Page 44 - Safe Wrestling

Matej Ipavec

Results and Discussion
This review demonstrates consistent patterns in wrestling injury epi-
demiology across levels of competition while also highlighting that the
apparent distribution of commonly reported injuries (Table 3.1) de-
pends substantially on the surveillance setting and reporting thresholds
employed. In men’s National Collegiate Athletic Association wrestling,
season-based surveillance captures a broad spectrum of orthopaedic
trauma, with an overall injury rate of 8.82 per 1,000 athlete-exposures
(AEs) and a markedly higher incidence during competition compared
with practice (injury rate ratio [IRR] 4.11) (Brinkman et al., 2021; Kay et
al., 2017).
Within this population, the knee (21.4%), shoulder (13.4%), and head/
face region (approximately 13%) represent the most frequently injured
anatomical areas, with sprains and strains predominating. Notably, con-
cussion and illness/infection each account for 7.3% of reported diag-
noses, reinforcing the need for prevention strategies that address not on-
ly musculoskeletal trauma but also infectious and dermatological condi-
tions characteristic of close-contact sports (Brinkman et al., 2021; Kay
et al., 2017; Powell et al., 2021). In contrast, elite tournament surveil-
lancetends to emphasisemorereadily observable acuteinjuries. During
surveillance at the 2020 Summer Olympics, most injuries were classified
as mild, with head and face involvement and skin lacerations or contu-
sions dominating the injury profile (Shadgan, Szabolcs, et al., 2021).
One of the most prominent modifiable injury risk factors identified
in the literature is rapid weight loss, which has been shown to nearly
double injury rates (23.18 versus 11.93 injuries per 1,000 hours) (Kim
& Park, 2021). Additional important risk factors include high-intensity
wrestling during practice sessions, which accounts for approximately
68% of practice-related injuries, inadequate warm-up procedures, im-
proper technical execution, and noncompliance with medical recom-
mendations affecting approximately half of wrestlers (Goodman et al.,
2018; Kay et al., 2017; Powell et al., 2021). Competition settings consis-
tently demonstrate significantly higher injury rates than practice, with
reported rate ratios ranging from twofold to fortyfold depending on the
specific injury category examined.
It is also important to recognise that studies measuring per-athlete
injury rates (e.g., 52 injuries per 100 wrestlers per season) versus per-
exposure rates (e.g., 6.0 injuries per 1,000 exposures) produce substan-

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