Epidemiology of injuries and injury burden in artistic swimmers: a longitudinal prospective study

Abstract Background Artistic swimming is a highly demanding sport, both physically and mentally, which, combined with the high training volume associated with this activity, generates a significant risk of injury. The objective of this study was to analyse the incidence, characteristics, and injury burden in female artistic swimmers. Methods The sample consisted of 390 unique swimmers (121 followed across both seasons; 511 athlete-seasons) classified into four age categories: U12 (< 12 years; n = 215), U16 (12–14 years; n = 102), U19 (15–18 years; n = 33), and Senior/Master (≥ 19 years; n = 40). Injuries were monitored and recorded in four clubs over two seasons (2023–2025) and in two clubs over one season (2024–2025). Results A total of 70 injuries were recorded in 65 swimmers. In the U12 category, 24 injuries were recorded (incidence: 0.23 injuries/1,000 h [95% CI 0.15–0.34]; injury burden: 8.49 days lost/1,000 h). In the U16 category, 26 injuries were recorded (incidence: 0.42 injuries/1,000 h [95% CI 0.27–0.61]; injury burden: 8.00 days lost/1,000 h). Inthe U19 category, 13 injuries were recorded (incidence: 0.70 injuries/1,000 h [95% CI 0.37–1.20]; injury burden: 18.00 days lost/1,000 h). In the Senior/Master category, seven injuries were recorded (incidence: 1.18 injuries/1,000 h [95%CI 0.47–2.44]; injury burden: 29.61 days lost/1,000 h). Most of the injuries were caused by non-contact mechanisms (80.0%). The lower limbs were the most affected region (45.7%), with the knee being the most frequently affectedlower-limb site (U12: 0.04 injuries/1,000 h; U16: 0.06 injuries/1,000 h; U19: 0.11 injuries/1,000 h; Senior/Master: 0.34 injuries/1,000 h). Muscle and tendon injuries were the most frequent injury type in the U12 category (37.5%), whereasjoint and ligament injuries predominated in the Senior/Master category (42.9%); both types were equally frequent in the U16 (23.1%) and U19 (30.8%) categories. The injuries with the highest injury burden were knee sprains and shoulder fractures. Conclusions The findings of this study suggest that preventive strategies should particularly consider the most common diagnoses observed, namely non-contact injuries, sprains, and muscle strains/tears/ruptures.