Background: Musculoskeletal pain (MSP) among adolescent athletes is a significant concern, with prevalence rates ranging widely. Research indicates a correlation between sports engagement and MSP, highlighting the paradoxical nature of physical activity. However, studies on the relationship between physical activity (PA), organized sports, and MSP among adolescent athletes yield conflicting findings. Understanding this intricate relationship is crucial for evaluating adolescent athletes' potential advancement in elite sports and comprehending how MSP influences their journey toward achieving excellence. 

Aim: This study aimed to determine if frequent MSP persisted among student adolescent athletes after a three-year period and to discern potential variances between athletes who sustain high levels of sports competition and those who end their elite training. Additionally, it sought to explore the influence of MSP on the strength and power of adolescent athletes.

Methods: Data utilized in this study were obtained from the Malmö Youth Sport Study (MYSS). The cohort study included adolescent student athletes at the age of 15-16 years old and with 68 % men, who underwent measurements at baseline (BASE) and during a follow-up (FU) session. Anthropometric measurements, grip strength, countermovement jump with arm swings (CMJ-AS), as well as questionnaire responses regarding self-reported MSP and physical activity, were collected from the student-athletes at both BASE and FU assessments. A Wilcoxon signed-rank test was used to compare participant characteristics from BASE to FU, Chi-Square test for investigating the prevalence of recurring MSP from BASE to FU, a Logistic regression for assessing if persistent MSP influenced the likelihood of continuing high-level competition after three year and Mann-Whitney U test for assessing the differences between MSP frequency group for strength and power.

Results: A total of 37 adolescent student athletes were in the final sample. ​​At BASE, among the adolescent student-athletes, 48.6% (n=18) experienced frequent MSP, while 51.4% (n=19) experienced infrequent MSP. By FU, the prevalence shifted, with 37.8% (n=14) experiencing frequent MSP and 62.2% (n=23) experiencing infrequent MSP. There was a significant association between MSP frequency at BASE and FU (p = 0.004), indicating that frequent MSP persisted among adolescent athletes over three years, while those with infrequent MSP at BASE remained infrequent at FU. This suggests a consistent pattern of MSP frequency over time. The study found no relationship between sustaining a higher level of competition and MSP frequency (p=0.457). Similarly, there were no statistically significant differences in maximal (max) grip strength and max CMJ-AS height between participants reporting frequent and infrequent MSP at both BASE (p ≥ 0.429) and FU (p ≥ 0.281).

Conclusion: An association was observed between MSP frequency at BASE and FU. Specifically, frequent MSP persisted among adolescent athletes over the three-year period, while those with infrequent MSP at BASE remained infrequent at FU. Despite this persistence in MSP, there was no significant decrease in the likelihood of sustaining a higher level of competition, nor were there significant differences in strength and power between participants with frequent and infrequent MSP.