Injury prevention and athlete health-risk management in freestyle wrestling: a scoping review of direct and transferable evidence

Abstract

This scoping review mapped direct evidence on injury prevention and health-risk management in freestyle and other Olympic-style wrestling and distinguished it from cautiously transferable evidence. Following PRISMA-ScR, PubMed, Web of Science Core Collection and Scopus were searched for records published from 1 January 2021 to 14 May 2026. A post hoc source-role audit separated wrestling-specific from contextual sources, and findings were narratively synthesised. Eighteen direct and 41 contextual sources were included: five surveillance studies, seven studies of screening, monitoring or performance proxies, one preventive-intervention trial and five health-risk studies. Surveillance definitions and denominators varied, and most screening studies did not prospectively assess injury prediction. In male cadet freestyle wrestlers, Wrestling+ recorded 20 injuries versus 30 in controls, although inconsistent effect estimates limit interpretation. Standardised surveillance is needed, and Wrestling+ may merit consideration in comparable populations; evidence for screening, health-risk management and implementation remains insufficient.