Abstract
Objectives: 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. Methods: 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). Results: 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, p = 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%). Conclusions: 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.