Weightlifting-Associated Lower Extremity Injuries Among Pediatric and Adult Patients: A National Analysis From 2014 to 2023.

Background: Weightlifting continues to increase in popularity due to its numerous benefits for physical health, performance enhancement, and age-related functional preservation. Although previous studies have investigated injury patterns in strength athletes, few have examined lower extremity injuries among the general population. Purpose: To evaluate the epidemiologic trends, injury characteristics, and mechanisms of weightlifting-associated lower extremity injuries in pediatric and adult patients. Study Design: Descriptive epidemiologic study. Methods: A retrospective cohort study of the National Electronic Injury Surveillance System (NEISS) was conducted to identify emergency department visits for lower extremity injuries related to weightlifting between January 1, 2014, and December 31, 2023. Patient demographic characteristics, injury diagnosis, body part, and mechanism of injury were collected. Patients were stratified into 4 age groups: pediatric (<18 years), young adult (18-39 years), middle-aged (40-64 years), and geriatric (≥65 years). Chi-square tests were used to analyze categorical variables, and temporal trends were evaluated using linear regression models. Results: The sample included 6846 cases (national estimate [NE] = 260,704). The mean age was 32.20 ± 30.71 years, with approximately 69.9% of the study population being male. Common diagnoses were contusion/abrasion (n = 1435; NE = 55,722; weighted percent of NE = 21.0%), fracture (n = 1321; NE = 48,344; 19.5%), and nerve injury (n = 348; NE = 15,397; 5.1%). The most commonly affected body parts were lower trunk (n = 2575; NE = 101,480; 37.6%), toe (n = 1697; NE = 60,871; 24.8%), and foot (n = 1389; NE = 52,860; 20.3%). Pediatric patients experienced the highest proportion of injuries to the toe (NE = 22,328, 35.2%) and foot (NE = 18,223, 28.7%), whereas high rates of lower trunk injuries were observed in young adults, middle-aged adults, and geriatric populations (NE = 60,594, 47.0%; NE = 25,559, 46.7%; NE = 4528, 33.7%; respectively). Pediatric patients demonstrated the highest proportion of injuries due to drop/crush injury (NE = 41,625; 65.5%), whereas young and middle-aged adults were commonly injured performing "nonspecific" lifting movements (NE = 46,286, 35.9%; NE = 22,130, 40.4%; respectively). Conclusion: The increased risk of foot and toe trauma in pediatric patients and high incidence of injuries due to dropped weights highlight the need for increased supervision, education, and protective equipment. In contrast, adult lifters were commonly injured performing lifting movements, resulting in increased rates of lower trunk injuries. Targeted, age-specific strategies to mitigate injury risk and promote safety regarding lower extremity weightlifting injuries are needed.