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Wrestling is a physically demanding sport with an inherently high risk of injury relative to other sports. Injury risk factors may change dramatically for athletes participating in off-season wrestling, given exposure to new opponents, training methods, and wrestling styles compared with in-season months; however, this has never been elucidated in the literature. This study seeks to characterize the injuries sustained while participating in off-season wrestling and compare them to injuries sustained during the in-season months for middle and high school age athletes. The National Electronic Injury Surveillance System (NEISS) database was queried (2000–2018) to directly compare national estimates and injury characteristics of middle and high school age patients (11–18 years of age) presenting to US emergency departments (EDs) with wrestling-associated injuries, stratified by in-season and off-season months. The average annual number of patients 11 to 18 years of age presenting to US EDs with wrestling-associated injuries was 20,157 (95% Confidence Interval [C.I.] 16,622–23,691) during in-season months and 5,321 (C.I. 3,954–6,688) during off-season months between 2000 and 2018. Those sustaining in-season injuries were significantly (p &lt; 0.001) more and less likely to injure their upper trunk (8.0%; C.I. 7.1% – 8.8%) and wrists (3.7%; C.I. 3.2% – 4.2%), respectively, than those presenting with off-season injuries (upper trunk: 5.3%; C.I. 4.2% – 6.5%; wrists: 6.6%; C.I. 5.1% – 8.1%). There were no significant differences with respect to the overall prevalence of injury diagnoses between in-season and off-season patient cohorts, including for fractures and dislocations (p &gt; 0.05). These findings may alleviate concerns that off-season wrestling is inherently more dangerous than in-season wrestling due to changes in wrestling styles or opponent skill levels as the prevalence of specific injury diagnoses between the two seasons is similar.

Comparison of in-season and off-season wrestling injuries presenting to United States emergency departments: 2000-2018