Musculoskeletal Complaint Patterns and Training Impact in Adult Triathletes During the 2023 Season

Objectives: To characterize self-report musculoskeletal complaints, anatomical distribution, healthcare utilization, training impact, and associations with demographic and training characteristics among adult triathletes during the 2023 season. Methods: A retrospective cross-sectional survey was conducted among community-based triathletes recruited through social media and triathlon organizations. Adults aged ≥18 years who completed or intended to complete at least one triathlon in 2023 were included (N = 245). Demographic characteristics, years of participation, race focus, and weekly training volume were collected. Main outcomes included self-reported musculoskeletal complaints, anatomical location, complaint classification, healthcare utilization, and training disruption. Results: Of 245 participants (60.0% male; most frequent age group 30-34 years), 127 of 242 with available complaint data (52.5%) reported at least one complaint, totaling 175 reported complaints. The lower extremity accounted for 79.4% of complaints, most commonly the hip/pelvis (22.3%), lower leg (18.7%), knee (17.3%), ankle (15.1%), and foot/toes (15.1%). Running was the most frequently reported activity associated with complaint onset (61%). The number of reported complaints was not significantly associated with the broad demographic or training characteristics examined. Healthcare utilization was reported for 62.4% of complaints with available healthcare data. Among complaints with available training impact data, 50.6% resulted in both missed and modified training, 28.2% in modified training only, and 21.2% in missed training only. Conclusions: More than half of the triathletes surveyed reported musculoskeletal complaints during the 2023 season, with lower-extremity and overuse complaints predominating and running most frequently associated with complaint onset. Broad demographic and general training characteristics were not significantly associated with the number of reported complaints. These findings highlight the burden and training consequences of self-reported musculoskeletal complaints among adult triathletes and support the need for prospective surveillance incorporating discipline-specific exposure and more detailed training load measures.