Background: Adolescent elite athletes have a high injury risk and many risk factors for injury have been suggested. However, there is a lack of prospective studies in adolescent elite athletes of age 15-16 years. Aim: The aim of the study was to prospectively explore risk factors associated with different injury prevalence profiles in adolescent elite athletes. Methods: Substantial injury was monitored in adolescent elite athletes (n=422) using the validated Oslo Sports Trauma Research Center Questionnaire over 20 weeks. Athletes were categorised in tertiles based on injury prevalence. Results: The median substantial injury prevalence for all athletes was 10% (IQR 0%-20%). Compared with the `no injury` group, previous injury (p<0.001, OR 3.91) and well-being (p<0.001, OR 0.93) were associated with the `high injury` group, and previous injury (p=0.006, OR 1.96) and being a female athlete (p=0.002, OR 2.08) with the `low injury` group. A female athlete with a previous injury and low perceived well-being (25th percentile) had a 48% risk (95% CI 36% to 59%) of belonging to the `high injury` group, compared with 7% (95% CI 4% to 12%) for a male athlete with no previous injury and high well-being (75th percentile). Conclusion: Medical personnel should be aware of the high injury risk and risk factors for injury in adolescent elite athletes, and closely monitor the rehabilitation post-injury as a previous injury is such a strong risk factor for a new injury.
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