A National Evaluation of Upper Extremity Weightlifting Injury Surveillance: The High Risk in Youth and Adults With an Underutilization in Older Adults.

BACKGROUND

Weightlifting improves physical fitness; however, injuries can lead to impaired functionality and long-term complications. Data on weightlifting-related injuries are limited.

PURPOSE: To evaluate the epidemiologic trends of weightlifting-associated upper extremity injuries, further stratified by age.

STUDY

DESIGN

Descriptive epidemiologic study.

METHODS

This analysis used the National Electronic Injury Surveillance System (NEISS) database, including all patients presenting to the emergency department (ED) with a primary upper extremity weightlifting injury between 2021 and 2024. Outcomes included patient demographic characteristics, final diagnosis, primary body region injured, and mechanism of injury (MOI). Patients were stratified into 4 age groups: pediatric (<18 years), young adult (18-39 years), middle-age (40-64 years), and geriatric (≥65 years). Chi-square tests and post hoc comparisons were used to evaluate categorical variables. Linear and logistic regression analyses were used to evaluate associations between age groups. Statistical significance was predetermined at <.05.

RESULTS

After application of inclusion and exclusion criteria, 3189 upper extremity weightlifting injuries (national estimate [NE] = 127,667) were analyzed. Across all ages, sprain/strain (NE = 36,054; 26.2%), fracture/crush/avulsion (NE = 22,388; 15.8%), and laceration/puncture (NE = 9020; 7.2%) were the most common diagnoses. Injuries most frequently involved the shoulder (NE = 45,825; 33.8%), finger (NE = 32,398; 28.1%), and upper arm (NE = 7827; 8.8%). The most common MOIs were drop/crush injuries (NE = 34,757; 30.1%), pulling movements (NE = 14,232; 10.5%), and overhead movements (NE = 11,110; 8.3%). Pediatric patients were 2.5 times more likely to sustain finger injuries (odds ratio [OR], 2.536; 95% CI, 2.191-2.935; P < .001) and injuries from drop/crush mechanisms (OR, 2.484; 95% CI, 2.166-2.849; P < .001) compared with all other age groups. The geriatric age group was 2 times more likely to sustain injuries from pushing movements (OR, 2.037; 95% CI, 1.326-3.130; P < .001) compared with all other age groups.

CONCLUSION

Sprain/strain and fracture/crush/avulsion were frequent upper extremity weightlifting injuries, often secondary to drop/crush injuries and overhead movements. Pediatric athletes were more likely to sustain finger and drop/crush injuries, whereas shoulder injuries affected all adult age groups. The low proportion of geriatric weightlifters suggests there may be underuse of a sport effective in combating osteoporosis. These insights into overall and age-specific injury patterns can help shape evidence-based recommendations to reduce the overall injury burden and promote safe resistance training.