Elite performance takes natural ability coupled with elite levels of training. That last part has an effect later in life, according to a new analysis. It found that one in four retired Olympians have some level of osteoarthritis, which causes changes in the joint and can lead to discomfort, pain and disability.

Researchers quizzed 3,357 retired Olympians aged around 45 on injuries and the health of their bones, joints, muscles and spine. They were also asked if they were currently experiencing joint pain, and if they had an osteoarthritis diagnosis. For comparison, 1,735 people aged around 41 from the general population completed the same survey. Researchers used statistical models to compare the prevalence of spine, upper limb and lower limb osteoarthritis and pain in retired Olympians with the general population.  

The team considered factors that could influence the risk of pain and osteoarthritis such as injury, recurrent injury, age, sex and obesity. They found that the knee, lumbar spine and shoulder were the most injury prone areas for Olympians. These were also among the most common locations for osteoarthritis and pain. After a joint injury the Olympians were more likely to develop osteoarthritis than someone sustaining a similar injury in the general population, the research found. The sportspeople also had an increased risk of shoulder, knee, hip and ankle and upper and lower spine pain after injury, although this did not differ with the general population.

 The athletes, who had competed at an Olympic level in 57 sports, also had an increased risk of lower back pain overall, and shoulder osteoarthritis after a shoulder injury. 

Researchers say the study may help people make decisions about recovery and rehabilitation from injuries in order to prevent recurrences, and to inform prevention strategies to reduce the risk and progression of pain and OA in retirement.