Injury account during the 1980 NCAA wrestling championships

Moderate and Severe Injuries at Five International Olympic-Style Wrestling Tournaments during 2016-2019

As a contact sport, wrestling may result in injuries. Based on the severity, they are classified as mild, moderate, severe and critical. All injuries occurring at international competitions are documented in a cloud-based surveillance system. The purpose of this study was to analyze the incidence and characteristics of moderate and severe (including critical) wrestling injuries that occurred during five international Olympic-style wrestling competitions in 2016-2019. Three Wrestling World Championships and two European Wrestling tournaments were organized by the Hungarian Wrestling Federation in 2016-2019. A total of 2483 wrestlers in three Olympic wrestling styles have competed in 3007 matches. Data from all injuries were recorded and analyzed to define rates, locations, types and severity, and to compare with previous reports. A total of 53 wrestlers sustained 55 injuries, which is equivalent to an overall injury incidence rate of 9.1‰ (9.1/1000 athletic exposures). Greco-Roman and Women Wrestling had the same injury incidence rate, while Freestyle had a lower one (9.5‰ versus 8.5‰). The injury proportion by regions and anatomic locations were on head and face 29.1%, spine and trunk 16.4 % and the upper-and-lower extremity injuries equally 27.3%. The most common types of injuries included ligament lesions, joint injuries, skin lacerations, and contusions. Five wrestlers (0.8‰) sustained strangulation or concussion. Wrestling injury rates during United World Wrestling competitions are not high, but when happen they can be serious. Despite relatively low incidence rate of injuries, there is a need for continuous education for medical teams, referees and coaches to avoid wrestling injuries.

Injuries in male and female elite Korean wrestling athletes: a 10-year epidemiological study

OBJECTIVES

To report injury patterns associated with the training activities of elite male and female South Korean wrestling athletes preparing for the Olympic Games.

METHODS

From 2008 to 2017, we prospectively collected data on elite wrestling athletes at the Korea National Training Center. Athletes were assessed by two sports medicine doctors, and data were stratified according to sex, wrestling style, weight class, injury location and injury severity. Χ²tests were used to compare groups. Injury risk was expressed in relative ratios with 95% confidence intervals (RR, 95% CI).

RESULTS

There were 238 male and 75 female elite wrestlers. Training time totalled 382 800 hours. We recorded 1779 injuries in 313 athletes aged >18 years (annual average, 4.04 injuries/athlete); 59% of these were mild injuries. When all athletes were considered, most injuries occurred in the lower extremities (37.5%), followed by the upper extremities (27.4%), trunk (25.4%) and the head and neck area (9.7%). Weight class significantly influenced injury severity for both wrestling styles among male athletes (Greco-Roman, P=0.031; freestyle, P=0.028), as well as among female freestyle wrestling athletes (P=0.013). The relative ratio of injury incidence for the lightweight class compared with the heavyweight class was high for Greco-Roman style compared with freestyle (RR 1.13, 95% CI 1.03 to 1.27; P=0.011).

CONCLUSIONS

Among male and female South Korean elite wrestling athletes training for the Olympic Games, most injuries were mild and occurred in the lower extremities. Weight class influenced injury severity in both wrestling styles, and lightweight athletes had higher injury rates.

lnjuries in wrestling: systematic review

OBJECTIVES

To identify all studies of injuries in wrestling, assess risk of bias and compute weighted average injury rates.

METHODS

17 online databases and nine grey literature resources were searched with no language/date limitations. Abstracts were assessed for inclusion and data abstracted independently by two reviewers.

RESULTS

Eleven studies of competitions, 27 databases, four surveys (699 wrestlers) and seventeen case reports (604 cases) were included. Studies provided varying completeness of data. Weighted average injury rates of 16.3/1000AE (AE = Athletic encounter) could be computed for 8/11 studies of competitions and 69.5/1000AE for 5/27 databases. Eleven of the databases focused on specific injuries. Weighted average injury rates by location for 8/11 competition studies and 7/16 databases were similar for the upper extremities (competitions 26%, databases 24%) and torso (15%, 12%), but dissimilar for head/neck (31%, 20%) and lower extremities (24%, 39%). Weighted average injury rates by injury type varied from 6/11 to 2/11 competition studies and 6/16 to 3/16 database studies. Percentages were similar for fractures (6%, 7%), dislocations/subluxations (6%, 6%), ligament tears/cartilage injuries (12%, 17%) and concussions/1000AE (2 competition studies, 1 database) in competitions (25%, 27%) and training (5.7%, 7.1%). Percentages were dissimilar for lacerations/abrasions/contusions (23%, 4%) and sprains/strains (38%, 26%). The differences may be due to the small number of databases providing specific data and the unknown proportion of training injuries. Databases extrapolating injuries to the national US level reported high annual numbers.

CONCLUSIONS

Average injury rates weighted by sample size are 16.3/1000AE for 8/11 competition studies and 69.5/1000AE for 5/27 databases. Competition data are likely to be accurate because they were observed by physicians, trainers and referees and the completeness and accuracy of database studies vary. Databases which extrapolated data to provide annual national rates estimated large numbers. Few studies provided data about the situations in which injuries occur and the causes of injuries.

Association of COL11A1 4603C/T polymorphism with cervical disc degeneration in collegiate wrestlers

BACKGROUND

The authors previously identified that COL11A1 gene polymorphism is not a susceptibility factor for lumbar disc degeneration (LDD) in athletes. However, the relationship between COL11A1 gene polymorphism and cervical disc degeneration (CDD) remains unclear. We hypothesized that significant associations between COL11A1 4603C/T gene polymorphism and CDD, but not LDD, in collegiate wrestlers exist. This study aims to examine the relationship between CDD, LDD, and COL11A1 4603C/T gene polymorphism in collegiate wrestlers.

METHODS

The subjects enrolled in this study were 92 (Study-1) and 123 (Study-2) Japanese collegiate male wrestlers. Study-1 and Study-2 were conducted in 2010-2012 and 2012-2015, respectively.

RESULTS

CDD and LDD prevalence among the wrestlers was 51.1% (47/92) and 43.9% (54/123), respectively. We found that COL11A1 4603C/T was significantly associated with CDD, but not with LDD. Using logistic regression analysis with concomitant confounding factors, we further confirmed that COL11A1 4603C/T was a significant risk factor for CDD (co-dominant genetic model [CC vs. CT+TT]: adjusted odds ratio [OR] 2.28; 95% CI: 1.13-4.59; dominant genetic model [CC+CT vs. TT]: adjusted OR 11.71; 95% CI: 1.36-101.06).

CONCLUSIONS

Results suggest that COL11A1 4603C/T gene polymorphism is associated with an increased risk of CDD, but not LDD, in Japanese collegiate wrestlers.

Assessment of Injuries During Brazilian Jiu-Jitsu Competition

Background:

Brazilian jiu-jitsu (BJJ) is a unique style of martial arts with rapid growth in the United States and internationally. Although studies have examined injuries in other martial arts and combat sports, to date, no published medical study has examined injuries in BJJ competitions.

Purpose:

(1) To estimate the incidence of injuries in BJJ competitions and (2) to identify and describe the types and mechanisms of injuries associated with competitive BJJ.

Study Design:

Descriptive epidemiology study.

Methods:

Injury data were obtained from records of on-site medical coverage at 8 statewide BJJ tournaments in Hawaii, USA, between 2005 and 2011.

Results:

The identified injury incidence on the day of matches was 9.2 per 1000 exposures (46 injuries out of 5022 exposures, ie, match participations). Orthopaedic injuries were the most common and accounted for 78% of all injuries (n = 36), followed by costochondral or rib injuries (n = 7) and lacerations requiring medical care (n = 3). The elbow was found to be the joint most commonly injured during BJJ competitions, with the arm bar being the most common mechanism. We propose that this BJJ-specific injury mechanism, the “arm bar,” be recognized as another mechanism of hyperextension injury to the elbow in sports.

Conclusion:

Comparison of the BJJ injury data with injury data reported for judo, taekwondo, wrestling, and mixed martial arts showed that BJJ competitors were at substantially lower risk of injury compared with these other sports. With orthopaedic injuries being most common and the elbow being the area most vulnerable to injury in BJJ, it is important that participants, referees, and physicians be properly educated about the unique mechanisms of injury that can occur, particularly to the elbow.

The effect of sex and fatigue on lower limb kinematics, kinetics, and muscle activity during unanticipated side-step cutting

PURPOSE

To determine how sex and fatigue affect lower limb kinematics, kinetics, and muscle activity during unanticipated side-step cutting.

METHODS

Twenty-three physically active subjects (men 11, women 12) performed 10 successful trials of cutting manoeuvres each to either side under unanticipated conditions in response to 2 light emitting diodes before and after fatigue conditions. Data were analysed and compared regarding sex and fatigue conditions using two-way repeated measures analysis of variance.

RESULTS

After fatigue-inducing exercise, women demonstrated larger impulses of ground reaction force (IGRF) during the first 50 ms (2.4 ± 0.8 vs. 2.1 ± 0.9, P < 0.05) than did men. Significant primary effects of sex indicated that women showed a smaller hip flexion angle at initial contact (40.4 ± 6.9° vs. 49.7 ± 9.1°, P < 0.05) and at maximum flexion angle (41.3 ± 7.7° vs. 51.4 ± 9.0°, P < 0.05) compared with men. Significant primary effects of fatigue were observed in the gluteus maximus muscle during 50 ms before initial contact (+21.5 ± 48.3 %, P < 0.05) and in the semimembranosus muscle during 50 ms before initial contact (-6.2 ± 20.1 %, P < 0.05) and the first 50 ms of side-step cutting (-7.9 ± 26.6 %, P < 0.05).

CONCLUSIONS

Our results suggest that sex differences, especially larger IGRF in a fatigue state combined with less hip flexion angle, lead to women having a higher risk for anterior cruciate ligament (ACL) injury. These findings may contribute to understanding the underlying mechanism of injury and development of preventive exercises against ACL injury.

Incidence, nature, and causes of fractures and dislocations in olympic styles of wrestling in iran: a 1-year prospective study

Background:

Several studies have evaluated the incidence of and risk factors for injuries among wrestlers, but there are limited data in this population. Understanding the incidence and risk factors could provide important information for educational and preventive efforts at the national and international levels.

Purpose:

To assess the incidence of and risk factors for fractures and dislocations among Greco-Roman and freestyle wrestlers in Iran.

Study Design:

Prospective cohort study.

Methods:

Members of 8 randomly selected wrestling clubs in Kermanshah, Iran, were followed for 12 months. Details of their training and the occurrence of fractures and dislocations were recorded. Related data on fractures and dislocations include site of injury, previous history of injury, coach supervision, and wresting technique that led to the injury.

Results:

A total of 495 male wrestlers were included in the study. Seven fractures and 8 dislocations were reported. The incidence of fractures and dislocations was 1.1 per 10 000 athlete exposures, with a fracture rate of 0.5 and a dislocation rate of 0.6. Of the 15 fractures and dislocations, 11 occurred among freestyle wrestlers (0.8 per 10 000 athlete exposures) and 4 occurred among Greco-Roman wrestlers (0.3 per 10 000 athlete exposures). There was a positive correlation between the incidence of wrestlers’ fractures and dislocations and their age (P < 0.01), years of wrestling experience (P < 0.01), previous history of fracture or dislocation (P < 0.01), and age of starting to wrestle (P = 0.03).

Conclusion:

The incidence of fractures and dislocations in this study was lower than that seen in previous studies. The risk of fracture and dislocation was heightened by a wrestler’s increased age and years of experience, history of previous fracture or dislocation, and younger age of starting to wrestle.

Lesões musculoesqueléticas em atletas de luta olímpica

OBJETIVO: Avaliar as lesões musculoesqueléticas em atletas de elite da luta olímpica. MÉTODOS: Avaliação retrospectiva de 95 atletas por meio de um questionário estruturado contendo informações sobre lesões prévias e dados clínicos e epidemiológicos. RESULTADOS: Foram relatadas 145 lesões em 81 (85,3%) atletas. As regiões anatômicas mais freqüentemente acometidas foram o joelho (25,5%), o ombro (20%), a coxa (15,2%) e o tornozelo (14,5%). As entorses e as lesões musculares foram as lesões mais comumente relatadas com 34,5% e 30,4%, respectivamente. O tratamento cirúrgico foi necessário em 9% das lesões e a maioria destas lesões (61,5%) localizavam-se nos membros.inferiores. CONCLUSÕES: Lesões do aparelho locomotor são frequentes nos praticantes de luta olímpica e os membros inferiores são o segmento mais acometido.

Wrestling injuries during the 2008 Beijing Olympic Games

BACKGROUND

Better understanding of the incidence, mechanisms, and characteristics of potential injuries in wrestling helps to implement preventive measures to better care for these athletes. Several studies have investigated the incidence and type of injuries in amateur and intercollegiate wrestling; however, there is a lack of studies that review the incidence and nature of injuries in elite wrestlers during Olympic Games or World Championships.

PURPOSE

The purpose of this study was to assess the injury profile of elite senior wrestlers in Greco-Roman, freestyle, and female wrestling during the 2008 Beijing Olympic Games.

STUDY DESIGN

Descriptive epidemiologic study.

METHODS

Study participants consisted of 343 wrestlers participating in the 2008 Beijing Olympic Games. Standard checkoff forms were used to collect the injury data, including injury type, severity, location, timing, and mechanism.

RESULTS

A total of 343 athletes sustained 32 injuries during 406 matches, which is equivalent to an overall incidence of 9.30 injuries per 100 athletes and 7.88 injuries per 100 matches. Among the 3 styles, freestyle had the highest injury rate (10.1%) and female wrestling the lowest (7.5%). In sum, 84.4% of all injuries were categorized as mild. Although the overall injury rate in male athletes was slightly higher than that among female athletes (9.7% versus 7.5%), this difference was not statistically significant (odds ratio = 1.21, 95% confidence interval = 0.46-3.68; P = .40).

CONCLUSION

The rate and severity of wrestling injuries during the 2008 Beijing Olympic Games were lower than previous reports. No serious and catastrophic injury was recorded, and most injuries were minor.

An epidemiologic comparison of high school and college wrestling injuries

BACKGROUND

Wrestling holds worldwide popularity, and large numbers of United States high school and college males participate. However, the sport's arduous nature results in high injury rates.

HYPOTHESIS

Wrestling injury rates and patterns will differ between high school and college practice and match exposures.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Wrestling-related injury data were collected during the 2005-2006 academic year from 74 nationally representative high schools via High School Reporting Information Online (RIO) and from 15 Division I, II, and III colleges via the National Collegiate Athletic Association Injury Surveillance System.

RESULTS

Certified athletic trainers reported 387 injuries among participating high school wrestlers during 166,279 athlete-exposures, for an injury rate of 2.33 injuries per 1000 athlete-exposures. Nationally, high school wrestlers sustained an estimated 99,676 injuries and 8741 skin infections during the 2005-2006 season. In college, 258 injuries occurred among participating wrestlers during 35,599 athlete-exposures, for an injury rate of 7.25 injuries per 1000 athlete-exposures. The injury rate per 1000 athlete-exposures was higher in college than high school (rate ratio [RR] = 3.11, 95% confidence interval [CI]: 2.66-3.64) and was higher in matches than in practice in high school (RR = 2.12, 95% CI: 1.73-2.59) and college (RR = 5.07, 95% CI: 3.96-6.50). Diagnoses in greater proportions of college wrestlers included lacerations (injury proportion ratio [IPR] = 5.98, 95% CI: 2.27-15.74) and cartilage injuries (IPR = 2.69, 95% CI: 1.26-5.74). Body parts injured in greater proportions of high school wrestlers included elbow (IPR = 3.90, 95% CI: 1.66-9.14) and hand (IPR = 2.59, 95% CI: 1.21-5.54). Almost half of all injured high school (44.9%) and college (42.6%) wrestlers resumed wrestling within <1 week. Skin infections represented 8.5% and 20.9% of all reported high school and college events, respectively, and frequently affected the head/face/neck (50.0%).

CONCLUSIONS

Rates and patterns of wrestling injury differ between high school and college and between practice and matches.

A comparison of pediatric freestyle and Greco-Roman wrestling injuries sustained during a 2006 US national tournament

The purpose of this study was to compare the epidemiology of freestyle and Greco-Roman wrestling injuries sustained during a 2006 United States (US) national tournament. A prospective injury surveillance study was conducted at the US 2006 ASICS/Vaughan Cadet and Junior National Championships. There were 83 freestyle- and 55 Greco-Roman-related injuries sustained, with the rate of injury per 1000 athlete-matches higher in freestyle (7.0) compared with Greco-Roman (4.6) wrestling [Rate ratio (RR)=1.51, 95% confidence interval (CI): 1.07-2.12]. Compared with Greco-Roman wrestling, there was a greater proportion of knee injuries in freestyle wrestling [injury proportion ratio (IPR)=4.17, 95% CI: 1.30-13.41]. In GrecoRoman wrestling, there were greater proportions of elbow (IPR=9.11, 95% CI: 1.13-73.59) and head/face/neck (IPR=1.72, 95% CI: 1.10-2.67) injuries and a greater proportion of concussions (IPR=1.95, 95% CI: 0.92-4.12), although the latter was statistically insignificant. Greco-Roman wrestlers sustained a greater proportion of injuries from being driven into the mat (IPR=2.97, 95% CI: 1.72-5.14). There were no statistically significant differences in injury outcome by wrestling style. The differing injury rates and patterns of injury between freestyle and Greco-Roman wrestling are likely due to the different rules between these styles that allow lower leg attacks in freestyle wrestling and encourage the use of throws in Greco-Roman wrestling.

Catastrophic injuries in wrestlers

BACKGROUND

There is a paucity of comprehensive information on catastrophic wrestling injuries.

OBJECTIVE

Our objective was to develop a profile of catastrophic injuries in wrestling and a list of relevant risk factors.

STUDY DESIGN

Retrospective review.

METHODS

We retrospectively reviewed 35 incidents that were reported to the National Center for Catastrophic Sports Injury Research over an 18-year period from 1981 until 1999.

RESULTS

Except in the case of one male college athlete, all injuries occurred in male high school wrestlers. There were 2.11 direct catastrophic injuries per year or 1 per 100000 participants. The majority of injuries occurred in match competitions (80%), with a trend toward more injuries in the low- and middle-weight classes. The position most frequently associated with injury was the defensive position during the takedown maneuver (74%), followed by the down position (23%), and the lying position (3%). Catastrophic injuries included 27 cervical fractures or major cervical ligament injuries, 4 spinal cord contusions with transient quadriparesis, 3 severe head injuries, and an acutely herniated lumbar disc. The injuries resulted in quadriplegia in 11, residual neurologic deficits in 6, paraplegia in 1, and death in 1 head-injured athlete.

CONCLUSIONS

Although catastrophic injuries in wrestling are rare, they do occur. Referees can help prevent such injuries by strictly enforcing penalties for slams and by gaining more awareness of dangerous holds. Coaches may also prevent serious injuries by emphasizing proper wrestling techniques.

A prospective study of high school wrestling injuries

We performed a prospective study to evaluate injury patterns in a large population of high school wrestlers during one season. Preseason screening was performed on 458 male wrestlers from 14 different high schools. Certified athletic trainers submitted detailed weekly team and individual injury reports. There were 219 injuries in 418 wrestlers followed throughout the season for an overall injury incidence of 52 injuries per 100 wrestlers per season and an injury rate of 6.0 injuries per 1,000 exposures. The most commonly injured areas were the shoulder (24%) and knee (17%). Injured wrestlers were an average of 5 months older and had a 32% higher experience level than noninjured wrestlers. Wrestlers with ligamentous laxity suffered fewer shoulder injuries than the other wrestlers. The majority of injuries occurred in practice (63%), although the injury rate was higher in match competitions. Sixty-eight percent of practice injuries occurred during hard wrestling, 23% during drills, and 9% during conditioning. The most common wrestling situation resulting in injury was the takedown position (68%). Our results show that the older and more experienced wrestler may be at greater risk of injury. Hard wrestling during practice and the takedown position resulted in the highest occurrence of injury.

Incidence, severity, aetiology and prevention of sports injuries. A review of concepts

Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)

Injuries in adolescent and preadolescent boys at two large wrestling tournaments

We evaluated injury patterns at two wrestling tournaments involving 1742 participants, aged 6 to 16 years. The overall injury rate was 12.7%. Injuries requiring withdrawal from the tournament occurred in 4.6% of the participants. Of all participants, 3% sustained an injury in their first match, and 1.1% sustained an injury during their first match that required withdrawal from the tournament. Primary areas of injury were the upper extremity (33%) and the neck and back (24%). Wilcoxon rank-sum tests revealed that increasing age and increasing weight were correlated with injury, whereas multiple logistic regression analysis revealed that only increasing age was correlated with injury. These findings suggest the need for medical supervision at large wrestling tournaments, where it is likely that severe injuries will occur. In addition, older wrestlers and perhaps heavier wrestlers are at an increased risk for injury.

Low back pain among retired wrestlers and heavyweight lifters

The lifetime incidence and prevalence of low back pain among 32 retired wrestlers (ages 39 to 62 years) and 13 retired heavyweight lifters (ages 40 to 61 years) were evaluated and compared to the corresponding results in a cross-sectional study of 716 men (ages 40 to 47 years). The radiologic findings and the findings upon physical examination in the athletes were compared to the findings in another study of normal, active, similarly aged men who were sampled at random. The lifetime incidence and prevalence of low back pain was higher among the wrestlers (59%) compared with both the lifters (23%) and the control group (31%). The tolerance for backache seemed to be higher among the athletes than the controls. A higher frequency of old fractures was found among the wrestlers. The athletes with fractures had a higher frequency of low back pain. A significant decrease in disk height was found among the lifters.

Nervous system sports-related injuries

With the evolution of sports medicine as a subspecialty comes a redirection of attention to the medical and athletic communities to the prompt recognition and timely treatment of many potentially serious conditions. Nervous system complications of sports injuries have gone largely unaddressed in the literature. It is the goal of this communication to review the wide range of nervous system injuries due to sports activities, discuss the mechanisms of such injuries, and focus attention on their prevention and management. The role of the neurologist and neurosurgeon as a sports medicine team member will be discussed, as will their roles in planning and development of programs and equipment at the secondary school, collegiate, and professional levels.

Medical Problems of Wrestlers

In brief: Wrestlers face a significant risk of injury and of contracting skin infections and respiratory and systemic illnesses. Because annual injury rates as high as 75% have been reported in wrestling, medical personnel should be present at all competitions. The article briefly describes mechanisms of injury and provides treatment guidelines for lacerations, cauliflower ear, and injuries to the spine, extremities, and ribs. Also provided is advice for the treatment and prevention of skin problems, including herpes gladiatorum, folliculitis, impetigo, fungal infections, and others.

Patterns of knee injuries in wrestling: a six year study

Data on knee injuries sustained by the University of Iowa wrestling team over a 6 year period were compiled. There were a total of 136 wrestlers during this time. Fifty-one different wrestlers sustained 136 injuries (64 knees). Multiple parameters were examined for each injury, including date of injury; days lost; diagnosis; side injured; mechanism; occurrence during competition or practice; whether the wrestler was in control, "on the bottom," or both wrestlers standing; type of move being made at the time of injury; how far into a match or practice the injury happened; initial versus recurrent injury; principal form of management; weight-bearing status; and presence of knee pads. Each wrestler's weight class, years of experience, rank on the team, lead leg, and compliance were noted. We found an incidence of 30 knee injuries per 100 wrestlers per year. There were 11.5 knee injuries per 100 wrestlers per year requiring a week or greater time loss. This comprises over one third of all serious wrestling injuries. Exposure data revealed injury rates in matches to be almost 40 times those of practice. Wrestlers with previous knee injuries were at high risk for reinjury. Early season competition is an extremely high risk period. The most frequent injuries were prepatellar bursitis, lateral and medial sprains, and lateral and medial meniscal tears. We noted a relatively higher rate of lateral versus medial meniscal tears compared to other sports and a somewhat common presentation of a meniscal tear resulting from minimal trauma. The lead leg was injured most often. The takedown was the most frequent situation where any injury occurred. Defensive wrestlers appeared to be at higher risk during takedowns. The wrestler "underneath" was also injured more often. Compliance correlated with decreased recurrence of injury. Approximately 50% of wrestlers were found to be noncompliant with medical recommendations. Junior varsity wrestlers lost significantly more time than varsity wrestlers with equivalent injuries. There was no correlation of injury rate with weight class, period of match, timing in practice, or years of experience.