Page 49 - Safe Wrestling

Injuries in Wrestling

wrestling demonstrated the highest severe injury rate among 25 sports
(1.73 per 1,000 athlete-exposures), with knee injuries accounting for
32.9% of severe injuries and lower leg/ankle/foot injuries contributing
an additional 22.5% (Hewett et al., 2005; Kay et al., 2017; Park et al., 2019).
Similarly, international tournament surveillance of moderate-to-critical
injuries demonstrated that lower-extremity injuries accounted for 27.3%
of clinically consequential cases, dominated primarily by knee injuries
(21.8%), with smaller contributions from ankle (3.6%) and groin injuries
(1.8%) (Molnár et al., 2022).
From a diagnostic perspective, the term ‘knee injury’ in wrestling en-
compasses a heterogeneous spectrum of tissue pathology rather than a
single dominant lesion. In a collegiate cohort study focused specifical-
ly on wrestling-related knee injuries in National Collegiate Athletic As-
sociation Division I athletes between 2010 and 2020, ligament injuries
accounted for the majority of primary knee injuries (53%), followed by
meniscal injuries (22%) and patellar injuries (10%) (Ford et al., 2023).
Treatment patterns corresponded with expected tissue-healing con-
straints. Most ligamentous injuries (93%) and patellar injuries (79%) were
managed conservatively, whereas most meniscal tears (60%) required
surgical intervention. Clinically, recurrent knee injury emerged as a sig-
nificant concern: approximately one in five wrestlers sustained recurrent
knee injuries within the study cohort, and recurrent injuries were associ-
ated with substantially longer return-to-sport times compared with pri-
mary injuries (68.3 ± 96.0 days versus 26.0 ± 56.4 days) (Ford et al., 2023).
These findings reinforce the importance of interpreting ‘time loss’ not
solely as a function of initial injury type, but also in relation to recurrence
risk and the cumulative burden of repeated knee trauma within a com-
petitive season.
The biomechanical plausibility underlying this injury burden is strong.
Wrestling-specific exposures repeatedly place the knee under combined
axial loading, rapid rotational torque, and forced flexion/valgus stress
during sprawls, scrambles, and takedown-defence sequences. Meniscal
injuries are particularly compatible with these demands; the wrestling
meniscus surgery literature notes that meniscal tears commonly occur
because hyperflexed knees are frequently subjected to substantial exter-
nal loading, including opponent body weight (Marigi et al., 2021).
In competitive male wrestlers undergoing isolated meniscal surgery,
outcome data provide an important downstream perspective on the
long-term burden of knee injury. Among 85 wrestlers treated surgical-

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