Wrestling: strength and conditioning, the weight rules, skin infections and injuries

Three styles, short bouts

Freestyle and Greco-Roman, which bans holds below the belt and using the legs, are the Olympic styles; women wrestle freestyle. Senior international bouts are two periods of 3 minutes, and a US college match is 7 minutes.

Sources 1, 2

Injuries happen most in matches

US college wrestlers were hurt about four times as often as high-school wrestlers, and matches about four times as often as practice. The knee, shoulder, head and face are hurt most, and concussion is the commonest single injury in college.

Sources 3, 4

The weight rules exist because wrestlers died

In 1997 three US college wrestlers died while cutting weight in sweat suits in the heat. US college rules now set a minimum weight, slow the rate of loss and ban saunas, sweat suits and diuretics, and British Wrestling groups under-15s so that there's no need to cut. This page gives the rules, not cutting methods.

Sources 5, 2, 6

Skin infections spread on the mat

Wrestling accounted for nearly three-quarters of skin infections in US high-school athletes. Shower straight after training, check your skin, and don't wrestle with a sore or rash: covering a contagious lesion isn't allowed.

Sources 7, 8, 9

Ear guards protect ears

College wrestlers wearing headgear had about half as many ear haematomas, the blood collections that become cauliflower ear. Headgear doesn't prevent concussion.

Sources 10, 11

One warm-up has a trial

Wrestling+, a 20-minute partner warm-up done at least twice a week, found fewer injuries in one trial in young freestyle wrestlers. Our warm-up follows its structure.

Sources 12, 13

The styles and the boutsStrong evidence

United World Wrestling's (UWW) rules, January 2026: in Greco-Roman it's forbidden to grasp the opponent below the belt or use the legs; freestyle bans a scissor lock with crossed feet on the head, neck or body; and women's wrestling bans all double Nelsons. Bouts are two periods of 3 minutes with a 30-second break for under-20s, under-23s and seniors, and two of 2 minutes for under-15s, under-17s and veterans, with at least 20 minutes between bouts. US college folkstyle matches are 7 minutes, in periods of 3, 2 and 2.

Sources 1, 2

Hard, repeated boutsEmerging evidence

In 12 elite Greco-Roman wrestlers in a simulated one-day tournament of five bouts, heart rate averaged about 85% of maximum and blood lactate rose above 17 mmol/L. Performance fell across the day, more in the upper body, and markers of muscle damage and inflammation rose.

Source 14

Strength, power, grip and backEmerging evidence

Elite wrestlers had 8% to 25% greater maximal strength and 14% to 30% more muscle power than amateurs in the same weight classes, with stronger grips and backs, while running speed didn't differ; the same held in women. In 168 elite wrestlers, anaerobic power, strength endurance, reaction time and wrestling-specific fitness best separated medal winners from the rest. These are associations.

Sources 15, 16, 17, 18

The neckEmerging evidence

Elite Greco-Roman wrestlers' neck rotation strength was almost three times that of non-athletes, though every group had weaknesses in some directions.

Source 19

Energy cost

The Compendium of Physical Activities lists competitive wrestling at 6.0 metabolic equivalents (METs), an estimated value rather than a measured one.

Source 20

What to train (our reading)

Leg and hip strength and power for shots and lifts, pulling strength and grip for hand-fighting, a strong neck and trunk, and repeated hard efforts with short recoveries.

How often wrestlers get hurtStrong evidence

The numbers, by group:

• US high-school boys (2005 to 2014): 2.38 injuries per 1,000 athlete-exposures; US college men (2004 to 2014): 9.28.
• US college men, 2014 to 2019: 8.82 per 1,000 athlete-exposures, with matches 4.11 times as risky as practice.
• 418 high-school wrestlers over one season: 6.0 injuries per 1,000 exposures, 52 per 100 wrestlers.
• 1,742 boys aged 6 to 16 at two tournaments: 12.7% injured, 4.6% badly enough to withdraw.
• A US national cadet and junior tournament: 7.0 injuries per 1,000 matches in freestyle and 4.6 in Greco-Roman.
• Olympic Games: 6.1 (Rio 2016) and 9.8 (Tokyo 2020) injuries per 100 wrestlers.
• Three Olympic Games compared: 4.8 injuries per 1,000 minutes in wrestling, fewer than judo, boxing or taekwondo.

Sources 3, 4, 21, 22, 23, 24, 25

KneesEmerging evidence

The knee was 21.4% of college injuries. In one college team over 6 years, knee injuries were about 40 times as common in matches as in practice, mostly bursitis in front of the kneecap, collateral ligament sprains and meniscus tears, and a previous knee injury and early-season matches raised the risk. After ACL reconstruction, 80% of 107 wrestlers returned to wrestling and 13% of the grafts failed. Our MCL sprain, meniscus tear, ACL and knee bursitis guides cover these.

Sources 4, 26, 27, 28

Shoulders and elbowsEmerging evidence

Shoulder and elbow injuries were about a fifth of wrestling injuries in a 2026 review: rotator cuff and AC joint injuries, shoulders coming out of place and elbow ligament injuries. Our dislocated shoulder, AC joint, rotator cuff and elbow dislocation guides cover these.

Sources 29, 21

ConcussionEmerging evidence

Concussion was the commonest specific injury in US college wrestlers, and the head and face were 21.4% of high-school match injuries. In 73 adolescent wrestlers, most concussions happened in matches and during takedowns, and hitting the head on the mat was the commonest cause. Emergency visits for wrestling concussions peaked at 15 and 16 years of age. The concussion section below has each body's rules.

Sources 4, 3, 30, 31

Necks and stingersEmerging evidence

In US college wrestlers, spine injuries ran at 0.71 per 1,000 athlete-exposures, and the commonest was a brachial plexus injury, the burning "stinger" down one arm, at 20%. Our stingers guide covers the warning signs and the checks before wrestling again, and our neck pain and pinched nerve in the neck guides cover other neck problems.

Source 32

Catastrophic injuriesStrong evidence

US school and college records from 1982 to 2025 list 83 catastrophic injuries from impacts in high-school boys' wrestling: 3 deaths, 45 with permanent disability and 31 serious with recovery. Wrestling had the third-highest rate of catastrophic head and neck injury among non-football school and college sports. In an earlier series, 74% happened to the defending wrestler during a takedown, and in Iran, wrong technique, poor coach supervision and mat problems were the commonest suggested causes.

Sources 33, 34, 35, 36

EarsEmerging evidence

Cauliflower ear affected 44% of 411 wrestlers in Tehran and 69% of 1,338 former wrestlers surveyed, and 96% of Finnish wrestlers and judoka with it had symptoms, usually pain. We don't have a guide to cauliflower ear; the ears section below covers prevention.

Sources 37, 38, 39

Skin infectionsStrong evidence

Wrestling accounted for 73.6% of skin infections reported in US high-school athletes. In US college men they ran at 14.23 per 10,000 athlete-exposures, about a fifth were repeat infections, and most came in team outbreaks. MRSA, a bacterium resistant to some antibiotics, was more common in wrestlers than in other athletes. The skin section below covers them.

Sources 7, 40, 41

Girls and women, and young wrestlersEmerging evidence

Emergency visits for girls' and women's wrestling injuries in the US rose between 2005 and 2019, half of them aged 14 to 18; they had fewer fractures and head or neck injuries than males and more sprains and strains. Youth wrestling injuries seen in US emergency departments fell over 10 years. Elite wrestlers who specialised before 12 had more serious injuries before college.

Sources 42, 43, 44, 45, 46

Wrestling+, the one tested warm-upEmerging evidence

Wrestling+ has three parts and 14 exercises in a set order, about 20 minutes, done at least twice a week under a coach's eye: running with shoulder rotations, grips, partner pulling, shoving, partner neck work and a supported bridge; then shoving, pulling, one-leg balance, pushing with raised legs and push-ups with the feet held, each with three levels; then one-leg balance, standing wrestling and pushing. Wrestlers move up a level when an exercise is easy, or all together after 3 to 4 weeks.

In one trial, 80 freestyle cadets aged 16 to 17 in Iran did Wrestling+ or their usual warm-up for a season of 24 weeks, and the Wrestling+ group had fewer injuries. The paper describes its allocation both as random and as by group, the wrestlers were a convenience sample, and some of its figures don't add up, so treat it as a first result.

Sources 12, 13

Rules against dangerous holdsStrong evidence

US college rules ban all body slams, choke holds and over-scissors; US high-school rules (2026-27) make any hold that presses on the throat or carotid artery illegal, and in 2025 added leaving the feet to cut out an opponent's leg to the banned leg-block move; UWW bans throat holds, holds on the head alone and holds that stretch the spine, and double Nelsons for under-15s and under-17s. Coach supervision, sound technique and good mats were the commonest suggested protections against catastrophic injury in Iran.

Sources 2, 47, 48, 1, 36

Ear guardsEmerging evidence

In college wrestlers, 26% of those wearing headgear had an ear haematoma against 52% without, though only about a third wore it all the time in practice. Ringside physicians back headguards to protect ears, not to prevent concussion. US college rules require ear guards whenever there's live wrestling, including practice; UWW allows soft ear protectors without a hard buckle.

Sources 10, 11, 2, 49

Skin hygieneStrong evidence

British Wrestling: shower straight away after every practice or match, check your face, neck, hairline and arms, and don't go to the club with a lesion or tape over it and carry on. A strict hygiene protocol cut ringworm cases from 10 to 1 in a college team, while a barrier cream added nothing, and disinfectants that keep working on the mat cut its bacteria during competitions.

Sources 9, 50, 51

Neck strengthMixed evidence

UWW's concussion policy recommends neck strengthening, but a review found no studies linking neck strength to fewer neck injuries in wrestling. Train the neck with controlled holds as part of strength work, not as protection against concussion (our reading).

Sources 52, 53, 19

Young wrestlersStrong evidence

British Wrestling groups under-15s by weight on the day, within 10% of the lightest wrestler, so there are no fixed classes to cut for, and UWW bans double Nelsons for under-15s and under-17s. The Wrestling+ authors name poor supervision, horseplay and mismatched partners as likely risks, and specialising before 12 went with more serious injuries.

Sources 6, 1, 12, 46

What isn't shownMixed evidence

Without good evidence in wrestling:

• Neck training preventing concussion or neck injury.
• Headgear preventing concussion.
• Barrier creams preventing ringworm.
• Core training preventing injury: stronger trunks went with fewer injuries in elite wrestlers, and a 4-week programme improved performance tests, but no prevention trial exists.
• Any safe amount or method of rapid weight loss.

Sources 52, 11, 50, 54, 55

Strength and powerEmerging evidence

Elite wrestlers are stronger and more powerful than amateurs, and reviews link maximal, explosive and endurance strength with success. In 20 young amateur wrestlers, 6 weeks of resistance training with jumps or with fast lifts, 3 times a week in the preseason, improved strength and wrestling tasks equally; in national-level wrestlers, pairing heavy lifts with jumps improved strength and explosiveness over 8 weeks.

Sources 15, 17, 56, 57

Conditioning: sprint intervalsEmerging evidence

In 15 trained wrestlers, adding 6 maximal 35 m sprints with 10 seconds' recovery, twice a week for 4 weeks of preseason training, raised their maximal oxygen uptake by 5.4% and their sprint power on a bike test. Our conditioning workout uses that set as published.

Source 58

The trunkEmerging evidence

In 20 junior Greco-Roman wrestlers, 4 weeks of core-specific training improved bridges and medicine-ball throws more than usual training.

Source 55

Grip and neck

Our grip strength guide reports a trial in which extra handgrip training twice a week helped young wrestlers over 4 months. Elite wrestlers have strong necks, and UWW recommends neck strengthening; our strength workout includes both.

Sources 19, 53

Before a competitionEmerging evidence

A review of US wrestling concludes that wrestlers should arrive tapered, well hydrated and well fed with carbohydrate, rather than after rapid weight loss. Cut training volume in the last week while keeping some short, sharp work (our suggestion).

Source 59

Fitting it in (our suggestion)

In season: 2 strength sessions a week on days without hard live wrestling, keeping lifting and hard mat sessions at least 3 hours apart, and the Wrestling+-style warm-up before practices. Preseason: add the conditioning session twice a week for 4 weeks, as in the sprint trial. Off season: heavier strength work and other sports.

Source 58

Why the rules existStrong evidence

Between November and December 1997, three previously healthy US college wrestlers died during rapid weight loss before weigh-ins: they restricted food and fluid and exercised hard in sweat suits under cotton warm-ups, in hot conditions. The American College of Sports Medicine had already called for rules to limit weight loss in 1996. The US college programme that followed aims to set weigh-ins as close to the match as possible, set a healthy weight class early in the season, and "Eliminate the tools used to accomplish rapid dehydration". US catastrophic injury researchers still warn that losing weight to make weight can cause serious injury or death.

Sources 5, 60, 61, 33

US colleges (NCAA)Strong evidence

The National Collegiate Athletic Association's (NCAA) rules for 2025 to 2027:

• Weigh-ins are two hours or less before the competition starts.
• Each wrestler's lowest weight class is certified between 1 September and 1 November, from body fat (minimums of 5% for men and 17% for women) and a hydration test: urine measured with a refractometer, not test strips, and above a specific gravity of 1.020 the wrestler comes back at least 24 hours later.
• Wrestlers descend to their class by losing "not more than 1.5% of body weight per week", a requirement that "shall never be altered or adjusted".
• Banned: laxatives, emetics, making yourself sick, hot rooms, hot boxes and steam rooms for any purpose; diuretics at any time; vapour-impermeable suits; and saunas during the season. Practice rooms mustn't be above 80°F (about 27°C) at the start of practice.
• A first serious weigh-in or banned-practice violation brings suspension from the next eight competition dates.

Sources 2, 61, 62, 63

US high schools (NFHS), from 2026-27Strong evidence

The National Federation of State High School Associations (NFHS) raised girls' minimum body fat from 12% to 19% for 2026-27, saying it "establishes a safer margin for minimal wrestling weight"; boys' minimum is 7%, and a lower figure needs a medical release. Each state association runs its own weight programme, with hydration testing and a limit on weekly loss.

Sources 64, 47, 65, 66

United World WrestlingStrong evidence

International weigh-ins happen on the morning of each weight category, together with a medical check, and finalists weigh in again the next morning. No allowance is made for the singlet, and wrestlers who miss the weight are eliminated.

Source 1

British WrestlingStrong evidence

British Wrestling uses a 10% rule for under-15s: wrestlers are grouped on the day within 10% of the lightest, so there are "no fixed body weight classes to cut for" and "no need to cut weight". It says forcing children to cut weight can be a form of abuse, that "restricting a child's food or liquid intake is neglect and a form of child abuse", and that diuretics risk an anti-doping ban.

Source 6

What the rules achievedEmerging evidence

After the NCAA programme, national championship wrestlers lost and regained less weight around weigh-ins, and the authors judged it effective in reducing unhealthy weight cutting. At one university, weight loss became more gradual in the programme's second year, and a 16-year survey of college injuries found practice injury rates didn't rise, which its authors thought might reflect the rules. A minimum weight programme in Wisconsin high schools reduced the weight wrestlers lost, weekly weight cycling and fasting. A review: minimum weights and shorter gaps between weigh-in and wrestling work to a degree, but unsafe practices continue.

Sources 67, 68, 69, 70, 71

Cutting is still common, and harmfulEmerging evidence

72% of 2,532 Michigan high-school wrestlers used at least one potentially harmful method each week, and 69% of 229 wrestlers at a World Championship had cut weight to compete, with coaches the main influence. Rapid weight loss raised markers of kidney strain, and a review linked weight cutting with poor sleep, fatigue and more injuries. Wrestlers are more prone to eating disorders than athletes in other sports.

Sources 72, 73, 74, 75, 76

Girls and womenEmerging evidence

Studies of US college women and high-school girls found the old minimum body fat was below almost every wrestler's, and their authors argued for a higher one; the NCAA and NFHS raised it. A review links low energy availability and low body fat with missed periods and bone loss, and recommends avoiding weight cycling, restrictive eating and deliberate dehydration.

Sources 77, 78, 79

What experts recommendStrong evidence

An American College of Sports Medicine expert consensus: minimum weights set from preseason body composition, shorter gaps between weigh-in and competition, and bans on unhealthy methods, with a sports nutrition professional's guidance for each athlete. The National Athletic Trainers' Association's position statement covers safe weight management in sport.

Sources 80, 81

What we suggest

Wrestle at a weight you can make with ordinary eating and training, and talk to your coach, and a sports dietitian if you can, about choosing a weight class (editorial, as on our boxing and martial arts pages). Never train in sweat suits or hot rooms to lose weight. If eating, weight or shape worries you, Beat's helplines are open 3pm to 8pm, Monday to Friday: 0808 801 0677 (England), 0808 801 0432 (Scotland), 0808 801 0433 (Wales) and 0808 801 0434 (Northern Ireland).

Source 82

What wrestlers catchStrong evidence

The commonest are herpes gladiatorum (the cold sore virus spread on the mat), bacterial infections such as impetigo, boils and MRSA, and ringworm (tinea), found in about a third of wrestlers across 13 studies. Molluscum, scabies and head lice spread by contact too.

Sources 83, 84, 85, 41

Herpes gladiatorumStrong evidence

At a US high-school wrestling camp, 34% of wrestlers caught it, mostly on the head. In outbreaks in Minnesota, partners caught it about a third of the time, mostly on the head, face and neck, the areas in contact; in 2007, an 8-day break from competition contained an outbreak in over 90% of exposed wrestlers. The NHS says to see a GP if a cold sore hasn't started to heal within 10 days, or if you have a weakened immune system.

Sources 86, 87, 88, 89

Ringworm and impetigoStrong evidence

In a Pennsylvania survey, 84.7% of responding schools had a wrestler with ringworm. The NHS: ringworm spreads by close contact and shared towels, so treat it early and don't share towels; impetigo stops being contagious 48 hours after starting treatment, and until then don't go to the gym or play contact sports.

Sources 90, 91, 92

Shower, check, stay off the matStrong evidence

British Wrestling: shower as soon as possible after every practice or match, check your skin, and with a lesion don't go to the club or cover it with tape and carry on; you can return when it's no longer contagious, usually dry and scabbed over, and in competitions you must pass the skin check at weigh-in. UWW's rules oblige its doctors to eliminate any wrestler who presents a danger of contagious disease, and British Wrestling's medical checks before weigh-in bar wrestlers with open or infected wounds or an infectious disease.

Sources 9, 1, 93

US high-school rules (NFHS, May 2026)Strong evidence

"Covering a communicable condition shall not be considered acceptable and does not make the wrestler eligible to participate." A suspected skin condition needs a written note from a health professional at weigh-in. The minimum treatment before returning:

• Impetigo and boils: no new lesions for 48 hours and at least 72 hours of antibiotic tablets; if lesions keep coming after 72 hours, consider MRSA.
• Herpes: a first episode of herpes gladiatorum means at least 10 days out, or 14 with fever or swollen glands; a recurrence needs at least 120 hours of antiviral tablets, with no new lesions and all lesions scabbed.
• Ringworm: 72 hours of treatment on the skin, or 14 days of tablets on the scalp.
• Scabies and head lice: 24 hours after treatment.
• Non-contagious conditions such as eczema and psoriasis need no treatment before wrestling.

Source 8

US college rules (NCAA)Strong evidence

A doctor or certified athletic trainer checks every wrestler's skin no more than 15 minutes before weigh-ins, and a communicable skin disease counts as a medical forfeit. The NCAA's guidance, revised in 2019, says skin infections are at least 21% of practice injuries and illnesses, that active herpes and pus-filled lesions can't be covered to wrestle, and that ringworm under prescribed treatment may be covered if it's in a place that can be covered securely.

Source 2

MatsEmerging evidence

At two college competitions, disinfectants that keep working on the mat cut bacteria by 63% over the day compared with ones that don't, and ringworm fungus was found in about 5% of mat samples across studies. Clean mats after every session (our suggestion).

Sources 51, 85

Preventive medicines are a doctor's decisionEmerging evidence

At a 28-day camp, daily antiviral tablets went with far fewer herpes outbreaks, and in a small trial an antifungal cut ringworm. The NCAA says wrestlers with recurrent herpes could be considered for season-long preventive treatment after talking to the team doctor. Ask your GP or team doctor; don't take someone else's medicine.

Sources 94, 95, 96, 2

Why cauliflower ear happens

A blow or rubbing collects blood under the skin of the ear, and if it isn't drained it hardens. In Tehran, only 23% of wrestlers with cauliflower ear had had their ear haematomas treated, and those with cauliflower ear more often reported hearing loss (11.5% against 1.8%); 76% of affected Finnish athletes had been treated by people who weren't health professionals.

Sources 37, 39

Ear guardsEmerging evidence

Ear guards about halved ear haematomas in college wrestlers. Wear them for all live wrestling, as US college rules require; UWW allows soft ear protectors without a hard buckle. Headguards haven't been shown to prevent concussion.

Sources 10, 11, 2, 49

A swollen ear

Get it seen the same day, so the blood can be drained and the ear kept under pressure, as our martial arts page explains.

United World Wrestling, December 2025Strong evidence

UWW's concussion policy, which British Wrestling publishes:

• Minimum rest before the staged return: 21 days for its under-15 and under-17 age groups, 14 days for under-20s, and 7 to 10 days for seniors and veterans. These are minimums, not targets.
• Then a 6-stage return, each stage at least 24 to 48 hours for under-23s, seniors and veterans and 48 to 72 hours for under-20s and younger, going back a stage if symptoms return.
• Written clearance from a doctor experienced in concussion before competing.
• A specialist review after 2 concussions in 12 months, and a 3-month break from training and competition after 2 in 3 months.

Sources 53, 97

US collegesStrong evidence

A wrestler with a suspected concussion is removed, can't return that day, and doesn't return until cleared by an appropriate health care professional. Officials are told: "When in doubt, call an injury timeout."

Source 2

Grassroots wrestling in the UKStrong evidence

The UK guidelines for grassroots sport: if in doubt, sit them out; get an assessment within 24 hours, from a healthcare professional or NHS 111; follow a graduated return; and no competition before day 21. Our concussion guide explains the stages.

Source 98

Everyone: seven questions

The PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or losing consciousness, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your doctor or a qualified exercise professional first. Veterans especially: in Iran, catastrophic events not caused by impacts were mostly heart problems in older wrestlers, and US high-school boys' wrestling recorded 43 such events from 1982 to 2025, 31 of them deaths.

Sources 99, 100, 33

Anyone thinking about cutting weight

Rapid weight loss killed three college wrestlers in 1997, raises markers of kidney strain and goes with poor sleep, fatigue and injury. Follow your governing body's rules, choose a weight class you can make with ordinary eating and training, and talk to your coach and a sports dietitian (our suggestion).

Sources 5, 74, 75

Worries about eating, weight or body shape

Wrestlers are more prone to eating disorders than athletes in other sports. The NHS: "If you think you may have an eating disorder, see a GP as soon as you can." Beat's helplines and our eating disorders guide can help, and you shouldn't cut weight.

Sources 76, 101, 82

Girls and women whose periods stop, or who keep getting stress injuries

Low energy availability goes with missed periods and bone loss. See a GP; our women's and menstrual cycle guides explain more.

Source 79

Children and young teenagers

A qualified coach, partners matched by size, ability and maturity, no weight cutting, and other sports too (our suggestion).

Sources 6, 12, 46

After a concussion, or more than one

Follow the staged return and get cleared before contact. UWW asks for a specialist review after 2 concussions in 12 months; our concussion guide explains the UK stages.

Sources 53, 98

Neck problems, or a past stinger

Stingers were the commonest spine injury in college wrestlers. Get a physiotherapist's check before live wrestling (our suggestion); our stingers and neck guides explain more.

Source 32

Cold sores that keep coming back, or eczema

Recurrences spread to partners, so tell your coach, don't wrestle with a sore, and ask your GP or team doctor about preventive treatment. Get eczema or psoriasis documented by a doctor before competitions, as skin checks may otherwise stop you.

Sources 87, 2, 8

Pregnant

Our pregnancy guide advises against contact sports in pregnancy. Stop live wrestling, and ask your midwife about other training.

People with epilepsy

Our epilepsy guide puts wrestling among sports where a seizure adds no extra risk. Tell your coach, and follow your usual care.

A head injury: call 999

The NHS says to call 999 if someone has hit their head and:

• Has been knocked out and hasn't woken up, or can't stay awake or keep their eyes open.
• Has a fit (seizure).
• Has problems with their vision or hearing, or clear fluid coming from their ears or nose.
• Has new numbness or weakness in any part of their body.
• Has problems with walking, balance, understanding, speaking or writing.

Source 102

Suspected concussion

Off the mat: if in doubt, sit them out. No return that day, and an assessment within 24 hours by a healthcare professional or NHS 111. Get help from NHS 111 straight away if they're being sick, feel dizzy, take medicine that thins the blood, or had been drinking alcohol.

Sources 98, 102

A neck injury

After a fall onto the head, with neck pain, or weakness, tingling or burning in the arms or legs: don't move them, as the UK guidelines say only trained healthcare professionals should, and call 999 (our suggestion).

Source 98

Skin infections

A cut or wound that's painful, swollen or red, feels warm or leaks pus needs an urgent GP appointment or NHS 111. Call 999 or go to A&E for spreading, hot, swollen skin with a very high temperature, a fast heartbeat, confusion or feeling faint.

Sources 103, 104

Dehydration

Get an urgent GP appointment or call NHS 111 if you feel unusually tired, feel dizzy on standing and it doesn't go away, or have dark yellow pee or are peeing less. Call 999 or go to A&E for blue, grey, pale or blotchy skin, skin that feels cold, fast breathing, confusion or being hard to wake.

Source 105

Dark pee or muscle pain far worse than the session explains

These can be signs of rhabdomyolysis, which put a 16-year-old in hospital after a preseason wrestling camp. Get medical help the same day: call NHS 111, or go to A&E if you feel very unwell. Our rhabdomyolysis guide explains more.

Source 106

A swollen ear

Get it seen the same day, before the blood hardens into cauliflower ear.

A dislocated shoulder or elbow, or a knee that gives way

Go to A&E if you can't move your arm or your shoulder looks out of place. Call 999 or go to A&E if you heard a crack, a joint has changed shape, or it's numb or tingling. A knee that gives way or locks needs checking: see our ACL and meniscus guides.

Sources 107, 108

"Cutting weight is how you win"Mixed evidence

One 1998 study found that high-school wrestlers below their recommended minimum weight placed more often, but dehydration harms high-intensity performance, a review advises competing tapered and well hydrated rather than after rapid weight loss, and the NCAA says coaches and wrestlers should avoid rapid weight cutting. Three wrestlers died cutting weight in 1997.

Sources 109, 59, 61, 5

"Sweat suits and saunas are a safe way to make weight"Strong evidence

All three wrestlers who died in 1997 wore sweat suits in the heat. US college rules ban such suits, saunas in season, hot rooms, laxatives, making yourself sick and diuretics, and British Wrestling warns that diuretics risk an anti-doping ban.

Sources 5, 2, 6

"Neck bridges and neck training prevent concussion"Mixed evidence

No study shows that neck strength reduces neck injury or concussion in wrestling. Train the neck for strength, not as protection.

Sources 52, 11

"Headgear stops concussion"Emerging evidence

Headgear about halved ear haematomas, but ringside physicians say headguards shouldn't be relied on to reduce the risk of concussion.

Sources 10, 11

"Cauliflower ear is a badge of honour; leave it"Emerging evidence

96% of Finnish athletes with cauliflower ear had symptoms, usually pain, and in Tehran hearing loss was more often reported with it. Prompt drainage prevents it.

Sources 39, 37

"Tape over ringworm or a cold sore and keep wrestling"Strong evidence

US high-school rules don't accept covering a contagious condition, US college rules don't allow active herpes to be covered, and British Wrestling says not to cover a lesion with tape and carry on.

Sources 8, 2, 9

"Skin infections come from dirty mats"Emerging evidence

Cleaning mats cuts their bacteria, but herpes spreads skin to skin, mostly where heads and faces meet, so showering straight after training and checking your skin matter as much.

Sources 51, 87, 9

"Wrestling is too dangerous for children"Emerging evidence

High-school injury rates are well below college rates, youth emergency visits fell over 10 years, and British Wrestling removes weight classes to cut for under 15. Coaching, matched partners and no weight cutting matter most (our reading).

Sources 3, 45, 6