Kabaddi Injuries: ACL Tear, Shoulder Instability and Ankle Sprain

Kabaddi combines high-speed pivoting with unpadded grappling and multi-player tackles. Three presentations account for most of the clinical work. However, the injury pattern is closer to collision sport than court sport, and that shapes both what you assess and what you can realistically promise from prevention.

What are the Most Common Kabaddi Injuries?

The literature is thin and mostly cross-sectional, so treat these figures as indicative rather than settled. A recent literature review summarises the pattern, and the following injuries are reported the most:

• Knee injury: The most injured lower-limb site at roughly 19 to 21%, with ACL tear the most common diagnosis in a series of 76 Indian players presenting with knee injury
• Shoulder injury: The most injured upper-limb site, at around 21% of upper-limb injuries
• Ankle sprain: Roughly 13 to 14% of injuries, typically sustained during tackles

The mechanism profile matters as much as the sites. In the published knee series, 72.4% of injuries were contact injuries and 88.2% occurred during matches rather than training. That contact-dominant profile is the key difference from football or basketball, and it limits how much primary prevention you can offer.

Knee Ligament Injury

Grappling applies valgus and rotatory load to a planted limb, so expect combined patterns rather than isolated ACL tears and screen the whole knee.

Assessment

• Ligament testing: Lachman and pivot shift, then a full collateral and posterolateral corner examination
• Meniscal testing: With attention to the lateral meniscus, which appears over-represented in kabaddi
• Effusion: Timing of onset, and any history of haemarthrosis
• Extension deficit: May indicate a displaced meniscal tear rather than guarding

Physiotherapy management

• Late presentation is the norm, with a mean delay of 14.4 months in the published series, so expect secondary meniscal or chondral damage
• Criterion-based progression with quadriceps symmetry as the priority, not calendar milestones
• Strength and hop symmetry above 90% before running, cutting and contact progressions
• Reintroduce contact and grappling last, as a distinct rehabilitation phase
• Given the high-pivot, high-contact profile, added rotatory control such as lateral extra-articular tenodesis may be discussed surgically, which is a conversation to support rather than pre-empt

Tip: Progress on criteria, which should include quadriceps symmetry, hop symmetry above 90%, and tolerance of graded contact before full grappling.

Traumatic Shoulder Instability

Forced abduction and external rotation while the raider's arm is held, or a fall onto an outstretched arm during a tackle.

Assessment

• Instability testing: Apprehension and relocation, plus load-and-shift to establish direction
• Hypermobility: Generalised joint hypermobility, which changes the prognosis
• Neurological screen: Axillary nerve involvement, which is easily missed acutely
• Injury history: Number of prior events, the strongest predictor of further instability

Physiotherapy management

• Progressive rotator cuff and scapular strengthening, loaded through range rather than at low level
• Build external rotation strength at end of range, where the tackle mechanism loads it
• Restore control in the apprehension position gradually, under supervision
• Counsel honestly on recurrence, since a systematic review of 1,310 athletes found a pooled recurrence rate of 54.7% after non-operative management, with only 51.5% returning to pre-injury level
• Raise surgical referral early in young contact athletes rather than after a third event

Lateral Ankle Sprain

Usually a defender grasping the ankle during a kick or roll, or the raider dragged down mid-stride.

Assessment

• Imaging: Ottawa Ankle Rules, with a lower threshold than in court sport given the higher-energy mechanism
• Palpation: ATFL, CFL, syndesmosis and fifth metatarsal base
• Injury pattern: Consider rotational and syndesmotic injury, since ankles are grasped and twisted rather than simply rolled

Physiotherapy management

• Early protected loading, then progressive calf and peroneal strengthening
• Balance and reactive control continued past symptom resolution
• Rebuild tackling and evasion tasks before clearance

Before You Clear a Player

Kabaddi asks for pivoting on a planted limb, shoulder loading at end of range and repeated contact under fatigue, so clearance should rest on strength and hop symmetry, tolerance of graded grappling as a distinct phase, and the player's confidence in the injured limb. Because most injuries are contact-related and match-based, the achievable gains sit in preparation and secondary prevention rather than primary prevention, and that 14-month median delay to presentation is itself a modifiable problem worth raising with players and coaches.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC12082175/ https://brieflands.com/journals/asjsm/articles/13314 https://www.sciencedirect.com/science/article/abs/pii/S0949328X26000025 https://pubmed.ncbi.nlm.nih.gov/37200329/