734 BO18 – Injury in an olympic and paralympic academy: is there a leak in the pathway pipeline?

Background Athlete health is known to affect successful performance. It has also been identified as the most important and feasible athlete retention issue to address by Australian high-performance sport system (HPSS) stakeholders. However, previous research has shown that one in four developing athletes enter the HPSS with a current injury and more than three quarters are injured during their scholarship season. Objective To investigate (1) the injury epidemiology, and (2) the reasons for athlete attrition at each pathway level mapped to the Foundations, Talent, Elite and Mastery (FTEM) framework over a four-year period (2019–2022). Design Descriptive epidemiological study. Setting Australian state academy of sport. Patients (or Participants) Developing and elite Olympic and Paralympic athletes. Interventions (or Assessment of Risk Factors) Nil. Main Outcome Measurements Injury incidence rate (IR), prevalence and burden. Results Four hundred and eighty-one injuries were reported across 124 athletes at an IR of 2.09 injuries per 365 athlete-days (95%CI=1.91–2.29). Most athletes (103, 83.1%) were injured at least once over the four-year period. The injury IR showed no statistically significant difference across the FTEM levels (IRR=1.05, 95%CI=0.93–1.19). The injury burden across the cohort was 49.59 days absence per 365 athlete-days (95%CI=43.99–55.90). Across the 4-year period 37 athletes (29.8%) exited the HPSS. The most common reason for leaving was deselection (n=18). Injury contributed to the exit of 11 of the developing athletes (FTEM levels T2 – T4), and one elite athlete (FTEM level E1). Conclusions Injury occurrence is common across the Australian HPSS pathway, resulting in considerable burden and time-loss from training and competition. Deselection was the main attrition factor, with more than half the deselected athletes impacted by injury, highlighting the negative influence injury has on athlete retention. Development of targeted prevention strategies to mitigate negative performance and attrition due to injury in pre-elite athletes should be prioritised.