Tendinitis & Other Weight Training-Related Injuries

Increasingly, male and female athletes of all ages have begun to participate in weight-training sports at a wide variety of competitive standards. This increased participation raises the question: Are weight-training sports safe? Justin W.L. Keogh, PhD, associate professor at Bond University in Australia, and Paul W. Winwood, PhD, academic staff member at the Bay of Plenty Polytechnic in New Zealand, attempted to answer this question via a systematic review of injury epidemiology in weight-training sports. They published the results online on June 21 in Sports Medicine.¹

The researchers found that weight-training sports have relatively low rates of injury when compared with common team sports. Specifically, the majority of weight-training sports have injury rates of approximately one to two injuries per athlete per year and approximately two to four injuries per 1,000 hours of training/competition exposure. These injury rates appeared to be the same regardless of age, sex, bodyweight class or the competitive standard of the athlete. The most common injury types were strains, tendinitis and sprains.

The authors pulled 184 potentially relevant full-text articles and, from this group, identified 20 papers to include in their review, the majority of which used retrospective designs. Fourteen of the studies had sample sizes of greater than 100 participants. The studies presented data for weightlifting and powerlifting, bodybuilding, strongman, Highland Games and CrossFit. Injury was generally defined as physical damage to the athlete that caused the athlete to modify or cancel at least one training session. Unfortunately, many of the studies reported data for only a subset of the variables recommended by the International Olympic Committee (IOC) to establish a complete understanding of the epidemiology of sports injury.

The injury incidence rates tended to be consistent across studies. There was a large range, however, in the reported incidence of injuries in competition (1.5–90%) vs. training. In general, however, it appeared that approximately half of injuries occurred during training, with bodybuilding having the lowest injury rate and strongman and Highland Games having the highest rates of injury. The authors note that there was only one published study that examined injury rates in individuals participating in strongman and Highland Games, and thus, the injury rates for these sports were based on limited data. The most common injuries occurred in the shoulder, lower back, knee, elbow and wrist/hand. The sites of injury varied by sport. In the case of powerlifting and CrossFit, the three most common sites of injury were shoulder, lower back and knee. The authors suggest that the relatively high rate of shoulder injuries in these sports may be due to the frequent use of heavy loads, as well as such exercises as the bench press and overhead presses. The authors also note that different competitive sports have different competitive goals and training practices that might alter relative loading, thereby affecting injury risk to various anatomical locations. For example, weightlifters have their highest rate of injury in the knees, followed by lower back and shoulder. This injury pattern may reflect the way in which the squat is performed in this sport.