Most gym injuries do not happen in a dramatic moment. They often start as a strain during a lift, a tweak after a class, a shoulder that complains after pressing, or a lower back that feels different after a heavy session.
A 2024 study in Sports Medicine - Open gives a useful large-scale view of those ordinary training problems. Cuthbertson-Moon and colleagues reviewed 10 years of New Zealand Accident Compensation Corporation claims for gym and fitness-related injuries in people aged 16 to 64.
The study at a glance
- Design: retrospective analytical review of national injury compensation claims
- Source: New Zealand Accident Compensation Corporation gym and fitness injury claims
- Period: July 1, 2011 to June 30, 2020
- Population: people aged 16 to 64 in New Zealand with accepted claims
- Total claims: 345,254
- Total treatment charges: NZ$241,298,275
- Analysis: claims by cause, contact mechanism, region, sex, age, body site, injury type, and free-text accident descriptions
This is not the same as following a group of gym users and measuring every training session. It is a claims-data study. A claim appears when someone seeks care through a registered provider and the injury is accepted by ACC. That makes the dataset large and useful, but it cannot measure the true risk of a squat, deadlift, class, machine, or training plan per hour of exposure.
What kinds of injuries dominated?
Soft tissue injuries made up almost the whole dataset. The study reported 331,343 soft tissue claims, or 96% of all gym and fitness injury claims. These claims accounted for NZ$213,049,197 in charges, or 88% of the total charges reported.
Fractures and dislocations accounted for 4,088 claims, about 1%. Laceration or puncture wounds accounted for 3,424 claims, also about 1%. For everyday athletes, that split matters: the common gym-injury story in this dataset was much more often strain, sprain, tendon, ligament, muscle, or contusion-type trouble than a catastrophic event.
Where did claims cluster on the body?
Among soft tissue claims, four sites accounted for 217,581 claims, or 66% of the soft tissue total. Those sites were not obscure. They were the same areas many lifters and fitness athletes already watch closely.
- Lower back/spine: 81,799 claims, 24%
- Shoulder, including clavicle and shoulder blade: 61,784 claims, 19%
- Neck/back of head/vertebrae: 37,845 claims, 11%
- Knee: 36,153 claims, 11%
The same four areas also carried much of the cost burden: about 76% of soft tissue claim charges. Lower back/spine charges were NZ$57,111,225; shoulder charges were NZ$52,245,523; knee charges were NZ$31,010,754; and neck/back of head/vertebrae charges were NZ$19,125,569.
What movements were most often recorded?
The leading cause category for soft tissue claims was lifting/carrying/strain: 162,598 claims, or 49%. Loss of balance or personal control followed with 57,038 claims, or 17%. Twisting movement accounted for 44,015 claims, or 13%, and being pushed or pulled accounted for 34,413 claims, or 10%.
A second mechanism table told a similar story. Strenuous movement with lifting accounted for 154,467 soft tissue claims, or 47%. Strenuous movement without lifting accounted for 84,469 claims, or 25%. Impact or contact with an object accounted for 39,610 claims, or 12%, and impact/contact with the ground or floor accounted for 25,351 claims, or 8%.
In the free-text descriptions, the most frequent stemmed words were also plain-language gym signals: back, gym, shoulder, lift, low, weight, exercise, press, squat, pull, class, heavy, deadlift, leg, bench, machine, push, and bar.
Who appeared most often in the claims?
Claims were split almost evenly by sex: 175,054 claims in females, or 50.7%, and 170,200 claims in males, or 49.3%. Males had a slightly lower number of claims but higher total charges: NZ$126,470,148 compared with NZ$114,828,127 for females.
The most frequently injured age groups were 26 to 30 years with 53,096 claims and 21 to 25 years with 52,240 claims. That does not necessarily mean those ages are biologically at highest risk. The study did not have complete participation or exposure data, so higher claim counts may partly reflect who was using gyms most often.
What this study can and cannot tell a lifter
The safest interpretation is descriptive. In this national claims dataset, gym and fitness injuries that reached ACC were mostly soft tissue claims, commonly linked to lifting, strenuous movement, and a small group of body sites.
- It can show which injury claims were common in New Zealand during the study period.
- It can show broad body-site and mechanism patterns.
- It can support prevention priorities for gyms, coaches, clinicians, and public health teams.
- It cannot calculate injury risk per training hour because exposure data were not available.
- It cannot tell whether a claim was new, old, or recurrent.
- It cannot confirm exactly what exercise the person was doing at the moment of injury.
- It cannot diagnose the source of pain in an individual athlete.
That distinction matters because athletes often over-read one painful session. A sore back after deadlifts may involve load, sleep, fatigue, warm-up, technique, equipment, previous injury, life stress, or something unrelated to the session. A claims study can remind us what patterns are common, but it cannot replace individual assessment.
What athletes should take from this
The study supports a practical habit: take small changes in body feedback seriously before they become a confusing blur. The lower back, shoulder, knee, and neck were the main claim clusters, so those areas deserve clear notes when they repeatedly appear after training.
- Record the exact zone, not just "back" or "shoulder".
- Note whether the sensation appeared during lifting, after class, later that day, or the next morning.
- Track intensity across several sessions instead of reacting to one isolated workout.
- Pay attention when the same zone returns after similar lifts, loads, ranges, speeds, or fatigue states.
- Seek qualified guidance when pain is persistent, worsening, follows a clear injury, causes weakness or numbness, or changes normal movement.
This is not about becoming afraid of lifting. Strength training has many health and performance benefits. The point is that training data should include body feedback, not only sets, reps, load, and personal records.
From a gym note to a body-map history
A training log often captures what the bar did. It may not capture what the athlete felt, where they felt it, or whether the same area kept returning. That is the gap TENSION is designed to help fill.
With TENSION, athletes can paint the precise lower-back, shoulder, knee, neck, or other body zone on a 3D body map, assign an intensity, save the session, and compare it with previous entries. Over time, that history can make recurring-zone discovery easier and help separate a one-off sensation from a repeated pattern.
- Map the body zone after heavy lifting, new exercises, classes, travel, poor sleep, or return-to-training weeks.
- Use intensity logging to see whether a sensation is settling, stable, or escalating.
- Review history before changing load, volume, exercise selection, or recovery plans.
- Bring clearer body maps to a physiotherapist, doctor, coach, or other qualified professional.
Read the study - Cuthbertson-Moon M, Hume PA, Wyatt HE, Carlson I, Hastings B. Gym and Fitness Injuries amongst those Aged 16-64 in New Zealand: Analysis of Ten Years of Accident Compensation Corporation Injury Claim Data. Sports Medicine - Open. 2024;10:53.
Turn one painful workout into a useful history
Learn why exact location history matters, what to note about training, sleep, fatigue, and recurrence, and how to prepare a clearer professional conversation.
Explore TENSION's 3D body-map pain tracker for athletes