Breakdown of Triathlon Injuries

Injuries tracked in Ironman show when medical help is needed throughout the race

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Five weeks after a bicycle crash that led to back and collarbone surgery, triathlete Lukas Verzbicas is out of the hospital. The injuries occurred during a training ride, but what happens when they occur during a real race?

He was released Tuesday and is continuing rehab at the US Olympic Training Center in Colorado Springs.

For the everyday, non-elite athlete, what does it mean?

A recent study aimed to figure out the types of injuries that occur in triathlons as well as how many and when they occur.

"Get active! Even 30 minutes a day is beneficial."

The study, led by Terry Rimmer, MD, a physician at St. Anthony Hospital in Oklahoma City, included 104 triathletes in the Ironman Distance Triathlon who needed medical care.

The Ironman Distance Triathlon is made up of a 2.4-mile swim, 112-mile bicycle ride, and 26.2 mile run. The Half Ironman is a 1.2-mile swim, 56-mile cycle, and 13.1 mile run.

The medical history and demographics of each of the 575 race participants were gathered.

For each of the participants that needed medical care during the race, a flow sheet of their information was created.

This contained their race category, arrival and departure times, physical examination, vital signs, diagnoses, and any treatments they were getting.

Every 15 minutes, researchers counted the total participants receiving medical attention in the main treatment area of the race.

"When an athlete subjects themselves to a large volume of work their body loses vital vitamins and nutrients through sweat and fatigue," said Jim Crowell, a fitness trainer at Integrated Fitness and dailyRx contributor.

"It is absolutely crucial to prepare correctly for such a long distance."

Depending on the injury, patients were classified as "severe" or "non-severe." Severe in this case meant that the patient needed to lie in a stretcher whereas non-severe cases could sit up on his or her own.

Researchers also recorded how long each treatment took.

Of the total number of race starters, about 38 percent were injured in the Ironman and about 11 percent in the half-Ironman.

Researchers found that between hours 6 and 7 of the race is when most, or 72 percent, of the half-Ironman injuries happened.

And between hours 9.5 and 11, the time between the two main waves of participants in both the half and full events, the greatest numbers of severely ill patients came in for treatment (at 50 to 67 percent of total serious cases).

"In my opinion injuries happen late in races because the body is depleted of key nutrients and because technique breaks down and people run with poor biomechanics which stresses the wrong parts of the body that aren't geared to take that sort of pounding," Crowell said.

"Prepare properly and fuel accordingly during the race and you will get much farther."

A higher number of serious injuries occurred during the full Ironman at almost 40 percent of total injuries.

The time it took to treat injuries averaged just over an hour at 62 minutes during hour 14 of the race.

The authors say that medical support should be modified to fit the flow of injuries that occur throughout non-elite Ironman events.

They recommend increasing support by 20 percent during the latter stages of the triathlons.

In other words, three physicians and nine nurses and other medical volunteers should be available for every 100 competitors.

"Understanding the ways that elite and non-elite athletes differ in their performance and treatment needs will allow physicians and race coordinators to more adequately prepare for the needs of their competitors," the authors said in their study.

They note that further research should be done on how useful these strategies will be before applying the data as common practice.

The authors report no conflicts of interest. The study was published in the May 2012 issue of the Clinical Journal of Sport Medicine.

Reviewed by: 
Review Date: 
September 6, 2012
Last Updated:
September 8, 2012