ArticlePloS one2026
Injury patterns and cumulative injury burden among U.S. competitive fencers: A survey.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFencing is a highly asymmetrical sport that combines both repetitive upper-extremity and lower-extremity actions. Although fencing related injuries have been described in clinical- and competition-based cohorts, population level data capturing both training and competition exposures and cumulative injury burden remains limited.
objectiveTo characterize injury patterns, mechanisms, and anatomical distribution among adult competitive fencers and to examine associations between training related exposures and reported injury burden.
methodsAdult competitive fencers registered with USA Fencing were invited to complete an anonymous web-based survey capturing demographics, training and competition exposures, and self-reported fencing related injuries. Injury burden was defined as experiencing three or more lifetime fencing-related injuries among injured respondents. Multivariable logistic regression was used to examine associations between training exposures and injury burden with continuous predictors modeled using restricted (natural) cubic splines to allow for non-linear relationships. Descriptive analyses, correlation analyses, and Poisson regression were performed as sensitivity analyses.
resultsAmong 303 respondents, 270 (89.1%) reported at least one fencing related injury, accounting for 571 total injuries. Overuse injuries predominated and most frequently involved the knee, ankle and dominant upper extremity with gradual-onset, non-contact mechanisms accounting for the majority of the injuries. Upper-extremity injuries were significantly more likely to occur on the dominant side. In multivariable analyses, years of fencing experience demonstrated a significant non-linear association with higher injury burden, while weekly training volume showed a non-linear association that approached statistical significance. Age at starting fencing, competition frequency, and sex were not independently associated with injury burden. Sensitivity analyses using Poisson regression yielded qualitatively similar findings.
conclusionsAmong adult competitive fencers, higher injury burden is most strongly associated with cumulative training exposure, particularly years of fencing experience, with additional contribution from weekly training volume. Injury patterns are characterized by overuse and pronounced dominant-side upper-extremity involvement, consistent with the sport's asymmetrical biomechanical demands. These findings underscore the importance of monitoring cumulative exposure and addressing asymmetrical loading to mitigate recurrent injury burden in fencing.
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