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Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis
Open accessAbstract
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”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [264]
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BackgroundMuscle Cramping in the Marathon: Dehydration and Electrolyte Depletion vs. Muscle Damage
Martínez‐Navarro, I., Vieco, A. M., Collado‐Boira, E., Hernando, B., Panizo, N., & Domingo, C. H. (2020) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000003713 · Cited by 27
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“Greater strength reserves can enhance neuromuscular fitness, improve athletic performance, and reduce sport injury risk (3,24,25).”
BackgroundIsometric Mid-Thigh Pull Performance in Rugby Players: A Systematic Literature Review
Martin, E., & Beckham, G. K. (2020) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk5040091 · Cited by 15
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“However, given the numerous beneficial neuromusculoskeletal adaptations that RT can stimulate [24,25,46] and the strong evidence of its efficacy in reducing injury risk in team sports [26,47,48], it is very likely that our and other’s [28] findings of no association or a positive association [30] between RT and RRI ar…”
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“The influence of some factors is known, e.g. IPP content; strength, proprioception and multi-component programmes have robust supporting evidence for reducing injury (Crossley et al., 2020; Lauersen et al., 2014, 2018), whereas stretching does not (Brunner et al., 2019; Lauersen et al., 2014).”
Marques, E. A., BALSHAW, T. G., Funnell, M. P., McDermott, E. J., Maeo, S., James, L. J., & Folland, J. P. (2025) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003819 · Cited by 12
“It is particularly beneficial for athletic development prevention and rehabilitation of musculoskeletal and sports injuries (3), and healthy aging (4), including numerous musculoskeletal conditions, such as osteoarthritis (5), osteoporosis (6), and sarcopenia (7).”
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“Te SFI has been shown to be prognostic of future MSK injury in various athlete populations [3, 4], suggesting its potential utility when used in conjunction with muscle strength testing, which has also been shown to be protective against MSK injury [32].”
BackgroundStrength and Conditioning for Volleyball: A Review
Rebelo, A., Valente‐dos‐Santos, J., Pires, I. G., Arrais, I., Pereira, J. R., & Turner, A. N. (2025) · Strength and conditioning journal · doi:10.1519/ssc.0000000000000895 · Cited by 21
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“(Lauersen et al. 2018)”
Prevalence and burden of health problems in top-level football referees
Moen, C., Andersen, T. E., Clarsen, B. M., Madsen-Kaarød, G., & Dalen-Lorentsen, T. (2022) · Science and Medicine in Football · doi:10.1080/24733938.2022.2055782 · Cited by 11
“The participants reported a relatively high amount of strength training and injury prevention exercise at baseline; however, since referees are not in a club setting and training is unsupervised, we do not know the content and quality of exercises which potentially could reduce injuries (Lauersen et al. 2018).”
BackgroundSelf-citationLoad monitoring, strength training, and recovery in futsal: Practitioners’ perspectives
Spyrou, K., Freitas, T. T., Herrero-Carrasco, R., Marín‐Cascales, E., & Alcaráz, P. E. (2022) · Science and Medicine in Football · doi:10.1080/24733938.2022.2144641 · Cited by 11
“Another important strategy commonly used by S&Cc to reduce injuries in sports (Lauersen et al. 2014, 2018) and enhance physical performance (Rønnestad and Mujika 2014) is strength training (ST), due to its well-documented benefits.”
BackgroundPerceptions of Professional Football Players on Injury Risk Factors and Prevention Strategies
Liporaci, R. F., Yoshimura, S., & Baroni, B. M. (2021) · Science and Medicine in Football · doi:10.1080/24733938.2021.1937689 · Cited by 11
“The muscular strengthening performed with traditional resistance exercises or with the socalled ‘functional exercises’ seems to be effective for injury prevention (Lauersen et al. 2014, 2018).”
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“Muscle strength-training exercises are used to increase muscular development and improve neuromuscular control (8, 9).”
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Comprehensive Return to Competitive Distance Running: A Clinical Commentary
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“[72] indicates the existence of a dose-response relationship between strength training and injury prevention.”
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How ‘STRONG’ is the British Army?
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“29,55 On the contrary, Lauersen et al 35 claimed that it is necessary to shift from multicomponent strength IPPs to single-component strength IPPs to prevent sports injuries, and a 10% increase in strength training volume reduced the risk of injury by .”
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“Furthermore, strength training has been consistently shown to be a vital component of MSKI reduction strategies [6].”
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“Considering the benefits to performance and injury reduction associated with strength training [27,29], it is surprising that 22% of SEB boxers and half of SDB boxers did not partake in this form of training.”
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A Finger in the Game: Sport-Specific Finger Strength Training and Onset of Injury
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Acute Effects of Resistance Exercise on Intraocular Pressure in Healthy Adults: A Systematic Review
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Self-citationKnowledge of gym goers on myths and truths in resistance training
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“It is well established in the literature that increasing strength and power capacity is an important strategy for improving sports performance [2] and injury prevention [3], and that higher levels of strength and power promote greater”
BackgroundRelationship between Training Factors and Injuries in Stand-Up Paddleboarding Athletes
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“It should be noted that the vast majority of research conducted so far, in which an injury prevention program is applied so as to research into its effect on a population, does not distinguish between different types of injury and types of RT [53].”
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COVID-19 National Football League (NFL) Injury Analysis: Follow-Up Study
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“Training is one of the most important interventions for injury prevention and improved athletic performance in athletes of all populations [5-7 The effects of detraining are a serious concern in regard to injury epidemiology.”
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“injury reduction have been observed in various sports [38, 39] and the implementation on boxing populations is low, especially among Senior Development Boxers (SDB) [36].”
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Metadata
- 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
- 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
- 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
- bronze
- doi.org
- 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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