Figure skating is a popular sport enjoyed by millions worldwide; however, research has largely overlooked the health challenges its participants face. Supported through an athlete’s maturation process from childhood to adulthood, participation in sports such as figure skating cultivates lifelong benefits for individuals and the sports community, improving long-term health and well-being.

However, athletes also face the risk of injuries and other health issues. This concern is particularly relevant for young athletes and female participants, often underrepresented in sports medicine research. Poor health can be devastating for the affected athlete and detrimental to the sports movement, which loses active participants.

Swedish figure skating has the world’s second-largest number of participants per capita, with over 51,000 participants, predominantly young girls. The sport continually evolves, increasing physical and mental demands on athletes. Despite its popularity, there is a notable gap worldwide in research on figure skaters' health. Media investigations and external reports often highlight injuries, violence, and unhealthy environments. Recent reports in Sweden have drawn attention to the exposure to violence in figure skating, including cases that violate children’s rights.

This dissertation explored the health of young Swedish figure skaters, identified risk factors for physical and mental health issues, and explored future ways to promote health and safety in figure skating.

Papers I and II were based on a cross-sectional study conducted via a questionnaire among a community population (N=400) of licensed competitive Swedish figure skaters of all levels. In total, 137 female skaters aged 12.9 years (SD 3.0) were included in the analysis.

Paper I investigated factors associated with sport injuries. It found that one-third of young skaters had sustained a severe injury episode in the past year, and one-fifth had an ongoing injury at the time of the study. Injury episodes primarily affected the lower extremities. Reported sport injury episodes were associated with being older and skipping more main meals per week.

Paper II examined mental health and associated factors. It showed that nearly half of the participants reported anxiety caseness, while one in ten reported depression caseness. Older participants exhibited poorer mental health, and anxiety caseness was associated with being older and with displaying a negative body image perception.

Papers III and IV employed reflexive thematic analysis of qualitative interviews with twenty Swedish licensed competitive figure skaters aged 12 to 25 (median age: 16).

Paper III focused on the athletes’ health-related experiences and how they balanced these with athletic performance. Young figure skaters held a positive view of their sports participation. They desired sustainability in their development and requested agency in decision-making. Young figure skaters sought accountability from adult stakeholders.

Paper IV explored young figure skaters' knowledge, experiences, and attitudes towards violence against children when participating in sports. Athletes struggled to recognise and report violence against children in sports, which was seen to perpetuate the normalisation and legitimisation of such behaviour.

In conclusion, very young athletes at the community level presented with a high degree of sport-related ill health that appeared to worsen with age, both physically and mentally. Repeated load, insufficient energy intake, negative body image perceptions and inadequate adult support contributed to adverse health consequences. This dissertation highlights the need for improved safety measures and consistent implementation of protection systems engaging collaborative resolutions across ecological levels within figure skating in Sweden and internationally.

This research emphasises the importance of addressing figure skaters' health needs, listening to young athletes’ experiences, and working towards creating safer and healthier environments for all sports participants.