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Injuries impair the chance of successful performance by sportspeople: a systematic review
  1. Michael K Drew1,2,
  2. Ben P Raysmith1,
  3. Paula C Charlton1
  1. 1 Department of Physical Therapies, Australian Institute of Sport, Bruce, Australia
  2. 2 Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
  1. Correspondence to Dr Michael K Drew, Senior Sports Physiotherapist, c/o AIS Physical Therapies, Australian Institute of Sport, Leverrier Cr, Bruce ACT 2614, Australia; Michael.drew{at}


Background Cost–benefit analyses have been proposed for determining acceptable risk of injury regarding training and competition participation. Currently, there is no best evidence synthesis of the literature evaluating the relationship between injury/illness and chance of success or failure.

Objective To evaluate the relationship between injury and/or illness and success and/or failure in athletic populations (individual and team sports).

Methods This review was prospectively registered (PROSPERO CRD42016036729) and a systematic electronic search was conducted in May 2016. Inclusion criterion was any study design describing the association between injury and/or illness and success or failure in athletic performance. Two independent authors screened search results, performed data extraction and assessed methodological quality and strength of evidence using a modified Downs and Black appraisal tool and a modified van Tulder method, respectively.

Results Of 10 546 titles identified, 14 satisfied the inclusion criteria and 7 had low risk of bias. Outcome measures associated with success and/or failure included: (1) availability of team members, (2) injury incidence, (3) injury burden, (4) squad utilisation and (5, 6) precompetition and in-competition injury. There was strong evidence that (1) increased availability of team members/athletes decreased the risk of failure and (2) precompetition and in-competition injuries were associated with increased risk of failure.

Conclusions Injuries have a detrimental impact on team and individual athletic success. Increased player availability improves chances of success. Conversely, injuries sustained both prior to and during competition may increase risk of failure. Injury prevention should therefore be a priority for maximising athletic performance.

  • Success
  • failure
  • performance
  • injury prevention
  • cost–benefit

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  • Contributors MD, PC and BR contributed to the original concept. PC and MD designed the search strategy which PC executed. MD and PC determined eligibility criteria and undertook the process of inclusion/exclusion. PC and BR independently assessed methodological criteria with MD providing the decision where consensus was not met. MD extracted all data from the included studies and PC confirmed the accuracy of this. All authors contributed to the drafting and final approval of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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