ReviewInjury epidemiology
From monocausality to systems thinking: a complementary and alternative conceptual approach for better understanding the development and prevention of sports injury.
Review in Injury epidemiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Risk factors associated with quadbike crashes: a systematic review.World journal of emergency surgery : WJES · 2022Pooled it
- Exercise Programs to Reduce the Risk of Musculoskeletal Injuries in Military Personnel: A Systematic Review and Meta-Analysis.PM & R : the journal of injury, function, and rehabilitation · 2020Pooled it
- Is the Acute: Chronic Workload Ratio (ACWR) Associated with Risk of Time-Loss Injury in Professional Team Sports? A Systematic Review of Methodology, Variables and Injury Risk in Practical Situations.Sports medicine (Auckland, N.Z.) · 2020Pooled it
- Injury Profile of Male and Female Senior and Youth Handball Players: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Does Acute Fatigue Negatively Affect Intrinsic Risk Factors of the Lower Extremity Injury Risk Profile? A Systematic and Critical Review.Sports medicine (Auckland, N.Z.) · 2020Pooled it
- Criteria-Based Return to Sport Decision-Making Following Lateral Ankle Sprain Injury: a Systematic Review and Narrative Synthesis.Sports medicine (Auckland, N.Z.) · 2019Pooled it
- Getting the most out of intensive longitudinal data: a methodological review of workload-injury studies.BMJ open · 2018Pooled it
- Associations Between Cognitive Function and ACL Injury-Related Biomechanics: A Systematic Review.Sports healthPooled it
- From young aces to injury cases: a qualitative study of stakeholder perspectives on injury risk in junior to elite badminton.Sports medicine - open · 2026Article
- When evidence fails in real life: Rethinking sports injury rehabilitation and prevention.Brazilian journal of physical therapy · 2026Review
- A Holistic Ecological Approach to Injury Prevention and Management in Youth Sport: A Scoping Review.Scandinavian journal of medicine & science in sports · 2026Article
- Body Composition Architecture and Injury Topology in Physically Active Young Adults: A Tanglegram-Based Cophylogenetic Approach.Journal of clinical medicine · 2026Article
- Monitoring of internal load, sleep, and well-being in relation to injury and illness in professional basketball.BMC sports science, medicine & rehabilitation · 2026Article
- A new conceptual framework for managing hamstring injury risk in soccer - implementing a data-informed approach: a narrative review.Biology of sport · 2026Review
- Prevalence and predictive factors of musculoskeletal injuries in triathletes: a cross-sectional study.BMC sports science, medicine & rehabilitation · 2025Article
- The Natural History of Bone Stress Injuries in Athletes: From Inception to Resolution.Sports medicine (Auckland, N.Z.) · 2025Review
- A Survey on Current Practices, Needs, Responsibilities and Preferences for Knowledge Dissemination in the Field of Injury and Illness Prevention Among Competitive Snow Sports Stakeholders.Sports medicine - open · 2025Article
- Beyond tame solutions: a new paradigm for injury prevention in sports.BMJ open sport & exercise medicine · 2025Article
- Risk management framework for competitive alpine skiing-co-developed with stakeholders.BMJ open sport & exercise medicine · 2025Article
- Hamstring injury risk in male professional football: do external training loads play a role?BMJ open sport & exercise medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The science of sports injury control, including both its cause and prevention, has largely been informed by a biomedical and mechanistic model of health. Traditional scientific practice in sports injury research has routinely involved collapsing the broader socioecological landscape down in order to analyse individual-level determinants of injury - whether biomechanical and/or behavioural. This approach has made key gains for sports injury prevention research and should be further encouraged and allowed to evolve naturally. However, the public health, Applied Human Factors and Ergonomics, and injury epidemiological literature more broadly, has accepted the value of a socioecological paradigm for better understanding disease and injury processes, and sports injury research will fall further behind unless it does the same. A complementary and alternative conceptual approach towards injury control known as systems thinking that builds on socioecological science, both methodologically and analytically, is readily available and fast developing in other research areas. This review outlines the historical progression of causal concepts in the field of epidemiology over the course of the modern scientific era. From here, causal concepts in injury epidemiology, and models of aetiology as found in the context of sports injury research are presented. The paper finishes by proposing a new research agenda that considers the potential for a systems thinking approach to further enhance sports injury aetiological understanding. A complementary systems paradigm, however, will require that sports injury epidemiologists bring their knowledge and skillsets forwards in an attempt to use, adapt, and even refine existing systems-based approaches. Alongside the natural development of conventional scientific methodologies and analyses in sports injury research, progressing forwards to a systems paradigm is now required.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.