Injury Risk and Injury Burden Are Related to Age Group and Peak Height Velocity Among Talented Male Youth Soccer Players

Abstract

Background:The relationship between injury risk (IR) in age groups and periods around peak height velocity (PHV) remains unclear. PHV is defined as the moment of the largest increase in body height.Purpose:To investigate injury risk and injury burden as functions of growth velocity (periods around PHV) and chronological age groupings (under 12 years [U12] to U19) in talented youth male soccer players.Study Design:Cohort study; Level of evidence, 2.Methods:A total of 170 players from the youth academy of a Dutch soccer club (highest professional league: Eredivisie) were observed for 1 to 3 seasons. Injuries, exposure, PHV age, and chronological age were registered. The injury incidence density (IID) and injury burden per 1000 hours of soccer participation, with 95% CIs, were calculated for 5 PHV periods and 7 age groups. These were compared with the overall cohort results using incidence ratios (IRs) and burden ratios (BRs) with 95% CIs.Results:The mean age at PHV was 14.4 ± 0.65 years (range, 12.8-16.5 years). The mean IID for the total cohort was 8.34 injuries per 1000 hours (95% CI, 7.71-9.02). Compared with the overall mean, a significantly higher IID was found for PHV period 4+5 (IR, 1.31 [95% CI, 1.00-1.71]; P = .049) and for the U15 group (IR, 1.49 [95% CI, 1.24-1.79]; P < .001). The overall injury burden was 58.37 injury days per 1000 hours (95% CI, 56.66-60.13). In PHV period 4+5, the injury burden was significantly higher (BR, 1.53 [95% CI, 1.39-1.68]; P < .001) when compared with the overall mean. Also, compared with the overall mean, the injury burden was higher in the U16 (BR, 1.48 [95% CI, 1.39-1.58]; P < .001), U15 (BR, 1.28 [95% CI, 1.19-1.38]; P < .001), and U17 groups (BR, 1.21 [95% CI, 1.13-1.31]; P < .001).Conclusion:Talented young soccer players were more prone to injuries during the 6 months after PHV (31% above overall mean) as well as in the U15 group (49% above overall mean). Based on the higher injury burden in the U16 (48%), U15 (28%), and U17 (21%) groups, we suggest that research on injury risk factors and preventive measures should primarily target these age groups. Additional interventions based on PHV may be of limited value from a screening perspective. Further research is needed on the interaction between age groups and PHV periods.

Skeletal maturation and growth rates are related to bone and growth plate injuries in adolescent athletics

“…Using the average height for this sample, an increase of one standard deviation above the mean represented an absolute growth rate of approximately 8.9 cm per year or 0.7 cm per month, which is within the expected range during the adolescent growth spurt . The observations of increased injury incidence and burden around PHV and with absolute monthly growth rates above 0.6 cm per month from other elite sports therefore seem to apply also in athletics, at least for bone and growth plate injuries. While rapid growth in leg length also impacted the overall injury rates, changes in trunk height were not associated with any of the injury categories.…”

“…the peak height velocity (PHV) observed around the age of 11-12 years in girls and 13-14 years in boys, although this varies between individuals. 4 Rapid growth and the period around PHV have been associated with an increased risk of injuries in elite sporting populations, [6][7][8][9][10] and suggested underlying mechanisms include decreased bone mineral density, increased tensile forces on vulnerable muscle attachments, decreased neuromuscular control, and reduced flexibility. 4,7,[11][12][13][14][15][16] Maturation is a more complex concept, referring to the process toward a mature state.…”

Influence of Size and Maturity on Injury in Young Elite Soccer Players

“…However, in addition to these, other factors which may increase the potential for injury in sport should be analyzed. Although there is an increasing interest in the role played by body composition, and anthropometric and growth characteristics as injury risk factors in youth soccer, the research on this topic is still scarce and controversial [ 21 , 25 , 26 , 27 ].…”

“…Previous studies suggested that the player’s age, evaluated as growth and maturation, is an important risk factor, especially in the life period around the peak height velocity (PHV) [ 25 , 26 , 28 , 29 ]. PHV is considered the moment with the largest increase in stature, implying a high growth velocity [ 30 ].…”

Adolescent Awkwardness: Alterations in Temporal Control Characteristics of Posture with Maturation and the Relation to Movement Exploration

“…Suggested mechanisms for this altered development in adolescents include (1) an underdeveloped ability to estimate an internal model of body orientation [4,9], potentially resulting from a growth spurt [10]; (2) slower movement detection times [11]; (3) mislaid processing mechanisms induced by extensive muscle activation [12]; and (4) the heavy reliance on visual sensory input due to a lack of automatized control strategies [13]. Considering the nature of these causes within the motor control system, it is perhaps unsurprising that a link has been shown between the age of peak height velocity (i.e., the year of the biggest growth in adolescence) and increased injury risk in sport [10,14,15]. Given this relevance, we aim to investigate some of the mechanisms of adolescent awkwardness, with a particular focus on postural movements.…”