Article Text

Download PDFPDF

Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis
  1. Jeppe Bo Lauersen1,2,
  2. Thor Einar Andersen3,
  3. Lars Bo Andersen1,4
  1. 1 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  2. 2 Department of Orthopedic Surgery, Hvidovre Hospital, Hvidovre, Denmark
  3. 3 The Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  4. 4 Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
  1. Correspondence to Dr Jeppe Bo Lauersen, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo 0863, Norway; jblau{at}


Objective This review aims to analyse strength training-based sports injury prevention randomised controlled trials (RCT) and present best evidence recommendations for athletes and future research. A priori PROSPERO registration; CRD42015006970.

Design Systematic review, qualitative analysis and meta-analysis. Sorting of studies and quality assessments were performed by two independent authors. Qualitative analyses, relative risk (RR) estimate with robustness and strength of evidence tests, formal tests of publication bias and post-hoc meta-regression were performed.

Data sources PubMed, Embase, Web of Science and SPORTDiscus were searched to July 2017.

Eligibility criteria for selecting studies RCTs on strength training exercises as primary prevention of sports injuries.

Results Six studies analysed five different interventions with four distinct outcomes. 7738 participants aged 12–40 years were included and sustained 177 acute or overuse injuries. Studies were published in 2003–2016, five from Europe and one from Africa. Cluster-adjusted intention-to-treat analysis established RR 0.338 (0.238–0.480). The result was consistent across robustness tests and strength of evidence was high. A 10% increase in strength training volume reduced the risk of injury by more than four percentage points. Formal tests found no publication bias.

Conclusion The included studies were generally well designed and executed, had high compliance rates, were safe, and attained consistently favourable results across four different acute and overuse injury outcomes despite considerable differences in populations and interventions. Increasing strength training volume and intensity were associated with sports injury risk reduction. Three characteristically different approaches to prevention mechanisms were identified and incorporated into contemporary strength training recommendations.

  • sports and exercise medicine
  • strength
  • injury prevention
  • review
  • meta-analysis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

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