Handball Injuries: Shoulder, ACL, Ankles, Fingers and Concussion

This article contains affiliate links: if you buy through them we may earn a commission, at no extra cost to you. Learn more.

A left back takes three steps, rises above the defense and fires a jump shot into the top corner. On the way down she lands on one leg, the knee caves in, and she doesn’t get up. The hall goes quiet. Anyone who has played team handball (the Olympic indoor game, not the wall game) knows the moments that worry players most: the knee on a landing, the shoulder that aches after every practice, the ankle on someone’s foot, the finger bent back by a hard pass, the elbow to the head in a crowded six-meter area. This page covers each one, what the research from Norway, Denmark and Germany says about preventing them, and when to stop and get checked.

This page is general information, not medical advice. If you’re hurt, see a sports medicine doctor, physical therapist (PT) or certified athletic trainer (AT). For the bigger picture of the sport, start at our handball hub.

How often handball players get hurt

Handball is fast and physical, and most injuries come from contact. In a study of six major international tournaments, team doctors reported about 1.5 injuries per match. The lower body took 42% of them, the head 23%, the arms and hands 18% and the trunk 14%. The most common single diagnoses were a bruised head (14%) and an ankle sprain (8%), and most injuries came from contact with another player. A 2022 systematic review of 27 studies found the same pattern across levels: the thigh, knee, ankle and shoulder get hurt most, players who work around the six-meter line are hurt more often, women’s risk is higher, and most injuries happen in games rather than practice.

The shoulder: overuse in throwers

A handball shot is a full overhead throw, hundreds of times a week. The arm cocks back into a lot of external rotation, then whips forward. Over a season, that adds up. Among 206 players in Norway’s elite men’s league, on average 28% had shoulder problems at any given time during the season, and 12% had problems bad enough to cut their training or performance or keep them out. Across studies, a 2022 review put the prevalence of shoulder problems in handball at 17–41%.

What raises the risk? In that Norwegian men’s study, players with less total shoulder rotation, weaker external rotation (the muscles that slow the arm down) and visibly poor shoulder-blade control had more problems. A later study of 329 men and women couldn’t confirm those same risk factors, so they’re useful clues, not a test. The clearest signal is load: in 679 elite youth players in Denmark, a week where handball hours jumped by more than 60% compared with the previous four weeks went with almost twice the shoulder injury rate, and the risk was higher still in players with weak external rotators or poor shoulder-blade control.

Warning signs: pain at the top of the throw or on release, a “dead arm” feeling, losing speed on your shot, pain at night, or clicking with pain. AAOS notes that young overhead athletes are at risk of rotator cuff tendinitis and impingement. Pain that keeps coming back after rest needs a professional look, not more throwing.

ACL injuries, especially in female players

Handball means sudden stops, cuts and one-leg landings, which is exactly how most ACL tears happen. In a three-season study of Norway’s top divisions, women tore their ACL about five times as often as men (0.31 vs 0.06 injuries per 1,000 player hours). Of 28 ACL injuries, 25 happened without contact, during the plant-and-cut moves the players made all the time, and 24 of the 28 happened in matches. Video analysis shows the knee caves inward within about 40 milliseconds of landing.

Men aren’t safe either. Germany’s ACL registry counted 84 ACL tears in men’s professional handball over seven seasons, and 46% of them were re-ruptures, a reminder that coming back well matters as much as the first surgery. AAOS describes the typical signs: a pop, the knee giving way, and swelling within 24 hours. A suspected ACL injury always needs a doctor.

Ankle sprains

Landing on a defender’s foot after a jump shot or rolling an ankle on a fake-and-cut is part of the game. AAOS describes a sprain as ligaments stretched past their limit: pain, swelling, bruising and an ankle that feels like it “gives out”. The National Athletic Trainers’ Association (NATA) says the most consistent risk factor for a sprain is a previous one, and recommends that athletes who have sprained an ankle tape or brace it for all practices and games. The IHF’s equipment rules allow ankle braces with straps as long as they have no hard parts, in the same color as the socks. If you can’t put weight on the foot, or it might be broken, see a doctor.

Finger and hand injuries

Hard passes, blocked shots and grabbing at the ball in defense bend fingers the wrong way, and goalkeepers stop shots with open hands. AAOS describes the common ones: a sprained (“jammed”) finger, where the ligaments of a finger joint are stretched or torn; mallet finger, where a ball hits the tip and the end of the finger droops because the tendon that straightens it is damaged (see a doctor promptly, ideally within a week); and finger fractures, with swelling, bruising, deformity or a finger you can’t move fully. A finger that looks crooked, can’t straighten, or stays swollen for more than a couple of days should be checked.

Contact injuries and concussion

Handball lets defenders use their body, so arms, elbows and heads meet. In a video study of 59 injuries at an Olympic handball tournament, 86% came from contact and the head was the most often hurt body part. Concussions are not rare: among 945 Danish community players aged 11–17, there were 0.8 concussions per 1,000 hours of handball, more in the older age groups. Almost half of those players kept playing after the hit, usually their own decision. A two-season French study of adult amateur players found higher concussion risk in women, younger players and wingers, and after falls where the head hit the floor.

The CDC’s HEADS UP rule is simple: if you think a player may have a concussion, remove them from play. “When in doubt, sit them out.” They stay out for the rest of that day and until a health care provider clears them. Signs include looking dazed, slow answers, clumsiness, headache, dizziness, nausea, blurry vision and feeling foggy (CDC). Call 911 for the danger signs: one pupil larger than the other, a headache that gets worse, slurred speech, weakness or numbness, repeated vomiting, seizures, growing confusion, or loss of consciousness. The American Medical Society for Sports Medicine (AMSSM) is clear there’s no same-day return after a diagnosed concussion, and return to school comes before return to sport.

Handball injury prevention: what the trials found

Much of handball’s prevention research comes from the Oslo Sports Trauma Research Center in Norway.

• Youth warm-up (Norway, 2005): 120 clubs and 1,837 players aged 15–17 were randomized. The warm-up trained running, cutting and landing technique, balance and strength. Teams that used it had about half as many players with acute knee or ankle injuries (4.8% vs 8.6%).
• ACL program for women (Norway, 2003): a 15-minute program of balance, planting and landing exercises over three seasons. Across all divisions, the drop in ACL tears wasn’t statistically clear, but in the elite division, players who actually completed the program had far fewer ACL injuries than those who didn’t.
• Adolescent knee program (Germany, 2018): 23 adolescent teams (average age about 15); severe knee injuries were much rarer in teams doing regular neuromuscular exercises (0.04 vs 0.33 per 1,000 hours).
• Shoulder program (Norway, 2017): 660 elite players on 45 teams. The OSTRC Shoulder Injury Prevention Programme (about 10 minutes, built into the warm-up three times a week: internal-rotation mobility, external-rotation and shoulder-blade strength, kinetic chain and upper-back mobility) cut the risk of shoulder problems by 28%. The average share of players with shoulder problems was 17% vs 23%.

Two honest caveats. First, a 2025 meta-analysis that pooled three shoulder trials didn’t find a statistically significant drop in shoulder injuries overall, so the shoulder evidence is promising but not settled; the knee and ACL evidence is stronger, and a summary of eight meta-analyses found ACL programs cut non-contact ACL injuries in female athletes by about two-thirds. Second, programs only work when teams do them: only 29% of coaches in the shoulder trial did it as often as recommended. How to fit it into a training week is on our handball training page, and the soccer version (FIFA 11+) is explained on our soccer injuries page.

Gear many players keep in the bag

None of these prevent injuries on their own, and none replaces rehab; ask your PT or athletic trainer what fits you. But many players use a light resistance band set like the THERABAND Resistance Bands for shoulder warm-ups, athletic tape like Mueller MTape for buddy-taping fingers, a strap brace like the McDavid 195 ankle brace after a sprain (check it meets your league’s no-hard-parts rule), and a mouthguard like the Shock Doctor Gel Max.

More choices in our best ankle braces and best resistance bands guides.

When to see a sports medicine doctor, PT or athletic trainer

• Right away (emergency): any concussion danger sign, a possible broken bone, a joint or finger that looks out of place, or numbness and tingling.
• Within a day or two: a pop and swelling in the knee, you can’t bear weight, a suspected concussion, or a fingertip that droops.
• Soon: shoulder pain that comes back every time you throw, a shot that’s lost speed for no reason, swelling that lasts more than a few days, or pain at night or at rest.

A sports medicine physician diagnoses and decides on imaging; a physical therapist guides rehab and the return to throwing, cutting and landing; a certified athletic trainer is often the first person on the court at high schools and colleges. Return to play is a process: from basic strength and range of motion, to running and cutting, to throwing at growing intensity, to full practice and then games, each step without pain or swelling. Let the person treating you sign off. Then look after the basics on our handball recovery page.

Handball injuries: FAQs

What is the most common injury in handball?

In elite international tournaments, head bruises and ankle sprains were the most common single diagnoses, and the lower body took the most injuries overall. Across all levels, the knee, ankle, thigh and shoulder are hurt most, and the shoulder leads among overuse problems.

Why do female handball players tear their ACL more often?

Researchers point to how players land and cut, strength and body mechanics, among other factors. In Norway’s top divisions, women had about five times the ACL rate of men, almost always without contact. The good news is that landing and balance programs work when teams do them regularly.

Does the OSTRC shoulder program really work?

In the big Norwegian trial of 660 elite players it cut the risk of shoulder problems by 28%. A later meta-analysis of several shoulder programs didn’t find a clear overall effect, so the evidence is mixed. It takes about 10 minutes, and it’s cheap insurance for throwers; ask your coach or PT to build it into the warm-up.

Can I play through a jammed finger?

Many players buddy-tape a mild sprain and keep going, but a finger that looks crooked, can’t straighten at the tip, or stays swollen should be seen by a doctor. Mallet finger, in particular, is best treated early, ideally within a week, according to AAOS.

Can a handball player go back in after a head knock if they feel fine?

Not if a concussion is suspected. The CDC says remove the player and keep them out for the day until a health care provider clears them, and AMSSM says there is no same-day return after a concussion diagnosis. Symptoms can show up hours later.

Are mouthguards and knee pads allowed in handball?

Yes, within limits. The IHF allows transparent or single-color mouthguards, soft knee and elbow protectors without uncovered hard parts, and strap ankle braces without hard components. Head protection and face masks are not allowed. National federations can adjust rules for lower-level club play, so check with your league.