Prevalence, incidence and characteristics of musculoskeletal injuries in Athletics (track and field): a systematic review and meta-analysis

OBJECTIVE: To quantify the extent of musculoskeletal injuries in Olympic Athletics (track and field) disciplines by synthesising the current evidence on the prevalence of injured athletes, injury event incidence rates and injury characteristics. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Web of Science, EMBASE, SPORTDiscus, CINAHL and Cochrane were searched from inception to 28 January 2025. ELIGIBILITY CRITERIA: Studies reporting athletics-related musculoskeletal injuries in Olympic Athletics disciplines. RESULTS: From 18 319 identified references, 216 studies were included; 38% of these studies were classified as having low study quality. Data synthesis was performed on 88 studies reporting on all injuries across all Athletics disciplines (21.6% with high study quality). The synthesised prevalence of injured athletes was 11.7% (95% CI 2.0% to 26.9%) for prospective studies only including championship/competition data, and 69.7% (95% CI 52.4% to 84.5%) for prospective studies combining training and competition data. The synthesised injury event incidence rates were 68.8 injuries per 1000 registered athletes (95% CI 39.4 to 120.2) for prospective studies only including championship/competition data, and 4.2 injuries per 1000 athlete-exposures (95% CI 2.1 to 7.7) and 3.8 injuries per 1000 hours of Athletics (95% CI 1.7 to 8.3) for prospective studies combining training and competition data. The Grading of Recommendations, Assessment, Development and Evaluation certainty of evidence was 'very low' for all outcomes, and 'low' for the injury event incidence rate per 1000 registered athletes for prospective studies conducted in championship/competition settings. Injuries were mainly located at the thigh, followed by the lower leg, foot and ankle. The main tissue type affected was the muscle, followed by tendon, ligament, skin, bone and joint. CONCLUSIONS: This systematic review with meta-analysis quantified the extent of musculoskeletal injuries in Athletics. Our findings inform future research and healthcare service planning and support targeted injury risk reduction strategies at all levels in Athletics.