"It's never just one thing": understanding risk factors for sports injuries in track and field.

BACKGROUND: Track and field athletes are vulnerable to injury due to numerous intrinsic and extrinsic factors, such as previous injuries, high training loads, inadequate recovery, and psychological stress. However, there is limited information about the lived experiences of athletes from low- and middle-income countries. OBJECTIVE: This study aimed to explore perceptions of risk factors for sports injuries among Sri Lankan track and field athletes and key stakeholders. METHODS: This qualitative study employed convenience sampling to recruit elite athletes, their parents, and diverse stakeholders, including doctors, physiotherapists, coaches, sports administrators, and academics. Face-to-face, semi-structured interviews were audio-recorded, transcribed, and analysed using reflexive thematic analysis. RESULTS: Thirty-two participants completed the study (12 athletes, 17 stakeholders, and 3 parents). Five overarching themes related to injury occurrence and persistence were apparent among participants, including: (i) recurrent injuries due to inadequate recovery and load management; (ii) nutritional deficits, limited recovery, and psychological stress increasing vulnerability; (iii) environmental and equipment limitations elevating biomechanical load and fatigue-related risk; (iv) fragmented injury-management pathways and non-standardised return-to-play decisions; and (v) minimal injury monitoring and documentation, which limited prevention and continuity of care. Lower-limb injuries were most common, often associated with high training loads, poor recovery, technique errors, suboptimal ground conditions, and unsuitable equipment. Stakeholders highlighted nutrition, hydration, recovery strategies, and mental stress as key contributors. Injury management was inconsistent, with many athletes self-managing or relying on coaches rather than multidisciplinary healthcare. Formal surveillance systems were largely absent, prompting stakeholder calls for a coordinated digital record-keeping approach. CONCLUSIONS: Sports injury prevention and management in Sri Lanka are constrained by limited facilities, suboptimal nutrition and recovery practices, and insufficient injury monitoring systems. Addressing these challenges requires integrated, multidisciplinary strategies that strengthen nutrition, recovery, psychological support, and record-keeping systems to optimise athlete health and performance.