Rising Trends in Wrestling-associated Injuries in Females Presenting to US Emergency Departments

Introduction: Wrestling is one of the fastest-growing sports among females in the United States(US). However, female wrestling injuries remain poorly characterized. In this study we describehistorical and projected national estimates of female wrestling injuries, and compare injurycharacteristics with those of male wrestlers.Methods: We queried the National Electronic Injury Surveillance System (NEISS) database (2005-2019) to compare national weighted estimates and injury characteristics of male vs female wrestlerspresenting to US emergency departments (ED) and projected annual female wrestling injuriesexpected by 2030.Results: Our analyses demonstrated a significant (P < 0.001) increase in female wrestling injuriesbetween 2005 (N = 1500; confidence interval [CI], 923 – 2,078) and 2019 (N = 3,404; CI 2,296 –4,513). Linear regression (R2 = 0.69; P < 0.001) projected 4,558 (CI, 3104 – 6033) such injuries in2030. Of female wrestling injuries 50.1% (CI, 44.1 – 56.2) occurred in patients 14-18 years of age.Compared with age-matched males, female wrestlers were significantly less likely to present withfractures (Female [F]: 10.6%; CI 7.5% – 13.7%; Male [M]: 15.7%; CI 14.7% – 16.7%; P = 0.003)or head/neck injuries (F: 18.5%; CI 13.2% – 23.9%; M: 24.6%; CI 23.2% – 26.0%; P = 0.018), andsignificantly more likely to present with strains/sprains (F: 48.8%; CI, 41.2% – 56.3%; M: 34.4%; CI31.6% – 37.1%; P < 0.001).Conclusion: Males and females possess distinctly unique physiology and anatomy, such asvariances in ligamentous and muscular strength, which may help to explain differences in wrestlinginjury characteristics. Prompt management of injuries and specific training strategies aimed atprevention may help to reduce the projected increase of female wrestling-associated injuries as thepopularity of the sport continues to rise.