Retrospective injury epidemiology of strongman athletes.

This study provides the first empirical evidence of strongman training and competition injury epidemiology. Strongman athletes (n = 213) (mean ± SD: 31.7 ± 8.8 years, 181.3 ± 7.4 cm, 113.0 ± 20.3 kg, 12.8 ± 8.1 years general resistance training, and 4.4 ± 3.4 years strongman implement training) completed a self-reported, 4-page, 1-year retrospective survey of physical injuries that caused a missed or modified training session or competition. Analysis by age (≤30 and >30 years), body mass (≤105 and >105 kg), and competitive standard (low and high level) was conducted. Eighty-two percent of strongman athletes reported injuries (1.6 ± 1.5 training injuries per lifter per year, 0.4 ± 0.7 competition injuries per lifter per year, and 5.5 ± 6.5 training injuries per 1,000-hour training). Lower back (24%), shoulder (21%), bicep (11%), knee (11%), and strains and tears of muscle (38%) and tendon (23%) were frequent. The majority of injuries (68%) were acute and were of moderate severity (47%). Strongman athletes used self-treatment (54%) or medical professional treatment (41%) for their injuries. There were significantly more competition injuries for the ≤30- than the >30-year athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.03) and >105-kg athletes compared with the ≤105-kg athletes (0.5 ± 0.8 vs. 0.3 ± 0.6, p = 0.014). Although 54% injuries resulted from traditional training, strongman athletes were 1.9 times more likely to sustain injury when performing strongman implement training when exposure to type of training was considered. To reduce risk of injury and improve training practices, strongman athletes should monitor technique and progressions for exercises that increase risk of lower back, shoulder, bicep, and knee musculoskeletal injuries. Clinicians should advise athletes who use of strongman resistance training programs can increase injury risk over traditional exercises.