Collegiate Female Lacrosse Players Demonstrate Asymmetry in Sideways Hop Landing Kinetics

Background:Women’s lacrosse is an increasingly popular sport. Current rules allow incidental body and stick-to-stick contact, with limited required protective equipment. Injuries to the head, face, and lower extremities are common, especially at higher levels of competition. Differences in injury rates and types based on competition level remain largely unknown.Purpose:To systematically review the literature to better understand injury differences between scholastic and collegiate female lacrosse athletes.Study Design:Systematic review; Level of evidence, 4.Methods:Under PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), 543 studies were identified in September 2025 in PubMed, Scopus, Google Scholar, and Cochrane Central databases that reported on injuries occurring in female scholastic (youth/high school) and collegiate lacrosse players. Inclusion criteria included studies reporting injury rates per athletic exposure (AE), injury mechanisms, body regions injured, injury diagnosis, and injury setting (practice vs game). Incidence rates for variables of interest were pooled as proportions using inverse-variance weighting and displayed in forest plots, with heterogeneity among studies assessed by the I2 statistic.Results:A total of 31 studies were identified and included in our analysis. The overall injury rate was 3.83 (range, 0.11-5.19) per 1000 AEs for collegiate athletes versus 0.72 (range, 0.07-8.69) for scholastic athletes. A significantly higher proportion of injuries occurred in scholastic athletes from direct contact with the ball (15.2% [556/3644] vs 7.9% [211/2668]; P < .001) and stick (18.7% [683/3644] vs 9.4% [116/1233]; P < .001), while collegiate players sustained a greater number of direct player-to-player injuries (15.2% [4508/29,651] vs 13.5% [513/3807]; P = .005) and noncontact injuries (36.9% [10,927/29,651] vs 22.7% [968/4269]; P < .001). Injuries to the head and face (19.4% [914/4718] vs 14.8% [4429/29,991]; P < .001), including concussions (16.8% [583/3470] vs 11.4% [3317/29,101]; P < .001), as well as ankle injuries (23.7% [637/2681] vs 16.2% [4817/29,723]; P < .001), were greater in scholastic athletes, while collegiate players sustained a higher number of knee injuries (18.1% [5381/24,342] vs 14.5% [455/3143]; P < .001) and lower leg injuries (10.6% [3146/29,733] vs 5.3% [127/2388]; P < .001). Injuries occurred more frequently during game competition at both competition levels.Conclusion:This review showed that in female lacrosse athletes, overall injuries were greater in collegiate athletes when compared with scholastic athletes, with a significantly greater proportion of player-to-player, noncontact, knee, and lower leg injuries at the collegiate level. Injuries to the head, face, and ankle, along with injuries involving contact with the ball and stick, were more commonly reported among scholastic athletes. Further studies evaluating potential rules and equipment modifications may guide targeted injury prevention strategies to improve athlete safety at the scholastic and collegiate levels.

The high incidence of anterior cruciate ligament (ACL) rupture in sports, particularly noncontact injuries, warrants determination of risk factors associated with these injuries. The role that leg dominance plays in injury risk during soccer has not been elucidated. One group has suggested injuries differ between the sexes, with women more likely to injure their non-dominant, support leg, but men more likely to injure their dominant, kicking leg (1). Others have reported that leg dominance is not a risk factor (2-3). PURPOSE: The purpose of this study was to compare biomechanical variables between the dominant and non-dominant limbs of female soccer players. METHODS: Thirty-two women from two NCAA Division I soccer teams (20.1 ± 1.2 yrs; 1.7 ± .1 m; 64.3 ± 6.1 kg) underwent biomechanical analyses of two tasks; a triple hop landing (TH) and a single-leg squat (SQ). Knee joint angles and external moments (normalized to mass X height) in the sagittal and frontal planes were assessed at peak knee flexion. Peak knee extension power during the TH landing was also assessed. Paired t-tests were performed to detect differences between biomechanical variables from the self-reported dominant (D) and non-dominant limbs (ND). RESULTS: No between limb differences were observed for the knee angles during the TH (sagittal plane D= 66 ± 9 and ND= 67 ± 10 deg, p=.767; frontal plane D= 7 ± 5 and ND= 6 ±6 deg, p=.360) or the SQ (sagittal plane D= 71 ± 12 and ND= 73 ± 13 deg, p=.333; frontal D= 8 ± 4 and ND= 10 ± 6 deg, p=.175). Additionally, no between limb differences in knee flexion moments for either the TH (D= 1.1± .3 and ND= 1.1 ± .3 Nm/kgm, p=.137) or the SQ (D=1.1 ± .2 and ND= 1.1 ± .3 Nm/kgm, p=.997) were observed. However, knee adduction moments were smaller in the dominant limb during both the TH (D= .35 ± .19 Nm/kgm; ND= .46 ± .22 Nm/kgm; p= .011) and the SQ (D= .24 ± .15 and ND= .31 ± .17 Nm/kgm, p= .030). No between limb differences were present for the TH landing power (p= .767). CONCLUSIONS: The greater knee adduction moments observed on the non-dominant stance limb for both the TH and SD would deter the knee from a deleterious risk knee abduction position, commonly associated with noncontact ACL injury. It is therefore plausible that the between limb differences contribute to women soccer players being more likely to sustain injury to their dominant preferred kicking limb.

Non-contact anterior cruciate ligament injury is a common sports injury, for which biomechanical factors are considered important. Gender and limb dominance influence lower limb biomechanics. Therefore, this study aimed to investigate the effects of gender and limb dominance on trunk and lower extremity biomechanics in the frontal plane during single-leg lateral jump landing. A total of 20 active individuals (10 male and 10 female) were recruited to perform lateral single-leg jump landing. The study was conducted in a motion analysis laboratory. Ten Vicon™ cameras (200 Hz) synchronized with an AMTI force plate (1,000 Hz) were used to capture kinematic and kinetic data. A three-dimensional (3D) model of the trunk and lower extremities was constructed using Visual3D software. Average data of ground reaction forces (GRFs), frontal motion of the trunk and lower limb, and frontal joint moment of the lower limb were reported and analyzed. A two-way mixed ANOVA model (2 × 2, gender × side) was used to analyze the primary effect. The significance level of 0.05 was set for statistical analysis. Active females exhibited significantly higher peak vertical GRF (p = 0.01) than males. The non-dominant limb had a significantly higher knee valgus moment at the peak vertical GRF (p &lt; 0.001), the knee valgus angle excursion (p = 0.03), and the hip abductor moment at the peak vertical GRF (p &lt; 0.001). Both groups used similar frontal plane lower extremity control strategies. A significantly higher knee valgus excursion, hip abductor moment, and knee valgus moment at the peak vertical GRF phase were observed in the non-dominant limb. Therefore, the non-dominant limb appeared to have higher loading at the hip and knee joints during landing.

Concussion screening among collegiate lacrosse athletes is a major safety priority. Although attention has been directed at concussion management following injury, less is known about the association between cognition and balance during preseason screening. The purpose of the study was to assess the relationship between balance and neurocognition among collegiate male lacrosse players and to examine predictive determinants of postural stability. Participants included a convenience sample of 49 male collegiate Division 3 lacrosse players who completed a demographic survey and performed the immediate postconcussion test (ImPACT) and instrumented Sensory Organization Test (SOT). There was a significant association between balance SOT performance and both verbal memory (r = .59, p < .01) and visual motor speed scores (r = .43, p < .05). Significant correlations between verbal memory and SOT Conditions 2, 5, and 6 were also noted (all p < .05). Verbal memory predicted 33% of the variance in the SOT composite balance score (p < .001). Our results indicate a significant relationship exists between postural stability and both verbal memory and visual processing speed among collegiate male lacrosse players and supports vestibulocortical associations. Findings warrant ongoing performance and executive function tracking and can serve as a conduit for integrated sensorimotor and dual-task training.

Football is a complex team sport with high physical, tactical and technical demands, exposing players to a high risk of both contact and non-contact injuries. To map the range of preventative strategies used to reduce non-contact lower limb injuries among male footballers. Our study was conducted as a scoping review. The review was guided in five stages: (1) defining the research question; (2) identifying relevant studies; (3) selecting the topic; (4) charting and collecting data; and (5) summarising and reporting the results. The research was guided by the population, concept, context framework, focusing on professional and amateur male soccer players across various age groups. It examined a range of preventative strategies targeting non-contact lower limb injuries, recognising their critical role in reducing player exclusion because of injury. The literature search was conducted across eight electronic databases: PUBMED, CINAHL, PEDro, EBSCOhost, Cochrane Library, SPORTDiscus, Scopus and ScienceDirect. Twenty-five (out of 617) studies met the inclusion criteria, and their outcomes have been presented. Outcomes revealed various injury inhibition programmes implemented for non-contact lower limb injuries among male footballers, which were: Nordic hamstring exercises, Copenhagen adduction exercise, muscle strengthening, stretching exercises, ankle taping, FIFA 11, FIFA 11+ warm-up programme, preseason preparation, running mechanics, high chronic training loads, bounding exercises and a multicomponent exercise programme. The study identified a range of preventative strategies commonly employed to reduce the risk of non-contact lower limb injuries among male football players. Considering the varying dynamics across teams and competitive levels, these strategies can serve as a valuable framework for developing injury prevention programmes.

Background: Non-contact tissue injury in elite athletes is influenced by multiple factors, including genetic predisposition. Although previous research has identified several genetic markers associated with injury susceptibility, the role of the CD36 (cluster of differentiation 36) gene, a key regulator of fatty acid transport into skeletal muscle and other vital tissues, remains unexplored in this context. A single-nucleotide polymorphism in the CD36 gene (rs1761667) involves an A-to-G substitution (with three genotypes = AA and GG homozygotes and AG heterozygotes), and previous data have reported that individuals carrying the AA genotype of the CD36 gene show reduced expression of the CD36 protein and poorer lipid metabolism. Additionally, it has been recently found that the frequency of the AA genotype is significantly lower in elite cyclists compared to field hockey players. No previous study has examined the association between the CD36 rs1761667 polymorphism and athlete injury risk. Therefore, the aim of this study was to investigate the potential association between the CD36 rs1761667 polymorphism and non-contact tissue injury susceptibility in elite Moroccan cyclists and field hockey players. Methods: Forty-three elite Moroccan male athletes, including 19 cyclists and 24 national team field hockey players, volunteered for this study. Non-contact tissue injuries during the 2022/2023 sports season have been recorded. Genotyping of the CD36 rs1761667 polymorphism was carried out using Sanger sequencing. Chi-square tests were used to analyze the Hardy–Weinberg equilibrium and compare the genotypes and characteristics of athletes with and without non-contact injuries. Results: During the 2022/2023 sports season, 21.05% of cyclists (4 out of 19) and 33.33% of field hockey players (8 out of 24) experienced non-contact tissue injuries. The genotypic frequency was similar in the injured and non-injured groups among cyclists (χ2 and p not calculated because “AA = 0” in both groups), field hockey players (χ2 = 3.30, p = 0.19), and all athletes (χ2 = 1.73, p = 0.41). Additionally, the dominant model of the CD36 rs1761667 polymorphism (AA+AG vs. GG) did not reveal a significant risk of non-contact injuries among cyclists (OR: 1.20, 95% CI: 0.13–19.09, p > 0.9999), field hockey players (OR: infinity, 95% CI: 0.23-infinity, p = 0.53), and all athletes (OR: 2.75, 95% CI: 0.32–34.12, p = 0.65). Furthermore, the recessive model (AA vs. AG+GG) did not demonstrate any effect on the risk of non-contact injuries in cyclists (OR and 95% CI not calculated, p > 0.9999), field hockey players (OR: 0.33, 95% CI: 0.05–2.40, p = 0.38), and all athletes (OR: 0.55, 95% CI: 0.10–2.60, p = 0.69). Conclusions: This study suggests that the association between specific genotypes (AA, AG, and GG) or alleles (A and G) of the CD36 gene and susceptibility to non-contact tissue injuries in Moroccan cycling and field hockey players is uncertain. Given the small sample size, further studies will be needed to explore and confirm these findings.

Association between ACTN3 R577X genotype and risk of non-contact injury in trained athletes: A systematic review

Background and Objectives: The insertion/deletion (I/D) polymorphism in ACE, the gene encoding the angiotensin-converting enzyme (ACE), has been suggested as a genetic variation that can influence exercise performance and risk of injury in elite athletes. The I allele has been associated with enhanced endurance performance and with reduced inflammation, while the D allele has been associated with improved performance in strength and power activities. However, the role of this genetic variant in the incidence of non-contact injury is underexplored. This study investigated the possible association of ACE I/D genotypes with the risk of non-contact injury in elite Moroccan athletes. Materials and Methods: Forty-three elite male athletes (19 cyclists and 24 field hockey players) from the Moroccan national team participated voluntarily. Non-contact injuries were recorded for all athletes and classified according to the IOC consensus statement by the medical staff of the teams. ACE I/D polymorphism genotyping was performed by polymerase chain reaction (PCR) using genomic DNA from blood samples. Results: There were four cyclists (21.05%) and eight field hockey players (33.33%) with a non-contact injury during the season. The distribution of the ACE I/D genotypes was similar in the athletes with vs. without non-contact injury for cyclists (DD/ID/II 25.00/50.00/25.00% vs. 46.67/40.00/13.33% non-injured, respectively; X2 = 0.69, p = 0.70), field hockey players (DD/ID/II 50.00/50.00/0.00% vs. 50.00/43.75/6.25%; X2 = 0.54, p = 0.76) and for the whole group of athletes (DD/ID/II 41.67/50.00/8.33% vs. 48.39/41.94/9.68%; X2 = 0.22, p = 0.89). In the whole group of athletes, neither the dominant (DD + ID vs. II = OR: 1.17, 95% CI: 0.15–16.56, p = 0.89) nor the recessive (DD vs. ID + II = OR: 1.31, 95% CI: 1.31–4.89, p = 0.69) models showed an increased risk of non-contact injury. Conclusions: The distribution of the ACE I/D genotypes was similar in elite cycling and field hockey athletes with or without non-contact injury during the season. These results indicate that there is no significant association between the ACE I/D polymorphism and the susceptibility to non-contact injury in these athletes. Further research is warranted to validate these findings and to investigate their broader implications for advancing knowledge in sports injury prevention and optimizing athlete management strategies.

Increased Posterior Tibial Slope (PTS) angle has been reported to be a risk factor for primary anterior cruciate ligament (ACL) tears. However, it is unknown whether increased PTS has an associated increased risk for non-contact versus contact ACL injury. The purpose of this study is to determine whether patients with non-contact ACL injury have a higher PTS angle than those with contact ACL injury. A total of 1700 patients who underwent primary ACL reconstruction between January 2011 and June 2023 at a single academic institution were initially included. Electronic medical records were reviewed for demographic information as well as evidence that the patient sustained a contact or non-contact ACL injury. Patients in the contact cohort were propensity score matched to patients in the non-contact cohort by age, sex and BMI. Additionally, patients in the contact cohort were then propensity score matched to a control group of patients with intact ACLs also by age, sex and BMI. One hundred and two patients with contact injury were initially identified and 1598 patients with non-contact injuries were identified. Of the 102, 67 had knee X-rays that were suitable for measurement. These 67 contact injury patients were propensity score matched to 67 noncontact patient and 67 patients with intact ACLs based on age, sex and BMI. There were no significant differences between contact and non-contact cohorts in age (28.7±6.3 vs. 27.1±6.5, p = 0.147), sex (Female: 36.0% vs. 34.3%, p = 0.858), or BMI (26.7±5.6 vs 26.1±3.4, p= 0.475). There was no significant difference in PTS angle between contact versus non-contact ACL injury patients (11.6±3.0 vs.11.6±2.8, p= 0.894). There was a significant difference in PTS between the contact ACL injury and the intact cohort (11.6±3.0 vs. 10.0±3.9, p= 0.010) and the non-contact ACL injury and the intact cohort (11.6±2.8 vs. 10.0±3.9, p = 0.010). There was no significant difference in the degree of PTS between patients who sustained contact versus non-contact ACL injuries. Additionally, there was a significantly increased PTS in both the contact and non-contact ACL injury cohorts compared to patients with intact ACLs.

Development of a preliminary evidence-based neuromusculoskeletal exercise guideline to reduce injury risk in the lower limb

Research is limited as to whether Functional Movement Screen scores relate to non-contact injury risk in rugby league players. This cohort study investigates whether the Functional Movement Screen score predicts non-contact injuries in elite adolescent rugby league players. Australian adolescent rugby league players ( n = 52; mean age 16.0 ± 1.0 years) from one club participated in this study. Functional Movement Screen scores, height, and mass were collected at the beginning of the preseason. Training, match exposure, and injury incidence data (non-contact match and training injuries with three levels of severity) were recorded for each individual athlete throughout the season. Linear and logistic regression analyses were conducted to investigate the association between Functional Movement Screen score (continuous score, ≤ 14 or &gt; 14, and three subscores) and injury risk, whilst controlling for exposure time. The mean Functional Movement Screen score for the sample was 13.4 (95% CI: 11.0–14.0). A total of 72 non-contact injuries were recorded (incidence rate: 18.7 per 1000 exposure hours; 95% CI: 11.6–24.8). There were no statistically significant associations between non-contact injury and Functional Movement Screen score for any of the analyses conducted. Our results suggest that the Functional Movement Screen does not reflect non-contact injury risk in elite adolescent rugby league players. Further research should investigate whether a more sport-specific movement screen in the preseason can more effectively predict injury risk in this population.

BackgroundStudies have shown a significant association between the radiographically measured lateral femoral condyle ratio (LFCR) and anterior cruciate ligament (ACL) injury. However, it is unclear whether LFCR measured by magnetic resonance imaging (MRI) is associated with a higher risk of noncontact ACL injury.ObjectiveTo investigate the effect of LFCR on the risk of noncontact ACL injury by MRI. 2 to investigate the association of LFCR measured by MRI with multiple bone morphological risk factors and evaluate the most sensitive risk predictors of noncontact ACL injury.MethodsA total of 116 patients, including 58 subjects with noncontact ACL injury and 58 age-matched and sex-matched controls with only meniscus injury, were included in this retrospective case-control study. LFCR, lateral tibial slope (LTS), lateral tibial height (LTH), medial tibial slope (MTS), and medial tibial depth (MTD) were measured on MRI. The differences in each index between the two groups were compared, and risk factors were screened by single-factor logistic regression analysis. Indicators with P values < 0.1 were included in the logistic regression equation. The critical values and areas under the curve (AUCs) of independent risk factors were determined by receiver operating characteristic (ROC) curve analysis. Finally, the diagnostic performance of each risk factor was evaluated by the Z-test.ResultsA total of 116 patients who met the inclusion criteria were included in the final analysis (58 cases in the noncontact ACL injury group and 58 cases in the control group). Patients with noncontact ACL injury had a higher femoral LFCR (0.64 ± 0.03) than patients with isolated meniscus tears. Among all the risk factors for ACL injury, the AUC for LFCR was the largest, at 0.81 (95% CI, 0.73-0.88), and when the critical value was 0.61, the sensitivity and specificity for the diagnosis of ACL injury were 0.79 and 0.67, respectively. When combined with LTH (> 2.35 mm), the diagnostic performance was improved. The AUC was 0.85 (95% CI, 0.78-0.92), the sensitivity was 0.83, and the specificity was 0.76.ConclusionThis study shows that an increased LFCR is related to an increased risk of noncontact ACL injury as determined by MRI. LFCR and LTH are sensitive risk factors for noncontact ACL injury and may help clinicians identify individuals prone to ACL injury, allowing prevention and intervention measures to be applied.

Earlier statements suggested a negative impact of coronavirus disease 2019 (COVID-19) infection on sports performance and injury risk. With the COVID-19 pandemic under control and the dominance of a less-severe strain of the virus, there is a need to confirm whether these adverse effects still apply to the current situation. Infected players would have a higher noncontact muscle injury incidence compared with noninfected counterparts. Cohort observational study. Level 3. Seven teams (n = 147 players) competing in the Spanish professional women's football league (Liga F) were prospectively monitored during the 2021-2022 season. Data from noncontact injuries were recorded and classified following the latest consensus statement from the International Olympic Committee. COVID-19 was certified by the medical staff by regular polymerase chain reaction analysis. Ninety-two players suffered at least 1 noncontact muscle injury during the season. Injury incidence during the season was similar in players with COVID-19 (n = 83) and players without infection (5.1 ± 6.7 versus 4.9 ± 10.0 injuries/1000 h of play, respectively; P = 0.90). Players with COVID-19 were not more likely to suffer noncontact injuries compared with those players without infection (R2 = 0.02; odds ratio [OR] 95% confidence interval [95% CI] = 0.36-1.38; P = 0.31). There was no effect of COVID-19 on the days of absence due to injury (R2 = 0.01; OR 95% CI = 1.00-1.01; P = 0.44) or in the classification of the severity of the injury (P = 0.79). COVID-19 has no significant effect on noncontact injury incidence and severity in professional female football players. Currently, COVID-19 infection does not alter noncontact muscle injury risk in professional football and requires no further attention in terms of injury management. Usual return-to-play protocols apply to COVID-19 considering the particularities of each player since the severity of infection, period of inactivity, and effects on the player's health and performance.

Background: Postural symmetry ensures balanced alignment and equal weight distribution, promoting optimal function and minimizing stress on muscles and joints. This study aimed to evaluate lower limb movement symmetry in response to mechanical perturbations. Methods: Twelve healthy young women were subjected to mechanical perturbation tests while standing on the Motek GRAIL system treadmill. Maximum values of kinematic and kinetic parameters and symmetry indices were counted to compare the responses of dominant and non-dominant limbs. Results: The study identified symmetrical and asymmetrical features in lower limb dynamics. Symmetry nearness was observed in the ankle joint angle (SI = 0.03), the hip torque (SI = 0.03), and the vertical component of the ground reaction force (SI = 0.04). However, significant asymmetries were found in the medio-lateral component of the ground reaction force (SI = 1.84), ankle torque (SI = 0.23), knee torque (SI = 0.19), hip angle (SI = 0.15), and knee angle (SI = 0.08). The anterior–posterior component of the ground reaction force (SI = 0.14) showed asymmetry but was not statistically significant. Conclusions: Perturbations impact lower limb dynamics, revealing dominance- and joint-specific asymmetries. Bilateral assessment is crucial for understanding postural control, guiding rehabilitation to restore symmetry, and reducing the risk of injuries, falls, and musculoskeletal strain, particularly in athletes and older adults. These findings emphasize the value of symmetry indices in optimizing therapy and prevention strategies.

The high prevalence of injury amongst cricket fast bowlers exposes a great need for research into the risk factors associated with injury. Both extrinsic (environment-related) and intrinsic (person-related) risk factors are likely to be implicated within the high prevalence of non-contact injury amongst fast bowlers in cricket. Identifying and defining the relative importance of these risk factors is necessary in order to optimize injury prevention efforts. The objective of this review was to assess and summarize the scientific literature related to the extrinsic and intrinsic factors associated with non-contact injury inherent to adult cricket fast bowlers. A systematic review was performed in compliance with the PRISMA guidelines. This review considered both experimental and epidemiological study designs. Studies that included male cricket fast bowlers aged 18 years or above, from all levels of play, evaluating the association between extrinsic/intrinsic factors and injury in fast bowlers were considered for inclusion. The three-step search strategy aimed at finding both published and unpublished studies from all languages. The searched databases included MEDLINE via PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Controlled Trials Register in the Cochrane Library, Physiotherapy Evidence Database (PEDro), ProQuest 5000 International, ProQuest Health and Medical Complete, EBSCO MegaFile Premier, Science Direct, SPORTDiscus with Full Text and SCOPUS (prior to 28 April 2015). Initial keywords used were 'cricket', 'pace', 'fast', 'bowler', and 'injury'. Papers which fitted the inclusion criteria were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). A total of 16 studies were determined to be suitable for inclusion in this systematic review. The mean critical appraisal score of the papers included in this study was 6.88 (SD 1.15) out of a maximum of 9. The following factors were found to be associated with injury: bowling shoulder internal rotation strength deficit, compromised dynamic balance and lumbar proprioception (joint position sense), the appearance of lumbar posterior element bone stress, degeneration of the lumbar disc on magnetic resonance imaging (MRI), and previous injury. Conflicting results were found for the association of quadratus lumborum (QL) muscle asymmetry with injury. Technique-related factors associated with injury included shoulder-pelvis flexion-extension angle, shoulder counter-rotation, knee angle, and the proportion of side-flexion during bowling. Bowling workload was the only extrinsic factor associated with injury in adult cricket fast bowlers. A high bowling workload (particularly if it represented a sudden upgrade from a lower workload) increased the subsequent risk to sustaining an injury 1, 3 or 4 weeks later. Identifying the factors associated with injury is a crucial step which should precede the development of, and research into, the effectiveness of injury prevention programs. Once identified, risk factors may be included in pre-participation screening tools and injury prevention programs, and may also be incorporated in future research projects. Overall, the current review highlights the clear lack of research on factors associated with non-contact injury, specifically in adult cricket fast bowlers. Johanna Briggs Institute Database of Systematic Reviews and Implementation Reports 1387 (Olivier et al., JBI Database Syst Rev Implement Rep 13(1):3-13. doi: 10.11124/jbisrir-2015-1387 , 2015).