Physiotherapy Training Protocols, Musculoskeletal Injury Patterns, and Rehabilitation Strategies in Competitive Roller Skaters: A Systematic Review

Abstract

Background: Competitive roller skating includes a variety of different disciplines: figure (artistic) skating, short-track and inline speed skating, roller derby, and roller hockey, each with unique mechanical demands on the musculoskeletal system.Although there has been rapid expansion in the number of athletes involved, injury epidemiology and the evidence base for physiotherapy-led training and rehabilitation of these athletes is fragmented.Objective: To make a systematic review of the literature for musculoskeletal injury patterns, physiotherapy training protocols and physiotherapy rehabilitation strategies in competitive roller skaters.Methods: :PubMed/MEDLINE, Scopus, SportDiscus, Web of Science and the Cochrane Library were searched using PRISMA 2020 guidance since inception to January 2026".Only studies reporting injury data, training or rehabilitation outcomes of competitive skaters that were observational or interventional were accepted.The methodological quality was assessed with the Newcastle-Ottawa Scale and the PEDro scale.Results: 28 studies (n≈5,900 skaters) were included.The prevalence of injuries in a competitive season varied between 47% among artistic skaters and 64-65% among speed skaters, with the most common injuries among the various disciplines being knee injuries, ankle/foot injuries, and lumbar spine injuries; while the most common injuries in the derby and "recreational contact" context were injuries of the upper limbs, especially fractures and concussion.Neuromuscular, balance and strength based physiotherapy programmes were shown to consistently improve balance, agility and skating specific performance and there is robust evidence in their favor which relates to the reduction of lower limb injury.Result: The incidence of injury in competitive roller skating is high and discipline specific.The most evidence-based and promising multicomponent NMT and structured, criterion-based rehabilitation is needed, but there is a lack of prospective trials in the various disciplines.