in the journal BMJ Open Sport and Exercise Medicine.

Angelo Richardson of Amsterdam University of Applied Sciences in The Netherlands and colleagues studied 60 young women who competed at the national or international level in soccer, basketball or gymnastics. The average age of the study participants was 17.

Every two weeks during the 2014-2015 season, the athletes filled out questionnaires that asked about health problems, including not just new injuries but also overuse injuries, which occur over time as a result of repeated stresses on tissues, bones and joints.

Overall, at any given time during the study, 48 percent of the athletes reported injuries, the authors found. And every two weeks, nearly 61 percent of the athletes were reporting some sort of health problem - either injury or illness.

Put another way, if a thousand athletes such as these were to participate in their sports for an hour, nine of them would sustain an injury, the researchers said. By comparison, a 2016 study of high school soccer players in the U.S. found that if a thousand of them were to practice or play soccer for an hour, only two would sustain an injury – with only a slight difference between girls and boys.

Injury rates were similar for all three sports. But when it came to “substantial” injuries, the soccer and basketball players were at higher risk, with rates of roughly 28 percent in each group, compared to the gymnasts, whose rate of substantial injuries was 16 percent.

The high prevalence of self-reported injuries among these talented female athletes suggests that efforts toward prevention are needed, the authors wrote.

“I believe this study provides some real value to what we know as health care providers who work in sport,” athletic trainer Scott Sailor, who is president of the National Athletic Trainers’ Association, told Reuters Health in an email.

“Often the data we have deals with time loss injuries and the majority of injuries athletic trainers treat on a daily basis are non-time loss,” said Sailor, who was not involved in the study.

It’s crucial that athletes be appropriately prepared for the demands of the sport, Sailor said. This involves making sure they have adequate strength and flexibility, but it goes beyond that, to making sure they have appropriate movement patterns - that the way they run, jump, lunge, land, etc. is efficient and effective so that they don’t get their joint in a position where their body can’t protect them from injuring tissues, he said.

“Working with athletic trainers or other sports medicine professionals can provide added benefit and ensure proper form, movement and reduced risk of injury. Equally important is ensuring our athletes have adequate nutrition, hydration and rest,” he said.

Failing to do these things predisposes the athlete to injury and illness, he added.

“Most training for athletes has now transitioned from maximum lifts in the gym to functional exercises that train sport-specific movement patterns,” said Lawrence Spriet, a researcher in the Department of Human Health and Nutritional Sciences at the University of Guelph in Ontario, Canada, in email to Reuters Health.

“Ensuring that athletes fuel properly through their diet, have consistent warm-ups and cool-downs before and after exercise, and use individualized training protocols can all assist in injury prevention,” said Spriet, who wasn’t involved in the study.

It is not uncommon for athletes to sustain injuries but it is essential to try to prevent injuries that cause time-loss from training and competition, decrease performance levels, and that can become chronic if not treated properly, Spriet added.

“Seeking treatment at the onset of complaints or injury will help avoid this,” he said.

SOURCE: bit.ly/2qgXKq2

BMJ Open Sport Exerc Med 2017.