Growth, maturation and injuries in high-level youth football (soccer): A mini review

Abstract

Understanding the challenges football (soccer) players face during adolescence is fundamental to avoid disruptions in their development due to injury. This mini review will describe basic concepts of somatic growth and biological maturity, examine data from 53 prospective epidemiological studies on high-level youth football players and discuss how age, growth and maturity may affect the injury patterns observed. Based on the existing evidence, at least every third player sustains an injury during a football season. The thigh (median for studies of boys: 25%, median for girls: 21%), ankle (b: 18%, g: 30%), knee (b: 17%, g: 18%) and hip/groin (b: 14%, g: 10%) are the body parts injured most often, while muscle strains (b: 31%, g: 25%), sprains (b: 20%, g: 27%) and contusions (b: 17%, g: 16%) are the most common injury types. Injury trends are, however, not consistent throughout adolescence, and players' age, maturity status and position relative to peak height velocity (PHV) have shown to influence the number, type and location of injuries sustained. Despite a high volume of observational injury studies published on high-level youth players, girls (7 studies) and settings outside of Europe (included in 23% of studies) are underrepresented and should receive extra attention in the future. Based on the available epidemiological data, tailored injury reduction programmes can be considered in youth football, alongside application of general training principles such as progression, variation and individualization which may be especially important during vulnerable phases such as the adolescent growth spurt.

Developmental stage and lower quadriceps flexibilities and decreased gastrocnemius flexibilities are predictive risk factors for developing Osgood–Schlatter disease in adolescent male soccer players

“…To the best of our knowledge, this study is the irst to reveal the developmental stage describing PHV age ± 6 months as a risk factor of OSD development prospectively. Consistent with our results, several studies have reported that the prevalence of sports injuries among adolescent soccer players is high during 6 months before or after the PHV age [6,27,46,49], and van der Sluis et al [45] demonstrated coaches and trainers should be careful with the training and match load on the soccer players at around the PHV age to minimize the risk of injuries. Around the PHV age, not only the attachments of muscle tendons are stressed by the muscle shortening [41,50], but the rapid growth of the limbs deteriorates balance and causes clumsy movements [21,34,35,37].…”

Effect of Rule Modifications on Kinematic Parameters Using Maturity Stage as a Moderating Variable in U-10 Football Players

“…Regarding the injury rate, young players with late development report higher injury rates than players with early development [ 64 ]; for this reason, it is necessary to give special attention to this kind of player in the adjustment of competitions.. Thus, the proposed rule modification reduces the number of accelerations and decelerations in zone 3, which is related to a lower injury rate, as distance covered, accelerations, and changes in pace are considered some of the main injury mechanisms in young players [ 65 , 66 ].…”

15-year regional emergency department study of youth sport and recreational injuries

“…21 The results of several recent studies linking higher growth rates (e.g., changes in height, leg length or body mass index) and peak height velocity have been associated with increased injury risk in high-level youth football players. [22][23][24] Injury frequency and incidence of injury were more than two times greater for males than females, as has been reported elsewhere in the ED literature.2,11,12,20 In addition to differences in social-related participation patterns, possible explanations include hormonal differences, increased joint laxity in female athletes, anatomical differences, and differences in motor control.26 However, girls tend to have higher exposure-based injury rates than boys in gender-comparable high school sports.27 Also, girls may actually be at increased risk for anterior cruciate ligament injuries in the knee28 and sport-related concussions. 29 In our study, the higher rates of injury in males were most pronounced in the 15-19 age group.…”

“…43 The finding of increased risk and severity of SRI's during the timing of the adolescent growth spurt warrants maturity-specific prevention programs where coaches are encouraged to identify periods of rapid growth where resources allow and monitor training load of individual athletes to reduce injury risk.22-24,44 Observing, talking to, and educating players and parents may be equally effective. 22 The employment of bio-banding, a method by which players are grouped together based on their maturity and biological age rather than their birth year, also could potentially help reduce the risk of injury among youth athletes. 45,46 Finally, the trend of increased frequency of injury among females during the study period is a concern, especially in view of research showing increased risk of for anterior cruciate ligament injuries in the knee28 and sport-related concussions.29 Injury prevention strategies specifically targeting these injury types are needed to reduce the increasing number of injuries in girls' SR activities.42,47 Irrespective of the trend of sports injuries, however, an effort should be made to decrease injuries in all SR activities to promote safe play in children.20…”