Comparison of Acute Orthopaedic Injuries From Cardiovascular Versus Strength Exercise in Adolescents and Young Adults to the Emergency Department: An Analysis of the National Electronic Injury Surveillance System Database, 2018-2022.

BACKGROUND

Adolescents and young adults comprise a growing cohort at risk for exercise-related injuries. Recent studies compare the effects of cardiovascular and strength exercise on mental health, cardiovascular disease, and mortality; however, there remains a gap in the literature about acute injuries from these exercise types.

HYPOTHESIS/PURPOSE: The purpose was to compare acute orthopaedic injuries sustained during cardiovascular exercise versus strength training in adolescents and young adults. A secondary aim was to compare the distribution of age, sex, and injury characteristics with the types of exercise. Finally, it was hypothesized that injuries would have increased throughout the previous 5 years.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

This retrospective study used a National Electronic Injury Surveillance System (NEISS) query to identify patients aged 14 to 22 years with orthopaedic injuries due to exercise activities from 2018 to 2022. Injuries were attributed to cardiovascular exercise or strength training, which included weightlifting. Descriptive data were reported, and statistical comparisons were conducted via chi-square tests, Fisher exact tests, or linear regressions.

RESULTS

The NEISS query identified 3105 cases. A total of 1474 (50.9%) cases were attributed to cardiovascular exercise and 1423 (49.1%) to strength training-including 1136 (39.2%) to weightlifting. Also, 48.4% of cardiovascular-related and 75.1% of strength-related injuries occurred in men. The number of patients with cardiovascular-related (b = -7.983; = .013), strength-related (b = -15.05; = .001), and weightlifting-related (b = -11.78; = .004) injuries decreased with increasing age. Most injuries were sprains/strains (68.2% cardiovascular-related vs 50.4% strength-related). There were more upper extremity injuries during strength training (65.9%) than cardiovascular exercise (16.3%) ( < .001). No significant changes were observed in the annual number of injuries (b = -20.70; = .442).

CONCLUSION

Thousands of adolescents and young adults are injured each year while exercising. Strength training injuries were more common in men, but cardiovascular exercise injuries were comparable between men and women. Young age was associated with higher injury rates from all exercise types. Cardiovascular and strength exercises were associated with different injury patterns. Future studies should consider longer periods and overall participation to compare the incidence between cardiovascular and strength exercise.