A 45-year global systematic evaluation of musculoskeletal injuries in swimmers: a systematic review and meta-analysis with 10973 athletes

INTRODUCTION: Swimming, as a universal popular sport, can carry a high risk of injury. The current research aimed to demonstrate a comprehensive overview of swimming-related musculoskeletal injuries in amateur, competitive and elite swimmers through the utilization of a systematic review and meta-analysis methodology. EVIDENCE ACQUISITION: A comprehensive search was performed in the five valid databases (the Scopus, PubMed, Medline, Embase, and Web of Science) utilizing two sets of keywords up to January 2025 based on the PRISMA approach. The prevalence of shoulder injuries and 95% confidence interval (CI) were calculated applying a random effect model. The quality assessment of the papers in the current review was performed utilizing the critical appraisal tools of Joanna Briggs Institute (JBI). EVIDENCE SYNTHESIS: The included papers totally comprised 10,973 individuals. The prevalence of injuries in these individuals was in the range between 0.3 and 91.2%. Shoulder injuries in 66 out of 94 studies (70.2%), knee in 34 out of 94 studies (36.1%), arm/forearm in 20 out of 94 studies (21.2%), neck in 16 out of 94 studies (17.02%), hand injuries in 14 out of 94 studies (14.8%), low back in 13 out of 94 studies (13.8%), and spine in 11 out of 94 studies (11.7%) were the highest prevalence in diversified injuries. The subgroup analysis showed that the polled prevalence of shoulder injuries in elite swimmers (46.03%; 95% CI 35.85, 56.22) was higher than the amateur (45.77%; 95% CI 29.96, 61.57) and competitive (33.96%; 95% CI 30.59, 37.33) individuals. The subgroup analysis showed that the polled prevalence of shoulder injuries in elite swimmers (46.03%; 95% CI 35.85, 56.22) was higher than the amateur (45.77%; 95% CI 29.96, 61.57) and competitive (33.96%; 95% CI 30.59, 37.33) individuals. CONCLUSIONS: These outcomes spotlight the urgent need for injury prevention and management protocols, in particular targeting vulnerable regions such as the shoulder and knee in swimmers.