Injury Incidence, Prevalence and Severity in High-Level Male Youth Football: A Systematic Review

Abstract

At a young age, high-level youth footballers enter structured practice where they engage in regular training and matches. The academy system is considered fundamental to a young footballer’s tactical, technical and physical development. Yet, with regular training and matches, high-level youth footballers may be exposed to the risk of injury. This systematic review analyses and summarises published scientific information on high-level youth football injury characteristics and calculates the risk of them sustaining an injury over the course of a typical season. The search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of the 1346 studies found, 23 fulfilled the inclusion criteria. Quality assurance scores for the selected research articles ranged between two and five out of eight. A high degree of heterogeneity between studies was observed. The probability of sustaining a time-loss injury during a high-level youth season ranged between\u2009<\u20091% and 96% for under 9- to under 16-year age groups and 50% and 91% for under 18- to under 21-year age groups. Pooled estimates for total (training and match) incidence per 1000 h was 5.8 for youth players aged under 9 to under 21 years, 7.9 for older players (under 17–under 21 years) and 3.7 for younger aged players (under 9–under 16 years). Training injury incidence rate ranged from 0.69 to 7.9 per 1000 h for all age groups in youth football. Match injury incidence rate for high-level youth players ranged from 0.4 to 80.0 per 1000 h. Close to one-fifth (18%) of all high-level youth football injuries were classified as severe and required\u2009>\u200928 days recovery time. Muscle strain injury accounted for 37% of all injuries reported in youth football. High probabilities (>\u200990%) of sustaining a time-loss injury over one typical high-level football season were found. High-level youth players lose large portions of the seasonal development to injury, with players seemingly suffering long absences from training and matches, consequently affecting health and well-being and possibly burdening club/parental finances and healthcare systems.