Injury risk and maturity status in Italian elite young football player

Abstract

Background. Football is one of the world's most popular sport with most players being younger than 18 years. Playing football can induce beneficial health effects in youth, but there is also a high risk of injury. In young football players, the relationship between injury risk in the different periods from peak height velocity (PHV) remains unclear. The objective of the study was to investigate the associations between the injury risk and injury burden in young Italian football players in different periods from PHV (pre-PHV, PHV and Post-PHV). Methods. One hundred and forty-one young players (age = 13.9 ± 0.8 years) were subdivided in three groups on the basis of maturity status: PHV was set by taking 6 months before and 6 months after the age at PHV; the 12 months before this year were allocated as the year before PHV (Pre-PHV); the 12 months after this year were allocated as the year after PHV (Post-PHV). The number of injuries was calculated for each player per year; injuries were classified by location, type, body-site and mechanism of injury (traumatic or overuse). Training and match injury incidence was also calculated and resulted 4.2 ± 6.9 per 1000 h and 10.0 ± 34.2 per 1000 h, respectively. Results. In total 25214 hours of exposure were recorded. A total of 83 injuries were reported. Most injuries (77%) were located in the lower limbs; the most common injuries were joint/ligament injuries (36%). Traumatic injury showed a tendency to increase from the year before PHV to the year of PHV, and after this period a decrease can be observed; while, overuse injuries incidence remains constant until PHV, and then decreased in the year after PHV, albeit the differences were not statistically significant. A non-significant higher training injury incidence was found at PHV, while match injury incidence was higher at Pre-PHV. Days missed due to injury show an increase up to PHV, and then a considerable decrease in the year after PHV; the difference among groups were statistically significant (p = 0.039); moreover, the effect size between PHV and Post-PHV was moderate. The mean of exposure shows a significant increase from the year before PHV to the year after PHV (p = 0.0089), furthermore, the effect size between Pre-PHV and Post-PHV was large. Conclusions. The results of this study on young Italian football players confirm the overall increased vulnerability of the athletes in the PHV period. Great attention should be given to the maturity status of the subjects. To try to limit injuries, training programs should be calibrated on the state of maturity of the players and not on their chronological age.

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

“…One approach to determining the extent of injuries is to count how many players sustain at least one injury over a season. In boys, this has ranged from 38 to 85% ( 18 – 25 ), with 0.4–2.2 injuries per player per season ( 19 – 42 ). Only one study reported seasonal injury proportion for girls (37%) ( 43 ), with another finding an average of 4.3 injuries per player per season ( 44 ).…”

“…Expressing injuries relative to training and match hours is therefore recommended. Using the median of point estimates for reported injury rates (this does not consider the size of each study, nor the uncertainty in their estimates) and keeping methodological differences in mind, the number of injuries per 1,000 h appears similar between genders ( Figure 1 ): around 6.3 (range: 1.3–12.1) for boys ( 18 – 20 , 24 , 26 , 27 , 29 , 31 – 33 , 36 , 37 , 41 , 42 , 46 – 57 ) and 6.4 (2.1–9.1) for girls ( 44 , 55 , 58 – 60 ). Matches are consistently associated with greater risk compared to training sessions in both boys (match: 13.4, training: 4.0) and girls (match: 22.4, training: 4.6) ( 18 – 20 , 24 – 26 , 29 , 31 – 33 , 36 , 42 , 46 – 50 , 53 – 55 , 58 , 60 – 63 ).…”

Methods to predict the timing and status of biological maturation in male adolescent soccer players: A narrative systematic review

“…Evidence of higher injury incidence, particularly microtraumatic damage to tissue (e.g., bone; muscle; tendon) during the period of PHV and increased general injury burden (15 vs 7 days) compared to pre-PHV (when the rate of growth in stature is at its slowest) [12] is reported in European youth soccer players [13]. Similarly, in a professional, male, Italian soccer academy, the highest injury incidence across academy age groups was reported in the U13 years, followed by the U15 and U14 years, corresponding to the period of PHV, yet caution is warranted when interpreting these findings as they are derived from a single club in Europe [14]. It would appear professional soccer clubs worldwide are becoming increasingly invested in monitoring injury rates and growth patterns of their players, particularly around PHV, due to the associated increases in injury risk, incidence, and severity that predispose players during this period [15,16].…”

“…From a holistic perspective, practitioners and researchers in this field may need to look beyond simply the methods they employ to assess maturational status and timing in academy soccer players and consider the wider implications of their choices on issues such as PLOS ONE injury risk. Recent work has highlighted an increase in injury risk and incidence around reported mean ages (i.e., 13-14 years) at PHV [11,14]. Furthermore, the growth spurt coupled with its maturity-associated variations are among some of the injury risk factors for the developing male athlete [10].…”