Standardising health history and injury surveillance of participants in endurance events: a modified Delphi consensus statement from the AMSSM runner health consortium.

Endurance events are popular worldwide and have many health benefits. However, runners and Para athletes may sustain musculoskeletal injuries or experience other health consequences from endurance events. The American Medical Society for Sports Medicine (AMSSM) Runner Health Consortium aimed to generate consensus-based survey items for use in prospective research to identify risk factors for injuries in runners and Para athletes training and competing in endurance events. The study design employed a modified Delphi approach, with a panel comprising 28 experts, including healthcare professionals, coaches, and athletes. Potential survey items were generated by panel members who subsequently engaged in three rounds of voting using Research Electronic Data Capture. Items were graded by clarity, relevance, and importance. Items achieving 80% consensus on all three aspects were retained. The response rate was 100% in R round 1 and 96% in Rrounds 2 and 3. Of 124 initial survey items, consensus was reached on 53, 34 and 22 items during Rrounds 1, 2, and 3, respectively. Two accepted items were removed due to redundancy. Combined with 10 non-voting items, 117 items covered key domains, including training and injury history, dietary behaviours and associated factors (such as menstrual function), footwear, mental health, and specific considerations for Para athletes. The consensus-based survey items should be considered by researchers to better understand the health of runners and Para athletes who train and compete in endurance sports to identify risk factors for injury.

Developing a data-driven multimodal injury and illness prevention programme in male professional football based on a risk management model: the IP2 NetWork.

Background: Current injury prevention programmes in football are limited by a one-size-fits-all approach, which predominantly focuses on preventive exercise programmes while ignoring differences in risk profiles between individuals and teams. Objective: To address this gap, we developed a new data-driven, customisable approach based on the principles of risk management. We collaborated with key stakeholders to identify focus areas for injury and illness prevention and determine their priorities. Setting: The team medical and coaching staff included members from 17 professional football clubs, the national team and a youth football academy in Qatar. Methods: In 2015, we launched a series of annual workshops under the Aspetar Sports Injury and Illness Prevention Programme. The workshops included club medical personnel and fitness coaches in a process to develop team-specific programmes for injury and illness prevention based on the principle of risk management. Over 2 years, workshops refined focus areas through discussions, surveys and small-group presentations, culminating in the creation a novel programme for football injury prevention. Results: Out of 44 focus areas first identified, 23 were selected as priorities for inclusion in multimodal injury and illness prevention programmes. The identified focus areas represent a variety of aspects, including social/behavioural/lifestyle, exercise programmes/training, load management, recovery and equipment. The top priorities included communication, the Nordic hamstring exercise, training load, recovery strategies, nutrition, sleep, warm-up, the Copenhagen adduction exercise and core and dynamic stability. Conclusion: We have developed a comprehensive framework for preventing injuries and illnesses in football grounded in the general principles of risk management. This framework has proven feasible and led to the creation of a new multicomponent programme, The Aspetar IP2 (Injury and Illness Prevention for Performance) NetWork, focusing on a range of areas beyond preventive exercise programmes only.

Artistic gymnastics-specific extension of the IOC 2020 consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport.

The incidence of injuries reported in artistic gymnastics varies greatly. This is partly due to inconsistencies in defining and reporting injuries in artistic gymnastics. The objective was to develop consistent definitions and methodology for reporting injuries in artistic gymnastics. A group of medical practitioners working with international-level artistic gymnasts from America, Asia, Australia and Europe came to a consensus on recommendations for defining and reporting injuries in artistic gymnastics. Development of the consensus statement was achieved through in-person and online discussions, online surveys and post meeting electronic discussions. This consensus statement is meant to serve as an extension to the recommendations made by the IOC on injury surveillance. The statement includes specific recommendations of injury definitions, characterising activity at the time of injury, and describing injury burden in artistic gymnastics. The following consensus statement has been developed to encourage consistency of injury surveillance in artistic gymnastics. Reporting injury in a consistent manner will help understand the true burden of injury in artistic gymnastics and help guide future work in injury prevention.

Types, frequencies and burden of health problems in elite luge athletes: a 46-week prospective cohort study.

Background: There is a research gap in the survey of injuries and illnesses in the sport of luge. Objective: To analyse the type, frequency and burden of injuries and illnesses that occurred over a preparation period and a competition period in elite luge athletes. Methods: In total 40 elite luge athletes, who were all part of a national team and competed internationally, self-reported acute injuries, overuse injuries and illnesses weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Results: The most frequently stated health problems were illnesses with 41.9% (n=75), followed by acute injuries at 31.9% (n=57). Overuse injuries accounted for 24.0% (n=43). Illnesses represented the greatest burden with a median severity score of 60.0 (IQR: 23.63), followed by acute injuries with 42.0 (IQR: 26.83) and overuse injuries with 35.0 (IQR: 23.95). In the case of acute injuries, the anatomical regions most affected were the hand (n=8, 14.0 %), foot (n=8, 14.0 %), head (n=7, 12.3 %) and neck (n=6, 10.5 %). In the case of overuse injuries, the shoulder (n=9, 20.9 %) and lumbar spine (n=7, 16.3 %) were most frequently reported. Strains (n=15, 26.3 %) and contusions (n=14, 24.6 %) were the predominant types of acute injuries. Four concussions were recorded, with none of the athletes taking a break from normal training of more than 3 days. This stands in contrast to the current recommendations for the return to sport after concussion. Conclusion: The results of this study represent the current incidence rates and health burden of acute and chronic injuries in this constantly evolving sport. 95% of all athletes reported at least one health problem during the observation period. These findings support the need for specific prevention programmes. The establishment of a concussion protocol should be considered.

Systematic video analysis of ACL injuries in professional Spanish male football (soccer): injury mechanisms, situational patterns, biomechanics and neurocognitive errors - a study on 115 consecutive cases.

Objective: A few video analysis studies have been published in recent years, but none specifically on Spanish football. We aimed to describe the mechanisms, situational patterns, biomechanics and neurocognitive errors related to anterior cruciate ligament (ACL) injuries in professional Spanish football matches. Methods: We identified 167 consecutive ACL injuries across 12 seasons of the top two leagues in Spanish football. 115 (69%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 81 cases. Neurocognitive errors were investigated for all non-contact injuries. Three independent reviewers evaluated each video. ACL injury epidemiology-month, timing within the match and pitch location at the time of injury was also documented. Results: More injuries occurred in defensive (n=68, 59%) than offensive (n=48, 41%) (p<0.01) playing situations. 16 (14%) injuries were direct contact, 49 (43%) indirect contact and 50 (43%) non-contact. Most injuries (89%) occurred during four main situational patterns: (1) pressing/tackling (n=47, 47%); (2) tackled (n=23, 23%); (3) landing from a jump (n=12, 12%) and regaining balance after kicking (n=6, 6%). Injuries generally involved a knee-dominant loading strategy in the sagittal plane with abducted hip and knee valgus. Of the non-contact injuries, 39 (78%) were deemed to involve a neurocognitive error. More (58%) injuries occurred in the first half of matches (p<0.01). Conclusions: ACL injuries in Spanish football occurred similarly with non-contact and indirect contact mechanisms (44%). Four in five non-contact injuries involved a neurocognitive error. Most injuries occurred during four previously identified situational patterns, with more injuries earlier in the match.

Twenty year analysis of professional men's rugby union knee injuries from the English premiership shows high rates and burden.

OBJECTIVES: To determine the rates, severity and burden of knee injuries in professional male rugby union from the English Premiership. METHODS: Injury and exposure data were captured over 20 seasons using a prospective cohort design. Knee injury incidence, days' absence and burden were recorded for each injury type and by pitch surface type for match and training. RESULTS: The rate of knee injury in matches was 9.8/1000 hours (95% CIs 9.3-10.3). Mean days lost were 50 (95% CI 46 to 53) in matches and 51 (95% CI 44 to 57) in training. In matches, medial collateral ligament injuries were the most common, while anterior cruciate ligament (ACL) injuries had the highest mean severity and burden. There was no significant change in the count of knee injuries over time; however, average severity increased significantly (annual change: 2.18 days (95% CI 1.60 to 2.77); p<0.001). The incidence of match knee injury was 44% higher on artificial pitches than grass pitches (incidence rate ratio: 1.44 (95% CI 1.21 to 1.69); p<0.01), with no significant difference in severity between surfaces. In matches, the tackle was the event most commonly associated with knee injuries for all diagnoses, except ACL injuries (running). In training, running was a more common injury event than the tackle. CONCLUSION: Knee injuries in matches are common and severe in English professional men's rugby union. Despite an increased focus on player conditioning and injury prevention throughout the study period, rates of knee injury remained stable, and resulting days' absence increased. New strategies for the prevention of knee injuries should be considered a priority.

Prospective cohort study identifying risk factors for sports injuries in adolescent athletes: the Healthy Injury-Free Adolescent Athletes (HIFAA) study.

A high incidence of injuries has been reported in young athletes. Several factors have been associated with athletes' sports injuries. However, scientific evidence is lacking, particularly for adolescent athletes. Hence, the Healthy Injury-Free Adolescent Athletes (HIFAA) was designed to evaluate sports injuries and examine associations with risk factors related to physical load and mental health. Secondary aims are to evaluate differences between sex, age, high school year and sports and examine injuries and the athletic situation 5 to 10 years after graduation. Adolescent athletes aged 15-19 years enrolled in high school and competing in sports to reach a national or international level of sports will be included. At inclusion, athletes will sign an informed consent form and fill out a baseline questionnaire addressing potential risk factors (eg, sports, training and competing health and injuries, and psychosocial status). Athletes will then prospectively be monitored weekly regarding injuries, physical (training/match/competing, perceived exertion) and psychological (fatigue, sleep, mental stress, recovery) load until graduation. A shortened version of the baseline questionnaire will be filled out every year, and a follow-up questionnaire regarding injuries, sporting situations and mental health will be filled out 5-10 years after graduation. Injuries are frequent among adolescent athletes, with consequences ranging from shorter interruptions in sports performance to mental health problems and early termination of sports. A reduction of these injuries is warranted. This study will provide a detailed understanding of risk factors, a prerequisite to introducing appropriate preventive measures.

Running shoe cushioning properties at the rearfoot and forefoot and their relationship to injury: study protocol for a randomised controlled trial on leisure-time runners.

Previous work has demonstrated the protective effect of shoe cushioning on injury risk in leisure-time runners, but most models currently available on the market have greater cushioning than those investigated so far. Also, the optimal level of cushioning and the role of cushioning on the forepart of the shoe for injury prevention are still unknown. The main aim of this study is to determine whether (1) current 'extra soft' cushioning material at the rear part of the shoe reduces injury risk compared with stiffer material and (2) cushioning under the forepart of the shoe also contributes to injury risk reduction. This randomised trial with a 6-month intervention will involve 1000+ healthy leisure-time runners who will randomly receive one of the three running shoe versions. Study shoe versions will differ in their cushioning properties (ie, stiffness) at the rear or the forepart. Participants will self-report any lower limb or lower back problems on a dedicated electronic system every week, while the system will collect training data from the participant's sports watch. Time-to-event analyses will be used to compare injury risk between the three study groups and to investigate the association between the runner's characteristics, cushioning level and position, training and injury risk. The study was approved by the National Ethics Committee for Research (Ref: 202405/02 v2.0), and the protocol has been registered on https://clinicaltrials.gov/ (NCT06384872, 02/08/2024). Outcomes will be disseminated through presentations at international conferences and publications in peer-reviewed journals, popular magazines and specialised websites.

Cryotherapy for treating soft tissue injuries in sport medicine: a critical review.

Sports medicine physicians and physiotherapists commonly use cryotherapy (eg, ice application) postinjury to decrease tissue temperature with the objective of reducing pain, limiting secondary injury and inflammation, and supporting healing. However, besides the analgesic effect of cryotherapy, a literature search revealed no evidence from human studies that cryotherapy limits secondary injury or has positive effects on tissue regeneration. Thus, our current understanding of the potential mechanisms and applications of cryotherapy largely relies on the results from animal studies. Importantly, treatment should not aim at obliterating the inflammatory and regeneration processes but instead aim to restore an adapted/normal regulation of these processes to improve function and recovery. However, some animal studies suggest that cryotherapy may delay or impair tissue regeneration. With the translation of laboratory animal studies to human sport medicine being limited by different injury and muscle characteristics, the effect of cryotherapy in patients with musculoskeletal injuries is uncertain. Thus, pending the results of human studies, cryotherapy may be recommended in the first 6 hours following an injury to reduce pain (and possibly haematoma), but it should be used with caution beyond 12 hours postinjury as animal studies suggest it may interfere with tissue healing and regeneration.

Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013-2020).

OBJECTIVE: To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis. METHODS: Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed and cross-referenced with broadcasted match footage. Videos with a clear observable painful event (ie, a player grabbing their posterior thigh) were included. Nine investigators independently analysed all videos to describe and categorise injury-inciting circumstances. We used three main categories: playing situation (eg, time of injury), player action(s) (eg, running) and other considerations (eg, contact). Player action(s) and other considerations were not mutually exclusive. RESULTS: We included 63 sudden-onset hamstring match injuries out of 295 registered injuries between 2013 and 2020. Running was involved in 86% of injuries. Hamstring injuries occurred primarily during acceleration of 0-10 m (24% of all injuries) and in general at different running distances (0-50 m) and speeds (slow to fast). At 0-10 m distance, indirect player-to-player contact and inadequate balance were involved in 53% and 67% of the cases, respectively. Pressing occurred in 46% of all injuries (injured player pressing opponent: 25%; being pressed by opponent: 21%) and frequently involved player-to-player contact (69% of the cases when the injured player was pressing vs 15% of the cases when the opponent was pressing) and inadequate balance (82% vs 50%, respectively). Other player actions that did not involve running (n=9, 14% of all injuries) were kicking (n=6) and jumping (n=3). CONCLUSION: The injury-inciting circumstances of sudden-onset hamstring match injuries in football varied. The most common single-player action (24%) was acceleration over a distance of <10 m. Pressing, inadequate balance and indirect contact were frequently seen player actions. Injury prevention research in football should look beyond high-speed running as the leading risk factor for sudden-onset hamstring injuries.

'Another world of pain'-athlete and sport physiotherapist perspectives on the unique experience of pain in sport.

Our objective was to explore athlete's and sports physiotherapists' experiences of sports-related pain in the upper and lower limb. Using a constructivist and pragmatic perspective, we carried out focus groups comprising a deliberate criterion sample of athletes and sports physiotherapists. We used a topic guide that moved from open exploratory questions to questions focusing on the phenomena of sports-related pain in athletes. We coded, developed candidate themes and refined finalised themes using reflexive thematic analysis. A member of our research team acted as a critical friend adding additional perspectives. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). We completed five focus groups comprising 12 athletes (n=5 female, n=7 male) and four sports physiotherapists (n=4 male) including one initial pilot (two athletes). We developed four final themes (1-4) and nine subthemes (1.1-4.3): (1) Athlete Pain Lens (1.1-pain is part of being an athlete and 1.2-pain shapes the life of an athlete), (2) Exploring And Navigating Pain (2.1-the sports-related pain spectrum and 2.2-making sense of pain), (3) The Emotional Toll of Pain (3.1-challenging emotions and 3.2-the impact of time) and (4) Coping, Community and Communication (4.1-coping with pain, 4.2-influence of community and support network and 4.3-communication, the broken key). We highlighted the distinct and challenging phenomenon of sports-related pain experienced by athletes and physiotherapists. Through effective communication, members of the athlete's community may recognise, and adjust to these challenges.

Epidemiology and clinical profile of sports injuries treated in the Douala General and Laquintinie Hospitals, in Cameroon.

Objectives: To describe the epidemiological patterns and clinical characteristics of sports injuries treated at two hospitals in Douala. Methods: This was a cross-sectional study conducted at the Douala General Hospital and Douala Laquintinie Hospital, involving medical records of patients treated for sports injuries from January 2012 to April 2022. Data extracted from records were entered into a data collection software and analysed using Microsoft Excel 2016. Severe injuries were defined as an injury score greater than or equal to 3 on the Abbreviated Injury Scale. Results: The prevalence of sports injuries was 1.12% among all trauma cases. There was a male predominance with 62 (86.1%) males and 10 (13.9%) females. The mean age was 24.97±13.8 years. Most injured persons were students 35 (48.6%), followed by the employed 26 (36.1%), athletes 6 (8.3%) and the unemployed 5 (6.9%). Recreational sports accounted for 43 (59.7%) injuries while 16 (22.2%) injuries occurred during physical education, 8 (11.1%) during trainings and 5 (6.9%) during competitions. Football injuries were 48 (66.7%), running injuries 10 (13.9%) and 9 (12.5%) occurred during long, high and triple jump. Among all injuries, fractures were 43 (59.7%), 11 (15.3%) joint sprains, 5 (6.9%) muscle injuries, 4 (5.6%) brain injuries while 9 (12.5%) were contusions and lacerations. Lower extremity injuries were 34 (47.2%), 21 (29.2%) injuries were on the upper extremities, 4 (5.6%) abdominopelvic, 3 (4.2%) thoracic injuries, 9 (12.5%) head injuries and 1 (1.4%) on the neck. Overall, 53 (73.7%) were severe injuries. Conclusion: The majority of sports injuries treated in these hospitals are fractures that occur during recreational sports, particularly football and predominantly involve the lower extremity. A significant proportion are severe injuries.

Systematic development of an injury and illness prevention programme for athletes with a physical impairment: the TIPAS study.

Background/aim: The participation of individuals with physical impairment in sports has numerous benefits, yet there is also the risk of sustaining sport-related injuries or illnesses. Therefore, prevention programmes of these problems are needed to ensure that individuals can maintain a healthy, active lifestyle. Currently, very few prevention interventions are accessible for these athletes. Therefore, the article aims to describe the development process of the Tailored Injury Prevention in Adapted Sports intervention, an online tailored injury and illness prevention intervention for athletes with a physical impairment. Methods: The development was guided by the Knowledge Transfer Scheme (KTS). Results: In the first step, a cohort study and a qualitative study were conducted to define the problem statement. In the second step, a systematic review was performed in order to learn from theory. Steps 3 and 4 involved an iterative process involving collaboration with diverse expert groups. This included defining athletes' needs and creating a health problem blueprint, after which the intervention content was created. To ensure accuracy and completeness, a feedback loop was incorporated. In the final phase of this step, we refined the language used within the intervention together with athletes. Finally, an effect and process evaluation will take place in the last step of the KTS. Conclusions: Through a five-step approach of the KTS, we developed an online injury and illness prevention intervention for athletes with a physical impairment. This intervention provides direct, timely feedback based on their current health status. Furthermore, it takes the sport and the physical impairment of the athletes into account with regard to the given prevention advices.

Identifying evidence-practice gaps for shoulder injury risk factors in competitive swimmers: uniting literature and expert opinion.

OBJECTIVES: To identify evidence-practice gaps regarding shoulder injury risk factors in competitive swimmers. METHODS: We gathered insights from 27 swimming experts including elite swimmers, coaches, high-performance staff and applied researchers using Concept Mapping. Participants brainstormed, sorted and rated (from 1 (least) to 10 (most) important and modifiable) their ideas of shoulder injury risk factors in competitive swimmers. Proposed risk factors rated above the grand mean for importance (6.2±0.4) or modifiability (6.5±0.5) ratings were considered highly important/modifiable. Expert opinions were then juxtaposed with systematic review findings to identify overlaps or convergences. RESULTS: Brainstorming generated 126 proposed shoulder injury risk factors for competitive swimmers, subsequently refined to 61 unique proposed risk factors by removing duplicates and combining similar responses. The participants sorted the 61 risk factors into seven distinct clusters. Experts perceived 36/61 proposed risk factors as highly important, of which 6 were supported by literature, 6 showed no association with injury, 2 had conflicting evidence and the remaining 22 have not yet been investigated, suggesting an evidence-practice gap. Three proposed risk factors 'inconsistent training load', 'poor stroke technique' and 'low posterior shoulder strength-endurance' exhibited high perceived importance, high perceived modifiability and supporting evidence. CONCLUSION: An evidence-practice gap was identified for 28 proposed risk factors perceived as highly important by swimming experts despite either (1) no relevant empirical research (n=22), or (2) no association with injury (n=6) from synthesised evidence. Greater collaboration between researchers and practitioners is needed to effectively address shoulder injury risk factors in competitive swimmers.

Microfractures, autologous matrix-induced chondrogenesis, osteochondral autograft transplantation and autologous chondrocyte implantation for knee chondral defects: a systematic review and network meta-analysis of randomized controlled trials.

Purpose: Despite the publication of several randomized controlled trials (RCTs), it is not clear which technique for the treatment of focal chondral and osteochondral defects of the knee grants the best clinical outcome. The aim of this network meta-analysis (NMA) was to compare the efficacy and safety of microfractures (MF), autologous chondrocyte implantation (ACI), autologous matrix-induced chondrogenesis (AMIC), osteochondral autograft transplantation (OCT) at short (< 1 year), intermediate (1-5 years) and long-term (> 5 years). Methods: We carried out an NMA with Bayesian random-effect model, according to PRISMA guidelines. The search was performed in MEDLINE, EMBASE, Web of Science, CENTRAL, CINAHL, SPORTDiscus, clinicaltrials.gov, WHO ICTRP, from inception to November 2022. The eligibilities were randomized controlled trials on patients with knee chondral and osteochondral defects, undergoing microfractures, OCT, AMIC, ACI, without restrictions for prior or concomitant surgery on ligaments, menisci or limb alignment, prior surgery for fixation or ablation of osteochondritis dissecans fragments, and prior cartilage procedures as microfractures, drilling, abrasion, or debridement. Results: Nineteen RCTs were included. No difference among treatments was shown in the pooled comparison of patient reported outcome measures (PROMs) at any timepoint. Safety data were not available for all trials due to the heterogeneity of reporting, but chondrospheres seemed to have lower failure and reoperation rates. Conclusion: This NMA showed no difference for PROMs with any technique. The lower failure and reoperation rates with chondrospheres must be interpreted with caution since adverse event data was heterogenous among trials. The standardization of the efficacy and safety outcome measures for future trials on knee cartilage repair and regeneration is necessary.

Subsequent musculoskeletal injury after concussion in National Football League players.

OBJECTIVE: To assess whether National Football League (NFL) players diagnosed with a concussion have an increased risk of injury after return to football. METHODS: A retrospective cohort study analysed the hazard of subsequent time-loss lower extremity (LEX) or any musculoskeletal injury among NFL players diagnosed with a concussion in 2015-2021 preseason or regular season games compared with: (1) all non-concussed players participating in the same game and (2) players with time-loss upper extremity injury. Cox proportional hazards models were adjusted for number of injuries and concussions in the prior year, player tenure and roster position. Additional models accounted for time lost from participation after concussion. RESULTS: There was no statistical difference in the hazards of LEX injury or any musculoskeletal injury among concussed players compared with non-concussed players, though concussed players had a slightly elevated hazard of injury (LEX injury: HR=1.12, 95% CI 0.90 to 1.41; any musculoskeletal injury: HR=1.08, 95% CI: 0.89 to 1.31). When comparing to players with upper extremity injuries, the hazard of injury for concussed players was not statistically different, though HRs suggested a lower injury risk among concussed players (LEX injury: HR=0.78, 95% CI: 0.60 to 1.02; any musculoskeletal injury: HR=0.82, 95% CI: 0.65 to 1.04). CONCLUSION: We found no statistical difference in the risk of subsequent injury among NFL players returning from concussion compared with non-concussed players in the same game or players returning from upper extremity injury. These results suggest deconditioning or other factors associated with lost participation time may explain subsequent injury risk in concussed players observed in some settings after return to play.

Associations between growth, maturation and injury in youth athletes engaged in elite pathways: a scoping review.

OBJECTIVE: To describe the evidence pertaining to associations between growth, maturation and injury in elite youth athletes. DESIGN: Scoping review. DATA SOURCES: Electronic databases (SPORTDiscus, Embase, PubMed, MEDLINE and Web of Science) searched on 30 May 2023. ELIGIBILITY CRITERIA: Original studies published since 2000 using quantitative or qualitative designs investigating associations between growth, maturation and injury in elite youth athletes. RESULTS: From an initial 518 titles, 36 full-text articles were evaluated, of which 30 were eligible for final inclusion. Most studies were quantitative and employed prospective designs. Significant heterogeneity was evident across samples and in the operationalisation and measurement of growth, maturation and injury. Injury incidence and burden generally increased with maturity status, although growth-related injuries peaked during the adolescent growth spurt. More rapid growth in stature and of the lower limbs was associated with greater injury incidence and burden. While maturity timing did not show a clear or consistent association with injury, it may contribute to risk and burden due to variations in maturity status. CONCLUSION: Evidence suggests that the processes of growth and maturation contribute to injury risk and burden in elite youth athletes, although the nature of the association varies with injury type. More research investigating the main and interactive effects on growth and maturation on injury is warranted, especially in female athletes and across a greater diversity of sports.