Strength training cuts sports injuries by two-thirds: meta-analysis of 26,610 athletes

Sports injuries are often treated as bad luck, but this landmark systematic review asked a different question: can structured exercise programs prevent them in the first place? The authors pooled 25 randomised controlled trials — 26,610 adult and adolescent participants and 3,464 recorded injuries — comparing athletes assigned to preventive exercise programs against controls who trained as usual.

The results separated cleanly by exercise type. Strength training was the standout: participants in strength programs sustained less than a third of the injuries seen in controls. Proprioception (balance-board style) training and programs combining several exercise elements were also clearly protective. Both acute injuries and overuse injuries responded, with overuse injuries almost halved overall.

The exception was stretching. Across the pooled trials, stretching programs produced no measurable reduction in injury risk — a finding that has since been replicated and has shifted professional practice away from stretching as a stand-alone prevention strategy.

As with any meta-analysis, the included trials varied in sport, age group and program design, so the exact size of the effect for a given athlete is uncertain. But the direction and consistency of the strength-training result made this one of the most cited papers in sports medicine.

Key findings

• 25 randomised controlled trials with 26,610 participants and 3,464 injuries were pooled.
• Strength training reduced sports injuries to less than one-third of the control rate.
• Overuse injuries were almost halved by preventive exercise programs.
• Proprioception (balance) training and multi-component programs also showed consistent protective effects.
• Stretching programs, whether pre- or post-activity, showed no beneficial effect on injury risk.

Clinical relevance

Injury prevention is trainable. For the athletes and active clients we see, a progressive strength program is not just performance work — it is the best-evidenced protection against both acute and overuse injury. It is also why our kinesiologists build strength progressions into rehabilitation and return-to-sport plans rather than relying on stretching routines.

Prepared by the Volt Health team as an educational summary of the cited publication. It is not medical advice; assessment and treatment decisions should always be made with a qualified health professional.