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Musculoskeletal and Sports Medicine

Upper Extremity Injuries in High School Goalkeepers

Friday, October 24, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 7
Disclosure(s):
Christian Nicolosi, MD: No financial relationships to disclose
Jeffrey W. Kepple, MD: No financial relationships to disclose
Mani P. Singh, MD: No financial relationships to disclose
Ashley E. Pietra, Other: No financial relationships to disclose
Background and/or Objectives: Most soccer injuries involve the lower extremities; however, goalkeepers are susceptible to upper extremity injuries due to frequent diving and ball contact. While collegiate and professional data show elevated shoulder and elbow injury rates in goalkeepers, data at the high school level are limited. Our study aimed to compare upper extremity injury rates between high school soccer goalkeepers and field players, examine sex-based differences, characterize injury type and mechanism, and identify prevention opportunities.

Design: Retrospective cohort study

Setting : High School RIO™ surveillance system was utilized for data collection. Analyses included soccer-related injuries to the shoulder, upper arm, and elbow. Chi-square and binomial proportion tests were used for comparisons.

Participants : High school boys’ and girls’ soccer players from the database were included in the study.

Interventions: None

Main Outcome Measures: Proportion of upper extremity injuries among goalkeepers vs. field players, Injury type (shoulder vs. elbow), mechanism (trauma vs. overuse), and sex-based comparison were collected.

Results: Of 1,008 goalkeeper injuries, 81 (8.04%) involved the upper extremity, compared to only 1.94% among field players—a 4.1-fold increased risk (p < 0.0001). Among goalkeepers, upper extremity injuries represented 19.3% of female and 16.8% of male injuries (not significant, p = 0.26). Shoulder injuries made up 84% of upper extremity injuries, significantly more than elbow injuries (16%, p < 0.0001). Most injuries (93.7%) were trauma-related.

Conclusions: High school soccer goalkeepers are significantly more likely than field players to sustain upper extremity injuries, primarily to the shoulder and caused by trauma. No sex-based differences were observed. A goalkeeper-specific prevention worksheet was piloted in youth and semi-professional settings. Future work will address distal upper extremity injuries, compare rates of injuries to other overhead sports and assess prevention strategies across age groups