This study used the National Electronic Injury Surveillance System (NEISS) to characterize sports- and recreation-related shoulder and elbow injuries in U.S. adults aged ≥65 presenting to emergency departments from 2010 to 2024, evaluating demographics, diagnoses, mechanisms, seasonality, and fracture risk by sport.
An estimated 248,207 shoulder and 106,031 elbow injuries occurred nationally over the study period. Fractures were the leading diagnosis for elbow injuries (32.1%) and a top diagnosis for shoulder injuries (26.5%), alongside strains/sprains (24.0%). Males accounted for 63.8% of shoulder and 60.3% of elbow injuries. Bicycling was the most common mechanism for both joints. The proportion of these injuries rose to ~8% of all older adult ED visits by 2024, with a summer peak.
- NEISS captures only ED visits, missing injuries managed outside emergency settings (e.g., urgent care, outpatient). - Narrative text analysis and logistic regression cannot establish causation or control for changes in activity participation rates over time. - No data on injury severity, surgical intervention, or long-term outcomes.
Clinicians and public health teams should counsel older adult patients—especially male cyclists—on fall prevention and protective equipment, given the rising fracture burden from sports and recreation. Summer months represent a peak risk window worth targeting for injury prevention messaging.
