The Epidemiology of Sports Injuries in Older Female Athletes: A National Analysis of Emergency Department Presentations

Background: Participation in sports and recreational activities is increasing among females aged 65 years and older, yet there is limited data describing differences in injury patterns across sport types in this population. We hypthothesized that sport-related injuries in older female athletes differ by activity type.

Methods: The National Electronic Injury Surveillance System (NEISS) database was queried (2014–2023) for sports- and exercise-related emergency department (ED) visits among females aged ≥65 years. National estimates were calculated using sample weighting. Injuries were categorized by sport, anatomic region, diagnosis, mechanism, and ED disposition. Sport categories were compared to identify differences in the distribution and patterns of injuries across activities.

Results: A total of 4,717 cases represented an estimated 247,695 national injuries. Injury incidence remained stable across the study period. Fitness training (28.3%), wheeled sports (23.9%), and walking/running (19.3%) accounted for the majority of cases. Trunk (26.0%) and head/neck injuries (21.4%) were the most common body part injured, and fractures represented 30.8% of diagnoses. Falls were the predominant mechanism (60.9%), and 18.4% of patients required hospitalization. Among sports-related ED presentations, wheeled sports demonstrated higher odds of head/neck injury and fractures. Court and field sports, while consisting of a low overall proportion of injuries, showed elevated wrist/hand injuries and fractures compared to other sports-related ED presentations. Aquatic sports had the lowest overall injury burden. Fitness training injuries accounted for the largest proportion of injury-related ED presentations, while walking and running sports represented a moderate proportion of cases compared with other sports.

Conclusion: Sport-related injury patterns in older females vary substantially by activity type. In this cohort, falls and fractures compose the primary mechanism and diagnosis among patients presenting to the emergency department, respectively. Aquatic and court/field sports accounted for a smaller proportion of emergency department presentations, whereas wheeled sports and fitness training represented a larger share of cases. These

Findings: increase awareness of sport-related injury patterns in older female athletes and may help inform future injury prevention efforts in this population screening, accurate diagnosis, and timely referral for treatment.