The role of genetic and epigenetic factors in sports-related muscle, bone, and brain injuries

Understanding how genetic and epigenetic factors influence predisposition, susceptibility, protection, severity, and recovery potential in sports-related muscle, bone, and brain injuries is gaining increasing attention, as these injuries represent a major concern for athletes' health and performance. This narrative review explores the role of specific genetic variants, such as those in <i>ACE, ACTN3, AMPD1, VDR,</i> and <i>APOE</i>, in predisposing athletes to injury. In parallel, the emerging role of microRNAs, including miR-21, miR-133a, miR-208a, and miR-214 in regulating gene expression related to muscle regeneration, inflammation, and neuroprotection, is highlighted. These small noncoding RNAs are influenced by environmental stimuli such as sports activity and training, and may serve as promising biomarkers for injury risk and recovery. This review is based on a narrative approach, involving targeted literature searches in databases such as PubMed, Scopus, and Web of Science, with no restrictions on language or publication date. Articles were selected based on relevance using predefined keywords and were categorized by injury type (muscular, bone, and concussion-related). However, several limitations remain, including population heterogeneity, small sample sizes, and the lack of functional validation of identified variants, which currently limits their clinical application. Ethical considerations surrounding the use of genetic data in athletes also need to be addressed. In the future, better integration of multiomic data could support the development of personalized and ethically sound strategies for injury prevention and athlete care.