Contents
The eye: a rare injury, but the most serious
The numbers come from a questionnaire answered by 163 competitive players in Australia (Genovese et al., 1990): 17.5 eye injuries per 100,000 playing hours, 26% of players injured at least once, the racquet as the source in 61% of cases, and only 8% of all the players surveyed used appropriate protective eyewear. Other studies find the ball more often than the racquet: the sources disagree on that point.
The 2024 systematic review gathers 29 publications across four racket sports: 25 case series and 4 case reports, all collected in a medical setting. It reports that a median 93% of eye injuries happened with no eyewear, that lensless guards are ineffective, and that no injury has been reported in a player wearing eyewear that complies with the current standards. Its authors state the limit: without population figures, causality is « very difficult to demonstrate », and no controlled study has measured the effect of eyewear on injuries. The federations' instruction stays simple: certified eyewear for juniors and in doubles (the detail per federation is in Age groups, balls and eyewear).
The cardiac question: what the studies say
Two British case series describe sudden deaths associated with squash: 30 deaths in the first (29 men, mean age 46.7, coronary heart disease in 23 of the 27 players examined after death) and 60 in the second (59 men, mean age 46, a certified coronary cause for 51 of them). In that second series, 45 of the 60 players had had warning symptoms, most often chest pain. These series say who died, not how often: no source gives deaths per player or per hour played, and no series newer than 1986 was found.
The effort itself has been measured: in 21 fit men aged 23 to 43, heart rate stayed at 80% of predicted maximum for the duration of a game (Northcote et al., 1983); in ten older men, a competitive game produced responses similar to those of an exhaustive treadmill test (Brady et al., 1989). The advice that follows is expert opinion, not the result of a trial: a 1997 medical review recommends a medical check-up for players over 40, with an exercise test when risk factors are present. No study has shown that screening lowers deaths in squash.
Squash's own conditioning
| Method | What you do | The technique point |
|---|---|---|
| Interval ghosting | Work/rest blocks of corner movement, no ball | Form first: stop the interval when technique collapses |
| Court shuttles | Fast runs between the court lines, a lunge or touch at each end | Brake under control before every change of direction |
| Lunge technique | Slow, held lunges into every playing position, pushing back to the T | Front knee tracking over the foot, never collapsing inward |
These are technique points, not proven prevention: no study has measured their effect on injuries in squash. Where injuries have been counted, the lower limb comes first: 76.48% of the injuries recorded in 67 England Squash funded players followed from 2004 to 2015, ankle and heel first (Horsley et al., 2020). The 2026 review, which gathers twelve studies, concludes that a reliable injury rate cannot yet be established for squash (McCartney et al., 2026).
What does not exist, and will not be sold to you
Squash has no FIFA 11+ equivalent: no controlled trial has tested an exercise programme (warm-up, strength, balance) on squash players with an injury outcome, and the two most recent reviews (2024 and 2026) list none. On return to play, one known exception: Squash Canada has published a squash-specific concussion policy since 2019, with return-to-sport steps; the World Squash rules do not mention concussion (Mangan and Heron, 2025). When prevention content circulates, it is general practice, not a validated squash protocol.
Frequently asked questions
Are ordinary glasses enough?
Should a player over 40 who is coming back see a doctor first?
How many conditioning sessions per week?
Sources
Eye: Genovese MT et al., Medical Journal of Australia, 1990 (questionnaire, 163 replies: 17.5 injuries per 100,000 hours; 26%; racquet 61%; 8% of the sample used appropriate protective eyewear); Mazarelo JFD, Winter SL & Fong DTP, The Physician and Sportsmedicine, 2024 (systematic review: 25 case series and 4 case reports); World Squash, protective eyewear specification page, read on 13 October 2026. · Heart: Northcote RJ et al., The Lancet, 1984 (30 deaths) and British Heart Journal, 1986 (60 deaths); Northcote RJ et al., British Heart Journal, 1983 (heart rate in play); Brady HR et al., European Heart Journal, 1989; Locke S et al., Sports Medicine, 1997. · Injuries: Horsley IG et al., Physical Therapy in Sport, 2020; McCartney RV, Fallon T & Heron N, Sports, 2026 (systematic review, 12 studies); Honeyfield A, master's thesis, Auckland University of Technology, 2024. · Concussion: Mangan N & Heron N, Sports, 2025. Content verified in October 2026.