Background Team handball has a rich tradition and interest among Icelanders. No studies have been published on the incidence and nature of injuries in Icelandic team handball.

Objective To examine and document the incidence, nature and severity of injuries in male team handball.

Design Prospective cohort study. The teams were followed for 9 months. Injuries were recorded by the players under supervision from their team physiotherapists, coaches and delegates on a special form. Coaches recorded training exposure.

Setting Icelandic elite male team handball.

Participants Players from all (eight) premiership and six best (of eight) second division teams were invited to participate. The selection was based on the 2006–2007 league position. 159 players from seven premiership and 4 s division teams entered the study. 109 players from four premiership and 2 s division teams finished it.

Main outcome of measurement (1) Incidence and severity of acute and overuse injuries. (2) Variation between teams and playing positions. (3) Use of braces and tape.

Results 86 injuries were recorded, 53 (61.6%) acute, and 33 (38.4%) overuse injuries. The injury incidence was 15.0 injuries per 1000 player hours during games and 2.2 injuries per 1000 player hours during training. Acute injuries were most common in knees (26.4%). Overuse injuries were most frequent in low back/sacrum/pelvic region (33.3%). No difference was in incidence of injuries between teams. Back court players were most frequent injured, goalkeepers least. 22.4% of the players used ankle braces during games and most training sessions. 28.2% used tape on fingers.

Conclusion The total injury incidence is similar than in previous, comparable studies. However, higher rate of overuse injuries in low back/sacrum/pelvic region raise questions about training methods and preparation for the Icelandic team handball players.