Conditions · Fencing injuries

For fencers, parents and coaches — why fencing injuries follow a pattern, and what to do about it.

Written by Hiro Nakano, DC, DACBSP · USA Fencing medical staff · Last updated November 13, 2026

A diagnosis from your history and an exam of the whole body — not just the spot that hurts. When imaging would change the plan, I order X-rays or MRI directly. Then why that spot took the load: the part a standard protocol skips.

How I work →

Hands-on care is the core of my work, learned in our family’s clinic in Japan, opened in 1926, and the same approach I use with USA Fencing’s national team. I choose the method and pressure from that day’s exam, then recheck your lunge and recovery right after treatment.

My background →

Rehab for fencers shares the same goals, so the exercises often look alike. What I adjust for you is the cue, the focus and the timing — built around your training week, recorded on your phone, and updated at each visit.

Your first visit →

The tip of a fencing blade is often called the second-fastest moving object at the Olympics, after a bullet.^[5] But in my experience, the injuries don’t come from the blade — they come from the legs that drive it.

Fencing asks the body to repeat the same asymmetric movement thousands of times. The lunge, the recovery, the push-off — always the same leg forward, always the same arm holding the weapon. Because the movement is fixed, the injuries follow a fixed pattern too. For most fencers, the question is not whether something will start to hurt, but where and when.

The research tells the same story from two sides. At USA Fencing national events, injuries that forced a fencer to withdraw were rare: about 0.3 per 1,000 bouts, across more than 78,000 competitors.^[6] Yet in a 2026 survey of adult competitive fencers, about 89% of those who responded had been injured at some point. Most of those injuries came from overuse, most happened in training rather than at competitions, and the more years someone had fenced, the more injuries they tended to have.^[7] In other words, fencing injuries rarely happen on the strip at Nationals. They build up quietly in practice.

A personal thank-you here: that survey was led by Kat Holmes, a three-time Olympian in épée who is now a doctor herself. Thank you, Kat. Fencing has never had much research of its own, and it means a lot that the questions are now coming from one of our own.

A confession: I’ve never fenced. I got into the sport almost by chance, through Dr. Jeremy Summers, a former national team sabre fencer who led USA Fencing’s sports medicine program for nearly a decade and now runs sports medicine at the UFC Performance Institute in Shanghai. He brought me in, I owe him a lot, and somehow I’m still here more than ten years later, now as part of USA Fencing’s national team medical staff. I traveled with the U.S. team as a volunteer member of the medical staff at the 2019 Pan American Games and the 2021 Tokyo Olympic Games, and I’ve treated fencers who competed at every Summer Olympics from London 2012 to Paris 2024. New York is a fencing town — every Olympics, it seems, someone from here makes the team — and it’s a fun sport to be around. This page is what I’d want every fencer, parent and coach to know.

Front leg (the lunge): hip, knee and ankle. Research matches what I see: in a review of fencers treated at a large teaching hospital, 73% of injuries involved the lower body, and the knee was the most common site (49%), followed by the ankle and hip.^[1]

Back leg (the push-off): the Achilles tendon and shin splints. In the same review, ankle and Achilles injuries were more often on the non-dominant side — the back leg for most fencers — while hamstring injuries were more often on the dominant, front-leg side.^[1]

Weapon arm: the shoulder — and in sabre, the wrist, often from blade contact during guard fights. In that review, 96% of arm injuries were on the dominant side.^[1]

Lower back: almost always connected to the front hip. On X-ray and MRI, I often see findings in the lumbar spine, such as spondylolysis, even in young fencers. Spondylolysis made up 3% of fencing injuries in the hospital review, and the authors note it hasn’t been commonly described in fencers.^[1] The hip connection isn’t only my impression, either: in young athletes from other sports, limited hip motion has been suggested as one reason the lower back takes extra stress.^[8] When it started and how much it matters is different for every athlete, which is why the exam matters more than the image alone.

This is the part I find most interesting. Two sabre fencers can have the same knee injury — same name on the MRI, same age, same sex, same weapon — and still need a different approach. One needs stability built from the toes and ankle. Another needs it from the trunk. Another needs to start with how they walk.

The rehab looks similar on paper, because the goal is the same. What changes is the cue, the focus and the timing. When a fencer gets a standard knee protocol without that, the injury often comes back. That’s the hard part of working with athletes, and it’s why I check the whole body in every athlete — not just the spot that hurts.

Fencers often tell me they were told their pain is from “overuse.” Of course it is — you train hard, and you train until it hurts. That’s what athletes do. The useful question is why the load went to that one place, and what has to change so it stops going there.

Pay attention to the front hip and knee:

• Pain that feels different from your usual soreness
• Pain deep in the joint, or in a spot you can’t reach with your fingers
• Pain in the front hip when you pull your knee toward your chest

That last one matters. When the front of the hip hurts, many fencers assume a tight hip flexor and hug the knee to the chest to stretch it. But that position bends the hip deeply and can pinch the joint. If it hurts, it may be the joint or the cartilage — not a tight muscle. A hip flexor is stretched by extending the hip, not by folding it.

The same instinct causes trouble at the top of the hamstring. Pain right at the sit bone is a different story from a “tight hamstring.” Injuries here often happen when the hamstring is stretched under load — hip bent, knee straight, which is exactly where the front leg ends up in a lunge — and they usually take longer to recover than a typical hamstring strain.^[10] The tendon there is also irritated by compression when the hip bends deeply, so stretching it harder tends to make it worse.^[11] I see this often: it hurts, so the fencer stretches it, and it gets worse. Get it checked early instead. In teenagers, the same spot can be a growth-plate problem rather than a tendon one.

Experienced fencers usually have their own warm-up, built over years — often after an injury, from someone who taught them. At national team camps, the routines keep evolving. If you don’t have one yet, a few basics work for almost everyone: band walks, bird dogs, bridges and a hip stretch.

Regular hands-on treatment helps, but how often depends on the person — I won’t pretend there’s one right schedule. Your own body is the best signal: when you feel stiff, when your lunge gets shorter, when it feels harder to get forward, that’s usually the time to come in.

The same goes for recovery tools — foam rolling, massage guns, stretching, compression boots, ice baths, sauna, walking in water. I can’t tell you which one is right for you. What I can tell you is that it varies from person to person, and what makes you feel better matters.

In growing fencers, the weak spot usually isn’t the tendon itself. It’s the growth cartilage where the tendon attaches to the bone. That’s why a sore heel in a 10-year-old is often not an Achilles problem, and why the weak spot moves as kids grow. In a study of a youth soccer academy, growth-plate injuries at the heel (Sever’s disease) peaked in the under-11 age group, those below the knee (Osgood-Schlatter disease) in the under-14 group, and those around the hip and pelvis in the under-17 group.^[9] Fencing hasn’t been studied this way yet, but in the hospital review, fencers under 13 had more Achilles-area injuries, and older fencers had more hamstring injuries.^[1]

The most common problem I see in growing fencers is Osgood-Schlatter disease. It’s a bone injury at the growth plate below the knee, so it shouldn’t be brushed off as “just growing pains.” Rest and growth are what ultimately resolve it, but treatment helps by working on the muscles and tendons to take pressure off the area.

Young fencers who only fence often grow a little lopsided, and the load keeps landing on the same place. So with kids, I’m thinking about their health sixty years from now, not just this season. That means adding things that have nothing to do with fencing: push-ups, squats, lunges on the other leg.

The research supports keeping kids in more than one sport. In a study that followed 1,544 high school athletes through a school year, those who were highly specialized in one sport had an 85% higher rate of lower-body injuries.^[2] Other studies point the same way, including one of professional baseball players: those who played more than one sport in high school had fewer injuries and longer careers.^[3][4]

I rarely wait for pain to reach zero. I look at whether it’s under control and whether it’s safe. People who have had pain for a long time often keep some uncomfortable sensation, and waiting for zero can mean waiting forever. Sometimes it’s safe and it just hurts — and that’s a different situation from an injury that isn’t ready.

I see an image as a result. The way you move put load on one spot, and over time that load caused a change you can see. No more and no less. The real work is figuring out how that load got there, and how to reduce it or reverse it.

I’m not a fencer, so I don’t give advice on technique or footwork. That’s your coach’s job, and a good coach is part of your recovery.

Knee Pain Treatment · Hip Pain Treatment · Ankle & Foot Pain Treatment · Shoulder Pain Treatment · Elbow, Wrist & Hand Pain Treatment · Low Back Pain Treatment · Athletes Are Not Pain-Free People · The Body Is Not Symmetrical

You don’t need to be fit or confident to start. Tell me what’s bothering you and what you want to be able to do again.

References

1. Cross ER, Lynch SM, Miller PE, Hunt DL, Stein CJ. Injury Patterns in Fencing Athletes – A Retrospective Review. Int J Sports Phys Ther. 2024;19(9):1108-1115. PMC
2. McGuine TA, Post EG, Hetzel SJ, Brooks MA, Trigsted S, Bell DR. A Prospective Study on the Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes. Am J Sports Med. 2017;45(12):2706-2712. DOI
3. Jayanthi NA, LaBella CR, Fischer D, et al. Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes: A Clinical Case-Control Study. Am J Sports Med. 2015;43(4):794-801. PubMed
4. Multisport participation in high school and injury rates and career length in professional baseball players. PMC
5. From duelling at dawn to wireless scoring: fencing through the ages with Olympic champion Szasz. Olympics.com. Olympics.com
6. Harmer PA. Incidence and characteristics of time-loss injuries in competitive fencing: a prospective, 5-year study of national competitions. Clin J Sport Med. 2008;18(2):137-142. DOI
7. Holmes K, Rojas M, Giannakis P, Poeran J, Bottoms L, Colvin A. Injury patterns and cumulative injury burden among U.S. competitive fencers: a survey. PLoS ONE. 2026;21(3):e0344263. DOI
8. Moley PJ, Gribbin CK, Vargas E, Kelly BT. Co-diagnoses of spondylolysis and femoroacetabular impingement: a case series of adolescent athletes. 2018. PMC
9. Materne O, Chamari K, Farooq A, et al. Shedding light on incidence and burden of physeal injuries in a youth elite football academy. Scand J Med Sci Sports. 2022;32(1):165-176. Full text
10. Askling CM, Tengvar M, Saartok T, Thorstensson A. Proximal hamstring strains of stretching type in different sports. Am J Sports Med. 2008;36(9):1799-1804. DOI
11. Goom TS, Malliaras P, Reiman MP, Purdam CR. Proximal hamstring tendinopathy: clinical aspects of assessment and management. J Orthop Sports Phys Ther. 2016;46(6):483-493. PubMed