Pediatric weight training fractures due to improper use: a review of national injury data, 2014-2023

Youth weight and resistance training are growing in popularity, offering benefits like improved performance and injury prevention. However, improper technique and lack of supervision can lead to injuries - many of which are preventable with proper training and guidance. This study examined weightlifting-related injury trends and causes among youth in U.S. emergency departments. It was hypothesized that injuries would increase from 2014 to 2023, teens would have the highest injury rates, and crush injuries to fingers and toes would be the most common.

The National Electronic Injury Surveillance System (NEISS), a publicly available database representing approximately 100 US EDs, was used to identify fractures related to weightlifting in patients 0-18 years old. Fractures were included in this study if caused by improper use of equipment, dropped weights, crush injuries, or falls due to misplaced equipment. Queries were restricted to fractures from 2014 to 2023.

From 2014 to 2023, an estimated 32,955 fractures related to weightlifting were identified, out of which, 28,647 were due to improper use. The mean age was 11.4 ± 5.9 years. Across the study period, the highest number of fractures from improper use in a year was in 2023 (NEISS cases = 114, NE = 3639, 12.7%). Most fractures occurred in males (NEISS cases = 679, NE = 20380, 71.1%). Adolescents (15-18) were the most injured age group (NEISS cases = 376, NE = 12646, 44.1%), with fractures occurring most frequently at home (29.6%) and at places of recreation or sports (21.1%). The most fractured body parts were the finger (38.9%) and toe (38%). There was a significant increase in finger fractures across time (p < .01).

Weight training-related fractures due to improper use display an observed increasing trend among male youth in the US, with an actual case count of 1386 in 2014 increasing to 2815 in 2023. Additionally, there was a significant increase in finger injuries. Future research should be focused on implementing more stringent safety guidelines, increased supervision, as well as proper equipment use, and education for youth in the US, especially in homes and places of recreation.