Evaluation of adolescent sport specialization and injury mechanism by sex: A secondary analysis

ObjectivesThe purpose of this study was to compare the association of sport specialization with previous overuse and acute injuries between male and female adolescent athletes.DesignCross-sectional study.MethodsQuestionnaires were completed by adolescent athletes from various sports at sport club summer events in the state of Wisconsin. Adolescent athletes (12–18 years old) who were active in organized sports in the previous year were recruited. The questionnaire contained demographics, sport participation, sport specialization classification, and previous injury history. Sport specialization classification was determined using common methods in sport specialization research. Previous injury was restricted to athletic injuries that occurred in the past year.ResultsTwo-thousand and eleven participants (age = 13.7 ± 1.6 years, females = 989) completed the questionnaire. Highly specialized athletes were more likely to report both acute and overuse injuries compared to low specialization athletes. However, this relationship differed by sex, with only moderate and highly specialized females being more likely (Moderate: OR [95%CI] = 1.74 [1.18–2.58], p = 0.005; High: OR [95%CI] = 1.69 [1.14–2.53], p = 0.010) to report an overuse injury compared to low specialization females. Highly specialized female athletes were more likely to report an acute injury (High: OR [95%CI] = 1.46 [1.06–2.02], p = 0.022) compared to low specialization females. Highly specialized male athletes were not associated with overuse or acute injuries.ConclusionsHighly specialized athletes were more likely to report acute and overuse injuries. However, when this analysis was separated by sex, only highly specialized females were more likely to report a previous overuse or acute injury.     

The epidemiology of back injuries in elite Gaelic football athletes: An 8-year prospective study

ObjectivesTo describe the epidemiology of back injury in elite male Gaelic football athletes between 2008 and 2016.DesignProspective cohort study.SettingInjury data from the National GAA Injury Surveillance Database.ParticipantsElite male Gaelic football athletes.Main outcome measuresIncidence of injury as a rate per 1000 h of exposure.Results38 datasets were analysed. Out of a total of 1606 time-loss injuries, 76 were back injuries (4.73%, 95% CI 3.80%–5.88%). The incidence of back injuries in match play was 1.72 (CI 95% 1.21 to 2.45) and in training was 0.2 (CI 95% 0.14 to 0.28) injuries per 1000 h of exposure. The majority of back injuries (63.16%, CI 95% 51.93–73.12) were new, as opposed to recurrent (35.53% CI 95% 25.7–46.74). Most back injuries were acute (51.32%, CI 95% 40.29–62.22), compared to chronic (31.58%, CI 95% 22.23–42.7) or overuse (11.84%, CI 95% 6.36–21.00). The majority of back injuries occurred during non-contact player activities (n = 60, 78.94% CI 95% 68.50–86.60).ConclusionsBack injury rates in Gaelic football are similar to soccer and Australian football but less than rugby union. Further research is needed to understand the factors leading to the onset and recurrence of back injury in Gaelic football athletes.     

Injury risk is different in team and individual youth sport

ObjectivesThis study compared sports injury incidence in young high-level athletes from various team and individual sports and investigated if sport participation patterns are linked to injuries.DesignProspective cohort follow-up.MethodsPupils from a public sports school (12–19 years) were recruited over two separate school years (2008–2009: 42 weeks, n = 199 athletes; 2009–2010: 40 weeks, n = 89 athletes). Training and competition volume and intensity were recorded via a personal sports diary. Sports injuries (time-loss definition) were registered by medical staff members using a standardized questionnaire.ResultsInjury incidence was significantly higher in team compared with individual sports (6.16 versus 2.88 injuries/1000 h, respectively), as a result of a higher incidence of both traumatic (RR = 2.17; CI95% = 1.75–2.70; p < 0.001), and overuse injuries (RR = 2.06; CI95% = 1.46–2.91; p < 0.001). A Cox proportional hazards regression revealed that team sports participation had a hazard ratio of 2.00 (CI95% = 1.49–2.68; p < 0.001) compared to individual sports, with additionally previous injury being a risk and age a protective factor. The number of competitions per 100 days was significantly higher in team sports, whereas the number of intense training sessions per 100 days was significantly lower. In team sports, the number of competitions per 100 days was positively associated with injuries (HR = 1.072; CI95% [1.033; 1.113]; p < 0.001), while in individual sports the number of competitions per 100 days had a protective effect (HR = 0.940; CI95% [0.893; 0.989]; p = 0.017).ConclusionsTeam sports participation entailed a higher injury risk, whatever the injury category. Further research should elucidate the role of characteristics related to sport participation in injury causation.     

A prospective study of sport injuries in youth females

ObjectivesTo examine sports and physical education (PE) injury rates in youth females during a school year and to investigate if an association exists between injury and phase of the menstrual cycle.DesignProspective cohort.SettingAn online questionnaire was used to record training and competition exposure and self-reported injuries for 30-weeks.Participants103 PE students (12–15 years) from a girls’ secondary school.Main outcome measuresInjury rates and prevalence of acute, gradual onset/overuse and substantial injuries.ResultsOn average, girls trained 3.4 h/week and competed 1 h/week. During the study, 74 participants reported 595 injuries. The average weekly prevalence of all injuries was 20.7% (95% CI: 20.0–21.3), of which 8.6% (95% CI: 8.3–9.0) were acute injuries and 12.0% (95% CI: 11.4–12.6) were gradual onset/overuse injuries. The overall rate of sport and PE injuries was 10.4 injuries/1000 h of exposure. The most common acute injury involved the ankle (35%) while the most common gradual onset/overuse injury involved the knee (51%). There was no significant association between the stage of the menstrual cycle and the likelihood of injury (P = 0.18).ConclusionThe high number of injuries in this population of girls suggests preventative measures, particularly targeting the lower extremity, are needed.     

Self‐regulatory skills: Are they helpful in the prevention of overuse injuries in talented tennis players?

Talented athletes use metacognitive skills to improve their performance. Also, it is known that these skills are important for managing one's health. The goal of this study was to identify the relationship between metacognitive skills and overuse injuries in talented tennis players. Metacognitive skills were measured in 73 talented tennis players (45 boys and 28 girls, age 11‐14) at the start of the season, using the Self‐Regulation of Learning Self‐Report Scale. Overuse injuries were monitored for one season using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Ordinal regression indicated that moderate or low selfmonitoring skills (compared to high selfmonitoring) (OR 4.555, CI 1.096‐18.927, P = 0.037) and exposure time (OR 1.380, CI 1.106‐1.721, P = 0.004) were associated with more time loss overuse injuries. A second analysis showed that this was the case in girls (OR 10.757, CI 1.845‐62.714, P = 0.008), but not in boys. Linear regression revealed that higher reflection scores and exposure time predicted overuse severity (F(5,58) = 2.921, P = 0.020, R² = 0.201). Possibly, selfmonitoring can help players to prevent themselves from time loss overuse injuries. Coaches should be aware that players can differ in selfmonitoring ability and thus in the ability to prevent overuse injuries. The role of reflection needs more research.     

Verletzungen und Überlastungsbeschwerden der deutschen paralympischen Athleten bei den Sommerspielen 2012 in London

BackgroundMusculoskeletal complaints are frequently recorded in paralympic athletes. Despite the increased training and competition load and more professional support of handicapped athletes, documentation of injury and illnesses during high-level competition is sparse. The aim of the study was the standardised recording and analysis of all athletes’ injuries of the German paralympic team during the London 2012 Paralympic Games.Material and MethodsDuring the In-competition-period all traumatic and overuse injuries of the 153 German athletes were recorded and documented in standardised case report forms. Documentation included effective date and severity of the injury, medical diagnosis, treatment modalities and consecutive restrictions in training and competition. Injury rates and localisations were analysed by sports discipline.ResultsDuring the in-competition-period, 140 athletes attended medical consultation for 201 different orthopaedic complaints (1,4/injured athlete). The men age of injured athletes did not differ from the uninjured athletes (∅ 33years). Higher injury rates were found in women's wheelchair basketball and rowing (1,6 injuries per competing athlete). Visual impaired athletes had no higher risk of injury.The most frequent diagnoses were myalgias (n = 105), tendinopathies (n = 14), unspecific back pain (n = 14), vertebral subluxations (n = 11), skin abrasions (n = 10), contusions (n = 6) and distorsions (n = 8). Injuries were mainly located at the upper extremities (37,6%) and spine (37,6%), whereas the lower extremities were only affected in 21,5%. 12,5% of the complaints were already existing before the arrival in London. Most athletes were able to continue their sporting activities (77%).ConclusionThe overall injury rate was higher in the German Paralympic team compared to the report of the International Paralympic Committee. This is probably due to the different definitions of injury (in this study: recording of all consultations regardless of severity) and the good availability of medical services for German athletes. The mean age of paralympic athletes is higher than for Olympic sports but within Paralympians, older athletes seem to have no higher risk for injury. Injury rates were higher in rowing and women's wheelchair basketball, whereas no higher prevalence of injuries was found in athletes with visual impairments. According to the presented results, sports-specific injury prevention programs may be developed and evaluated in the future.     

The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveillance method

Little is known about the true extent and severity of overuse injuries in sport, largely because of methodological challenges involved in recording them. This study assessed the prevalence of overuse injuries among Norwegian athletes from five sports using a newly developed method designed specifically for this purpose. The Oslo Sports Trauma Research Center Overuse Injury Questionnaire was distributed weekly by e‐mail to 45 cross‐country skiers, 98 cyclists, 50 floorball players, 55 handball players, and 65 volleyball players for 13 weeks. The prevalence of overuse problems at the shoulder, lower back, knee, and anterior thigh was monitored throughout the study and summary measures of an injury severity score derived from athletes' questionnaire responses were used to gauge the relative impact of overuse problems in each area. The area where overuse injuries had the greatest impact was the knee in volleyball where, on average, 36% of players had some form of complaint (95% CI 32–39%). Other prevalent areas included the shoulder in handball (22%, 95% CI 16–27%) the knee in cycling (23%, 95% CI 17–28%), and the knee and lower back in floorball (27%, 95% CI 24–31% and 29%, 95% CI 25–33%, respectively).     

Risk of acute and overuse injuries in youth elite soccer players: Body size and growth matter

ObjectivesThis study investigated anthropometric measures and growth as risk factors for overuse and acute injuries in younger (U10–U12) and older (U13–U15) elite level soccer players.DesignProspective cohort study.MethodsHeight, weight, and sitting height were measured at the start and the end of the 2016–2017 competitive season and growth velocities were calculated. Throughout the season, injuries were registered continuously by the (para-)medical staff of the included clubs. We analyzed the injury risk using multilevel Poisson regression models, accounting for club and team clustering.ResultsOf the included 314 players (11.7 ± 1.7 years of age), 160 players sustained 133 overuse and 163 acute injuries (i.e. 106 injuries in 69 players of the younger group, 190 in 91 players of the older group). In the younger group, risk of overuse injuries was associated with an increase in leg length over the season (incidence rate ratio (IRR) 1.620 [95% CI 1.230–2.117]) and risk of acute injuries with relatively younger age (IRR 1.003 [95% CI 1.000–1.006]). In the older group, a higher leg length was associated with an increased risk of overuse injuries (IRR 1.055 [95% CI 1.011–1.108]), and a higher weight and a lower growth rate with an increased risk of acute injuries (IRR 1.043 [95% CI 1.021–1.067] and 0.903 [95% CI 0.831–0.981], respectively).ConclusionsInjury risk factors differ by age group and type of injury. The age-specific anthropometric and growth-related risk factors should be monitored and these risk profiles should be considered to manage injury risk effectively.     

Swedish translation and validation of a web‐based questionnaire for registration of overuse problems

The main aim of this study was to translate the Oslo Sport Trauma Research Center (OSTRC) Overuse Injury Questionnaire into Swedish. The validity and applicability of the questionnaire for studying overuse injuries among Swedish handball, volleyball, tennis, and orienteering top athletes were also examined. The back‐translation method was used for translation. An expert committee further developed it for use in a study of injuries in handball, orienteering, tennis, and volleyball. A 10‐week pretest was then conducted on 43 athletes, average age 21 (18–31) from these sports, during which time the athletes completed the modified OSTRC questionnaire on a weekly basis. In the 10th week, four additional questions were added in order to examine the questionnaire's content validity. No major disagreement was found in the translation. The athletes perceived the web‐based questionnaire to be smooth and easy to complete, accurately capturing overuse injuries. However, suggestions were made to add questions relating to the hip for orienteerers and to the hand/fingers for handball players. The average prevalence of overuse injuries for all athletes, in any anatomical area was 22% (95% confidence interval 20–25). Construct validity appeared to be high, and we therefore suggest that the questionnaire may be used when studying overuse injuries in different sports.     

Gradual increase in the risk of match injury in Norwegian male professional football: A 6‐year prospective study

The aim of this study was to monitor injury incidence and pattern in Norwegian male professional football over six consecutive seasons and compare the risk of injury between the preseason and competitive season. All time loss injuries were recorded by the medical staff of each club. In total, 2365 injuries were recorded. The incidence of acute injuries was 15.9/1000 match hours [95% confidence interval (CI): 14.9–16.8], 1.9/1000 training hours (95% CI: 1.7–2.0), and 1.4 (95% CI: 1.3–1.5) overuse injuries/1000 h. A linear regression model found an annual increase of 1.06 acute match injuries/1000 h (95% CI: 0.40–1.73), corresponding to a total increase of 49% during the 6‐year study period. When accounting for interteam variation and clustering effects using a general estimating equation model, the increase in injury incidence was 0.92 (95% CI: ?0.11–1.95, P = 0.083). No difference in the risk of acute match injuries (rate ratio (RR): 0.86, 95% CI: 0.73–1.01), acute training injuries (RR: 1.16, 95% CI: 0.99–1.36), or overuse injuries (RR: 1.04, 95% CI: 0.89–1.21) was observed between the preseason and competitive season. In conclusion, the overall risk of acute match injuries in Norwegian male professional football increased by 49% during the study period, although this increase was not fully consistent across teams. We detected no change in the risk of training and overuse injuries or any difference between the preseason and competitive season.     

Injuries in amateur soccer players on artificial turf: A one-season prospective study

BackgroundEpidemiological studies in soccer are important for injury prevention. However, most of the available information is limited to elite players.ObjectiveTo determine the epidemiology of injuries in amateur soccer players on artificial turf.DesignProspective cohort study during one competitive season (2010–2011).SettingAmateur soccer players. Participants: 231 players (aged 24.7; range: 18–38 years).Main outcome measuresInjury incidence was recorded prospectively according to the consensus statement for soccer.Results213 injuries were recorded; 57% of the players suffered injuries. Injury incidence was 5.1 (95% CI: 4.3–5.9) injuries/1000 h exposure. Injury incidence was higher in matches than in training (32.2 [95% CI: 23.1–41.3] vs. 2.4 [95% CI: 1.8–3.0] injuries/1000 h; p < 0.001). The thigh (22.1%), knee (20.2%), and ankle (19.2%) were the most affected regions. The most frequent diagnoses were thigh strain/muscle rupture (18.3%), and ankle and knee strain/ligament injury (17.3% and 11.3%, respectively). Time-loss due to injury was 20.3 (95% CI: 16.8–23.73) days. Most injuries (79%) were traumatic; 21% were overuse injuries. Re-injuries accounted for 10% of all injuries sustained during the season.ConclusionsInjury incidence in amateur soccer players is higher during matches played on artificial turf than during training sessions.     

Comparison of injuries sustained on artificial turf and grass by male and female elite football players

The objective of this study was to compare incidences and patterns of injury for female and male elite teams when playing football on artificial turf and grass. Twenty teams (15 male, 5 female) playing home matches on third‐generation artificial turf were followed prospectively; their injury risk when playing on artificial turf pitches was compared with the risk when playing on grass. Individual exposure, injuries (time loss) and injury severity were recorded by the team medical staff. In total, 2105 injuries were recorded during 246 000 h of exposure to football. Seventy‐one percent of the injuries were traumatic and 29% overuse injuries. There were no significant differences in the nature of overuse injuries recorded on artificial turf and grass for either men or women. The incidence (injuries/1000 player‐hours) of acute (traumatic) injuries did not differ significantly between artificial turf and grass, for men (match 22.4 v 21.7; RR 1.0 (95% CI 0.9–1.2); training 3.5 v 3.5; RR 1.0 (0.8–1.2)) or women [match 14.9 v 12.5; RR 1.2 (0.8–1.8); training 2.9 v 2.8; RR 1.0 (0.6–1.7)]. During matches, men were less likely to sustain a quadriceps strain (P=0.031) and more likely to sustain an ankle sprain (P=0.040) on artificial turf.     

The injury profile of Karate World Championships: new rules, less injuries

The aim of this paper is to document the injury rate in high-level modern competitive karate after a change of competition rules was implemented in the year 2000, and to compare it with the injury rate found before the rules were changed. A prospective recording of the injuries resulting from 2,762 matches in three consecutive World Karate Championships (representing 7,425 min of active fighting) was performed, and compared with the results from 2,837 matches from the three last World Karate Championships (representing 7,631 min of active fighting) held before the change of competition rules. In total, 497 injuries were recorded, with an incidence of 0.180 injuries per match or 6.7 per 100 min of active fighting. There were 1,901 male category fights (in which 383 injuries were recorded), and 861 female category fights (in which 114 injuries were recorded). The global injury incidence was almost double with the old rules compared to the one with the new rules [OR 1.99, 95% CI (1.76–2.26); p < 0.00001]. In male category, the risk of injury was higher before the rules were changed [OR 1.81, 95% CI (1.56–2.09); p < 0.00001], and also in female category [OR 2.71; 95% CI (2.64–2.80); p < 0.00001]. The rate of severe injuries was not different before and after the change of rules. The implementation of the new competition rules in competitive karate has been associated with a significant reduction in injury rate, making competition safer for athletes.     

Epidemiology of injuries during the Wheelchair Basketball World Championships 2018: A prospective cohort study

Several international sports federations have implemented a standardized injury reporting system during their championships. However, very few studies have investigated athletes with disabilities during major championships apart from the Paralympic Games. Therefore, the aim of this study was to assess the rate and characteristics of injuries during the Wheelchair Basketball World Championships 2018 (WBWC). This prospective cohort study was conducted during the WBWC held in Hamburg, Germany, from August 16 to August 26, 2018. Physicians or physiotherapists of all 28 participating teams (total 336 players) were asked to report all newly incurred injuries (with location, diagnosis, cause, and estimated duration of absence) daily on a standardized injury report form. Prevalence and incidence rates were calculated. Medical staff of 11 teams (132 players) reported 100 injuries, equivalent to 75.8 per 100 players (95% CI: 60.9-90.7) or 68.9 per 1000 player-days (55.4-82.4). Eight time-loss injuries were reported (6.1 injuries per 100 players [95% CI: 1.9-10.3] or 5.5 injuries per 1000 player-days [1.7-9.3]). More injuries were incurred during matches (n = 68) than during training. Most injuries affected the neck/cervical spine (16%), thoracic spine/upper back (15%), and shoulder (14%). The most frequent diagnosis was muscle spasms (25%), the most frequent cause was overuse (52%). A high rate of non–time-loss injuries compared to Paralympic Games was reported. Future studies should focus on the etiology of muscle spasms and further identify injury mechanisms of traumatic and overuse injuries in wheelchair basketball players to develop adequate preventive measures.     

Former male elite athletes have better metabolic health in late life than their controls

Elite‐class athletes have longer life expectancy and lower risk for chronic noncommunicable diseases possibly because of physically active and healthier lifestyle. In this study, we assessed former male Finnish elite‐class athletes’ (n = 392) and their matched controls’ (n = 207) body composition, and risk for the metabolic syndrome (MS) and nonalcoholic fatty liver disease (NAFLD) in later life. Compared with the controls, the former athletes had lower body fat percentage (24.8% vs 26.0%, P = 0.021), lower risk for MS [odds ratio (OR) 0.57, 95% confidence interval (CI) 0.40–0.81], and NAFLD (OR 0.61, 95% CI 0.42–0.88). High volume of current leisure‐time physical activity (LTPA) was associated with lower body fat percentage (P for trend < 0.001). When current volume of LTPA increased 1 MET h/week, the risk of MS and NAFLD decreased (OR 0.99, 95% CI 0.98–0.99 and OR 0.97, 95% CI 0.96–0.98, respectively). Although a career as an elite‐class athlete during young adulthood may help to protect from developing metabolic syndrome, present exercise levels and volume of LTPA seem equally important as well.     

Is risk‐taking in talented junior tennis players related to overuse injuries?

Overuse injuries are a serious problem in junior tennis. Gaining insight in age‐specific risk factors can contribute to prevention. The developmental cognitive processes that take place during adolescence make talented players more inclined to take risks. This may be even more pronounced in the high performance culture in which they move. Therefore, this study focuses on the relationship between risk‐taking and overuse injuries in talented tennis players. Seventy‐three talented tennis players (45 boys and 28 girls, age 11–14 years) were monitored for 32 weeks, using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Risk‐taking was measured at the start of the season with the Iowa Gambling Task. Linear regression analyses were executed to predict (a) overuse injuries, (b) time loss overuse injuries and (c) overuse severity, by risk‐taking, exposure time, and injury history. In boys, risk‐taking contributed significantly to time loss overuse injuries [F(1,39) = 7.764, P = 0.008, R² = 0.15] and to overuse severity [F(1,39) = 5.683, P = 0.022, with an R² of 0.13] In girls, time loss overuse injuries [F(1,23) = 6.889, P = 0.018, R² = 0.20] and overuse severity [F(1,23) = 7.287, P = 0.013, R² = 0.24] were predicted by exposure time. Coaches and trainers should be aware that talented male tennis players who are inclined to take risks, are more likely to maintain risky behavioral patterns related to overuse injuries.     

Association between movement patterns and risk of musculoskeletal injuries in navy cadets: A cohort study

ObjectiveTo investigate the association of movement patterns evaluated by the Dynamic Movement Assessment (DMA) with the occurrence of musculoskeletal injuries in navy cadets.DesignCohort study.SettingParticipants were filmed performing the six functional tests of the DMA (deep squat, step up, single-leg squat, hop, plank and side-plank tests).Participants240 navy cadets.Main outcome measurementsDepending on the number of certain movement patterns on the Dynamic Movement Assessment (DMA), participants were classified as high, moderate, medium or low risk of developing injuries. Predictive associations between injuries and risk classification were examined using logistic regression analysis.ResultsConsidering sex, previous injuries and the type of secondary school as covariates, participants who were classified as high risk were not more likely to develop injuries. Non-military high school was an independent risk factor for any injuries (OR = 3.14, 95% CI [1.43,6.91]; OR = 4.57, 95% CI [1.92,10.83]), overuse injuries (OR = 2.58, 95% CI [1.05,6.30]; OR = 2.55, 95% CI [1.06, 6.14]) and acute injuries (OR = 4.88, 95% CI [1.19,19.99]), respectively. Previous musculoskeletal symptoms also increased the chance of AI (OR = 4.45, 95% CI [1.15,17.18]; OR = 5.91, 95% CI [1.13,30.88]).ConclusionsMovement patterns evaluated by DMA are not associated with an increased risk of injuries. However, attendance of a non-military high school and previous musculoskeletal symptoms are associated with musculoskeletal injuries.     

Injury pattern according to player position in Japanese youth handball: A cross-sectional study among 2377 players

ObjectiveAlthough the incidence and pattern of injuries in youth handball have widely been investigated, it is unclear whether the characteristics of injuries differ on the basis of player position. This study aimed at revealing the player position-based injury profile in Japanese youth handball players.DesignCross-sectional.SettingInjury questionnaire.ParticipantsOverall, 2377 participants who played in the 2018 and 2019 Japanese National High School Handball Championships were included.Main outcome measuresPrevalence, body region, type, severity, and mechanism of injuries were collected through a questionnaire.ResultsThe overall prevalence of injury within the previous year was 46.7%, and the proportion of back players (52.8%) who sustained at least one injury was higher than that of players in other positions (p < 0.001). Differences in player positions were found among overuse injuries by body region, with a higher proportion of the lower leg and knee in wings and backs, respectively (p = 0.047). Among traumatic injuries, a higher proportion of ligamentous rupture in backs and fracture in lines were seen (p = 0.011).ConclusionThere were significant differences in the prevalence and patterns of injuries between player positions. Therefore, injury prevention programmes should consider the characteristics of player positions.     

Can orthotic insoles prevent lower limb overuse injuries? A randomized‐controlled trial of 228 subjects

Lower limb overuse injuries are common among people who are exposed to physical stress. Orthotic shoe insoles are widely used to prevent lower limb overuse injuries. Here, we conducted a randomized‐controlled study to examine whether the use of orthotic insoles prevents lower limb overuse injuries. Participants (n=228) were randomly assigned to use (n=73) or not to use (n=147) orthotic insoles. The insoles were molded to the shape of the foot to provide support during physical activity. The main outcome measure in the present study was the physician‐diagnosed lower limb overuse injury. Thirty‐four (46.6%) subjects in the insole group were diagnosed with a lower limb overuse injury compared with 56 (38.1%) in the control group (P=0.29) during the 6‐month study period. When body mass index and the results of a 12‐min running test and muscle strength were adjusted in a Cox's regression model, the hazard ratio for lower limb overuse injury in the insole group was 1.3 (95% confidence intervals: 0.8–2.1) compared with the control group. Use of orthotic insoles was not associated with a decrease in lower limb overuse injuries. Our findings suggest that routine use of orthotic insoles does not prevent physical‐stress‐related lower limb injuries in healthy young male adults.