Background Track and field athletes are at high risk of both acute and overuse injuries, with an incidence ranging from 1 to 30 injuries per 1,000 athletic exposures, due to the diverse biomechanical demands of events like overuse injuries in distance runners, traumatic injuries in jumpers, and upper-limb injuries in throwers. Exercise-based interventions have demonstrated injury-preventive effects in other sports; however, their effectiveness in athletics remains unclear. Objective This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effectiveness of exercise-based interventions in preventing sports injuries among track and field athletes by conducting a comprehensive search of PubMed, Web of Science, Scopus, and SPORTDiscus for articles published between 2012 and 2025. The final search was performed on January 1, 2025. Methods A total of 2410 records were retrieved and 10 randomized controlled trials met the inclusion criteria. Studies involving track and field athletes (P) exercise-based injury prevention interventions (I) compared with a control group (C) reporting injury incidence risk or rate (O) and employing an RCT design (S) were included. Study quality was assessed using the PEDro scale. Meta-analysis was conducted using RevMan 5.4 employing a random-effects model to calculate pooled rate differences with 95% confidence intervals. Study quality was evaluated using the Physiotherapy EvidenceDatabase scale and the Cochrane Risk of Bias 2 .0 tool to assess methodological rigor and potential bias. Results Ten RCTs were included. Interventions included strength training, neuromuscular training, gait retraining, and flexibility or conditioning programs. Only six trials reported statistically significant reductions in injury incidence. Meta-analysis of three eligible studies showed a significant reduction in injury incidence in the intervention group compared to controls (mean difference: -7.63 injuries per 1,000 h; 95% CI: -12.07 to -3.20; p = 0.0007; I² = 88%). Only three studies were eligible for meta-analysis due to consistent outcome reporting in injuries per 1,000 exposure hours. Conclusion Exercise-based interventions, particularly strength, neuromuscular, conditioning, flexibility, and gait retraining programs, show moderate-to-strong evidence for reducing injury incidence among track and field athletes.
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