Epidemiology of Bowling-Related Injuries Presenting to US Emergency Departments From 2014 to 2023

Bowling is a widely practiced sport in the United States, both recreationally and competitively. Despite its popularity, bowling carries a risk of injury. However, comprehensive epidemiological data on bowling-related injuries are extremely limited, especially in comparison with those for other well-known sports. This study aims to provide an updated review of epidemiological patterns by age, sex, body region, and mechanism of injury for bowling-related injuries in the United States between 2014 and 2023.

Retrospective epidemiological study.

Bowling-related injury data from 2014 to 2023 were extracted from the National Electronic Injury Surveillance System. Variables included age, sex, body region, diagnosis, disposition, and injury mechanism. Weighted national estimates were calculated. Statistical analyses included linear regression, t-tests, analysis of variance, and chi-square tests, with significance set at P < .05.

A total of 3299 injuries were identified, corresponding to a national estimate of 141,844 injuries. The mean age was 34 years; 51.6% were male. Adults (19-64 y) had the highest injury rates. Trunk (21.9%), head/neck (13.4%), and finger (12.6%) were the most commonly injured regions across all age groups. Sprains/strains were the most frequent diagnosis (29.9%). Falls were the leading mechanism (27.5%), especially in children and seniors. Most patients (95%) were treated and released. Injury incidence declined over the study period, with a sharp drop in 2020, likely due to the COVID-19 pandemic and declining bowling participation.

Bowling-related injuries most commonly affect the trunk and upper extremities, with falls and overexertion as leading mechanisms. Injury patterns vary by age, with children and seniors demonstrating higher rates of falls and acute injuries, and adults demonstrating higher rates of overuse injuries. Understanding the epidemiology of bowling-related injuries can inform targeted prevention strategies, including supervision and equipment for children, conditioning for adults and seniors, and education on safe techniques for all bowlers.