Shedding Light on Incidence and Burden of Physeal Injuries in Youth Elite Football Academy: A 4-Season Prospective Study.

Abstract

INTRODUCTION\nPhyseal injuries have been overlooked in epidemiological research in youth sports. Our prospective study investigated the incidence, severity, and burden of physeal injuries in a youth elite football academy.\n\n\nMETHODS\n551 youth male football players from Under-9 to Under-19 were included and observed over four consecutive seasons. Injuries involving the physis were diagnosed and recorded according to type, location, and diagnosis. Injury incidence (II), severity (days lost), and injury burden (IB) were calculated per squad per season (25 players/squad).\n\n\nRESULTS\nThere were 307 physeal injuries: 262 apophyseal- (85%), 26 physeal- (9%), 2 epiphyseal- (1%) and 17 other physeal-injuries (5%) with 80% (n=245) causing time-loss. The overall mean incidence of time-loss physeal injuries was 6 injuries/squad-season leading to a total of 157 days lost/squad-season. The U-16s had the highest burden with 444 days lost per squad-season [Median: 20 (95%CI:12-30) days; II: 10 (95%CI:7.3.1-13.4)]. Apophyseal injuries of the hip-pelvis resulted in the greatest burden [Median: 13 (95%CI: 10-17); II: 2.5 (95%CI: 2.1-3.0)]. Peak apophyseal injury incidence per body parts occurred in U-11 for foot-ankle (II: 2.4; 95% CI: 1.0-4.9), U-14 for knee (II: 4.5; 95% CI: 2.7-7.1), and in U-17 for hip-pelvis (II: 6.4; 95% CI: 4.2-9.3).\n\n\nCONCLUSION\nPhyseal injuries accounted for a quarter of all-time loss with the largest injury burden in U-16. Most physeal injuries involved the lower limb and affected the apophysis. Physeal and apophyseal injuries incidence, burden and pattern vary substantially depending on age. Hip-pelvic apophyseal injuries accounted for the largest injury burden.