Injuries in weightlifting and powerlifting: an updated systematic review.

abstractObjective: To systematically review the literature on the incidence, prevalence, anatomical injury localisation and risk factors in Olympic weightlifting and powerlifting. Design: Updated systematic review, PROSPERO registration (CRD42022382364). Data sources: Four databases (PubMed, Embase, SPORTDiscus and Web of Science) were searched on 19 February 2024. Eligibility: Reports assessing injury incidence and prevalence in Olympic weightlifting and powerlifting, published between January 2015 and February 2024, were included in addition to reports from a previous systematic review. The 'Quality Assessment Tool for Observational Cohort and Cross-sectional Studies' was used to assess methodological quality. Results: Of 1765 screened records, eight new reports were found, resulting in 17 reports in the review. 12 reports covered weightlifting and seven covered powerlifting, with two of the reports included in both categories as they addressed both sports. In weightlifting, the period prevalence of injuries during competitions was 10.7%-68%, the incidence was 2.4-3.3 injuries/1000 hours of training, and the most common injury sites were the knee, lower back, shoulder and hands/fingers. In powerlifting, one report showed a point prevalence of 70%. Injury incidence was 1.0-4.4 injuries/1000 hours of training, and the most common injury sites were the lower back/pelvis, shoulder and elbow/upper arm. Both sports showed a high prevalence of pelvic floor dysfunction (eg, urinary incontinence) among females (50%) compared with males (9.3%). Conclusions: This updated systematic review supports the conclusions of previous reviews and shows new findings that pelvic floor dysfunction is very common in both sports. Due to the distinctly different study designs and settings, further direct comparisons between sports were difficult. In weightlifting, reports mainly focused on injuries during competitions. In powerlifting, injury incidence was low, but injury prevalence was high when defining injury as a painful condition that impairs training/competition.