In a review of risk factors for lower extremity injury,¹ it was said that alignment of the hip, knee, and ankle has received substantial interest as a potential risk factor. We aimed to quantify the anatomical location of athletic injuries produced during training in order to confirm whether lower extremity injuries are the most common. A second aim was to detect if the knee was the most commonly injured anatomical site in the lower extremity.

We recorded the anatomical location of the training injuries of 2701 athletes in a prospective study (from January 2003 to January 2005). Written informed consent was obtained from the subjects. We studied athletes who trained a minimum of 10 hours a week. The mean (SD) age of the subjects was 39.62 (12.98) years (range 14–63).

We recorded the anatomical location of the injuries suffered exclusively while training; these numbered 781. The injuries were most often found in the lower extremities (n  =  660; 84.5%), followed by the vertebral column (n  =  58; 7.4%), the upper extremities (n  =  44; 5.6%), the trunk (n  =  14; 1.8%), and the head (n  =  5; 0.6%).

In the lower extremities, the injuries were most often found in the knee (n  =  234; 35.4%), followed by the ankle (n  =  169; 25.6%), the foot (n  =  124; 18.8%), the thigh (n  =  70; 10.6%), the iliac region (n  =  40; 6.1%), and the leg (n  =  23; 3.5%). The injuries in the vertebral column were most often found in the lumbar region (n  =  30; 51.7%), followed by the thoracic (n  =  17; 29.3%) and cervical (n  =  11; 19.0%) regions. In the upper extremities, the injuries were most often found in the shoulder (n  =  19; 43.2%), followed by the forearm (n  =  17; 38.6%), the arm (n  =  13; 29.5%), and the hand (n  =  4; 9.1%).

Therefore this study confirms that the knee is the most commonly injured anatomical site during athletic training.