Page 47 - Safe Wrestling

Injuries in Wrestling

lar joint sprains. Importantly, several modifiers emerged with practical
implications for prevention planning: injuries occurred more frequent-
ly among first-year collegiate athletes than among more experienced
competitors, were substantially more common during competition than
practice (approximately fourfold higher), and were more likely to occur
later in matches (approximately 2.5-fold higher than during early phas-
es). Collectively, these findings support fatigue, elevated match intensity,
and high-risk positional exchanges as plausible contributors to upper-
extremity injury risk.
From a clinical-management perspective, the distribution of out-
comes was heterogeneous. Although many injuries were treated non-
operatively, more than one-quarter resulted in at least 14 days of time
loss, while a smaller subset required surgical intervention. These find-
ings highlight why upper-extremity injury surveillance should evaluate
not only incidence but also severity and functional impact (Goodman et
al., 2018; Maunder et al., 2025).
More recent findings from the National Collegiate Athletic Association
Injury Surveillance Program (2014–2019) similarly identify the shoulder
as one of the most frequently injured anatomical regions overall, while al-
so suggesting meaningful differences according to event type. Shoulder
injuries accounted for a larger proportion of competition injuries than
practice injuries, and clinically relevant burdens were also identified in
the arm/elbow and hand/wrist regions. These patterns align closely with
wrestling-specific exposure mechanisms, as takedowns and high-force
transitional movements constitute common contexts for injury occur-
rence, while both opponent contact and surface contact contribute sub-
stantially to overall injury mechanisms.
Importantly, when analyses are restricted to moderate-to-critical in-
juries in international Olympic-style tournaments, the upper extremity
still accounts for more than one-quarter of all injuries, with shoulder and
elbow injuries each representing approximately one in ten cases. This
supports the interpretation that upper-limb trauma is not only common
but also contributes meaningfully to higher-burden outcomes requiring
medical attention and, in some cases, match termination (Brinkman et
al., 2021; Molnár et al., 2022; Powell et al., 2021).
Mechanistically, these findings correspond closely with the biome-
chanical demands of live wrestling. High-load hand fighting and post-
ing manoeuvres can generate substantial valgus stress at the elbow and
traction or torsional forces at the shoulder, while throws and failed take-

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