Calf muscle injury in elite athletics: an 8-season prospective cohort study

Objective To describe epidemiological data of indirect calf muscle injury (CMI) in elite track and field athletes. To investigate relationships between CMI and athlete characteristics to inform future injury prevention strategies. Design Descriptive epidemiology study. Methods A total of 201 track and field athletes, mean age 25.9 +/− 4.4, were prospectively observed over 8-seasons (616 athlete seasons). The main outcome measures were injury location, injury number, incidence, incidence proportion, severity, burden and recurrence. Poisson generalised linear regression models were used to explore relationships between potential risk factors. Results There were 85 CMIs during the study period. Thirty three percent of CMIs were classified as severe. Soleus injuries had the highest incidence, burden and recurrence and were present across all event groups. Incidence proportion of all CMIs was 11.1 %, with the highest incidence of injuries occurring in April. Acute CMI was the most common mechanism, with the right lower limb (58 %) being more affected than the left (42 %). There was no association between CMI occurrence and sex, though there was a significant positive effect between both age and previous lower limb injury. Conclusion Calf muscle injury is prevalent in elite track and field athletes. CMI has a peak incidence in April which can have a detrimental effect on an athlete's performance goals for the impending summer competition season. The soleus muscle is the most injured muscle with the biggest burden and recurrence making it a muscle of focus when developing rehabilitation and prevention programs. Older athletes, and athletes with a previous lower limb injury, are more at risk of CMI in elite athletics. Due to the burden and potential performance impact of CMI, further injury prevention efforts are required to reduce the impact of this injury type.