Training-related injury patterns and return-to-sports in elite fencing athletes: a prospective cohort study

To prospectively examine training-related injury incidence, anatomical distribution, and return-to-sports according to sex, weapon category, injury onset (acute vs. overuse), and tissue type in elite fencing athletes.

This prospective injury surveillance study followed elite fencing athletes training at a high-performance facility for 12 months. All acute and overuse training-related injuries were recorded using the International Olympic Committee injury report form. Injury incidence was calculated per 1,000 training hours. Injury location, tissue type, injury onset, and return-to-sports were analyzed according to sex and weapon category.

A total of 471 injuries were recorded, yielding an overall incidence of 3.22 injuries per 1,000 training hours. Overuse injuries demonstrated a significantly higher incidence than acute injuries (2.59 vs. 0.63 injuries per 1,000 training hours; p < 0.001). Female athletes had a higher injury incidence than male athletes (3.86 vs. 2.66 injuries per 1,000 training hours; p < 0.001). Saber athletes exhibited the highest injury incidence, followed by epee and foil athletes. The lower extremity was the most frequently injured region (57.54%). Return-to-sports differed significantly by sex, injured body region, and tissue type (p < 0.05), with ligament injuries requiring the longest return-to-sports duration (p < 0.001).

Elite fencing athletes experience a substantial burden of training-related injuries, with overuse injuries predominating during training exposure. Injury patterns and return-to-sports vary according to sex, weapon category, and tissue type. These findings support the development of sex- and weapon-specific injury prevention strategies, particularly targeting lower extremity injuries and ligament-related time loss.