The Center for Podiatric Care and Sports Medicine

Extreme Athletes and Sports Injuries: Scientists Look At What Makes Triathletes So Tough

Posted by on Wednesday, November 20th, 2013


Most people know triathlons as “that sport where you run, bike, and swim.” This type of race is notoriously grueling and requires tremendous endurance. But did you know there are actually four different variations for the most hardcore athletes to choose from? Regardless of which type of triathlon event a person signs up for, researchers from Tel Aviv University have discovered the common threads that make these athletes so exceptional.

chicago triathlon
The Chicago Triathlon is the largest event of its type in the USA with 5,303 finishers in 2012. Image Source:

What Is A Triathlon?

Before explaining what makes a triathlete so unique, we should first discuss what a triathlon exactly is

– A sprint distance is… a half mile swim, a 12-14 mile bike, and a 5K (3.1 mile) run.

– The Olympic distance is… a nearly 1 mile swim, a 25 mile bike, and a 10K (6.2 mile) run.

– The half Ironman is… a 1.2 mile swim, a 56 mile bike, and a 13.1 mile run.

– A full Ironman is… a 2.4 mile swim, a 112 mile bike, and a 26.2 mile run.

Pretty intense, huh?! Needless to say, this is a sport for a very elite group. Even so, the number of triathlon participants has surged over the past decade to about 550,446 triathletes racing in 2012. The greatest growth has been in the more health-conscious 35-44-year-old demographic. Women now make up 37 percent of all participants, compared to 27 percent a decade ago. The triathlon, especially the Ironman, is seen as “the Holy Grail” for fitness buffs.

Common Triathlete Injuries

According to a 2011 Norwegian study published in the British Journal of Sports Medicinealmost nine in 10 triathletes reported some form of overuse injury in the six months prior to their participation in the Norse Xtreme Triathlon. More than half of the group said an injury was significant enough to disrupt their training.

The most common overuse injuries included:

– Knee injuries (25%)

– Lower leg injuries (23%), and

– Lower back injuries (23%).

There were also 41 (out of 174) cases of acute injuries, with bike crashes constituting the majority of accidents. There were no acute injuries associated with the swimming portion of the race.

Think You’re Up To The Challenge?

“In our study, triathletes rated pain lower in intensity, tolerated it longer, and inhibited it better than individuals in a control group,” said Professor Ruth Defrin from Tel Aviv University. She added, “We think both physiological and psychological factors underlie these differences and help explain how triathletes are able to perform at such a high level.”

Tel Aviv University scientists looked at 19 triathletes who competed in at least two events per year compared to 17 non-athletes who jogged, swam, or took aerobics classes. The test subjects endured a battery of pain tests and filled out questionnaires. Researchers found that triathletes identified pain as well as non-athletes, but perceived it as less intense and could withstand it much longer. They also reportedly feared and worried less about pain. While detecting physical pain seems to be pretty straightforward, a person’s attitude, motivation and life experiences affect how that pain is interpreted, thus allowing triathletes to “go the distance.”

Before starting triathlon training, it is always best to consult a sports medicine doctor. Come visit us at The Center for Podiatric Care and Sports Medicine in NYC for advice on training, custom orthotics and footwear choice, total body conditioning, and injury prevention strategies.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.