Qin et al. 2025, ACWR and sports injury risk: systematic review and meta-analysis

This meta-analysis of 22 single-arm cohort studies found a statistically significant positive association between ACWR values and injury occurrence, with a pooled overall injury incidence of 0.72 (95% CI 0.60–0.82), and subgroup analysis showed the 0.8–1.3 range associated with the lowest injury incidence (56%) across the included studies. The authors conclude that while elevated ACWR (above approximately 1.3) carries meaningful predictive signal, the ratio’s utility is constrained by the methodological limitations identified in the wider literature. Evidence is moderate.