Page 46 - Safe Wrestling

Matej Ipavec

An important practical implication emerging from international wres-
tling research concerns the potential preventive role of proactive offi-
ciating. In a prospective comparative investigation, the injury rate was
10.64% under routine refereeing practice compared with 4.54% when ref-
erees were specifically instructed to intervene promptly and proactive-
ly in high-risk or dangerous situations (Shadgan, Konstantinou, et al.,
2021).
With regard to the head and neck complex specifically, catastroph-
ic injury case series emphasise that the standing and takedown phases
represent particularly critical danger contexts. Catastrophic events have
frequently been reported during standing or takedown situations, high-
lighting the importance of technical instruction, rule enforcement, and
supervision during these phases of wrestling activity (Boden et al., 2002).

Injuries of the Upper Extremity
Upper-extremity injuries represent a substantial and recurrent compo-
nent of the wrestling injury burden across all levels of competition, and
they appear particularly relevant in relation to time loss and performance
limitation because they directly affect grip fighting, posting, and upper-
limb control – core determinants of wrestling performance. In a recent
systematic synthesis focused specifically on shoulder and elbow injuries,
these injuries together accounted for approximately one-fifth of all re-
ported wrestling injuries (21.2%), with a weighted injury rate of 14.1 per
10,000 athlete-exposures (AEs). Within this aggregate, shoulder injuries
were consistently more common than elbow injuries (14.1% versus 7.2%
of total injuries), a pattern that is biomechanically plausible given the
shoulder’s high mobility and reliance on dynamic stabilisation under
substantial external loading during throws, sprawls, and scrambles. The
most frequently reported clinical entities clustered into several recognis-
able patterns, including shoulder sprains and strains (such as rotator cuff
and acromioclavicular joint injuries), shoulder instability events, and el-
bow instability conditions, particularly ulnar collateral ligament injuries
(Goodman et al., 2018; Maunder et al., 2025; Snyder et al., 2024).
Collegiate surveillance data further reinforce both the magnitude of
this burden and its context-specific risk gradients. In National Collegiate
Athletic Association wrestling between 2009 and 2014, the incidence
of shoulder and elbow injuries was 21.59 per 10,000 athlete-exposures,
with frequently reported diagnoses including elbow ulnar collateral lig-
ament tears, shoulder impingement syndromes, and acromioclavicu-

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