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August 30, 2026Sport Sciences for HealthOpen Access

Incidence of lower limb injuries in children and adolescents practicing combat sports: a systematic review

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Why the study?

The incidence rate of lower limb injuries in children and adolescents practicing combat sports needed to be assessed.

What is the incidence rate of lower limb injuries in children and adolescents practicing combat sports?

Population

Individuals ≤19 years old practicing combat sports across 30 included studies

Comparison

Grappling sports vs striking sports

Design

Systematic review

Key result

Children and adolescents practicing combat sports experienced lower limb injury incidence rates ranging from 0.07 to 23.66 per 1,000 athlete exposures, with higher rates observed in striking sports.

Authors

FLFernando de LimaRLRenato LocksGMGilberto Melo

Discussion

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Overview

Documents youth combat sports lower-limb injury incidence; leaves open targeted prevention trials.

Key Points

  • To assess the incidence rate of lower limb injuries in children and adolescents aged 19 years and younger participating in combat sports.
  • Searched five databases (Embase, PubMed, SCOPUS, SPORTDiscus, Web of Science) through February 4, 2026, for studies examining combat sport participants aged ≤19 years.
  • Extracted injury incidence rates (IR) per 1,000 athlete exposures (AE), participant demographics, sport modalities, and protective gear usage from 30 eligible studies.
  • Across 30 included studies (18 wrestling, 5 taekwondo, 4 judo, 3 karate), overall lower limb injury IR ranged from 0.07 to 23.66 per 1,000 AE.
  • Striking sports demonstrated substantially higher injury rates (4.60 to 23.66 per 1,000 AE; karate: 5.00–12.74, taekwondo: 4.60–23.66) than grappling sports (0.07 to 3.85 per 1,000 AE; wrestling: 0.07–1.86, judo: 3.85).
  • The most frequently reported lower limb injury sites across all combat disciplines were the feet/toes, knees, and ankles.

Study Design

Type

Systematic Review

Structured PICO

What is the incidence rate of lower limb injuries in children and adolescents practicing combat sports?

P
Population
Children and adolescents aged 19 years or younger practicing combat sports, evaluated across 30 prospective studies for the incidence of lower limb injuries.
E
Exposure
Practicing combat sports (Wrestling, Taekwondo, Judo, Karate)
O
Outcome
Incidence rate of lower limb injuries per 1000 athlete exposure (AE)safety

Striking combat sports are associated with higher incidence rates of lower limb injuries than grappling sports in children and adolescents.

Limitations

  • Variability in injury definitions and exposure measurement
  • Limited reporting hindered further analyses according to injury characteristics, age, sex, and athlete level
  • Reliance on US-based public datasets with potential sample overlap
  • Scarcity of evidence for judo and absence for several other combat sports
  • Insufficient data for statistical pooling and robust assessment of publication bias
  • overlapping samples

Cite This Study

Lima et al. (2026) conducted a systematic review in Lower limb injuries. Combat sports (striking vs grappling) was evaluated on Incidence rate of lower limb injuries per 1000 athlete exposures. Children and adolescents practicing combat sports experienced lower limb injury incidence rates ranging from 0.07 to 23.66 per 1,000 athlete exposures, with higher rates observed in striking sports.

synapsesocial.com/papers/6a93e9743affd7f5e23e6b3chttps://doi.org/10.1007/s11332-026-01929-w
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