Age-Related Risk Factors for Injury and Reinjury
Age significantly influences injury risk, recovery capacity, and the likelihood of recurrent musculoskeletal injuries. Both younger and older populations face unique physiological and biomechanical challenges that increase vulnerability to initial and repeat injuries.
Young Athletes and Young Adults (10–24 years)
Individuals aged 10–24 years are particularly susceptible to growth-related and overuse injuries. This increased risk arises from high levels of sports participation combined with rapid physical development. Injury incidence is highest during periods of accelerated growth, particularly when training loads increase faster than the musculoskeletal system can adapt [Adirim & Cheng, 2003; Brenner & Watson, 2024].
During adolescence, skeletal immaturity and rapid growth create structural vulnerabilities. Growth cartilage at the physes and apophyses is mechanically weaker, while temporary imbalances between bone mineralization, muscle strength, and tendon stiffness are common during growth spurts [DiFiori et al., 2014]. These physiological factors reduce tissue load tolerance, predisposing young athletes to repetitive stress and overuse injuries.
Recurrent injuries in this age group most frequently involve the ankle, knee, and shoulder, reflecting the high mechanical demands placed on these joints during training and sport participation [Swenson et al., 2009; Wik et al., 2021; Materne et al., 2021].
Older Adults (≥70 years)
In older adults, particularly those aged 70 and above, a history of trauma substantially increases the risk of subsequent and recurrent injuries [McGwin et al., 2001]. This risk is further amplified by chronic medical conditions, reduced physical capacity, and functional impairments.
Several age-related physiological factors contribute to reinjury risk in this population: frailty, muscle weakness, slow gait speed, and fatigue are independently associated with higher rates of recurrent injury [Colón-Emeric et al., 2024; Jehu et al., 2021]. Polypharmacy—especially medications affecting balance, alertness, cognition, or muscle function—further increases susceptibility. Neurologic and sensory deficits, including cognitive impairment, dementia, prior stroke, visual or hearing impairment, and peripheral neuropathy, compromise balance, coordination, and reaction time [Rivan et al., 2021; Welburn et al., 2023].
Environmental and social factors such as living alone, reliance on walking aids, depression, and low physical activity levels compound these risks [Colón-Emeric et al., 2024; Jehu et al., 2021; Namoos et al., 2024]. Additionally, female sex and advanced age—particularly individuals over 85 years—are associated with higher rates of recurrent injury [Mangram et al., 2023].
References:
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Brenner, J.S. & Watson, A., 2024. Overuse injuries, overtraining, and burnout in young athletes. Pediatrics, 153(2), p.e2023065129. https://doi.org/10.1542/peds.2023-065129
Colón-Emeric, C.S., McDermott, C.L., Lee, D.S. & Berry, S.D., 2024. Risk assessment and prevention of falls in older community-dwelling adults: a review. JAMA, 331(16), pp.1397–1406. https://doi.org/10.1001/jama.2024.1416
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Mangram, A., Berdeja, J., Cocanour, C. et al., 2023. Best practices guidelines geriatric trauma management. American College of Surgeons.
Materne, O., Chamari, K., Farooq, A. et al., 2021. Injury incidence and burden in a youth elite football academy: a four-season prospective study. British Journal of Sports Medicine, 55(9), pp.493–500. https://doi.org/10.1136/bjsports-2020-102859
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Namoos, A., Thomson, N., Olson, C. & Aboutanos, M., 2024. Physical injury and psychological impact: understanding the high risk of depression on older adults with recurrent falls. Advances in Geriatric Medicine and Research, 6(4), p.e240008. https://doi.org/10.20900/agmr20240008
Rivan, N.F.M., Singh, D.K.A., Shahar, S. et al., 2021. Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults. BMC Geriatrics, 21(1), p.593. https://doi.org/10.1186/s12877-021-02525-y
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Wik, E.H., Lolli, L., Chamari, K. et al., 2021. Injury patterns differ with age in male youth football: a four-season prospective study. British Journal of Sports Medicine, 55(14), pp.794–800. https://doi.org/10.1136/bjsports-2020-103430