Rehabilitation burden of injuries in national-level Indian athletics: A prospective cohort study

Abstract

Purpose. Injuries are common in athletics and reduce athlete availability. While injury incidence is well described, less is known about rehabilitation burden – the time from injury onset to unrestricted sports participation – particularly in Indian athletes.

Material & Methods. This prospective cohort study followed 95 national-level track-and-field athletes (56 men, 39 women) over one competitive season (November 2023 – October 2024). Injury surveillance was conducted by physiotherapists using International Olympic Committee (IOC) consensus definitions. Rehabilitation duration was measured from injury reporting until medical clearance for unrestricted participation. Descriptive statistics were used, and rehabilitation burden was calculated as days lost per 1000 athlete-days.

Results. Seventy-seven injuries occurred in 71 athletes (74.7%). Muscle injuries were most frequent (n=25; mean rehabilitation 13 days), whereas tendon, bone stress, and joint injuries required longer recovery. Post-operative injuries (n=3) showed the longest rehabilitation duration (mean 260 days). Severe injuries accounted for 36.4% of cases and required a median of 60 days, compared with 20 days for moderate and 5.5 days for mild injuries. Overuse injuries resulted in substantially greater time loss than acute injuries (mean 87 vs. 12 days). Throwers sustained the highest number of injuries (n=30) and had the longest average rehabilitation duration (mean 70 days). Overall rehabilitation burden was 106 days per 1000 athlete-days, indicating approximately 10% athlete unavailability.

Conclusions. Although muscle injuries are common and short-lived, severe, overuse, and post-operative injuries contribute disproportionately to rehabilitation burden in national-level athletics. Targeted prevention strategies, structured rehabilitation, and adequate physiotherapy resources are essential to reduce athlete unavailability.