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A total of 1488 retired female Olympians and 998 female controls completed the survey. Poisson regression analysis was used to determine prevalence ratios (aPR) with 95% confidence intervals (CI) adjusted for age, body mass index (BMI) and\/or previous significant injury or current persistent pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adjusting for age, BMI and previous significant injury, more retired female Olympians reported stiffness, pain and\/or osteoarthritis (OA) (aPR [95% CI]) in the cervical spine (stiffness 1.42 [1.08\u20131.86]; OA 1.85 [1.01\u20133.39]), lumbar spine (stiffness 1.41 [1.18\u20131.67], pain 1.41 [1.15\u20131.73]) and hip (OA 1.82 [1.08\u20133.06]) compared with controls. Stiffness, pain and OA at the knee were also higher for Olympians, but not when adjusting for prior injury. No differences were observed between groups for self-reported disease states, however the prevalence of most health conditions increased among Olympians following retirement, except for depression which decreased. Both groups rated their health-related quality of life (retired female Olympians: 88\/100; Controls: 89\/100) and mental health similarly, while the prevalence of participation in weekly sport (aPR: 0.75 [0.66\u20130.85]) and physical activity (aPR: 0.91 [0.87\u20130.95]) was slightly lower in retired Olympians when adjusted for age, BMI and current persistent musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Retired female Olympians report poorer musculoskeletal health than the general population, a difference only partly attributable to previous significant injury, which suggests elements of elite athletic exposure may underlie some of these outcomes. Primary and secondary prevention of shoulder, hip and knee injuries remains a priority with consideration to long-term outcomes. Future research should broaden our understanding of retired female athlete health by exploring the largely under-researched domains of cognitive, reproductive, breast and pelvic floor health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40279-026-02497-2","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T17:17:32Z","timestamp":1784827052000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Legacy of Olympic Sport: A Cross-Sectional Comparison of the Musculoskeletal and General Health of 1488 Retired Female Summer and Winter Olympians and 998 Female General Population Controls"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9514-8782","authenticated-orcid":false,"given":"Lauren","family":"Guilfoyle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5456-3878","authenticated-orcid":false,"given":"Alan","family":"MacPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9815-956X","authenticated-orcid":false,"given":"Dale","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-129X","authenticated-orcid":false,"given":"Kay M.","family":"Crossley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8057-4911","authenticated-orcid":false,"given":"Amber T.","family":"Donaldson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2294-921X","authenticated-orcid":false,"given":"Lars","family":"Engebretsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9691-0532","authenticated-orcid":false,"given":"Suzanne","family":"Leclerc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0268-0460","authenticated-orcid":false,"given":"Eric G.","family":"Post","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3783-0505","authenticated-orcid":false,"given":"Craig","family":"Ranson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Schamasch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malav","family":"Shroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9279-4076","authenticated-orcid":false,"given":"Jenna M.","family":"Schulz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-4574","authenticated-orcid":false,"given":"Torbj\u00f8rn","family":"Soligard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3519-7101","authenticated-orcid":false,"given":"Jane S.","family":"Thornton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4676-217X","authenticated-orcid":false,"given":"Debbie","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,23]]},"reference":[{"key":"2497_CR1","unstructured":"International Olympic Committee. 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KMC is a senior advisor for BJSM and JST on the Editorial Board of BJSM. KMC is the project leader of the GLA:D, Australia, and holds research funding from Levin Health, the Australian Football League, the Australian National Health and Medical Research Council and the Medical Research Future Fund. JST is the IOC Director of Health, Medicine and Science. DP holds peer-reviewed funding from World Rugby, the IOC and Scottish Rugby Union. TS works as Scientific Manager for IOC Health, Medicine and Science and is Co-Editor of the BJSM IPHP issues. MW is the Chief Medical Officer and Head of Health and Wellbeing for the Canadian Olympic Committee. The remaining authors declare that they have no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was performed in accordance with the standards of ethics outlined in the Declaration of Helsinki. Ethical approval for this study was obtained from the Edinburgh Napier University Ethics Committee (SAS\/00011).","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"A participant information sheet provided detailed study information, including confidentiality and data handling. Participants were notified they were consenting to their anonymous data being used in the study through the completion and submission of the survey.","order":3,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":4,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request.","order":5,"name":"Ethics","label":"Availability of data and material","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":6,"name":"Ethics","label":"Code availability","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"LG, DP and AMP conceived the study. DP served as primary project administrator and acquired funding for this project which has led to this publication. DP, LE, MS, PS and TS developed the data collection tool (survey), study resources and were involved in data collection via survey recruitment. LG and DP conducted formal analysis and data curation. LG prepared\/wrote the original draft(s). LG, AMP, DP, DC, KC, AD, NE, LE, SL, EP, CR, PS, JS, TS, JT and MW critically reviewed and contributed to editing drafts of the paper. All authors read and approved the final version.","order":7,"name":"Ethics","label":"Author contributions","group":{"name":"EthicsHeading","label":"Declarations"}}]}}