Objectives To report injury patterns associated with the training activities of elite male and female South Korean wrestling athletes preparing for the Olympic Games.

Methods From 2008 to 2017, we prospectively collected data on elite wrestling athletes at the Korea National Training Center. Athletes were assessed by two sports medicine doctors, and data were stratified according to sex, wrestling style, weight class, injury location and injury severity. Χ²tests were used to compare groups. Injury risk was expressed in relative ratios with 95% confidence intervals (RR, 95% CI).

Results There were 238 male and 75 female elite wrestlers. Training time totalled 382 800 hours. We recorded 1779 injuries in 313 athletes aged >18 years (annual average, 4.04 injuries/athlete); 59% of these were mild injuries. When all athletes were considered, most injuries occurred in the lower extremities (37.5%), followed by the upper extremities (27.4%), trunk (25.4%) and the head and neck area (9.7%). Weight class significantly influenced injury severity for both wrestling styles among male athletes (Greco-Roman, P=0.031; freestyle, P=0.028), as well as among female freestyle wrestling athletes (P=0.013). The relative ratio of injury incidence for the lightweight class compared with the heavyweight class was high for Greco-Roman style compared with freestyle (RR 1.13, 95% CI 1.03 to 1.27; P=0.011).

Conclusions Among male and female South Korean elite wrestling athletes training for the Olympic Games, most injuries were mild and occurred in the lower extremities. Weight class influenced injury severity in both wrestling styles, and lightweight athletes had higher injury rates.