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Introduction
In recent years, the value of regular monitoring in protecting the health of athletes has received increasing recognition. 1 2 The International Olympic Committee, together with several major International Federations and National Olympic Committees, has developed a surveillance system designed to record injuries and illnesses in major championships, 3 and this has been successfully implemented in several Olympic Games, World Championships and other major sporting tournaments. 4-11 Similarly, the International Paralympic Committee has conducted systematic injury surveillance at the 2002, 2006 and 2010 Winter Paralympic Games. 12-14 However, with the exception of certain sports such as football, 15 there are few prospective studies of health problems among Olympic-level athletes outside of the brief period in which they are competing in major championships. Little is known, therefore, about their patterns of illness and injury in their normal training and preparation phases.
Among the possible explanations for this lack of knowledge are the methodological challenges faced when conducting longer term studies in this group of athletes. The methods currently employed in a majority of prospective surveillance studies are based on those developed for recording football injuries, 16 and while they may work well for team sports, they are difficult to implement among groups of individual athletes or those without a centralised team structure. 17 Standard methods of injury surveillance may also be poorly suited to collecting information on overuse conditions, which represent the predominant injury type in many Olympic sports. 10 18-20 We have recently discussed these limitations in detail, 21 made general recommendations for more appropriate methodology 21 and developed new tools that are better suited to the study of overuse injuries. 22
Our first aim in the present study was therefore to modify our new method 22 such that it can be used to record not only overuse injuries but also all types of health problems in studies of large, heterogeneous groups of athletes. Our second aim was to apply the method to analyse the patterns of illness and injury in the Norwegian Olympic and Paralympic teams during their preparations for the 2012 games in London.
Methods
Recruitment
During the summer of 2011, the coaches of the Norwegian national teams in all candidate sports for the London Olympic or Paralympic Games were asked to...