Background Physical activity and sports participation are promoted to counteract the increased prevalence of overweight and obesity in children and young adults. Both high BMI and physical activity level have been associated with an increased risk of sports injuries.

Objective To determine the relationship between sports injuries and overweight in sports participants (4–24 years), taking physical activity into account.

Design Data were obtained from the 2006–11 ‘Injuries and Physical Activity in the Netherlands’ (OBiN) retrospective survey.

Setting OBiN is a continuously executed national survey among Dutch households on accidents, sports injuries and physical activity.

Participants Analyses were based on a representative sample of 3 846 sports participants.

Risk factor assessment A sports activity is a physical activity that, according to the respondent, is associated with the term ‘sports’. Respondents who confirmed that they had participated in any kind of sports activity at least once in the previous 12 months were regarded as sports participants. BMI (weight status) was based on self-reported individual weight and height and was calculated as weight (kg)/height (m)².

Main outcome measurements Sports injuries, the main outcome measurement, were included if they were in accordance with the following definition: 'Physical damage of a musculoskeletal nature, sustained in the recall period as a result of a sudden event during sports activities or as a result of a gradual process related to sports activities.'.

Results Of all sports participants, 14.7% were overweight. Compared to normal-weight sports participants, the odds of sustaining a sports injury was 0.73 (CI:0.53–1.00, P=.050) for overweight sports participants; the odds for underweight sports participants was 0.80 (CI:0.56–1.15, P=.226).

Conclusions There is some evidence that overweight sports participants (4–24 years) do not have an increased injury risk compared to normal-weight sports participants, even when the level of physical activity is accounted for.