Timing of musculoskeletal injuries during a single athletic event: A systematic review

Abstract

Aim: The aim of the study is to examine the relationship between musculoskeletal injury and time within an athletic event and to propose that these injuries may be fatigue-related. Background: Musculoskeletal injuries impede athletic performance. The identification of risk factors is essential to reducing injury. Materials and Methods: We searched PubMed, Embase, SPORTDiscus, and CINAHL and performed manual reference checks. Included articles reported the timing of acute musculoskeletal injury in a single athletic event; 23 articles were selected for multireviewer assessment of quality and levels of evidence. Results: Eighty-seven percent of studies found a higher incidence of injury in later stages of play (second half or later in the second half) and 60% found this to be significant. All but two articles suggested that injury trends were related to fatigue development. Conclusion: Based on our review, a connection between the development of musculoskeletal injury and duration of play supports the concept that fatigue is a risk factor for injury. Clinical Significance: A greater understanding of the correlation between fatigue and musculoskeletal injury is essential to designing injury prevention programs that will decrease the onset of musculoskeletal injury in athletes. Ultimately, preventative strategies that reduce injury risk will lead to superior health and performance in athletes during athletic careers and later in life.