Pediatric Martial Arts–Related Injuries Treated in Emergency Departments in the United States From 2004 to 2021

Abstract

Background: Participation in martial arts has been increasing for several years, with millions of children and adolescents engaging in the sport annually. Yet, the most comprehensive examination of martial arts–related injuries was completed almost 2 decades ago. Purpose: To describe the epidemiology of martial arts–related injuries presenting to US emergency departments (EDs) among pediatric patients. Study Design: Descriptive epidemiological study. Methods: Data were obtained from the National Electronic Injury Surveillance System for patients aged 3 to 17 years who were treated in US EDs from 2004 through 2021. Results: A total of 5656 cases were included in the analysis. An estimated 176,947 children (95% CI, 128,172-225,722) were treated for martial arts–related injuries in US EDs. The rate of martial arts–related injuries per 10,000 children increased from 1.43 in 2004 to 2.07 in 2013 (slope = 0.07; P = .005) and then decreased to 1.44 in 2021 (slope = −0.10; P = .02). The mean injury rates were 2.22 per 10,000 children aged 12-17 years and 1.15 per 10,000 children aged 3-11 years. The most common injuries occurred in children aged 6 to 11 years (39.3%), were strains/sprains (28.4%), and were associated with falling (26.9%). The mechanism of injury differed by the style of martial arts. Compared with other activity types (formal class, horseplay, and unspecified), competition carried a 2.56 times greater risk of head/neck injuries and a 2.70 times greater risk of traumatic brain injuries. Conclusion: Martial arts are a significant source of injuries for children aged 3 to 17 years. To continue decreasing the injury rate, the creation and implementation of standardized risk-mitigation rules and regulations that could be applied to all martial arts styles are recommended.