Table 3.

Characteristics of selected studies.

Study	Country	Aims	Status	Sample	Duration	Methodology	Results
Raya-González et al. (2021) [10]	Spain	To analyze the differences in professional handball players’ injury profile according to the team’s competitive-level (i.e., First division vs. Second division).	Elite	53 professional men’s handball players.	2015–2016 and 2016–2017 for the First division league and 2017–2018 and 2018–2019 for the Second division league.	A prospective cohort study (over four consecutive seasons).	No differences were found between the two teams. The second division team presented more injuries during training and a higher injury load than the first division team.
Mashimo et al. (2021) [14]	Japan	To reveal the injury profile based on player position in Japanese youth handball players.	Basic categories	2377 handball players.	Leagues 2018 and 2019.	Cross-sectional. Injury questionnaire.	There were significant differences in injury prevalence and patterns between player positions. The overall prevalence of injuries was 46.7%, with back players sustaining at least one injury higher than players in other positions.
Luig et al. (2020) [17]	Germany	To identify patterns and mechanisms of injury situations in men’s professional handball.	First or second league	1899 handball players.	Seasons from 2010 to 2013 and from 2014 to 2017.	Prospective study Video analysis	Contact injury is the most common, with wingers and pivots being the most affected. The most commonly injured areas are: knees (28.8%), ankles (20%), hands (11.7%) and thighs (9.5%). Injury risk is highest in the last ten minutes of each half of the game.
Asker et al. (2020) [15]	Sweden	To investigate whether players of both genders with shoulder muscle weakness, range of motion (ROM) rotation deficits, scapular dyskinesia in pre-season had a higher rate of new shoulder injuries compared to players without these characteristics.	Elite	452 handball players.	Season 2014–2015.	Prospective cohort study. The following were measured: shoulder strength, isometric external rotation, isometric internal rotation and eccentric rotation. Isometric abduction strength and scapular dyskinesia. OSTRC questionnaire on a weekly basis.	In the women handball players, an association was found between weakness between isometric external rotation and isometric internal rotation and the risk of injury. Association between scapular dyskinesia during glenohumeral abduction and risk of shoulder injury in the men handball players.
Goes et al. (2020) [16]	Brazil	To describe the prevalence and identification of factors associated with musculoskeletal injuries, including tendinopathy and joint and muscle injuries.		82 handball players Age: 25.2 years.	March 2018 to December 2018.	Cross-sectional observational study. Self-reported questionnaire.	Muscle injuries had the highest incidence followed by joint injuries and tendinopathies.
Palmer et al. (2021) [18]	International 131 countries	To describe the self-reported prevalence and nature of Olympic-career injury and general health and current residual symptoms in a self-selected sample of retired Olympians.	Retired Olympic	3357 retired Olympians.		Injury questionnaire.	Injury prevalence was highest in handball (82.2%).
Asai et al. (2020) [19]		To examine the incidence, type, and location of acute injuries in Japanese young handball players during national competition.	Basic categories	169 injuries were reported.	550 games from 2013 to 2018, held in March of each year.	Retrospectively assessed injuries.	The incidence of injuries in girls was lower than in boys. The greatest number of injuries were in the lower extremities, with the ankle being the most frequent. No statistical differences were found in the incidence of injuries by specific position
Florit et al. (2019) [21]	Spain	To describe the incidence and severity of tendinopathy in a multi-sport club with professional and youth teams.	Professionals and non-professionals	839 players (age: 8–38 years).	8 seasons (2008– 2016).	A retrospective epidemiological study. Classification with the Orchard Sports Injury Classification System (OSICS).	5.2% of professional players and 2.7% of young players had shoulder tendinopathy.
Ruehlemann et al. (2019) [20]	Germany	To objectively assess measures of knee joint stability with an established test battery in non-elite handball.	Non elite	165 handball players Age: 24.3 years.	-	Questionnaire. Battery of tests to measure balance, agility, speed and strength.	The data obtained can be used for an objective assessment of the functionality and stability of the knee.
Asker et al. (2018) [2]	Sweden	To assess the prevalence of shoulder problems among adolescent elite handball players to investigate possible differences in gender, school grade, playing position and level of play.	National and regional	471 handball players Age: 16.4 years.	Seasons 2014–2015 and 2015–2016.	Prospective cohort study. Baseline questionnaire and a modified Swedish version of the OSTRC.	Higher incidence of injuries in men and women front-line players, especially in the women.
Von Rosen, et al. (2018) [26]	Sweden	To describe injury patterns in terms of type: location, prevalence and incidence, recurrence and severity; time to first injury, in adolescent athletes and to compare differences in injury data by gender and sport type.	Elite	42 handball players Age: 17 years.	52 weeks.	Prospective cohort study. Weekly questionnaire (OSTRC and other questions). Injury history questionnaires (Questback online survey).	The most common and most severe injury was in the knee (17.2%). Most injuries occurred during competition and with no significant differences between genders.
Aasheim et al. (2018) [1]	Norway	To record overuse injuries among junior men players over the course of a handball season.	Elite	145 handball players Age: 17 years.	10 months.	Prospective cohort study. Baseline questionnaire. OSTRC questionnaire	Incidence of overuse injuries in young men particularly in the shoulder (higher average prevalence) and knee (higher relative load).
Aman et al. (2019) [24]	Sweden	To examine acute injuries in licensed floorball, football, handball and ice hockey players of all ages. To identify the most common and severe injuries at each body location and recommend average injury prevention.	Sportsmen and women from the Swedish Sports Confederation.	Total number of licensed players in the country.	From 2006 to 2015.	Observational study	The most common injury in both sexes is sprained/broken knee injury, followed by hand/finger fracture.
Oshima et al. (2018) [25]	Germany	To research the relationship between static balance and the incidence of non-contact anterior cruciate ligament injuries in high school athletes.	Handball at school	104 handball players Age: 15 years.	From April 2009 to 2011.	Prospective study. Postural sway is measured with a Gravicorder GS-31). Anthropometric data are collected.	Poor static balance may be a risk factor for non-contact ACL (anterior cruciate ligament) injury. Balance training effective in the prevention of ACL injuries in women.
Tabben et al. (2019) [23]	France	To study the association between players, characteristics, technical components of the game and the risk of injury during the men’s matches at the 2017 World Handball Championships.	Elite	387 handball players Age: 27.3 years.	11 to 29 January 2017.	Exploratory study An IOC injury and illness surveillance protocol using a methodology adapted for handball.	Most affected body parts in the men are: ankle, head/face, knee and thigh. Players more likely to be injured in front row. Older players at higher risk of injury than younger players.
Mónaco et al. (2019) [22]	Spain	To estimate the influence of position, category and maturity stages on the incidence and pattern of injuries in handball players.	Elite	164 handball players Age: 15.5 years.	Seasons 2011–2012 and 2012–2013.	Cohort study. Medical examination. Classification of injuries using OSICS-10.	In men, the most frequently injured areas are the ankle, knee and thigh. Most common injuries are ligament/joint sprains and muscle strains. The second line has higher risk of knee injury. Incidence is higher in matches than in training.
Møller et al. (2017) [29]	Denmark	To research whether an increase in handball load is associated with higher rates of shoulder injury compared to a smaller increase or decrease, and whether the association is influenced by scapular, isometric shoulder control.	Elite	679 handball players Age:16 years.	31 weeks 13 October 2013 to 11 May 2014.	Cohort study. Assessment of isometric shoulder rotation, abduction strength, ROM and scapular control at baseline and mid-season. Injury monitoring by SMS, telephone and the medical examination surveillance system (SPEx).	The number of injuries increased with a 60% increase in training load. Scapular dyskinesia and reduced rotational strength increased the risk of shoulder injury with a 20% increase in training load.
Rafnsson et al. (2017) [30]	Iceland	To examine the incidence, type, location and severity of injuries in Icelandic elite handball players and compare across factors such as physical characteristics and playing position.	Elite	109 handball players Age: 23.4 years.	Season 2007–2008.	Prospective cohort study	A high number of acute injuries, mainly in the lower extremities. The most frequent areas of injury were the lumbar region or pelvis, the knee, shoulders and sprains. Sixty-four percent of the injuries were non-contact. Higher incidence of injuries in goalkeepers, followed by fullbacks and forwards.
Andersson et al. (2018) [27]	Norway	To assess whether previously identified risk factors are associated with the overuse of shoulder injuries in men and women players.	Elite	329 handball players.	From October 2014 to March 2015.	Prospective cohort study. Baseline questionnaire. Measurement of external rotation, internal rotation and ROM, isometric strength of internal and external rotation on the dominant side. Measurement of scapular control. Recording of shoulder problems through the OSTRC.	A possible risk factor for overuse shoulder injury was identified as gender. The women had a higher prevalence of shoulder problems.
Åman et al. (2018) [28]	Sweden	To identify which injuries to focus prevention efforts on in order to have a significant impact on reducing acute injuries nationally.	National level	130,573 handball players.	2006–2013.	Data collected from the Swedish insurance company Folksam.	Increased internal rotation ROM was significantly associated with overuse shoulder injury.
Aman et al. (2016) [32]	Sweden	To identify high-risk sports with respect to reported acute injury incidence and injury severity in 35 sports.	National level	All ages.	2008 to 2011.	Insurance company details.	Upper and lower extremities were at high risk of injury and trunk/back at minimal risk in both genders. Lower extremities had a higher proportion (higher risk in women) compared to upper extremities.
Bere et al. (2015) [33]	Qatar	To describe the pattern of injuries and illnesses at the 2015 Men’s Handball World Championship.	Elite	384 handball players.	From 15 January to 1 February (18 days).	Internal Olympic Committee (IOC) surveillance system.	Lower extremities accounted for 58.3% of injuries (mainly ankle, thigh and knees). Of the injuries, 61.4% were contact injuries and more frequent during the second part of the first half. Highest incidence of injury to players on the 6-m line, followed by wingers, front row and goalkeepers.
Giroto et al. (2017) [31]	Brazil	To investigate the incidence and risk factors for handball injuries in elite Brazilian handball.	Elite	339 men and women handball players Age: 23.4 years.	From May to November 2011	Prospective cohort study. Baseline questionnaire.	The most common injuries of traumatic origin were ankle and knee. The most common overuse injuries were shoulder and knee. Tendinopathy was the most recorded. The majority of injuries, were of moderate severity (2–7 days).
Clarsen et al. (2015) [34]	Norway	To describe the extent of overuse problems in five different sports.	Elite	55 handball players.	13 weeks	Prospective cohort study. Weekly questionnaire.	High incidence of overuse injury in the knee and shoulder.
Clarsen et al. (2014) [35]	Norway	To determine whether rotator cuff strength, glenohumeral joint range of motion and scapular control are associated with shoulder injuries.	Elite	206 handball players Age: 24 years.	S30 weeks.	Prospective cohort study. Baseline questionnaire. Glenohumeral internal and external rotation was measured. ROM was measured. Isometric strength of internal and external rotation and abduction. Assessment of scapular control. OSTRC questionnaire.	Internal risk factors associated with shoulder injury.
Engebrestsen et al. (2013) [5]	England	To analyze injuries and illnesses that occurred at the London 2012 Olympic Games.	Elite	349 handball players.	24 July to 12 August 2012.	IOC injury and illness surveillance system. Daily reporting of injuries in a standardized way.	A greater number of injuries have occurred during competition than during training. Women players had a total of 26.3% injuries with 5.8% with injuries with more than 7 days lost. Men players had 17.4% of injuries with 3.4% with injuries with more than 7 days lost.
Moller et al. (2012) [3]	Denmark	To assess the incidence of injuries in elite handball and whether gender and previous injuries are a risk factor for new injuries.	Elite	517 handball players Ages: Under 16 and under 18.	From September 2010 to April 2011.	Cohort study. Baseline questionnaire. Weekly injury.	Most injuries were traumatic in origin and the remainder were from overuse. Sixty-five per cent of the injuries were new and 35% were recurrent. For the U16 group a previous injury was a significant risk factor for injury. Moderate injuries had the highest incidence.