Effects of the wrestling + injury prevention program in freestyle wrestlers: a two-arm randomized controlled trial

J Orthop Surg Res. 2025 May 19;20(1):486. doi: 10.1186/s13018-025-05911-z.

Abstract

Background: To assess the effectiveness of the Wrestling + injury prevention program on incidence of injuries, neuromuscular mechanisms and dynamic balance of freestyle (FS) wrestler.

Methods: The participants of this study consisted of FS wrestling players in Qom province (Iran). A total of 80 participants were assigned to this study and using simple and random method with computer divided into experimental (EXP, n = 40) and control (CON, n = 40) groups. The groups were blinded against each other. The follow-up period was one season (6 months). EXP replaced their warm-up by Wrestling + program. CON performed a standard warm-up program. The primary outcome was the injury incidence density (injuries per 1000 h of wrestling exposure), compared between groups by incidence rate ratios (RR). Also, the secondary outcome was neuromuscular mechanisms and dynamic balance.

Results: The per-protocol analysis showed a reduction of the overall injury incidence density in the EXP group by 58% compared to the CON group. Additionally, within-group analyses revealed significant improvements in neuromuscular mechanisms and dynamic balance for both the EXP and CON groups following 24 weeks of warm-up programs (p < 0.05). Furthermore, between-group comparisons indicated significant differences favoring the EXP group relative to the CON group (p < 0.05).

Conclusion: The Wrestling + program is effective in reducing injuries among FS wrestlers with overall injuries reduced by 58%. Moreover, the results indicate that the Wrestling + program is more effective than traditional warm-up routines in improving neuromuscular mechanisms and dynamic balance among FS wrestlers. Therefore, it is recommended that coaches use a Wrestling + program to reduce the incidence of injury in FS wrestlers.

Keywords: Athletic injures; Dynamic warm-up; Neuromuscular mechanisms; Primary prevention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Athletic Injuries* / epidemiology
  • Athletic Injuries* / prevention & control
  • Humans
  • Incidence
  • Male
  • Postural Balance / physiology
  • Warm-Up Exercise* / physiology
  • Wrestling* / injuries
  • Wrestling* / physiology
  • Young Adult