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Cited by 262Sports injuries and preventionSports Performance and TrainingLower Extremity Biomechanics and Pathologies

Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: A systematic review, qualitative analysis and meta-analysis

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Lauersen, Jeppe Bo, Andersen, Thor Einar, Andersen, Lars Bo·2018·British Journal of Sports Medicine
DOI 10.1136/bjsports-2018-099078
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Abstract

Objective: This review aims to analyse strength training-based sports injury prevention randomised controlled trials (RCT) and present best evidence recommendations for athletes and future research. A priori PROSPERO registration; CRD42015006970. Design: Systematic review, qualitative analysis and meta-analysis. Sorting of studies and quality assessments were performed by two independent authors. Qualitative analyses, relative risk (RR) estimate with robustness and strength of evidence tests, formal tests of publication bias and post-hoc meta-regression were performed. Data sources: PubMed, Embase, Web of Science and SPORTDiscus were searched to July 2017. Eligibility criteria for selecting studies: RCTs on strength training exercises as primary prevention of sports injuries. Results: Six studies analysed five different interventions with four distinct outcomes. 7738 participants aged 12–40 years were included and sustained 177 acute or overuse injuries. Studies were published in 2003–2016, five from Europe and one from Africa. Cluster-adjusted intention-to-treat analysis established RR 0.338 (0.238–0.480). The result was consistent across robustness tests and strength of evidence was high. A 10% increase in strength training volume reduced the risk of injury by more than four percentage points. Formal tests found no publication bias. Conclusion: The included studies were generally well designed and executed, had high compliance rates, were safe, and attained consistently favourable results across four different acute and overuse injury outcomes despite considerable differences in populations and interventions. Increasing strength training volume and intensity were associated with sports injury risk reduction. Three characteristically different approaches to prevention mechanisms were identified and incorporated into contemporary strength training recommendations.

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  • Pre-emptive strengthening exercises targeting the foot, ankle, hip abductors, quadriceps, and trunk/core can support joints and reduce injury risk in some contexts.

    “Pre-emptive strengthening exercises targeting the foot, ankle, hip abductors, quadriceps, and trunk/core can support joints and reduce injury risk in some contexts”

    From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [264]

    The Participant diary and Mechanisms for prevention of acute and overuse injuries sections (page unavailable) report reduced ACL injuries with a knee, pelvis and core programme, and reduced anterior knee pain with exercises intended to improve quadriceps function and joint alignment. The Review section proposes that strengthening adjacent tissues may reduce joint loads. The copy does not establish injury reduction from exercises specifically targeting the foot, ankle or hip abductors; it describes other knee and ankle injury results as mixed. (LLM, conf=0.86)

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Authors
Lauersen, J. B., Andersen, T. E., & Andersen, L. B.
Affiliations
  • Hvidovre Hospital (DK)
  • Oslo Sports Trauma Research Center (NO)
  • Western Norway University of Applied Sciences (NO)
Corresponding author
Lauersen, Jeppe Bo
ORCID
Venue
British Journal of Sports Medicine
Publisher
BMJ
Published
2018-08-21
Volume
52
Issue
24
Pages
1557-1563
ISSN
  • 0306-3674 (ISSN-L)
  • 1473-0480
DOI
10.1136/bjsports-2018-099078
OpenAlex
W2888705663
Cited by
262
References
75
Citations by year
2026: 43 · 2025: 46 · 2024: 40 · 2023: 31 · 2022: 34 · 2021: 37 · 2020: 23 · 2019: 7 · 2018: 1
FWCI
3.48
Type
journal article
Language
en
Open access
Locations
  • British Journal of Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports injuries and prevention
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Keywords
resistance training, sports injury prevention, acute sports injuries, overuse injuries, dose-response relationship, training volume, injury risk reduction, prevention mechanisms, athletes
MeSH terms
Athletic Injuries, Humans, Primary Prevention, Cumulative Trauma Disorders, Randomized Controlled Trials as Topic, Resistance Training

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