Background The majority of studies in handball register only time loss injuries. From previous studies and our experience working with handball players we know that playing with overuse problems are common and such symptoms can affect their performance.

Objective To register the prevalence of overuse problems in low back, knee and dominant shoulder among Icelandic male handball players using questionnaire designed by OSTRC in Oslo, Norway.

Design Prospective cohort study. Players from the two highest division in Iceland were invited.

Setting Icelandic elite male handball players.

Patients (or Participants) Out of 14 elite male handball teams invited, totally 229 players from 13 teams participated. The first questionnaire was answered by 206 players; 137 answered the final one.

Interventions (or Assessment of Risk Factors) The questionnaire was distributed sixteen times to players via e-mail, every second week from September 25th 2012 to April 22nd 2013.

Main Outcome Measurements The prevalence of overuse problems (every problems registered) and substantial problems (problems affecting performance or participation) were calculated for knee, low back and dominant shoulder. This was done for each questionnaire by dividing the number of players that reported problems (overuse or substantial overuse) by the total number of respondents.

Results The response ratio was 71.5%. During the research period 91% of participants reported overuse problems and 61% reported substantial overuse problems. The average prevalence of overuse problems was 34% (31–37 95% CI), varying from 21–47%, highest during the pre-season period (September 25th to October 8th). The average prevalence of substantial overuse problems was 12% (10–14 95% CI), varying from 6–15% over the research period.

Conclusions Substantial overuse problems are constantly affecting many players during the season. High prevalence in the first two questionnaires raises speculations about the training methods during the pre-season.