What are the injury rates in powerlifting? What are the most common injuries we see? How does it compare to other sports?
These are all questions that we will be answering today in an attempt to dispel some misinformation surrounding powerlifting/strength training.
Powerlifting and strength training have been traditionally given a bad rap due to preconceived notions about how it will tear your shoulders up, destroy your back, damage your knees, etc. I'm sure we've all heard these statements at some point in our lives and therefore should just stick to regular sports for exercise-based activities. Ironically, powerlifting is one of the safest sports to participate in and strength training has been shown to reduce injury rates for other sporting activities by as much as 50% (Lauersen et al. 2014)
Let's dive in by first addressing the injury rates in powerlifting and compare them to other common sports that people play.
According to Dudagoitia in 2021 who looked across 11 studies, powerlifting injury rates were found to exist between 1.0-4.4 injuries per 1000 hours trained, with the low back, shoulders, and knees being the most common injuries. If we put this into more layman's terms, a powerlifter who trains 4x a week for 1.5 hours at a time over the course of the year would only experience one injury roughly every 1.4 - 3.2 years.
Contrast this to other common sports such as track and field at 3.57 injuries/1000 hours trained, American football at 9.6/1000 hours trained, wrestling at 5.7 injuries/1000 hours trained, and soccer at 15 injuries per 1000 hours trained (Aasa et al. 2017, Dudagoitia et al. 2021, Stromback et al. 2018, Tung et al. 2024).
Additionally, most injuries in powerlifting are of the acute type (59%) and chronic type (30.4%), with novice lifters trending towards acute injuries and experienced lifters trending towards chronic types. Furthermore, the injuries accrued in powerlifting tend to be non-catastrophic (Aasa et al. 2017 & Dudagoitia et al. 2021) meaning that they have highly favorable prognoses. We seldomly see things like ACL tears or separated shoulders in powerlifting as we might in football, soccer, or wrestling that take months, if not years, to properly rehab.
Lastly, most of these injury rates reported were on elite powerlifters who have been competing for quite some time and are at the highest echelons of the sport. What we might surmise from this is that for the novice or recreational lifter, injury rates would likely be much lower.
So although we might hear about that one friend or family member who swears that lifting weights is one of the most dangerous things you can do, empirical evidence tends to trend towards the opposite conclusion.
What we forget to consider is that strength training (not just powerlifting) is an extremely powerful tool for increasing bone density, muscle mass, and improving athletic foundations that can reduce our risk of injuries during other sporting activities. In some cases, even as high as 50% (Lauersen et al. 2014).
So is powerlifting dangerous? Perhaps it is. The injury rate is non-zero, especially if we compare it to doing nothing (yet people get hurt doing "nothing" all time time...but I digress).
However, when you consider how it compares to other common sports one might also be participating in with the hopes that they're "safer", that is unfortunately a misinformed conclusion.
Citations:
Aasa U, Svartholm I, Andersson F, et alInjuries among weightlifters and powerlifters: a systematic reviewBritish Journal of Sports Medicine 2017;51:211-219.
Dudagoitia, E., García-de-Alcaraz, A., & Andersen, L. L. (2021). Safety of powerlifting: A literature review. Science and Sports, 36(3), E59-E68. https://doi.org/10.1016/j.scispo.2020.08.003
Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine 2014;48:871-877.
Strömbäck E, Aasa U, Gilenstam K, Berglund L. Prevalence and Consequences of Injuries in Powerlifting: A Cross-sectional Study. Orthop J Sports Med. 2018 May 14;6(5):2325967118771016. doi: 10.1177/2325967118771016. PMID: 29785405; PMCID: PMC5954586.
Tung MJ-Y, Lantz GA, Lopes AD, et al. Injuries in weightlifting and powerlifting: an updated systematic review. BMJ Open Sport & Exercise Medicine 2024;10:e001884. doi:10.1136/ bmjsem-2023-001884
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