Epidemiology of Match-Related Injury Events in French Handball: A One-Season Nationwide Cohort Study Across 323 628 Players.

Nationwide data on match-related injuries in handball remain limited. This study described injury-event epidemiology during one French handball season and examined injury patterns according to sex, age, competition level, and timing within the season. This nationwide cohort study included all licensed players participating in official championship matches. An injury event was operationally defined as any physical complaint occurring during a match, including warm-up, and recorded in the electronic match report, irrespective of medical attention or time loss. Seasonal prevalence of players with at least one recorded injury event and injury incidence rates per 1000 athlete-exposures (AEs) were calculated. Poisson regression estimated incidence rate ratios (IRRs) with 99% confidence intervals (CIs). Among 323 628 players participating in 177 279 matches, 78 147 injury events were identified. Overall, 16.2% of players reported at least one match-related injury (female: 19.1%; male: 14.7%), with the highest proportion observed among players aged 22-26 years in both sexes. Overall incidence was 23.5/1000 AEs (99% CI 23.3-23.7). Injury incidence was higher in female than male players at each competition level (IRRs 1.21-1.32) and increased from departmental to national competition. A significant sex-by-competition-level interaction was observed (p < 0.001), with the larger female-to-male difference supported primarily at national level. The foot/ankle (19.8%), knee (15.5%), hand/wrist (15.2%), and head/neck (14.6%) were the most frequently reported anatomical locations. Weekly incidences varied across the season, with peaks in October, February, and April. These findings provide nationwide estimates of match-related injury event patterns and may inform targeted surveillance and prevention strategies.