Int J Sports Med 2014; 35(11): 943-948
DOI: 10.1055/s-0034-1367049
Orthopedics & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Injuries and Overuse Syndromes in Competitive and Elite Bodybuilding

J. Siewe
1   Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
G. Marx
1   Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
P. Knöll
1   Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
P. Eysel
1   Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
K. Zarghooni
1   Department of Orthopedic and Trauma Surgery, University of Cologne, Cologne, Germany
M. Graf
2   Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
C. Herren
2   Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
R. Sobottke
2   Centre of Orthopedic and Trauma Surgery, Medical Centre Aachen, Würselen, Germany
J. Michael
3   Department of Orthopedic, Trauma and Spine Surgery, Marienhaus Hospital, Bendorf-Neuwied-Waldbreitbach, Germany
› Author Affiliations
Further Information

Publication History

accepted after revision 29 December 2013

Publication Date:
02 June 2014 (online)


Competitive bodybuilding is a weightlifting sport similar to powerlifting, strongman competition and Olympic weightlifting, which aims to increase muscle mass, symmetry, and body definition. Although data regarding rates of injury, overuse syndromes and pain during routine training is available for these other disciplines, it is rare for competitive bodybuilding. The aim of this study was to investigate rates of injury, pain during workouts and/or overuse syndromes, as well as the influence of particular intrinsic and external factors. Data was collected using questionnaires from 71 competitive and elite bodybuilders. The information included training routines and prior injuries. Participants were recruited from bodybuilding clubs in Germany. 45.1% of athletes reported symptoms while training. The overall injury rate was computed to be 0.12 injuries per bodybuilder per year (0.24 injuries per 1 000 h of bodybuilding). Athletes over 40 exhibited higher rates of injury (p=0.029). Other investigated parameters showed no effects. Most injuries occurred in the shoulder, elbow, lumbar spine and knee regions. A large proportion of bodybuilders complained of pain not resulting in interruptions of training/competition. The injury rate is low compared to other weightlifting disciplines such as powerlifting, Olympic weightlifting or strongman competition. In comparison to team or contact sports the injury rate is minimal.

  • References

  • 1 Bahr R. No injuries, but plenty of pain? On the methodology for recording overuse symptoms in sports. Br J Sports Med 2009; 43: 966-972
  • 2 Bahr R, Reeser JC. Injuries among world-class professional beach volleyball players. The Federation Internationale de Volleyball beach volleyball injury study. Am J Sports Med 2003; 31: 119-125
  • 3 Baltzer AW, Ghadamgahi PD, Granrath M, Possel HJ. American football injuries in Germany. First results from Bundesliga football. Knee Surg Sports Traumatol Arthrosc 1997; 5: 46-49
  • 4 Bjorneboe J, Bahr R, Andersen TE. Risk of injury on third-generation artificial turf in Norwegian professional football. Br J Sports Med 2010; 44: 794-798
  • 5 Bjornestad J, Kandal O, Anderssen N. Vulnerable discipline: Experiences of male competitive bodybuilders. J Health Psychol 2013; : 1-13 [published ahead of print]
  • 6 Brown EW, Kimball RG. Medical history associated with adolescent powerlifting. Pediatrics 1983; 72: 636-644
  • 7 Caine CJ, Caine DJ, Lindner KJ. The epidemiologic approach to sports injuries. In: Caine DJ, Caine CG, Lindner KJ. (eds.). Epidemiology of Sports Injuries. Champaign: Human Kinetics; 1996: 1-13
  • 8 Eberhardt A, Dzban’ski P, Fabirkiewicz K, Iwan’ski A, Ronge P. Frequency of injuries in recreational bodybuilding. Phys Ed Sport 2007; 51: 40-44
  • 9 Echegoyen S, Acuna E, Rodriguez C. Injuries in students of three different dance techniques. Med Probl Perform Art 2010; 25: 72-74
  • 10 Escamilla RF, Fleisig GS, Zheng N, Barrentine SW, Wilk KE, Andrews JR. Biomechanics of the knee during closed kinetic chain and open kinetic chain exercises. Med Sci Sports Exerc 1998; 30: 556-569
  • 11 Fees M, Decker T, Snyder-Mackler L, Axe MJ. Upper extremity weight-training modifications for the injured athlete. A clinical perspective. Am J Sports Med 1998; 26: 732-742
  • 12 Gabbe BJ, Finch CF, Bennell KL, Wajswelner H. How valid is a self reported 12 month sports injury history?. Br J Sports Med 2003; 37: 545-547
  • 13 Gabbett TJ, Godbolt RJ. Training injuries in professional rugby league. J Strength Cond Res 2010; 24: 1948-1953
  • 14 Goertzen M, Schoppe K, Lange G, Schulitz KP. Injuries and damage caused by excess stress in bodybuilding and powerlifting. Sportverletz Sportschaden 1989; 3: 32-36
  • 15 Harriss DJ, Atkinson G. 2014 Update – ethical standards in sport and exercise science research. Int J Sports Med 2013; 34: 1025-1028
  • 16 Haykowsky MJ, Warburton DE, Quinney HA. Pain and injury associated with powerlifting training in visually impaired athletes. J Vis Impair Blind 1999; 93: 236-241
  • 17 Jankauskiene R, Kardelis K, Pajaujiene S. Muscle size satisfaction and predisposition for a health harmful practice in bodybuilders and recreational gymnasium users. Medicina (Kaunas) 2007; 43: 338-346
  • 18 Keogh J, Hume PA, Pearson S. Retrospective injury epidemiology of one hundred one competitive Oceania power lifters: the effects of age, body mass, competitive standard, and gender. J Strenght Cond Res 2006; 20: 672-681
  • 19 JWL Keogh. Weightlifting. In: Caine DJ, Harmer P, Schiff M. (eds.). Epidemiology of Injury in Olympic Sports. Oxford: Blackwell; 2009: 336-350
  • 20 Killen NM, Gabbett TJ, Jenkins DG. Training loads and incidence of injury during the preseason in professional rugby league players. J Strength Cond Res 2010; 24: 2079-2084
  • 21 Kolt GS, Kirkby RJ. Epidemiology of injury in elite and subelite female gymnasts: a comparison of retrospective and prospective findings. Br J Sports Med 1999; 33: 312-318
  • 22 König DP, Kausch T. Epidemiologische Studie in einem Bodybuildingcenter. In: Liesen H. (eds.). Regulations- und Repairmechanismen: Deutscher Ärzteverlag. 1994
  • 23 Lander JE, Hundley JR, Simonton RL. The effectiveness of weight-belts during multiple repetitions of the squat exercise. Med Sci Sports Exerc 1992; 24: 603-609
  • 24 Lavallee ME, Balam T. An overview of strength training injuries: acute and chronic. Curr Sports Med Rep 2010; 9: 307-313
  • 25 Mosley PE. Bigorexia: bodybuilding and muscle dysmorphia. Eur Eat Disord Rev 2009; 17: 191-198
  • 26 Peters MA, Phelps L. Body image dissatisfaction and distortion, steroid use, and sex differences in college age bodybuilders. Psychol Schools 2001; 38: 283-289
  • 27 Quinney HA, Warburton DER, Webster A, Calvert R, Haykowsky MJ. Powerlifting injuries associated with elite powerlifting training. Can J Appl Physiol 1997; 20: 49
  • 28 Raske A, Norlin R. Injury incidence and prevalence among elite weight and power lifters. Am J Sports Med 2002; 30: 248-256
  • 29 Reeves RK, Laskowski ER, Smith J. Weight training injuries: part 1: diagnosing and managing acute conditions. Phys Sportsmed 1998; 26: 67-96
  • 30 Reeves RK, Laskowski ER, Smith J. Weight training injuries: part 2: diagnosing and managing chronic conditions. Phys Sportsmed 1998; 26: 54-73
  • 31 Seil R, Rupp S, Tempelhof S, Kohn D. Injuries during handball. A comparative, retrospective study between regional and upper league teams. Sportverletz Sportschaden 1997; 11: 58-62
  • 32 Siewe J, Rudat J, Rollinghoff M, Schlegel UJ, Eysel P, Michael JW. Injuries and overuse syndromes in powerlifting. Int J Sports Med 2011; 32: 703-711
  • 33 Spiller HA, James KJ, Scholzen S, Borys DJ. A descriptive study of adverse events from clenbuterol misuse and abuse for weight loss and bodybuilding. Subst Abus 2013; 34: 306-312
  • 34 Stocker D, Pink M, Jobe FW. Comparison of shoulder injury in collegiate- and master’s-level swimmers. Clin J Sport Med 1995; 5: 4-8
  • 35 Teitz CC, O’Kane J, Lind BK, Hannafin JA. Back pain in intercollegiate rowers. Am J Sports Med 2002; 30: 674-679
  • 36 van Mechelen W, Hlobil H, Kemper HC. Incidence, severity, aetiology and prevention of sports injuries. A review of concepts. Sports Med 1992; 14: 82-99
  • 37 Wilson F, Gissane C, Gormley J, Simms C. A 12-month prospective cohort study of injury in international rowers. Br J Sports Med 2010; 44: 207-214
  • 38 Winwood PW, Hume PA, Keogh JW, Cronin JB. Retrospective injury epidemiology of strongman athletes. J Strength Cond Res 2014; 28: 28-42
  • 39 Wretenberg P, Feng Y, Arborelius UP. High- and low-bar squatting techniques during weight-training. Med Sci Sports Exerc 1996; 28: 218-224
  • 40 Zazryn T, Cameron P, McCrory P. A prospective cohort study of injury in amateur and professional boxing. Br J Sports Med 2006; 40: 670-674