Efficacy of exercise interventions in injury prevention for track and field athletes: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Track and field athletes are at high risk of both acute and overuse injuries, with an incidence ranging from 1 to 30 injuries per 1,000 athletic exposures, due to the diverse biomechanical demands of events like overuse injuries in distance runners, traumatic injuries in jumpers, and upper-limb injuries in throwers. Exercise-based interventions have demonstrated injury-preventive effects in other sports; however, their effectiveness in athletics remains unclear. OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effectiveness of exercise-based interventions in preventing sports injuries among track and field athletes by conducting a comprehensive search of PubMed, Web of Science, Scopus, and SPORTDiscus for articles published between 2012 and 2025. The final search was performed on January 1, 2025. METHODS: A total of 2410 records were retrieved and 10 randomized controlled trials met the inclusion criteria. Studies involving track and field athletes (P) exercise-based injury prevention interventions (I) compared with a control group (C) reporting injury incidence risk or rate (O) and employing an RCT design (S) were included. Study quality was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4 employing a random-effects model to calculate pooled rate differences with 95% confidence intervals. Study quality was evaluated using the Physiotherapy EvidenceDatabase scale and the Cochrane Risk of Bias 2 .0 tool to assess methodological rigor and potential bias. RESULTS: Ten RCTs were included. Interventions included strength training, neuromuscular training, gait retraining, and flexibility or conditioning programs. Only six trials reported statistically significant reductions in injury incidence. Meta-analysis of three eligible studies showed a significant reduction in injury incidence in the intervention group compared to controls (mean difference: -7.63 injuries per 1,000 h; 95% CI: -12.07 to -3.20; p = 0.0007; I² = 88%). Only three studies were eligible for meta-analysis due to consistent outcome reporting in injuries per 1,000 exposure hours. CONCLUSION: Exercise-based interventions, particularly strength, neuromuscular, conditioning, flexibility, and gait retraining programs, show moderate-to-strong evidence for reducing injury incidence among track and field athletes. REVIEW REGISTRATION: PROSPERO registration number CRD420251083247.