Daily Report on Injuries and Illnesses

Country Physician´s name Date of report / 08 / 2018

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Please report: (1) All injuries (traumatic and overuse) and (2) all illnesses newly incurred in competition or training during the European Athletics
Championships regardless of the consequences with respect to absence from competition or training. The information provided is for medical and
research purposes and will be treated confidentially.
(1) Injury - Example:
Athlete’s Date of birth Event Training or Competition Date & time of injury Mode of Onset Right OR
gender (round / heat / final) 08/08/18 7:35 pm (Sudden/Gradual) Left side
Male 14/07/89 High jump Competition/final Sudden Left

New injury OR Recurrent Injured body part, Code Type of injury Code Cause of injury and Codes Estimated
injury side 27 l Contributing factors absence
New injury Ankle, lateral Sprain 8 Slipped and fell, rain 1.1 / D (days) 10

Athlete’s Date of birth Event Training or Competition Date & time of Mode of Onset Right OR
gender (round / heat / final) injury (Sudden/Gradual) Left side

New injury OR Injured body Code Type of injury Code Cause of injury and Codes Estimated
Recurrent injury part, side Contributing factors absence
(days)
Athlete’s Date of birth Event Training or Competition Date & time of Mode of Onset Right OR
gender (round / heat / final) injury (Sudden/Gradual) Left side

New injury OR Injured body Code Type of injury Code Cause of injury and Codes Estimated
Recurrent injury part, side Contributing factors absence
(days)
Athlete’s Date of birth Event Training or Competition Date & time of Mode of Onset Right OR
gender (round / heat / final) injury (Sudden/Gradual) Left side

New injury OR Injured body Code Type of injury Code Cause of injury and Codes Estimated
Recurrent injury part, side Contributing factors absence
(days)
Athlete’s Date of birth Event Training or Competition Date & time of Mode of Onset Right OR
gender (round / heat / final) injury (Sudden/Gradual) Left side

New injury OR Injured body Code Type of injury Code Cause of injury and Codes Estimated
Recurrent injury part, side Contributing factors absence
(days)
(2) Illness - Example:
Athlete’s gender Date of birth Event Diagnosis Mode of Onset Date of occurrence
Female 14/07/89 4x 100m relay (women) Tonsillitis, cold (Sudden/Gradual) 08/08/18
Sudden
Affected system Code Main symptom(s) Code Cause of illness Code Estimated absence
Upper respiratory tract 1 Fever, pain 1,2 Infection 1.2 (days) 2

Athlete’s gender Date of birth Event Diagnosis Mode of Onset Date of occurrence
(Sudden/Gradual)
Affected system Code Main symptom(s) Code Cause of illness Code Estimated absence
(days)

Athlete’s gender Date of birth Event Diagnosis Mode of Onset Date of occurrence
(Sudden/Gradual)
Affected system Code Main symptom(s) Code Cause of illness Code Estimated absence
(days)

Athlete’s gender Date of birth Event Diagnosis Mode of Onset Date of occurrence
(Sudden/Gradual)
Affected system Code Main symptom(s) Code Cause of illness Code Estimated absence
(days)

Athlete’s gender Date of birth Event Diagnosis Mode of Onset Date of occurrence
(Sudden/Gradual)
Affected system Code Main symptom(s) Code Cause of illness Code Estimated absence
(days)
No injury or illness in any athlete of our team today ¨

Definitions and codes see reverse. Please use additional forms if needed.
0
 Codes and Classifications
For injuries
Sport and event
Please state the event (e.g. 100m hurdles; shot put; 4x 400m relay; Decathlon – long jump).
Training or Competition (round / heat / final)
If the injury occurred during competition, please state the round (e.g. heats, qualification B, final).
If the injury occurred at another occasion, please specify whether it was training, warm-up or others.
Injured body part - Location of injury
Head and trunk Upper extremity Lower extremity
1 face (incl. eye, ear, nose) 11 shoulder / clavicle 21 hip
2 head 12a/p upper arm (anterior/posterior) 22 groin
3 neck / cervical spine 13a/p elbow (anterior/posterior) 23a/p thigh (anterior/posterior)
13m/l elbow (medial/lateral) 24a/p knee (anterior/posterior)
4 thoracic spine / upper back 14a/p forearm (anterior/posterior) 24m/l knee (medial/lateral)
5 sternum / ribs 15a/p wrist (anterior/posterior) 25a/p lower leg (anterior/posterior)
6 lumbar spine / lower back 16a/p hand (anterior/posterior) 26 Achilles tendon
7 abdomen 17a/p finger (anterior/posterior) 27m/l ankle (medial/lateral)
8 pelvis / sacrum / buttock 18a/p thumb (anterior/posterior) 28a/p foot / toe (anterior/posterior)
Type of injury - Diagnosis
1 concussion (regardless of loss of consciousness) 12 tendinosis / tendinopathy
2 fracture (traumatic) 13 arthritis / synovitis / bursitis
3 stress fracture (overuse) 14 fasciitis / aponeurosis injury
4 other bone injuries 15 impingement
5 dislocation, subluxation 16 laceration / abrasion / skin lesion
6 tendon rupture 17 dental injury / broken tooth
7 ligamentous rupture 18 nerve injury / spinal cord injury
8 sprain (injury of joint and/or ligaments) 19 muscle cramps or spasm
9 lesion of meniscus or cartilage 20 growth plate disturbance / avulsion
10 strain / muscle rupture / tear 21 other
11 contusion / haematoma / bruise
Mode of onset - Cause of injury
Mode of onset Causes Contributing factors
1 Sudden onset incident 1. Traumatic injury A Recurrence of previous injury
1.1 2 Gradual onset incident 1.1. Contact injury B Violation of rules (obstruction, pushing)
1.1.2 Contact with another athlete C Field of play conditions
1.1.3 Contact: moving object (e.g. discus) D Weather condition
1.1.4 Contact: immobile object (e.g. hurdles) E Equipment failure
1.2 Non-contact injury F Fatigue
2. Overuse injury G Psychological
Z Other
Estimated duration of absence from training and/or competition (in days)
Please provide an estimate of the number of days that the athlete will not be able to undertake his/her normal training
programme or will not be able to compete.
0= 0 days 7= 1 week 28 = 4 weeks
1= 1 day 14 = 2 weeks > 30 = more than 4 weeks
2= 2 days 21 = 3 weeks >180= 6 months or more

For illnesses
Affected system
1 Upper respiratory tract 5 Uro-genital, gynecological 9 Dermatologic/skin
(nose, sinuses, pharynx, larynx) or reproductive 10 Musculo-skeletal
2 Lower respiratory tract 6 Endocrine or metabolic 11 dental
(trachea, bronchi, lungs) 12 Ophthalmological/otological
3 Gastro-intestinal 7 “Blood” (Hematologic or immune) 13 Psychiatric/Psychological
4 Cardio-vascular 8 Neurologic, CNS 14 Other
Main symptom(s)
1 Pain, ache or soreness 6 Irregular heartbeat, palpitation, 9 Dizziness or vertigo
2 Fever, excess sweating or chills syncope, collapse or chest pain 10 Rash, itch or eczema
3 Nausea, vomiting or diarrhoea 7 Congestion, hyper-secretion, 11 Numbness, weakness or tingling
4 Weight loss or dehydration rhinorrhoea or discharge 12 Mood/sleep disturbance, anxious
5 Fatigue, lack of energy, lethargy 8 Cough, wheezing, dyspnoea or depressed
or arterial hypotension or shortness of breath 13 Other

Cause of illness/symptom(s)
Mode of onset Causes of sudden illness Causes of gradual onset illness
1 Sudden onset incident 1.1 Pre-existing disease (exacerbations of allergy, 2.1 Pre-existing disease (exacerbations of allergy, asthma,
2 Gradual onset incident asthma, diabetes, degenerative, systemic inflammatory diabetes, degenerative, systemic inflammatory disorders,
disorders, congenital, etc.) congenital, etc.)
1.2 Infectious (viral, bacterial, fungal…) 2.2 Infectious (viral, bacterial, fungal…)
1.3 Environmental (heat, cold, altitude…) 2.3 Environmental (heat, cold, altitude…)
1.4 Nutritional, endocrine or metabolic disturbance 2.4 Nutritional, endocrine or metabolic disturbance
1.5 Drug related or toxic reaction 2.5 Drug related or toxic reaction
1.6 Exercise related (dehydration, exhaustion…) 2.6 Exercise related (dehydration, exhaustion…)
1.7 Psychiatric 2.7 Psychiatric
1.8 Other/idiopathic 2.8 Other/idiopathic