Sex differences in martial arts injuries presenting to emergency departments in the United States from 2015 to 2024.

Abstract

Martial arts participation in the United States is increasing, particularly among females, but sex-specific injury patterns remain poorly understood. The purpose of our study was to examine sex differences in martial arts injuries presenting to United States emergency departments by year, age, body region, diagnosis, and martial arts style. We hypothesized injury distributions would differ between females and males METHODS: We conducted a retrospective cohort study where we queried the National Electronic Injury Surveillance for martial arts injuries recorded from 2015 to 2024. We calculated national injury estimates, injury incidence per 100,000 patients, and crude risk differences with 95% confidence intervals between females and males by age, region, diagnosis, and style. A total of 7613 cases corresponded to a national estimate of 277,753 martial arts injuries. Females had a significantly higher proportion of injuries among youth ages 2-17 years (46.1% vs 33.1%; RD 0.13; 95% CI, 0.09-0.17); foot (23.8% vs 17.3%; RD 0.07; 95% CI, 0.04-0.09), hand (14.7% vs 11.9%; RD 0.03; 95% CI, 0.01-0.05), and leg injuries (16.7% vs 14.4%; RD 0.02; 95% CI, 0.00-0.04); strains and sprains (29.9% vs 21.2%; RD 0.09; 95% CI, 0.05-0.12); and striking-style injuries (53.2% vs 32.2%; RD 0.21; 95% CI, 0.18-0.25). Most female injury incidence patterns post-2020 decreased or remained stable, while many male injury incidence patterns sharply rose, particularly those associated with grappling and mixed martial arts. Significant sex differences exist in martial arts injuries presenting to United States emergency departments. Injury distributions align with style categories, with females accounting for more striking-related injuries and males more grappling/mixed martial arts-related injuries. Post-2020 trends show widening sex differences in injury incidence. We highlight specific sex differences in martial arts emergency department injuries for use by healthcare professionals, coaches, and organizations. Recognition of sex-specific injury patterns may inform sex-specific training, injury prevention, and rehabilitation strategies for martial arts athletes across the lifespan.