Page 50 - Safe Wrestling

Matej Ipavec

ly between 2001 and 2017, 89% returned to sport participation, yet only
65% returned to competitive wrestling, suggesting that the sport-specific
physical demands of wrestling may meaningfully limit complete com-
petitive return even when general athletic participation is restored. Al-
though the overall index-surgery failure rate was relatively low (9.4%),
reoperation profiles differed according to surgical procedure type, with
substantially higher rates following meniscal repair compared with par-
tial meniscectomy (21% versus 3%) (Marigi et al., 2021).
Anterior cruciate ligament (ACL) injury and reconstruction repre-
sent another particularly high-impact pathway within wrestling due to
prolonged rehabilitation requirements, implications for athletic perfor-
mance, and graft-failure considerations in young athletes. In a cohort of
107 competitive wrestlers undergoing ACL reconstruction, 80% returned
to play at a median of 280 days, while the overall graft-failure rate reached
13% at a median follow-up of 5.3 years. Importantly, graft type was asso-
ciated with differential failure risk, with lower failure rates observed fol-
lowing bone-patellar tendon-bone autografts compared with hamstring
tendon autografts (8% versus 21%) (Marigi et al., 2022). Although such
findings cannot be interpreted as direct evidence for primary prevention
effectiveness, they underscore the substantial clinical burden associated
with knee injury events in wrestling and strengthen the rationale for pre-
ventive strategies targeting high-risk positions and movement patterns.
Across studies, several modifiable contextual factors appear to ampli-
fy lower-extremity injury risk. Rapid weight loss (RWL) is particularly im-
portant because it is common, seasonally concentrated, and potentially
modifiable through education and policy interventions. In elite Korean
wrestlers monitored prospectively, injury rates were approximately 1.98
times higher during weight-loss periods compared with non-weight-loss
periods. Lower-extremity injuries represented the largest injury category
by anatomical region (38%), with the knee and ankle among the most
frequently affected sites (Kim & Park, 2021). The tissue-pathology dis-
tribution within this cohort further supports the hypothesis that rapid
weight loss may contribute to ligamentous vulnerability and acute insta-
bility events, as ligament and joint-capsule sprains represented the most
common injury category.
Finally, emerging screening evidence suggests that neuromuscular
control and landing mechanics may assist in identifying athletes at ele-
vated risk for lower-extremity injury, particularly among female wrestlers.
In a prospective cohort study involving 47 elite Turkish national-team fe-

50