We found that the overall injury incidence in golf is 2.5 per 1000 full rounds (18 holes) of golf. The highest injury incidence was observed in special athletes, then professionals, and the lowest incidence was among amateurs. Men and women did not show evidence of a difference in injury incidences. Overall, the injury incidences were relatively low in all categories, which makes golf a safe sport in general.

Based on our knowledge and systematic search, this is the first systematic review to present pooled injury estimates per exposure time in golf. Previous studies have presented the injury epidemiology regarding the types of injuries in golf very well, but statistical synthesis that would have notified exposure time has been lacking. The pooled injury incidence of 2.5 per 1000 full rounds ranks golf among sports with low injury incidence [7]. This injury estimate also turns to 1 injury per 400 full rounds of golf or an injury incidence of 0.6 per 1000 h. Thus, this makes golf a relatively safe sport for everyone, regardless of age and fitness. This is important, as golf has been shown to improve cardiovascular health, mental health, and balance especially in the elderly population. These potential benefits are achievable without an increased injury risk. As golf is a growing sport, it is vital to have reports on the injuries to better guide athletes, trainers, and policymakers in their decisions.

It was unsurprising that professionals had higher injury incidence than amateurs, as this has been reported in other sports (ice hockey, rugby, tennis, etc.) as well [26,27,28]. A possible explanation for the higher incidence in professionals could be better documentation of injuries, higher intensity of training, and competition. Furthermore, previous reports have described that special athletes have higher injury incidences than professional athletes without disabilities [29, 30]. Males have been reported to have more injuries in team sports than women [31]. Previous reports in individual sports have reported similar injury incidences between men and women [32, 33]. In our current review, we did not find evidence of a difference in golf injuries between men and women.

This systematic review was performed according to the pre-defined protocol, and we did not have protocol deviations. Furthermore, this is the largest and first report to provide the pooled injury incidence estimates in golf. We were able to include one study to focus on special athletes, which can be seen as a strength, as sports research has had minimal reporting in general on disabled participants [34].

A clear limitation is the limited number of publications included in this review as only seven studies were eligible. Furthermore, the injury definitions varied between the studies, and thus, this caused heterogeneity in the estimates. Furthermore, there were issues with the risk of bias assessment as the included studies did not control for possible confounders in their analyses, and the presented injury estimates were not age-adjusted or adjusted with injury history. One of the included studies was a retrospective questionnaire and one was prospective but only one questionnaire about the injuries was fulfilled after 12 months of follow-up; thus, both studies have a high risk of recalling bias, and the presented injury estimates may be underestimates rather than overestimates. Another limitation was the lack of injury mechanism. Furthermore, only two of the studies presented handicaps, which was raised as important background information in the recent consensus statement [16]. A further limitation is that the studies were conducted all in high-income countries and in three regions (North America, Europe, Asia, and Australia). Thus, these results may not be generalizable to minorities or to middle- and low-income countries, as golfers seem to have backgrounds with higher socioeconomic status and educational levels [35].

More research is needed in all levels of play and age and genders to have better injury incidence estimates in golf. Future research should better attempt to control possible confounders and present age-adjusted injury estimates. Reporting of injury mechanisms would further strengthen the analyses of injury burden in golf.

The incidence of injuries while playing golf is 2.5 per 1000 full rounds (18 holes). The highest incidence was observed among special athletes. Professionals have a higher incidence than amateurs. Men and women seem to have similar incidences. Thus, it seems that the injury rate in golf is low, although more and better quality evidence is needed to better inform athletes, trainers, and policymakers.