A retrospective profile of musculoskeletal injuries of ultra-endurance triathletes in South Africa
Authors:   , Momberg Courtney Dean 
Published: October 2021

Aim The aim of this study was to determine the injury profile of ultra-endurance triathletes in South Africa. Background An ultra-endurance triathlon comprises a combination of swimming, cycling and running; the distances covered are a 3.8km swim, 180km cycle and a 42.2km run all in succession. Ultra-endurance triathlon has grown in popularity since its inception in the 1970s. However, there is insufficient data relating to injuries in the South African context especially related to age and gender. Methods This Institutional Research Ethics Committee of the Durban University of Technology approved study included 100 active members of My Training Day and ultra-endurance triathletes associated with My Training Day that were training and taking part in the 2017 South African ultra-endurance triathlon (2017 South African Ironman Race). After signing the informed consent form and letter of information, participants completed an online questionnaire on training and injury profiles. All data captured was anonymous and confidential. Data was described using frequency tables for categorical data and summary statistics for continuous data. Odds ratios were reported and a p value < 0.05 was considered statistically significant. For triathletes reporting injuries, linear regression was used for factors associated with injury severity. Results Questionnaires were returned by 86 ultra-endurance triathletes, of which 71 were deemed viable giving a response rate of 71%. The past and periodic (day of the race) prevalence of ultra-endurance triathlon-related musculoskeletal injury was 46.5% and 9.85% respectively. The most common site of injury in the year leading up to the 2017 ultra-endurance race was the posterior compartment of the lower limb, being the hamstring / calf (36.4%), while there was an equal split of injuries on race day with the shoulder, hamstring / calf, knee / quadriceps region all having the same percentage (28.6%). Of the 71 participants 66.2% were male and 33.8% were female. The most common age group was 30 to 34 years (25.7%). The majority of the participants started participating in ultra-endurance triathlons between 24 and 29 years of age (32.4%). There was no significant difference in age between those who had injuries prior to the event and those who did not (p = 0.079). There was no statistically significant difference in prior injury prevalence between males and females (p = 0.395). There was a borderline non-significant difference indicating younger athletes were at higher risk for injury on race day (p = 0.069). Females had a higher risk of injury on race day (p = 0.039). Conclusions and recommendations The results concur with previous research and add further insight into factors predisposing triathletes to injury. The most common injuries require investigation to develop preventative interventions to reduce injuries in triathletes. Further research into age and gender interactions as risk factors for injury is needed in South Africa. Health professionals require education about ultra-endurance triathlon-related injuries to improve preventative and curative interventions.