Gender- and age-specific patterns of tennis-related injuries in pediatric populations: Insights from emergency room data (2014-2023)

INTRODUCTION: Pediatric tennis participation has grown steadily, yet limited research exists on sex- and age-based injury differences in this population. Understanding these patterns can inform tailored injury prevention efforts. MATERIALS AND METHODS: We queried the National Electronic Injury Surveillance System (NEISS) for tennis-related emergency department (ED) visits in patients under 18 years old from 2014 to 2023. Injuries were analyzed by sex, age group, injury type, and body region. National estimates (NEs) were calculated using NEISS sample weights. Statistical comparisons were performed to assess gender differences in injury patterns. RESULTS: A total of 1679 pediatric tennis-related injuries were reported, corresponding to a national estimate of 48,368 cases based on the database's sample weighting system. Males accounted for 53.1% of injuries, with a peak incidence at age 14; females made up 46.9%, peaking at age 16. Significant sex-based differences emerged across multiple domains. Males were more likely to experience fractures (p < 0.001), lacerations (p < 0.001), and upper extremity injuries, particularly to the elbow, eyeball, and face. In contrast, females sustained more ankle injuries (p < 0.001) and had a higher prevalence of strains and sprains (p < 0.001). By age, males sustained significantly more injuries in elementary school years (p < 0.001), while females had more injuries during high school (p < 0.001). DISCUSSION AND CONCLUSION: Distinct injury patterns exist between sexes in pediatric tennis injuries. Males more frequently experienced high-impact trauma, likely reflecting play style and biomechanics, while females showed a higher rate of lower extremity overuse injuries, especially at the ankle. These findings align with known neuromuscular and biomechanical differences in movement and landing strategies between sexes. The high rate of head and ocular trauma in males further supports the need for facial and eye protection in youth tennis. These findings support the need for sport and sex-specific injury prevention strategies which include neuromuscular training and protective equipment to promote safety among young tennis players.