title: The Epidemiology of Injuries Across the Weight-Training Sports.
abstract: BACKGROUND
  Weight-training sports, including weightlifting, powerlifting, bodybuilding, strongman, Highland Games, and CrossFit, are weight-training sports that have separate divisions for males and females of a variety of ages, competitive standards, and bodyweight classes. These sports may be considered dangerous because of the heavy loads commonly used in training and competition.
  
  
  OBJECTIVE
  Our objective was to systematically review the injury epidemiology of these weight-training sports, and, where possible, gain some insight into whether this may be affected by age, sex, competitive standard, and bodyweight class.
  
  
  METHODS
  We performed an electronic search using PubMed, SPORTDiscus, CINAHL, and Embase for injury epidemiology studies involving competitive athletes in these weight-training sports. Eligible studies included peer-reviewed journal articles only, with no limit placed on date or language of publication. We assessed the risk of bias in all studies using an adaption of the musculoskeletal injury review method.
  
  
  RESULTS
  Only five of the 20 eligible studies had a risk of bias score ≥75 %, meaning the risk of bias in these five studies was considered low. While 14 of the studies had sample sizes >100 participants, only four studies utilized a prospective design. Bodybuilding had the lowest injury rates (0.12-0.7 injuries per lifter per year; 0.24-1 injury per 1000 h), with strongman (4.5-6.1 injuries per 1000 h) and Highland Games (7.5 injuries per 1000 h) reporting the highest rates. The shoulder, lower back, knee, elbow, and wrist/hand were generally the most commonly injured anatomical locations; strains, tendinitis, and sprains were the most common injury type. Very few significant differences in any of the injury outcomes were observed as a function of age, sex, competitive standard, or bodyweight class.
  
  
  CONCLUSIONS
  While the majority of the research we reviewed utilized retrospective designs, the weight-training sports appear to have relatively low rates of injury compared with common team sports. Future weight-training sport injury epidemiology research needs to be improved, particularly in terms of the use of prospective designs, diagnosis of injury, and changes in risk exposure.
authors.affiliation: Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia. jkeogh@bond.edu.au.|Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand. jkeogh@bond.edu.au.|Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD, Australia. jkeogh@bond.edu.au.
authors.forename: Justin W L
authors.initials: JW
authors.lastname: Keogh
authors.affiliation: Sports Performance Research Institute New Zealand (SPRINZ), AUT Millennium, AUT University, Auckland, New Zealand.|Department of Sport and Recreation, School of Applied Science, Bay of Plenty Polytechnic, Tauranga, New Zealand.
authors.forename: Paul W
authors.initials: PW
authors.lastname: Winwood
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D013177:Sports; D013180:Sprains and Strains / Q000453:epidemiology*; D014891:Weight Lifting