Upper extremity injuries in high school soccer goalkeepers

Soccer participation continues to grow globally and in the United States, accompanied by an inherent risk of injury. Although most soccer injuries involve the lower extremities, goalkeepers experience disproportionately higher rates of upper extremity (UE) injuries due to position-specific demands. Although this pattern is well described at collegiate and professional levels, data among high school athletes remain limited.

To compare prevalence, characteristics, and outcomes of UE injuries between high school soccer goalkeepers and field players, as well as assess gender-based differences among goalkeeper injuries.

Data were obtained from the National High School Reporting Information Online surveillance system from 2008 to 2018. UE injuries were defined as injuries to the shoulder, upper arm, or elbow resulting in ≥1 day of time loss. Injuries distal to the elbow were excluded. Injury prevalence, event setting, anatomical site, mechanism, recovery time, and return-to-play status were compared between injuries to goalkeepers and injuries to field players, and between injuries to male and female goalkeepers. Chi-square testing was used with statistical significance set at α = .05.

Among 10,355 total soccer injuries, 266 involved the UE. Goalkeepers sustained a higher proportion of UE injuries than field players (8.0% vs. 1.9%, p <.001), representing a 4.1-fold increased burden of injury. No significant gender-based differences in UE injury prevalence were observed among goalkeeper injuries. Most goalkeeper UE injuries occurred during competition (58%) and involved the shoulder/upper arm (84%), with trauma accounting for 94% of cases. Often this was due to diving or falling on an outstretched arm. Goalkeepers more frequently required >22 days for recovery yet were more likely to return to sport than field players (93.6% vs. 79.9%, p = .006).

Among high school soccer players, UE injuries occur more frequently in goalkeepers than in field players, mirroring trends in collegiate and professional levels. These findings highlight the need for goalkeeper-specific UE injury prevention strategies, particularly at the high school level.