Understanding injury rates and costs is crucial for targeted prevention, yet data across sports remain sparse. Furthermore, information on the impact of the COVID-19 pandemic on injuries across sports is limited. This study aimed to describe injury incidence rates, injured body regions, costs, and mean cost per 1000 athlete year across different sports before and during the COVID-19 pandemic. The study analyzed insurance data from licensed Norwegian athletes aged 13-50 years participating in football, handball, athletics, gymnastics, and swimming over a four-year period (2017-2020). Injury incidence rates, body region, costs, and mean cost per 1000 athlete year, as well as differences in injury rates between sports, sex, age groups, before and during the first year of the COVID-19 pandemic were analyzed. Over the full study period, the highest injury incidence rates were found in athletics, followed by handball, compared to football, gymnastics, and swimming. Lower extremity injuries accounted for the highest incidence rates and costs across sports. Surgical interventions in handball and football accounted for more than half of the costs. Over one fifth of injuries in gymnastics led to permanent medical impairment. During the first year of the COVID-19 pandemic, the number of licensed athletes and incidence rates decreased, except for athletics, which experienced an increase in both. The findings highlight the need for targeted injury prevention measures, particularly in athletics and for lower extremity injuries in handball and football. The fact that one in five injuries in gymnastics resulted in medical impairment is a cause for concern. The impact of the COVID-19 pandemic on sports participation and injury incidence underscores the influence of external factors on sports-related injuries.
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