New European research has revealed some of the factors putting young elite athletes at a higher risk of injury, including a lack of sleep and lack of self-confidence.

The new findings come from Philip von Rosen, a researcher at the Department of Neurobiology, Care Sciences and Society, Sweden, who surveyed 680 adolescent elite athletes across 16 different sports in an effort to understand better the injury risk factors affecting young people.

The participants were asked to complete online questionnaires about training exposure, injury and illness over a one or two-year period, and at the start of each term also completed a background questionnaire about competence-based self-esteem, nutrition, self-perceived stress and sleep.

Von Rosen found that every week, an average of three in every ten adolescent elite athletes suffered an injury.

Over the course of a year, almost all of them had been injured at least once, with around 75 percent reporting that they had been seriously injured at least once during the year. Von Rosen also found that young women were at a higher risk of injury than young men, and remained injured for longer.

The risk of injury also increased with low self-esteem, and when athletes increased the volume and intensity of their training but reduced the duration of their sleep, there was a 100 percent rise in risk of injury.

When all of these factors were combined, and an athlete with low self-esteem increased the volume and intensity of his or her training while skimping on sleep, they had a three times higher risk of injury compared to an athlete with average self-esteem who had not changed his or her training or sleeping habit.

Dealing with an injury also had a negative effective on the mental health of the athletes, leading them to experience a loss of identity and loneliness and feel excluded from their regular sports practice.

"The high risk of injury in adolescent elite athletes shows that early-intervention injury-prevention strategies are needed in order to avoid long-term consequences of injury and to encourage continuing engagement in sport," says von Rosen. "We therefore recommend that medical teams are made available for all athletes at every national sports high school to reduce the unhealthy behavior associated with being injured, to prevent new injuries and to help injured athletes return to sport."