External stressors prior to traumatic knee injury: A cohort study on youth athletes.

Background:Data on external stressors, such as social and environment variables and other "life events", and its relation to injury in youth athletic population are scarce. Investigating if external stressors is associated with injury risk may help coaches and other team staff to provide a more safe sport environment. The aim of the present study was to evaluate different aspects of external stressors and its potential association to traumatic knee injury in youth athletes.Methods:This study comprised of youth female and male athletes from Swedish national sports high schools, aged 15–19 years, participating and competing in soccer, handball, or floorball. The athletes recorded any traumatic knee injury that had occurred during high-school in a web-based injury form. Data on external stressors and subjective perceived stress was also collected.Results:The majority (60%) of stress factors noted was related to sport context. More athletes in the injured group of athletes reported life event stressor (p=0.001) and experienced stress more often (p=0.02) compared to the group of non-injured athletes. No differences between injured and non-injured athletes in terms of change of club, team coach, training protocol or game formation were noted (p>0.05). A weak correlation (r=0.20, p=0.02) was found between the number of stressors and injuries.Conclusions:A high prevalence of external stressors are present in youth elite athletes with a majority of stress factors related to sport context. Life event stressors are present prior to injury and seem to be associated with traumatic knee injury to some degree.