Drole Kristina, Paravlic Armin, Steffen Kathrin, Doupona Mojca
Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
Faculty of Sports Studies, Masaryk University, Brno, Czechia.
Front Sports Act Living. 2025 Aug 29;7:1664247. doi: 10.3389/fspor.2025.1664247. eCollection 2025.
While training and competition load are well-documented risk factors for injury, the influence of dual-career loads, life stressors and overall load on both injury and illness remain less clear. The aim of this study was to investigate whether injury/illness occurrence is influenced by the training, competition, academic and work loads, as well as the overall load (sum of academic/work, training and competition loads) and life events in elite male handball players.
In this 45-week prospective cohort study, 189 elite male handball players weekly reported their load across training, competition, academic, and work domains. We derived an "overall load" variable as the sum of training, competition, academic and work hours. Health problems, including acute non-contact, overuse injuries and illnesses, were recorded using OSTRC-H2-SLO, while psychosocial load was assessed using the LESCA questionnaire. Multivariate logistic regression and non-parametric tests were used to identify risk factors and group differences.
Injured athletes reported significantly higher training (MD = 2.6 h; < 0.001), and overall loads (MD = 2.9 h; = 0.042), but lower academic loads (MD = 2.5 h; = 0.001) than non-injured athletes. Similarly, ill athletes had higher training load (MD = 1.55 h; = 0.026) and competition loads (MD = 0.23 h; < 0.001) but lower academic loads (MD = 2.24 h; = 0.001). Training load emerged as a significant predictor of both injury (OR = 1.33) and illness (OR = 1.23), and competition load strongly predicted illness (OR = 37.00). Academic and work loads were not significant predictors. Higher LESCA total scores were associated with increased injury ( = 0.041) and illness risk ( = 0.017), while negative scores were associated with increased illness risk ( = 0.012).
Training and competition loads are key modifiable risk factors for injury and illness, while dual career might serve as a protective factor. While negative life events appear to be associated with illness, the overall volume of life changes-regardless of whether they are positive or negative-emerges as a significant factor in injury risk. Our results support the development of an integrated biopsychosocial model of athlete's health, where sports- and non-sports-related loads, together with life events shape an athlete's vulnerability to injury and illness.
虽然训练和比赛负荷是已被充分记录的受伤风险因素，但双重职业负荷、生活压力源以及总体负荷对伤病的影响仍不太明确。本研究的目的是调查精英男子手球运动员的伤病发生是否受到训练、比赛、学业和工作负荷，以及总体负荷（学业/工作、训练和比赛负荷之和）和生活事件的影响。
在这项为期45周的前瞻性队列研究中，189名精英男子手球运动员每周报告他们在训练、比赛、学业和工作领域的负荷情况。我们得出一个“总体负荷”变量，即训练、比赛、学业和工作时长的总和。使用OSTRC-H2-SLO记录健康问题，包括急性非接触性损伤、过度使用损伤和疾病，同时使用LESCA问卷评估心理社会负荷。采用多因素逻辑回归和非参数检验来确定风险因素和组间差异。
受伤运动员报告的训练负荷（平均差=2.6小时；<0.001）和总体负荷（平均差=2.9小时；=0.042）显著高于未受伤运动员，但学业负荷（平均差=2.5小时；=0.001）较低。同样，患病运动员的训练负荷（平均差=1.55小时；=0.026）和比赛负荷（平均差=0.23小时；<0.001）较高，但学业负荷（平均差=2.24小时；=0.001）较低。训练负荷是受伤（比值比=1.33）和患病（比值比=1.2）的显著预测因素，比赛负荷强烈预测患病（比值比=3）。学业和工作负荷不是显著的预测因素。LESCA总分较高与受伤风险增加（=0.041）和患病风险增加（=0.017）相关，而负分与患病风险增加（=0.012）相关。
训练和比赛负荷是伤病的关键可改变风险因素，而双重职业可能起到保护作用。虽然负面生活事件似乎与疾病有关，但生活变化的总体量——无论其是积极还是消极——都是受伤风险的一个重要因素。我们的结果支持建立一个综合的运动员健康生物心理社会模型，其中与运动和非运动相关的负荷，以及生活事件共同塑造了运动员受伤和患病的易感性。
