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

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.