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– Injuries and illnesses can have a significant impact on athletes’ health and performance, especially during the Olympics and Paralympics where an athlete may be competing for just a few days or weeks. By studying which injuries and illnesses occur, and which groups of athletes are most affected, we can gain knowledge that helps prevent health problems during the Games and thereby give athletes better conditions to perform at a high level, says Kalle Torvaldsson, PhD student at Linköping University in collaboration with the Swedish Olympic Committee and one of the researchers behind the study.

Para athletes and youth elite athletes most affected

The study, published in the British Journal of Sports Medicine, is the first to systematically review research on health problems among participants in the Olympics, Youth Olympics, and Paralympics. The researchers analysed data from 27 previous studies and more than 80,000 athletes who competed between 2000 and 2022.

The results clearly show that Para athletes are the most affected, followed by youth athletes competing at the Youth Olympics. Regular Olympic participants are affected to a lesser extent.

– Para athletes often have an underlying impairment that can increase the risk of injury or illness. For example, wheelchair sports include increased load on the arms and shoulders, which can affect injury risk in those body areas. Why youth athletes are more affected is not as clear – it may be a combination of many factors, such as biological maturity, training and competition experience, limited medical resources, or risk-taking, says Kalle Torvaldsson.

Respiratory infections most common

When it comes to illnesses, respiratory infections are the most common cause, especially during the Winter Games where cold temperatures and close contact make viruses spread more easily. Female athletes had consistently slightly higher rates of illness than male athletes, mainly at the Youth Olympics.

A particularly concerning finding was that concussions were four times more common among participants at the Youth Olympics than among participants at the Olympics.

- The higher incidence of concussions and respiratory illnesses among youth athletes were something that surprised us. It raises questions about why youth athletes seem to be affected more often and is something that needs to be explored further, explains Kalle.

He believes an important part of prevention involves education and changed routines:
- It could involve rule changes in certain sports that reduce risky situations, for example in contact sports. Another part could be increasing knowledge about how concussions occur and how to quickly identify them so that correct treatment can be implemented in time.

Decline during the pandemic

The researchers also found that both injuries and illnesses decreased over time in the Paralympics, and that illness cases decreased during the 2020 and 2022 Olympics. A likely explanation is the strict hygiene measures introduced during the COVID-19 pandemic.

– The pandemic clearly showed that strict hygiene routines reduce the occurrence of illness, but at the same time, routines that are too strict can negatively affect athletes. It is about finding a balance – increasing knowledge of how illness spreads and introducing simple, clear hygiene routines that work in athletes’ everyday lives without restricting them too much, says Kalle.

Hygiene routines during travel are also crucial, and at major competitions such as the Olympics and Paralympics it is important that everyone around the athletes – not only athletes and health teams – follow the routines to reduce the risk of illness.

Focus on the whole athlete

Behind the study are researchers from Linköping University, Lund University, the International Olympic and Paralympic Committees, the Norwegian School of Sport Sciences, Stellenbosch University and the University of Pretoria in South Africa, as well as Northeastern University in the United States. For youth athletes, future efforts should include increasing knowledge about respiratory infections and concussions, while for Para athletes there is a need for more support adapted to different impairments.

- I think it is important not to focus only on results and medals, but also on athletes’ health and well-being. That could be reflected in creating an environment where athletes receive adequate medical support and where well-being is prioritised, concludes Kalle Torvaldsson.

Read the full study here:

. Torvaldsson, K. Fagher, K. Derman, W. Engebretsen, L. Lindblom, H. Dias Lopes, A. Runciman, P. Schwellnus, M. Soligard, T. Sonesson, S. Steffen, K. Hägglund, M. British Journal of Sports Medicine, online July 21, 2025. https://doi.org/10.1136/bjsports-2025-109980