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Injury incidence, severity and profile in Olympic combat sports: a comparative analysis of 7712 athlete exposures from three consecutive Olympic Games
  1. Reidar P Lystad1,
  2. Alexander Alevras1,
  3. Iris Rudy1,
  4. Torbjørn Soligard2,
  5. Lars Engebretsen2,3,4
  1. 1Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
  2. 2Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  3. 3Department of Orthopaedic Surgery, University of Oslo, Oslo, Norway
  4. 4Oslo Sports Trauma Research Center, Oslo, Norway
  1. Correspondence to Dr Reidar P Lystad, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia; reidar.lystad{at}


Objectives To describe and compare the epidemiology of competition injuries in unarmed combat sports (ie, boxing, judo, taekwondo and wrestling) in three consecutive Olympic Games.

Methods Prospective cohort study using injury data from the IOC injury surveillance system and exposure data from official tournament records at three consecutive Olympic Games (ie, Beijing 2008, London 2012 and Rio de Janeiro 2016). Competition injury incidence rates per 1000 min of exposure (IIRME) were calculated with 95% CIs using standard formulae for Poisson rates.

Results The overall IIRME was 7.8 (95% CI 7.0 to 8.7). The IIRME in judo (9.6 (95% CI 7.8 to 11.7)), boxing (9.2 (95% CI 7.6 to 10.9)) and taekwondo (7.7 (95% CI 5.6 to 10.5)) were significantly higher than in wrestling (4.8 (95% CI 3.6 to 6.2)). The proportion of injuries resulting in >7 days absence from competition or training was higher in wrestling (39.6%), judo (35.9%) and taekwondo (32.5%) than in boxing (21.0%). There was no difference in injury risk by sex, weight category or tournament round, but athletes that lost had significantly higher IIRME compared with their winning opponents (rate ratio 3.59 (95% CI 2.68 to 4.79)).

Conclusion Olympic combat sport athletes sustained, on average, one injury every 2.1 hours of competition. The risk of injury was significantly higher in boxing, judo and taekwondo than in wrestling. About 30% of injuries sustained during competition resulted in >7 days absence from competition or training. There is a need for identifying modifiable risk factors for injury in Olympic combat sports, which in turn can be targeted by injury prevention initiatives to reduce the burden of injury among combat sport athletes.

  • sporting injuries
  • boxing
  • judo
  • martial arts

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  • Twitter @RLystad, @TSoligard, @larsengebretsen

  • Contributors RPL, TS and LE conceived the study. TS and LE provided the injury data. RPL, AA and IR collated the exposure data. RPL conducted the analysis and wrote the first draft of the manuscript. RPL, TS and LE interpreted the findings and reviewed and edited the manuscript. All authors approved the final manuscript.

  • Funding The International Olympic Committee funded the collection of the Olympic Games injury data.

  • Competing interests TS and LE work in the Medical and Scientific Department of the IOC as Scientific Manager and Head of Scientific Activities, respectively.

  • Patient consent for publication Not required.

  • Ethics approval This research was approved by the Macquarie University Human Research Committee (reference number: 5201700320) and was conducted in accordance with the requirements of the National Health and Medical Research Council’s National Statement on Ethical Conduct in Human Research (2007; updated May 2015).

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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