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HOOTMAN, J. M., C. A. MACERA, B. E. AINSWORTH, C. L. ADDY, M. MARTIN, and S. N. BLAIR. Epidemiology of musculoskeletal injuries among sedentary and physically active adults. Med. Sci. Sports Exerc., Vol. 34, No. 5, pp. 838–844, 2002.This study describes the types and frequencies of musculoskeletal injuries among a cohort of adults with above average activity levels who were enrolled in the Aerobics Center Longitudinal Study (Dallas, TX).Participants were adults aged 20–85 yr who completed a baseline clinical examination (1970–1982) and returned a mailed follow-up survey in 1986. Participants (5,028 men, 1,285 women) were measured for aerobic fitness, height, and body weight during the baseline examination. They reported detailed information about their physical activity levels and injury experiences on the follow-up survey (1986). An injury was defined as any self-reported soft tissue or bone injury that occurred within the previous 12 months. Activity-related injuries were those injuries participants attributed to participation in a formal exercise program.A quarter of all participants reported a musculoskeletal injury. Of these, 83% were activity-related. More than 66% of activity-related injuries occurred in the lower extremity; the knee was listed as the joint most often affected. There were no significant sex differences in the prevalence of injury, regardless of cause. Sport participants had the highest proportion of all-cause and activity-related musculoskeletal injuries among both men and women. Self-perceived severe injuries had a significant negative impact on physical activity levels since almost 1/3 of subjects reported permanently stopping their exercise program after injury.These results suggest the need for developing and implementing injury prevention programs targeted toward moderately active adults.