A Cross-Sectional Survey of Musculoskeletal Injuries in South African Shotokan Karate

<b>Objectives:</b> This study investigated the prevalence and severity of musculoskeletal injuries within South Africa’s most popular karate style, Shotokan, a previously unexamined area. As an exploratory study, it aimed to generate hypotheses by determining the prevalence, severity, and nature of these injuries to address this significant gap in the national combat sports literature. <b>Methods:</b> A descriptive, cross-sectional design was employed, utilizing a confidential online questionnaire distributed through various Shotokan organizations. The study gathered 155 responses (26.85% response rate). <b>Results:</b> The findings revealed a high injury prevalence, with 47.3% of participants reporting at least four injuries. These injuries occurred equally in training and competition (56.5%) and developed both acutely and over time (53.4%). Experienced practitioners at the Shodan level were particularly affected. The knee was the most frequently injured body part (11.6%), and muscle strains were the most common injury type (19.3%). Notably, 26.2% of karatekas continued training despite being injured. A significant weak positive correlation was found between years of training experience and injury levels (rs = 0.275, <i>p</i> = 0.007). However, no significant associations were found between injury prevalence and age, BMI, or training frequency. General practitioners were the most consulted healthcare professionals (22.0%). <b>Conclusions:</b> This study establishes a high prevalence of musculoskeletal injuries among South African Shotokan karatekas, particularly associated with experienced practitioners. These findings are hypothesis-generating, and the cross-sectional design precludes causal inferences. The data provides a crucial foundation for future longitudinal research to investigate causality and for developing evidence-based injury prevention protocols, particularly for the knee.