Increased injury rates after the restructure of Germany’s national second league of team handball

Scientific injury data in men's professional team handball injuries are rare and even less scientific information exists on injury prevention. In 2011, Germany's national second team handball league was restructured by merging the existing two regional leagues into one league. This study evaluates the injury patterns in professional team handball and compares the injury rates between the first and second league before and after the restructure. All players of Germany's national first and second men's team handball leagues have mandatory trauma insurance with the same insurance company. This retrospective cohort study analysed the injury data of three consecutive seasons 2010-2013 using standardized injury definitions. 1194 professional team handball players were included in this study. The majority of severe injuries affected the lower extremities, shoulders, and hands. The average injury incidence significantly differed between the first (4.9 injuries per 1000 h) and the second league (3.9 per 1000 h, p < 0.01). The injury incidence in the restructured second league had increased from 3.7 to 4.1 per 1000 h (p < 0.01) and prevalence from 67.1 to 79.3% (p < 0.001), thus almost to the same levels of the first league. The second league showed more time-loss injuries at all severity levels. This study yielded a high injury incidence after the restructure of the national second team handball league and presents details on prevalence, incidence, and patterns of injury in professional men's team handball. This study is an important basis for developing injury prevention strategies that should focus on the shoulders, hands, and lower extremities and on reducing the number of matches and travel burden. III