Review
Epidemiology and associated injury risk factors in figure skating: A systematic review

https://doi.org/10.1016/j.jsams.2025.01.012Get rights and content

Abstract

Objectives

To identify and critically appraise the available evidence on injury epidemiology and risk factors in figure skating.

Methods

Eight electronic databases were searched from inception to 01 November 2023. Studies were included if they reported injury epidemiology and/or injury risk factors in figure skating. Non-English publications were excluded. Risk of Bias of included studies was assessed using the QUIPS tool (quality in prognostic factor studies).

Results

This systematic review identified twenty-nine studies (n = 4202 figure skaters), with an injury prevalence of 2.1 %–34 %. An injury incidence of 1.37 injuries/1000 total training hours was reported in one study (n = 8). Three significant intrinsic risk factors (older age, previous history of stress fracture and a higher body mass) and eight significant extrinsic risk factors (training more than 12 sessions per week, skipping meals, RED-s indicators, hamstring and quadriceps immobility, training rather than competing, increased time on-ice time and boot-foot length difference) were identified from individual studies. Age, as the most studied risk factor, requires careful interpretation due to study design limitations.

Limitations

Existing data lacks quality of evidence and current reported injury risk factors in figure skating should be interpreted with caution.

Conclusions

High-quality research of injuries and injury risk factors in figure skating is scarce. The inconsistent reporting of injury data across the currently available literature due to variations in injury definition and data collection methods makes it difficult to compare and draw conclusions. A critical need exists for standardized research approaches to accurately determine the true burden of injury in this sport.

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Section snippets

Practical implications

This systematic literature review identifies:
  • •
    The injury prevalence ranges between 2.1 % and 34 %. However, we predict that these values may underestimate the burden of injury due to the data collection methods and injury definitions used.
  • •
    Three intrinsic and eight extrinsic injury risk factors were statistically significant. The modifiable nature of many of these factors highlights the importance of the development of targeted prevention strategies, which should be integrated into training and

Protocol registration

We followed the 2020 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines,13 led by the PERSiST guidelines for implementing PRISMA in exercise, rehabilitation, sport medicine and sport science.14 Our protocol for this systematic review was registered on PROSPERO (CRD42021293641) before the search was conducted.

Inclusion criteria

All quantitative studies which aimed to investigate the epidemiology of injury (incidence, prevalence, clinical characteristics) and/or injury risk

Results

Our search produced 5260 records, of which 865 were removed as duplicates (Fig. 1). During the title and abstract screening, 4267 records were excluded. Screening of 127 full-text articles found 27 eligible for inclusion. The reference lists of all included articles were screened, and two additional eligible studies were identified. The final number of studies that met the inclusion criteria for this systematic review was 29. Prior to consensus the observed inter-rater agreement was 95.1 %

Discussion

To our knowledge, this is the first systematic review focusing on the epidemiology and associated risk factors of injury in figure skating. The injury prevalence range in figure skating is 2.1 %–34 %,19,20 with only one study reporting the injury incidence per 1000 exposure hours (1.37 injuries/1000 total training hours34). Currently, the lower limb is reported as the most injured anatomical site (n = 23, 79 %),6,8,19,24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34,36, 37, 38, 39, 40, 41,43, 44, 45

Conclusion

Good quality research investigating figure skating injuries and injury risk factors is scarce. Overall, studies investigating the epidemiology of injury and injury risk factors are exposed to a moderate risk of bias. The injury prevalence ranged from 2.1 % to 34 %. These values may be an underestimation of the burden of injury due to the data collection methods and injury definitions used across the included studies. While fractures, joint sprains, and bone stress injuries are most commonly

Funding information

All authors affirm that they have no financial affiliation (including research funding) or involvement with any commercial organization that has a direct financial interest in any matter included in this manuscript.

Confirmation of ethical compliance

This research was approved by the Univeristy of Pretoria's research ethics committee. Research ethics number: 302/2022.

CRediT authorship contribution statement

Natasha T. Schmidt: Conceptualization, Methodology, Formal analysis, Investigation, Data curation, Writing – original draft, Visualization. Dina C. Janse van Rensburg: Conceptualization, Methodology, Writing – review & editing, Supervision. Marlene Schoeman: Formal analysis, Data curation, Writing – review & editing. Manuela Besomi: Data curation, Writing – review & editing. Audrey Jansen van Rensburg: Data curation, Writing – review & editing, Resources. Dan Garnett: Data curation, Writing –

Declaration of competing interest

All authors declare that there is no conflict of interest (i.e., personal associations or involvement as a director, officer, or expert witness).

Acknowledgments

None.

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