Landing mechanics as a predictor of lower extremity injury risk in elite female wrestlers: A prospective study

This study aimed to investigate the relationship between landing mechanics and lower extremity injury risk in elite female wrestlers. Considering the biomechanical requirements of wrestling, we hypothesized that elevated LESS scores would correspond to an increased injury risk. A prospective cohort study was conducted with 47 elite female wrestlers from the Turkish national team. Before the competitive season, participants underwent a standardized jump-landing assessment, and LESS scores were recorded. Injury occurrences were monitored throughout the two seasons. We conducted a Receiver Operating Characteristic (ROC) curve analysis to establish the optimal LESS cut-off value for predicting injury occurrence. The relationship between LESS scores and injury risk was evaluated using Pearson’s Chi-square and Fisher’s exact tests. The optimal LESS cut-off score was identified as 5.5 (AUC = 0.683, p = 0.025), with a sensitivity of 71.43% and specificity of 65.38%. Athletes with LESS scores >5 demonstrated a significantly higher injury incidence (p = 0.012). Notably, among the 21 athletes with LESS scores above the cut-off value, 15 experienced injuries. An increased risk of lower extremity injury was observed in elite female wrestlers exhibiting higher LESS scores. These findings highlight the importance of LESS as a screening tool for injury prevention strategies. Future studies should explore targeted neuromuscular training programs to enhance landing mechanics and reduce injury risk.