Fighting for safety: head and spine injuries in martial arts presenting to U.S. emergency departments.

OBJECTIVE: Repetitive impacts to the head and spine are commonly reportedin martial arts-related injuries. This study describes cranial and spinal injury presentations among martial arts participants recorded by U.S emergencydepartments, characterizing their patterns to better inform future safety and injury-prevention efforts. METHODS: The National Electronic Injury Surveillance System (NEISS) was surveyed for martial arts injuries from 2014 to 2023. Case narratives were reviewed to extract fighting style, injury type, mechanism, hospital disposition, age, gender, and relevant notes. Patients were stratified into 10-year age cohorts. Weighted analyses generated national estimates and confidence intervals. Associations between age and diagnosis were assessed via logistic regression. All analyses were conducted in R. RESULTS: Over a ten-year period (2014-2023), 1,104 sampled martial arts-related narratives were identified in NEISS, corresponding to a survey-weighted national estimate of 36,635 emergency department presentations for neuroaxis injuries with a mean patient age of 24.5 years. Jiu-jitsu (26.9%) and karate (26.8%) were most frequently associated with injury. Among the most common injuries were lumbar (19.8%) and cervical (18.3%) strains, with throwing or flipping an opponent (17.1%) as the predominant mechanism. Concussions were more common in younger patients, particularly in the 10-19 (30.6%) and 20-29 (23.4%) age groups. Concussions constituted 18.4% of all injuries, with jiu-jitsu (26.8%) and karate (26.7%) being the most causational fighting styles. CONCLUSION: Martial arts-related head, neck, and spine injuries were recorded across all age groups in this analysis, with throwing and flipping techniques among the commonly reported mechanisms. These findings underscore the value of continued attention to safety practices in martial arts participation.