Cited by 1,255Sports injuries and preventionKnee injuries and reconstruction techniquesLower Extremity Biomechanics and Pathologies

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Understanding injury mechanisms: a key component of preventing injuries in sport

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Bahr, R, Krosshaug, T·2005·British Journal of Sports Medicine

DOI 10.1136/bjsm.2005.018341PMC PMC1725226

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Abstract

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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“Quoi qu’il en soit, le constat principal est qu’au regard des caractéristiques sociales, sanitaires et sporti-ves, c’est bien un problème multifactoriel intrinsèque et extrinsèque (Bahr & Krosshaug, 2005 ou Caine et al., 2008) dont il s’agit.”
The netball injury evidence base: a scoping review of methodologies and recommendations for future approaches
Horne, S., Shaheen, A. F., Baltzopoulos, B., & Hills, L. (2024) · Systematic Reviews · doi:10.1186/s13643-024-02629-7 · Cited by 1
“This requires the continual, systematic collection of high-quality data from injury surveillance systems across various settings [22], and a multifactorial approach to understand the complex interactions between multiple risk factors and injury mechanisms [23, 24].”
BackgroundMethod
The impact of decreased tibial torsion angle on ankle sprain in football
Bayrak, A. (2024) · Spor Hekimligi Dergisi · doi:10.47447/tjsm.0823 · Cited by 1
Causal inference did not detect any effect of jump load on knee complaints in elite men's volleyball
Bache-Mathiesen, L., Bahr, R., Sattler, T., Fagerland, M., Whiteley, R., & Skazalski, C. (2024) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.14635 · Cited by 1
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Relationships Between Modifiable Risk Factors of Hamstring Strain Injury
Ripley, N., Comfort, P., & McMahon, J. (2023) · Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004640 · Cited by 1
생활체육인과 전문체육인의 부상 심각도에 영향을 주는 요인 탐색: 성별, 연령, 운동 수준 및 스포츠 활동 습관에 대한 다항 로지스틱 회귀 분석을 중심으로*
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Maheshwari, S., Kuber, R., Lamghare, P., Thomas, J., Arkar, R., Avhad, M., Tharmalingam, T., Bhamare, D., Katuri, S., Nagraj, H., et al. (2023) · The Egyptian Journal of Radiology and Nuclear Medicine · doi:10.1186/s43055-023-01073-2 · Cited by 1
Association of personal and equipment-related factors on ACL injury risk in alpine skiers with cautious or risk-taking behaviour: A case-control study
Ruedl, G., Posch, M., Pocecco, E., Tecklenburg, K., Schliernzauer, B., Kennedy, M., Faulhaber, M., & Burtscher, M. (2023) · AIMS Public Health · doi:10.3934/publichealth.2023026 · Cited by 1
“While potential external factors for a skiing-related injury include the equipment used and environmental factors such as snow quality, potential internal factors such as sex, age, body composition, fitness, and skill level have also been identified [5].”
BackgroundInfluential
Causes and prevention of injuries among basketball players
Kaushık, N., Sharma, M., & Chaudhary, G. (2023) · International journal of physiology, nutrition and physical education · doi:10.22271/journalofsport.2023.v8.i1e.2723 · Cited by 1
Lesiones por sobreuso en el deportista: una necesaria actualización en su conceptualización
Cerezo, J. B. (2022) · Journal of MOVE and Therapeutic Science · doi:10.37382/jomts.v4i1.635 · Cited by 1
Effect of laterality and fatigue in peroneal electromechanical delay
Flevas, D., Pappas, E., Ristanis, S., Giakas, G., Vekris, M., & Georgoulis, A. (2022) · SICOT-J · doi:10.1051/sicotj/2022018 · Cited by 1
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The development of a clinical screening tool to evaluate unilateral landing performance in a healthy population.
Blaiser, C. D., Roosen, P., Vermeulen, S., Bleecker, C. D., & de Ridder, R. (2022) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2022.05.012 · Cited by 1
Risk of surgery and epidemiological profile of athletes presenting to a single sports injury clinic in Hong Kong
Wong, A., Man, G.-N. C. W., Wu, Y.-M., Wong, H., Ong, M., & Yung, P. (2022) · Journal of Orthopaedics Trauma and Rehabilitation · doi:10.1177/22104917221082314 · Cited by 1
“To further appreciate the complete picture, a comprehensive model of injury causation was developed.(23) It hypothesised that the stress and load on the susceptible joint may not directly lead to injury but exposes the joint to a vulnerable situation, especially in athletes with reduced neuromuscular control.”
Background
Safety optimization in an accident-prone aquatic context: A qualitative study of drowning risk detection by public pool lifeguards
Vignac, É., Lebihain, P., & Soulé, B. (2022) · Journal of Safety Research · doi:10.1016/j.jsr.2022.03.001 · Cited by 1
Females exhibit lower limb biomechanics associated with an increased risk of ACL injury during a handball-specific side stepping
Picot, B., Falcoz, E., Rémy-Néris, O., Guegan, C., & Lempereur, M. (2022) · Science & sports · doi:10.1016/j.scispo.2021.09.002 · Cited by 1
Prävention von Schulterverletzungen bei Überkopfsportarten
Jung, C., Tepohl, L., Grim, C., & Mauch, F. (2021) · Obere Extremitat · doi:10.1007/s11678-021-00672-7 · Cited by 1
“Aus ätiologischer Sicht werden Sportverletzungen sowohl von externen als auch von internen Kräften, die auf den Körper wirken, verursacht [7].”
Background
Sports medicine: bespoke player management
Stuart, S., Powell, D., Marshall, S. J., Clark, C. C. T., Martini, D. N., Johnston, W., & Godfrey, A. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818914-6.00021-1 · Cited by 6
Comparison of the Plantar Pressure and Foot Function and Range of Motion in Distance Runners With the Normal, Pronated, and Supinated Feet During Static Standing
Keivanfar, N., Shadmehr, A., Otadi, K., Mir, S. M., & Salehi, S. (2020) · Journal of Modern Rehabilitation · doi:10.18502/10.32598/jmr.15.1.3 · Cited by 1
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Background
Principais lesões esportivas em atletas de Judô de alto rendimento e seus principais fatores associados
Marreiro, C. S., Archanjo, N. F., Pimentel, H. D. S. R., da Silva, M. J. A., & Fernandes, R. (2020) · doi:10.32749/nucleodoconhecimento.com.br/saude/lesoes-esportivas · Cited by 1
Effects of Lace up Brace on the Ankle Muscles Activity in Different Foot Position during Drop Landing with and without Fatigue
Yalfani, A., & Raeisi, Z. (2019) · doi:10.22054/nass.2019.10532 · Cited by 1
“Concerning the prevention of primary injury and recurrence of injury, the use of protective and supportive equipment such as brace and tape highly recommended to athletes by therapists, doctors, and coaches of the teams (Bahr and Krosshaug, 2005).”
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Injury Prevention in Youth Football Players : Training Effects and Programme Implementation
Lindblom, H. (2019) · Linköping University medical dissertations · doi:10.3384/diss.diva-160778 · Cited by 1
“Maintenance Routines for programme use, n (%) Have routines 16/178 (9) Have plans 8/178 (5) No routines or do not know 154/178 (87) Education via the club, n (%) Education offered 45/175 (26) Plans to offer education 10/175 (6) No education 77/175 (44) Do not know 43/175 (25) Use of the programme in 2012, n (%)‡ Use e…”
Background
Comparison of efficacy and safety of different fixation devices for anterior cruciate ligament reconstruction
Jin, J., Yu, L.-P., Wei, M., Shang, Y., & Wang, X. (2019) · Medicine · doi:10.1097/md.0000000000014911 · Cited by 1
Tendencia al riesgo y lesión deportiva en fútbol y fútbol sala femenino
Olmedilla, A. (2018) · Revista Guillermo de Ockham · doi:10.21500/22563202.3846 · Cited by 1
Development of a test method to evaluate laceration risk of studded footwear
Oudshoorn, B. Y. (2018) · Sheffield Hallam University · doi:10.7190/shu-thesis-00090 · Cited by 1
Diagnosis of acute groin injuries in athletes
Serner, A. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098211 · Cited by 1
“Injury type Total 94 96 97 Acute 79 (84) 79 (82) 84 (87) Non-acute 15 (16) 17 (18) 13 (13) Number of acute injuries per athlete 0 injuries 18 (24) 18 (24) 17 (23) 1 injury 43 (57) 44 (59) 42 (56) 2 injuries 8 (11) 7 (9) 10 (13) 3 injuries 4 (5) 4 (5) 4 (5) 4 injuries 2 (3) 1 (1) 1 (1) 5 injuries - 1 (1) 6 injuries - -…”
L’accidentologie des sports de montagne en France : un état des lieux basé sur l’exploitation de données secondaires
Soulé, B., Lefèvre, B., Boutroy, É., & Reynier, V. (2017) · doi:10.1016/j.scispo.2017.04.008 · Cited by 1
Injury assessment of common nage-waza judo techniques for amateur judokas
Lage, I. P., Gutiérrez-Santiago, A., Curran, P., & Lage, M. (2016) · doi:10.1080/24748668.2016.11868942 · Cited by 1
“However, the identification of the causes of injuries (Bahr and Krosshaug 2005; Meeuwisse et al. 2007) and the development of injury prevention strategies (Steffen et al. 2010) are very important for the optimization of the health benefits of sports.”
Background
The Effects of Military Body Armor on Isometric and Isokinetic Knee Behaviors
Phillips, M., Starnes, C., Shapiro, R., & Bazrgari, B. (2015) · doi:10.1080/21577323.2015.1095255 · Cited by 1
“…these conditions is often analogous to athletic activities that have been identified as high risk for knee injuries, involving dynamic movements, such as landing, pivoting, sudden decelerating, and changing of direction (Griffin et al., 2000; Bahr & Krosshaug, 2005; Alentorn-Geli et al., 2009).”
Background
Risk factors for injury in men´s professional football
Kristenson, K. (2015) · doi:10.3384/diss.diva-117170 · Cited by 1
“Roald Bahr and Tron Krosshaug subsequently expanded this model (Bahr and Krosshaug, 2005), to include a more comprehensive approach to the description of the inciting event from a biomechanical point of view (Figure 2).”
Background
Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries across Artificial Turf Systems of Various Infill Weight
Meyers, M. (2014) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967116s00184 · Cited by 1
Lesiones deportivas: un modelo psicológico aplicado
Pedrosa, I., Soto-Sánchez, A., Suárez-Álvarez, J., & García-Cueto, E. (2012) · doi:10.1174/021093912803758174 · Cited by 1
Effect of Anticipation and Fatigue on Lower Extremity Joint Loads during Side-cutting in Female Soccer Player
Park, E.-J., Lee, Y.-S., Lim, B.-O., Kim, Y.-W., & Lee, K.-K. (2011) · doi:10.5763/kjsm.2011.29.1.26 · Cited by 1
Modeling the neuromotor capacities of professional soccer player with a lower-limb injury during a Countermovement Jump
Memain, G., Carling, C., Bouvet, J., Maille, P., Tamalet, B., Fourcade, P., & Yiou, E. (2025) · Movement & Sport Sciences - Science & Motricité · doi:10.1051/sm/2025018 · Cited by 1
The Role of Kinematics in Sports Injury Rehabilitation.
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An Overview of Injuries in Senior Women’s Football in Malta
Mercieca, F., Cumbo, R. K., & Seychell, D. (2020) · doi:10.5604/01.3001.0014.5696 · Cited by 1
“Therefore prevention of sports injuries is vital (Krosshaug 2014).”
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Match-related risk factors for injury in male professional football
Bengtsson, H. (2017) · Linköping University medical dissertations · doi:10.3384/diss.diva-142788 · Cited by 1
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Biomechanics of Lower Limb Injuries
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Epidemiology, Risk Factors and Prevention
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Students Knowledge about Handling Sport Injuries
Putri, S. T., Sumartini, S., Sulastri, A., & Nurfatin, L. (2017) · doi:10.5220/0007062804460449 · Cited by 1
Injury Prevention in Different Sports
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PECULIARITIES OF SPORTS INJURES OF SPRINT AND THROWING COHORTS IN TRACK AND FIELD ATHLETICS
Rekus, L., Rekuvienė, E., Burkauskienė, A., Rekienė, D. E., Senikienė, Ž., Paršeliūnas, A., & Šakalys, E. (2013) · doi:10.33607/bjshs.v1i88.147 · Cited by 1
The Influence of Interlimb Differences on Anterior Cruciate Ligament Injury Risk Factors in Female Collegiate Soccer Athletes
Greska, E. (2012) · doi:10.25777/bcse-bx21 · Cited by 1

Authors: Bahr, R., & Krosshaug, T.
Affiliations: Oslo Sports Trauma Research Center (NO)
Corresponding author: Bahr, R
ORCID: Bahr, R
Krosshaug, T
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
DOI: 10.1136/bjsm.2005.018341
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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Understanding injury mechanisms: a key component of preventing injuries in sport

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