Prevalence,diagnosisandmanagementofmusculoskeletaldisordersineliteathletes:Amini-review

Musculoskeletal injuries in elite sports represent one of the most impactful issues affecting athletic performance, causing significant absence from training and competition, progressive deterioration in physical health, and negative effects on emotional and social dimensions of athletes' lives. The economic consequences extend beyond individual professionals to sports entities, with estimated losses reaching 74.7 million pounds according to some studies. The prevalence of musculoskeletal injuries varies considerably across different sports, with incidence rates particularly high in elite athletes due to the extreme physical demands placed upon them. This mini-review was conducted to provide a comprehensive overview of the most common musculoskeletal injuries in elite sports, examining precipitating factors, clinical presentations, evidence-based diagnostic approaches, and treatment recommendations with the goal of preventing conditions that may alter performance and general health.

The authors conducted a narrative review of the scientific literature on musculoskeletal disorders in elite athletes, organizing their findings by anatomical region: head and neck, upper limb (shoulder, elbow, wrist and hand), and lower limb. For each region, they examined the epidemiology, risk factors, mechanisms of injury, clinical presentation, diagnostic evaluation, and treatment recommendations. The review drew upon multiple sources including epidemiological studies, systematic reviews, and observational studies to compile prevalence and incidence data across various sports. The authors also presented classification systems for injuries, such as the Rockwood classification for acromioclavicular injuries, and detailed specific injury mechanisms unique to particular sports.

The prevalence of musculoskeletal injuries in elite athletes ranges from 10% to 42.8%, with incidence reaching 76% in certain sports. By anatomical region, the head and neck account for approximately 4% of injuries, with cervical spine injuries representing 15% of all sports-related cervical injuries. In the upper limb, shoulder injuries show high sport-specific variation: 69% in baseball, 60% in swimming, 50% in tennis, and 22% in volleyball. Rotator cuff syndrome affects 5% of elite athletes, with 48.2% being partial-thickness tears.

Lateral elbow tendinopathy has a prevalence of 1% in the general population but is the most prevalent injury in beach tennis elite players. In the lower limb, muscle injuries represent 31-61% of all injuries in soccer players, with hamstrings being most affected (37%), followed by adductors (23%), quadriceps (19%), and calves (13%). Notably, 92% of muscle injuries in American soccer occur in non-contact situations. The review also identified that 16% of muscle injuries in elite soccer players are recurrences, associated with longer competition absence than original injuries.

Among specific populations, 53.8% of elite bowling athletes had de Quervain's tenosynovitis, and 30% of professional golfers reported wrist problems.

For clinicians working with elite athletes, this review emphasizes the importance of sport-specific injury prevention strategies and early identification of risk factors. The high recurrence rate of muscle injuries (16%) underscores the need for comprehensive rehabilitation rather than premature return to play. The finding that most muscle injuries occur in non-contact situations suggests that prevention should focus on training load management, neuromuscular conditioning, and technique optimization rather than just protective equipment. For athletes, understanding that injuries like rotator cuff tears, tendinopathies, and muscle strains often result from repetitive microtrauma rather than single traumatic events can inform training practices and self-monitoring.

The economic and performance costs documented in this review support investment in preventive programs, particularly those addressing the most common injury patterns in each sport. The review also highlights that conservative treatment remains appropriate for many conditions, with surgery reserved for specific structural injuries or failure of extended conservative management.