Epidemiology and pathomechanics of overuse injuries in single figure skating: A systematic review (2020–2026)

Background. Figure skating is a sport characterized by a unique combination of artistic expression and extreme athletic demands. The introduction of the new ISU Judging System in the 2004/2005 season drastically changed the landscape of the sport, promoting the execution of highly scored, multi-rotational jumps. This forces athletes to generate higher vertical velocities, resulting in the absorption of impact forces ranging from 4 to 5 times their body weight on a single lower limb during landing. Combined with early sport specialization, very high training volumes, and the specific, mobility-restricting design of the skating boot, these factors have led to a drastic increase in injury rates, predominantly characterized by overuse injuries. Aim. The aim of this study is to systematize and critically analyze the latest scientific literature from 2020 to 2026 (including fundamental works serving as a historical and biomechanical background) regarding the epidemiology, pathomechanics, and risk factors of overuse injuries in single figure skaters. Results. The results indicate that overuse injuries account for 50% to nearly 70% of all injuries in single figure skating. The most frequently injured areas are the foot and ankle (approx. 29%), knee joint (approx. 19%), and lower back (approx. 15%). Stress fractures and bone stress reactions, including spondylolysis, constitute a significant percentage of diagnoses. The stiffness of the skating boot forces a compensatory transfer of landing forces to the lumbopelvic-hip complex (LPHC). The main identified risk factors include chronological age (the cumulative effect of loading), lack of jump count monitoring, early specialization, and Relative Energy Deficiency in Sport (RED-S).