Effects of physical, psychosocial and dual-career loads on injuries and illnesses among elite handball players

Drole, Kristina (avtor), Doupona, Mojca (mentor), Steffen, Katrin (komentor)

The aim of this doctoral thesis was to examine how training, competition, academic, work, and psychosocial loads contribute to the occurrence of injuries and illnesses in elite Slovenian male handball players. The thesis comprises five articles; the first outlines the study protocol. Over the course of one competitive season, 189 athletes (mean age 23.3 ± 4.4 years) were monitored using weekly health and load questionnaires, as well as five blood biomarker samplings. The second study confirmed excellent reliability (Cronbach’s α = 0.82–1.00; ICC = 0.84–1.00) of the first standardized athlete health monitoring tool in the Slovenian language – the OSTRCH2-SLO questionnaire. The third article showed that 79% of athletes experienced at least one health problem during the season, with an overall incidence of 2.19 health problems per player per year. Position-specific analyses indicated elevated risks among wing and backcourt players, with the knee, ankle, shoulder, and lower back identified as key sites of injury. The fourth article revealed weak to moderate but significant associations between subjective and objective measures of stress and load. In approximately half of the athletes, subjective measures corresponded moderately to strongly with blood biomarkers, supporting their use as practical and cost-efficient monitoring tools. The fifth article identified training load as the strongest predictor of injury, with each additional training hour increasing injury odds by 33%, while competition load (OR = 37.0, p < 0.001) and a lower testosterone-to-cortisol ratio (OR = 0.976, p = 0.010) were associated with a higher risk of illness. Dual-career engagement was not associated with greater health risks and may serve a protective role, whereas life events representing psychosocial load increased susceptibility to both injury and illness. Overall, these findings support a biopsychosocial model of athlete health, integrating physical, dual-career, and psychosocial loads with blood biomarkers into comprehensive health problem monitoring and prevention.

• Jezik: Angleški jezik
• Ključne besede: load, stress, dual career, health problems, blood biomarkers, overreaching
• Vrsta gradiva: Doktorsko delo/naloga
• Organizacija: FŠ - Fakulteta za šport
• Leto izida: 2025
• PID: 20.500.12556/RUL-177347
• Datum objave v RUL: 21.12.2025

Sekundarni jezik

• Jezik: Slovenski jezik
• Naslov: Vpliv telesnih in psihosocialnih obremenitev ter dvojne kariere na poškodbe in bolezni vrhunskih rokometnih igralcev

Izvleček

Namen te doktorske disertacije je preučiti, kako trenažna, tekmovalna, akademska, delovna in psihosocialna obremenitev prispevajo k pojavu poškodb in bolezni pri vrhunskih slovenskih rokometaših. Disertacija obsega pet člankov; prvi opisuje protokol raziskave. V eni tekmovalni sezoni je bilo spremljanih 189 športnikov (povprečna starost 23,3 ± 4,4 leta) z uporabo tedenskih vprašalnikov o zdravstvenih težavah in obremenitvah ter petih odvzemov vzorcev krvnih biomarkerjev. Druga raziskava je potrdila odlično zanesljivost (Cronbach’s α = 0,82–1,00; ICC = 0,84–1,00) prvega standardiziranega orodja za spremljanje zdravja športnikov v slovenskem jeziku – vprašalnika OSTRC-H2-SLO. Tretji članek je pokazal, da je 79 % športnikov med sezono utrpelo vsaj eno zdravstveno težavo, pri čemer je bila skupna incidenca 2,19 zdravstvenih težav na igralca na leto. Analize glede na igralna mesta so pokazale povečano tveganje pri krilnih in zunanjih igralcih, pri čemer so se koleno, gleženj, rama in spodnji del hrbta izkazali kot najpogostejša mesta poškodb. Četrti članek je razkril šibke do zmerne, a statistično pomembne povezave med subjektivnimi in objektivnimi merami stresa in obremenitve. Pri približno polovici športnikov so subjektivne mere stresa zmerno do močno sovpadale s krvnimi biomarkerji, kar podpira njihovo uporabo kot praktičnih in stroškovno učinkovitih orodij za spremljanje. Peti članek je prepoznal trenažno obremenitev kot najmočnejši dejavnik tveganja za poškodbe, saj je vsaka dodatna ura treninga povečala verjetnost poškodbe za 33 %, medtem ko sta tekmovalna obremenitev (OR = 37,0, p < 0,001) in nižje razmerje testosteron/kortizol (OR = 0,976, p = 0,010) bila povezana z večjim tveganjem za bolezen. Vključenost v dvojno kariero ni bila povezana z večjimi zdravstvenimi tveganji in lahko deluje zaščitno, medtem ko so življenjski dogodki, ki predstavljajo psihosocialno obremenitev, povečali dovzetnost za poškodbe in bolezni. Ugotovitve podpirajo predlagan biopsihosocialni model zdravja športnikov, ki v strategije spremljanja in preprečevanja zdravstvenih težav vključuje telesne in psihosocialne obremenitve, dvojno kariero ter krvne biomarkerje.

• Ključne besede: obremenitev, stres, dvojna kariera, zdravstvene težave, krvni biomarkerji, preseganje