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Understanding injury mechanisms: a key component of preventing injuries in sport
Open accessAbstract
Anterior cruciate ligament (ACL) injuries are a growing cause of concern, as these injuries can have serious consequences for the athlete with a greatly increased risk of early osteoarthrosis. Using specific training programmes, it may be possible to reduce the incidence of knee and ankle injuries. However, it is not known which programme components are the key to preventing knee and ankle injuries or how the exercises work to reduce injury risk. Our ability to design specific prevention programmes, whether through training or other preventive measures, is currently limited by an incomplete understanding of the causes of injuries. A multifactorial approach should be used to account for all the factors involved-that is, the internal and external risk factors as well as the inciting event (the injury mechanism). Although such models have been presented previously, we emphasise the need to use a comprehensive model, which accounts for the events leading to the injury situation (playing situation, player and opponent behaviour), as well as to include a description of whole body and joint biomechanics at the time of injury.
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“Although creatine supplementations do not appear to affect training-related plasma lactate levels, which have been correlated with muscle damage in the acute phase, little is known about the effect of an artificial increase in muscle mass on joint mechanics and core stability.44,45”
From Creatine supplementation in the pediatric and adolescent athlete-- A literature review (2023) · cites this paper as [44]
In the citing paper
“little is known about the effect of an artificial increase in muscle mass on joint mechanics and core stability.44,45”
From Creatine supplementation in the pediatric and adolescent athlete-- A literature review (2023) · cites this paper as [44]
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Theodorakos, I., Rueterbories, J., Lund, M., Andersen, M. S., de Zee, M., & Kersting, U. (2016) · doi:10.1080/23335432.2015.1132638 · Cited by 13
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Metzger, G. A., Minneci, P. M., Gehred, A., Day, A., & Klingele, K. E. (2023) · Journal of Orthopaedics · doi:10.1016/j.jor.2023.03.010 · Cited by 10
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“This research direction focuses on utilizing SCV-based technologies for posture analysis, motion capture, and biomechanical assessment to enable injury risk prediction, prevention, and optimized rehabilitation (51).”
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“Such in-depth biomechanical analyses are thus crucial for creating a better understanding of the injury mechanisms of lateral ankle sprains and improving prevention strategies and rehabilitation methods in the future (Bahr & Krosshaug, 2005).”
Self-citationLima, Y., Gouttebarge, V., & Bayraktar, B. (2024) · Research in Sports Medicine: An International Journal · doi:10.1080/15438627.2024.2324257 · Cited by 10
“Systematic video analysis of injury events is an accurate and reliable method to describe the injury characteristics (Krosshaug et al., 2005).”
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“Injury is multifactorial with non-modifiable and modifiable risk factors [37].”
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Fronza, H. P., Stolf, S., Taguchi, C. M. C., Coto, N., & Padilha, A. C. (2020) · Dental Traumatology · doi:10.1111/edt.12597 · Cited by 10
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Functional Assessment and Injury Risk in a Professional Soccer Team
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“Finally, and as the main limitation of this study, it is important to remember that the explanatory models of the injury suggest that it is the result of a complex interaction among contexts, and intrinsic and extrinsic factors [2,59].”
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A comparative analysis of ENP's and SHO's in the application of the Ottawa ankle rules.
Hopkins, M. (2010) · International Emergency Nursing · doi:10.1016/j.ienj.2009.10.004 · Cited by 10
Concussion in Youth Hockey: Prevalence, Risk Factors, and Management across Observation Strategies
Williamson, I. J., & Goodman, D. (2009) · Journal of ASTM International · doi:10.1520/jai101851 · Cited by 10
The effect of 8-weeks wrestling training on unilateral muscle imbalances
Tatlıcı, A., Lima, Y., Çiftçi, B., Aktaş, S., & Badak, T. (2021) · Physical Education of Students · doi:10.15561/20755279.2021.0401 · Cited by 10
“It was reported many times that approximately 70% of ACL injuries occur during non-contact and the most common mechanism of injury is external valgus and femoral rotation [14, 16, 17, 20, 21].”
BackgroundBuckthorpe, M., Verhagen, E., D'Hooghe, P., Osti, L., Paolo, S. D., & Villa, F. D. (2025) · Knee Surgery, Sports Traumatology, Arthroscopy · doi:10.1002/ksa.70049 · Cited by 9
“Understanding injury mechanisms is key to designing e ff ective injury risk mitigation practices [4, 49].”
Ternell, K. H., Tosarelli, F., Buckthorpe, M. W., Samuelsson, K., Senorski, E. H., & Villa, F. D. (2025) · The American Journal of Sports Medicine · doi:10.1177/03635465251330007 · Cited by 10
“2,35 Developing a successful injury prevention program requires a thorough understanding of the mechanisms behind ACL injuries.”
Jokela, A., Pasta, G., Villa, F. D., Abrantes, A., Kalogiannidis, D., García-Romero-Pérez, Á., Marano, M., Skibinskyi, D., Mazzoni, S., Pruna, R., et al. (2025) · Orthopaedic Journal of Sports Medicine · doi:10.1177/23259671241309647 · Cited by 9
Saito, T., Matsumura, N., Kawamoto, S., Doi, N., Aoyama, T., & Nagai-Tanima, M. (2023) · BMC Sports Science, Medicine and Rehabilitation · doi:10.1186/s13102-023-00747-8 · Cited by 9
“Understanding the characteristics of situations and actions leading to injuries is crucial in preventing their occurrence [7].”
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Sonesson, S., Dahlström, Ö., Perera, N. P. P., & Hägglund, M. (2022) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2022.11.008 · Cited by 9
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“, neuromuscular control [24,25], experience of stress, and coping strategies) [15,16].”
BackgroundCritical social framework on the determinants of primary healthcare access and utilisation
Hamiduzzaman, M., Bellis, A. D., Abigail, W., & Fletcher, A. J. (2021) · Family Medicine and Community Health Journal · doi:10.1136/fmch-2021-001031 · Cited by 9
Plangtaisong, P., Shen, W., Wheeler, P., & Fong, D. (2021) · doi:10.1016/j.medntd.2021.100082 · Cited by 9
Chin, M., Leppänen, M., Kulmala, J., Vasankari, T., Parkkari, J., & Pasanen, K. (2021) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2021.110318 · Cited by 9
The Beighton Score and Injury in Dancers: A Prospective Cohort Study.
Armstrong, R. (2020) · Journal of sport rehabilitation · doi:10.1123/jsr.2018-0390 · Cited by 9
EL PERFIL DE LOS CORREDORES Y SU PROPENSIÓN AL ACCIDENTE DEPORTIVO
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“For example, high-contact sports, such as rugby union and soccer [16,41,43] have been demonstrated to predispose participants to higher rates of injury compared to physical exercise of a non-contact nature [61], such as volleyball [45], in which the forces exerted on the participants’ joints, and thus the incidence, p…”
BackgroundPerceived Injury Risk among Junior Cricketers: A Cross Sectional Survey
Gamage, P., Fortington, L., & Finch, C. (2017) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph14080946 · Cited by 9
“, age, gender, health, skills, physical fitness, previous injury and so forth), as well as external factors such as the environment, rules and adherence to rules, and sports governance [6].”
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“…risk factors including age, sex, skill level, risk taking behaviour etc. and extrinsic risk factors including the environment and the equipment, e.g. time of binding adjustment (Bahr & Krosshaug, 2005; Burtscher, Sommersacher, Ruedl & Nachbauer, 2009; Sulheim, Holme, Rodven, Ekeland & Bahr, 2011).”
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“Knowledge about the number of accidents such as drownings occurring in a sports activity is the basis for preventing them (Bahr & Krosshaug, 2005).”
BackgroundInjury Prevention Strategies for Mixed Martial Arts
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“INJURY PREVENTION PLAN DESIGN For an injury reduction plan to be effective, it should target interventions toward athletes who are at increased risk for each injury (4,25).”
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Pattern Of Musculoskeletal Injuries In Professional Basketball League In Nigeria
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“Within this theoretical framework, assessment approaches based on static or proxy risk indicators are limited in their ability to capture key processes such as physiological drift, micro-trauma accumulation, or changes in movement stability [11].”
Palermi, S., Vittadini, F., Pedret, C., Vecchiato, M., Villa, F. D., Corsini, A., Jokela, A., & Lempainen, L. (2025) · Clinical Journal of Sports Medicine · doi:10.1097/jsm.0000000000001377 · Cited by 8
“16,17 Although athlete interviews provide extensive data, they often lack clarity in delineating injury moments.”
Risk factor of pickleball injury: systematic review and meta-analysis
Prayudho, S., Nasrulloh, A., & Skaliy, A. (2024) · Health, sport, rehabilitation · doi:10.58962/hsr.2024.10.3.115-124 · Cited by 8
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“ME risk factors are multifactorial (intrinsic and extrinsic factors) and can assist in checking the susceptibility to ME during participation in sport [17].”
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Does graded motor imagery benefit individuals with knee pain: A systematic review and meta-analysis.
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Musculoskeletal Injuries in Table Tennis during Competition: A Systematic Review
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Situations and mechanisms of non-contact knee injury in adult netball: A systematic review.
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Epidemiology of Injuries in Ultimate (Frisbee): A Systematic Review
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“In regard to establishing the causes and mechanisms of sports injury, it is important to account for all the factors involved [11,12], including: intrinsic risk factors (e.”
BackgroundSituational factors associated with concussion in cricket identified from video analysis
Saw, A., Howard, D. J., Kountouris, A., McIntosh, A., Orchard, J., Saw, R., & Hill, T. (2020) · Journal of Concussion · doi:10.1177/2059700220947197 · Cited by 8
“, equipment, playing situation, player behaviour) necessitate sport-specific research.(19) In cricket, one study by Ranson et al.”
Background
Metadata
- Authors
- Bahr, R., & Krosshaug, T.
- Affiliations
- Oslo Sports Trauma Research Center (NO)
- Corresponding author
- Bahr, R
- ORCID
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2005-05-23
- Volume
- 39
- Issue
- 6
- Pages
- 324-329
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- PMC
- PMC1725226
- OpenAlex
- W2077950187
- Cited by
- 1,255
- References
- 0
- Citations by year
- 2026: 80 · 2025: 87 · 2024: 78 · 2023: 73 · 2022: 86 · 2021: 104 · 2020: 87 · 2019: 68 · 2018: 68 · 2017: 60 · 2016: 83 · 2015: 64 · 2014: 54 · 2013: 53 · 2012: 34
- FWCI
- 3.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
- Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- injury mechanisms, sports injury prevention, anterior cruciate ligament injury, knee injury, ankle injuries, injury risk factors, injury prevention programs, joint biomechanics, osteoarthritis risk
- MeSH terms
- Anterior Cruciate Ligament Injuries, Athletic Injuries, Biomechanical Phenomena, Female, Humans, Knee Injuries, Male, Physical Education and Training, Risk Factors, Sports, Ankle Injuries
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