The combined effects of growth and maturity status on injury risk in an elite football academy.

This study aimed to explore the interaction between growth rate on specific injury incidence and burden on pre-, circa- and post-peak height velocity (PHV) periods. Injury and stature data collected during the 2000-2020 seasons in an elite football academy were retrospectively analysed. Only players with height measurements from childhood until the attainment of adult height were included in the study (N = 84). Growth data were smoothed using a cubic spline to calculate daily growth rate and height. Growth rate was categorised into three groups: fast (> 7.2 cm/year), moderate (3.5-7.2 cm/year) and slow (< 3.5 cm/year). Percentage of observed adult height was used to classify players as pre-PHV (< 88%), circa-PHV (88-95%) or post-PHV (> 95%). Overall and specific injury incidence and burden and rate ratios for comparisons between growth rate groups were calculated on pre-, circa- and post-PHV periods, separately. Overall injury incidence and burden were greater in pre-PHV players with quicker growth rates compared to players growing moderately and slowly. All in all, players with more rapid growth-rates were at higher risk for growth-related injuries in all pre-, circa- and post-PHV periods. Post-PHV, the incidence and burden of joint/ligament injuries were 2.4 and 2.6-times greater in players growing slowly compared to players growing moderately. Practitioners should monitor growth rate and maturity status and consider their interaction to facilitate the design of targeted injury risk reduction strategies.

Peak Height Velocity Affects Injury Burden in Circa-PHV Soccer Players.

Growth and maturation are potential risk factors for soccer injuries. This research sought to describe how peak height velocity (PHV) affects overall and specific injury burden in circa- and post-PHV elite academy soccer players. Injuries and growth data collected from 2000 to 2020 were studied retrospectively. Longitudinal height records for 124 players were fitted with the Super-Imposition by Translation and Rotation model to calculate PHV (cm/year) and age at PHV. Players were classified according to PHV percentile (fast:≥75th; average: 25-75th; slow:≤25th) and maturity status (circa- or post-PHV). Overall and specific injury burden (days lost/player-season) and rate ratios for comparisons between groups were calculated based on zero-inflated negative binomial models. Confidence intervals were calculated at the 95% confidence level (CI) and the significance level was set at<0.05. In circa-PHV, players with fast PHV had 2.6 (CI: 1.4-4.8)- and 3.3 (CI:1.3-6.7)-times higher overall burden and 2.9 (CI:1.1-7.1)- and 4.1 (CI: 1.4-15.2)-times higher for growth-related injury burden compared to players with average and slow PHV, respectively. Regular monitoring of growth seems important to detect players at higher risk for being disrupted by growth-related injuries.

An injury burden heat map of all men's and women's teams of a professional football club over a decade.

The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green - yellow-red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers.

Relative skeletal maturity status affects injury burden in U14 elite academy football players.

Maturation progresses at different times and at different rates between individuals. Thus, differences in maturity status exist among players in the same chronological age-based category, especially in U14 players. The purpose of this prospective study was to describe injury burden according to the relative skeletal maturity status in U14 elite academy football players. From 2011 to 2020, injuries and individual exposure (training and match) were prospectively recorded in 183 male U14 players. Skeletal age (SA) was assessed using the Tanner-Whitehouse 2 method. Relative skeletal maturity status [SA minus chronological age (CA)] was classified as follows: early (SA-CA > 0.5), on-time (SA-CA ± 0.5), and late (SA-CA < -0.5). Overall and specific injury burden (days lost/1000 h) and rate ratios for comparisons between groups were calculated. Overall injury burden was 2.8 times higher (3.6 times in training) in early maturers compared with late maturers. Growth-related injuries were the most burdensome injuries in all three groups, but significant differences were not found between groups. Muscle injuries were 4 times more burdensome in early maturers compared with on-time and late maturers. Besides, joint/ligament injuries were 7 and 12 times less burdensome in late maturers than in on-time and late maturers, respectively. Significant differences between groups in overall and specific injury burden were not found in matches. Our results showed different injury patterns in U14 early, on-time, and late maturers. Hence, monitoring maturity seems crucial to detect potential injuries that cause the greatest disruption, and facilitate design of targeted injury prevention programs.

Progression in Youth Soccer: Selection and Identification in Youth Soccer Players Aged 13-15 Years.

Bidaurrazaga-Letona, I, Lekue, JA, Amado, M, and Gil, SM. Progression in youth soccer: Selection and identification in youth soccer players aged 13-15 years. J Strength Cond Res 33(9): 2548-2558, 2019-The aim of this study was to identify the factors that are important for the identification and selection of young soccer players. Ninety-four adolescent soccer players from the under-13 (U13; age = 12.3 ± 0.3 years; n = 50) and under-15 (U15; age = 14.0 ± 0.2 years; n = 44) categories belonging to a professional club participated in the study. Anthropometric measurements, physical tests (sprint, agility, endurance and jump), and maturity status (age at peak height velocity) were recorded over 4 seasons. Comparisons were performed among new players joining the club (Enter players, n = 15), players progressing to the next age category (Club players, n = 54), and players leaving the club (Deselected players, n = 25). A 2-way repeated measures analysis of variance (ANOVA) was performed to determine if significant differences existed between groups and testing time. Better physical performance and improvements observed during the season in performance were found to be one of the main factors for U13 players to continue in the club (p < 0.05-0.001). In the U15 group, although body size, maturation and physical performance appeared to be the most important characteristics for being identified to play in the club (p < 0.05), Club players demonstrated better improvements during the season (p < 0.05). Overall, these results indicate that the identification or promotion of players by coaches depends on indicators which are age-dependent. Therefore, this study has shown that the talent identification program was more a selection process than a promotion process, selecting and identifying a posteriori rather than a priori.

Does a 1-Year Age Gap Modify the Influence of Age, Maturation, and Anthropometric Parameters as Determinants of Performance Among Youth Elite Soccer Players?

Bidaurrazaga-Letona, I, Lekue, JA, Amado, M, and Gil, SM. Does a 1-year age gap modify the influence of age, maturation, and anthropometric parameters as determinants of performance among youth elite soccer players? J Strength Cond Res 33(9): 2541-2547, 2019-Because age-groups in soccer often comprise children born within a 2-year time frame, characteristics that define the profile of a successful player may not be appropriate for the oldest or youngest players of the same age-group. Therefore, this study aimed to determine to what extent performance was influenced by age, maturation, and body size in elite soccer players with barely 1-year age gap. Anthropometry, 15-m sprint test, modified Barrow's agility test, Yo-Yo intermittent recovery test level 1, countermovement jump, and handgrip test were conducted in players aged 12 years and under (n = 82; age, 11.1 ± 0.6 years) and between 12 and 13 years (n = 79; age, 12.8 ± 0.6 years). A total score of performance, chronological age, and age at peak height velocity were calculated. Descriptive statistics, Student's t-tests, and multiple linear regressions were performed. The explained variance in composite score was greater in the older (54%) than in the younger (30%) players. Sum of skinfolds was the primary predictor of 15-m sprint and countermovement jump in the younger group, whereas in the older group, chronological age and body size appeared as predictors of performance (41%). Body size explained the variance in most tests in older players. In the younger group, biological maturity status explained the variance in endurance (35%) and handgrip (59%) tests. In summary, chronological age and sum of skinfolds influenced the most tests; however, predictors differed between age groups. These findings highlight the importance of assessing individual differences in young male soccer players regardless of their similarity in age.

Pubertal development of body size and soccer-specific functional capacities in adolescent players.

Pubertal growth in body size and functional capacities were examined in adolescent soccer players (n = 33). The average age at baseline was 10.9 (9.8-11.8 years). Peak height velocity (PHV) and growth curves for body mass and functional performance (countermovement jump, 15-m sprint, agility and Yo-Yo intermittent recovery test - level 1) were determined with Bayesian multilevel models. Estimates for PHV and age at PHV were 8.1 cm/year (95% credible interval: 4.2-18.5 cm/year) and 12.9 years (95% credible interval: 11.8-15.5 years), respectively. Peak body mass velocity occurred 0.48 year after PHV. Jump performance maximum velocity occurred about 2 years after PHV and peak sprint performance maximum velocity was coincident with PHV. Agility and intermittent endurance run performance showed a quadratic trend of improvement of performance, starting to level off at about 3-4 years after PHV. The modelling procedures were efficient to determine pubertal growth curves aligned for chronological age and age at PHV, considering individual differences in maturation when interpreting the development of performance in youth soccer.

Lost in transition: Exploring injury risk in academy footballers shifting between the second and first teams.

OBJECTIVES: To compare the injury profiles of football players shifting between second and first teams with those of second- and first-team players, and to examine the opinions of shifting players. DESIGN: Prospective cohort study. METHODS: 170 male players from Athletic Club (second team = 90, shifting = 20, first team = 60) were followed over eight seasons. Injuries and exposure time were recorded following the FIFA consensus, and 18 shifting players answered a seven-item questionnaire on their experience. RESULTS: 35 % shifting players became full-time first-team players, in contrast to only 8 % of second-team players (odds ratio = 6.4, p < 0.01). There were no differences in the overall injury incidence, but the overall burden of injuries was higher in second-team (172 days lost/1000 h) and shifting players (194 days lost/1000 h) compared with first-team players (114 days lost/1000 h, p < 0.01). Shifting players had a higher burden of knee joint/ligament injuries compared with first-team players (137 vs. 18 days lost/1000 h, p < 0.01) and anterior cruciate ligament (ACL) ruptures (122 vs. 10 days lost/1000 h, p < 0.01). There was a trend towards a higher burden of ACL ruptures in shifting players than in second-team players (122 vs. 41 days lost/1000 h, p = 0.07). Shifting players reported constant pressure and better communication with the second-team coaching staff than with the first-team staff. CONCLUSIONS: The high burden of injuries in shifting players, particularly from ACL ruptures, highlights the need for action. Ensuring high-quality communication between second- and first-team staff remains a key challenge.

Acute pre- and post-competitive soccer match-play changes in neuromuscular factors, physical performance, and muscle response in youth male players.

There is a paucity of literature analyzing the impact of fatigue from actual competitive soccer match-play on measures of neuromuscular function and muscle damage markers in youth players. Aims The main purpose was to analyze the acute pre- and post-competitive soccer match-play changes in measures of landing mechanics, stretch-shortening cycle capability, physical performance, muscle damage, and match intensity. A secondary purpose was to explore whether the players' maturity status and chronological age were associated with post-soccer match-play responses. Methods Thirty-two male youth outfield soccer players from two chronological competition age groups (U14 and U16) were assessed pre-and post-competitive soccer match-play for 2D dynamic knee valgus at landing (DKV), leg stiffness, reactive strength index, 20 m sprint time, CMJ-Abalakov jump height, creatine kinase and urea activity and visual analogue scale for muscle soreness (VAS). Players' maturity status was also estimated using a previously validated regression equation. Results There were statistically significant (p < 0.05) post-competitive soccer match-play impairments in all measures of stretch-shortening cycle capability and muscle damage markers assessed irrespective of the age group. Likewise, significant post-match play alterations in landing mechanics (DKV of the dominant leg) and physical performance (sprint time and jump height) scores were documented for the U14 players. Significant interactions between maturity and landing mechanics and VAS responses to competitive soccer match-play were also found whereby more mature players demonstrated larger post-match changes. Conclusion The findings of this study suggest the existence of a negative influence of competitive match-play on neuromuscular function and muscle damage in youth soccer.

Estimating Maturity Status in Elite Youth Soccer Players: Evaluation of Methods.

PURPOSE: The objective of this study is to evaluate the concordance of predicted maturity status classifications (pre-, circa-, or post-peak height velocity (PHV)) relative to observed age at PHV in youth soccer players. METHODS: Longitudinal height records for 124 male soccer players were extracted from academy records spanning the 2000 to 2022 seasons. Age at PHV for each player was estimated with the Superimposition by Translation and Rotation model. Players were classified as pre-, circa-, or post-PHV using both ±1- and ±0.5-yr criteria to define the circa-PHV interval. Maturity status was estimated with several prediction protocols: maturity offset (Mirwald, Moore-1, Moore-2), maturity ratio (Fransen), and percentage of predicted adult height (PAH%) using the Khamis-Roche and Tanner-Whitehouse 2 equations using several bands: 85% to 96%, 88% to 96%, 88% to 93%, and 90% to 93% for the circa-PHV interval, and visual evaluation of individual growth curves alone or with PAH% based on Khamis-Roche and Tanner-Whitehouse 2. Concordance of maturity status classifications based on complete growth curves and predicted estimates of maturity status was addressed with percentage agreement and Cohen's kappa. RESULTS: Visual evaluation of the growth curves had the highest concordance (≈80%) with maturity status classifications (pre-, circa-, post-PHV) based on longitudinal data for individual players. Predicted maturity offset with the Mirwald, Moore-1, and Fransen equations misclassified about one-third to one-half of the players, whereas concordance based on PAH% varied with the band used, but not with the method of height prediction. CONCLUSIONS: Visual assessment of the individual growth curves by an experienced assessor provides an accurate estimate of maturity status relative to PHV. Maturity offset prediction equations misclassify the majority of players, whereas PAH% provides a reasonably valid alternative.

What Are the Load and Wellness of Young Second-Team Football Players When Transitioning to the First Team? A Comparison of 2 Consecutive Preseasons.

PURPOSE: To compare the load and wellness of second-team academy football players during a first-team preseason with those of first-team players and those of their previous second-team preseason. METHODS: Athletic Club's first- (n = 10) and second-team (n = 9) players were prospectively followed during the 2019-20 first- and second-team and 2020-21 first-team preseasons. Weekly external and internal loads and average wellness z-scores (fatigue, sleep quality, muscle soreness, stress, and mood) were compared between preseasons and teams. RESULTS: While training together during the 2020-21 preseason, second-team players performed more decelerations <-3 m/s2 per week than first-team players (moderate effect size). For first-team players, there were only small differences between preseasons in external load, but session rating of perceived exertion was higher (moderate) and stress (moderate) and mood (large) z-scores were worse in 2020-21. For second-team players, more total distance (large), accelerations >3 m/s2 (large), and decelerations <-3 m/s2 (very large) were performed; total loading (moderate) and session rating of perceived exertion (moderate) were higher; and fatigue (very large) and stress (moderate) z-scores were worse during the 2020-21 first-team preseason compared to their previous second-team preseason. CONCLUSIONS: Players transitioning from the second team faced higher external and internal loads, fatigue, and stress during the first-team preseason compared to the previous second-team preseason. Player development and monitoring plans appear necessary to manage the transition from the academy to the first team.

The burden of injuries according to maturity status and timing: A two-decade study with 110 growth curves in an elite football academy.

Injuries have a negative impact on the development of football players. Maturation is a potential risk factor for football injuries but available data on this topic provide limited evidence due to methodological shortcomings. The aim of this study was to describe the injury burden of male academy football players according to growth curve-derived maturity status and timing. Injury and growth data were collected from 2000 to 2020. Longitudinal height records for 110 individual players were fitted with the Super-Imposition by Translation and Rotation model to estimate age at peak height velocity (PHV). Players were clustered according to maturity status (pre-, circa-, post-PHV, or adults) and timing (early, on-time, late maturers). Overall and specific injury burdens (days lost/player-season) and rate ratios for comparisons between groups were calculated. Overall injury burden increased with advanced maturity status; pre-PHV players had 3.2-, 3.7-, and 5.5-times lower burden compared with circa-PHV, post-PHV, and adult players, respectively. Growth-related injuries were more burdensome circa-PHV, while muscle and joint/ligament injuries had a higher impact post-PHV and in adults. Further, in the pre-PHV period, late maturers showed lower burden of overall, growth-related, anterior inferior iliac spine osteochondrosis, and knee joint/ligament injuries compared with on-time maturers. In adult players, however, injuries were less burdensome for early maturers than on-time and late maturers. In addition, joint/ligament injuries of adult late maturers were 4.5-times more burdensome than those of early maturers. Therefore, monitoring maturity seems crucial to define each player's maturation profile and facilitate design of targeted injury prevention programmes.Highlights Injury burden is significantly lower in football players at pre-peak height velocity (PHV). Growth-related injuries are most burdensome circa-PHV, while muscle and joint/ligament injuries are more burdensome post-PHV and especially in adults.Before PHV, growth-related and knee joint/ligament injuries have lower burden in players who mature late than those who mature on-time. Adult late maturers have greater burden of overall and joint/ligament injuries than early maturers.Football academies should regularly assess the maturity status and timing of young football players, as the impact of injuries varies with maturation status and timing.Management of the maturity-related injury risk profile, in combination with other relevant factors (training load, neuromuscular and biomechanical factors, physiotherapy, coaching, communication, psychosocial factors …), might help improve the success of player development programmes and protect the health of young football players.

Injuries are negatively associated with player progression in an elite football academy.

BACKGROUND: The aim was to investigate the association of injuries with male football player continuity, progression and chances of reaching the First team in an elite academy. METHODS: Injuries and exposure time were prospectively recorded, following the FIFA guidelines, over 6 seasons (2011-2017) in Under (U)12, U14, U16, U19, 2nd/3rd team and First team players from the same professional football club. RESULTS: U19 and 2nd/3rd team players progressing to the next level had a lower injury burden and higher match availability compared to players that did not progress. Injury burden was lower in players progressing from U12 to U14. All players progressing from the 2nd/3rd teams to the First team had a match availability higher than 84% and did not suffer an anterior cruciate ligament (ACL) rupture or an injury requiring over 200 (+200) days to return to play. In U19 and 2nd/3rd team players, injuries requiring +100 and +200 days to return to play, ACL ruptures and groin pain, but not hamstring and ankle ligament injuries, were associated with lower odds of continuing in the academy each season. CONCLUSION: Injuries were negatively associated with player progression, and injury prevention and return-to-play strategies should be a priority for football academies.

An injury audit in high-level male youth soccer players from English, Spanish, Uruguayan and Brazilian academies.

OBJECTIVES: To identify the most common injury types/locations in high-level male youth soccer players (YSP). DESIGN: Prospective cohort surveillance study. SETTING: Professional soccer club academies. PARTICIPANTS: Six hundred and twenty-four high-level male YSP [Under 9 (U9) to U23 year-old age groups] from academies in England, Spain, Uruguay and Brazil. MAIN OUTCOME MEASURES: Injury type, location and severity were recorded during one season. Injury severity was compared between age groups, while injury type and location were compared between nations. RESULTS: Four hundred and forty-three training or match injuries were recorded, giving an injury rate of 0.71 per player. Non-contact injuries were most common (58.5%), with most (44.2%) resolved between 8 and 28 days. Most injuries (75.4%) occurred in the lower limbs, with muscle (29.6%) the most commonly injured tissue. U14 and U16 suffered a greater number of severe injuries relative to U12 and U19/U20/U23/Reserves. Tendon injury rate was higher in Brazil vs. Spain (p < 0.05), with low back/sacrum/pelvis injury rate highest in Spain (p < 0.05). CONCLUSIONS: The proportion of severe injuries in U14 and U16 suggests YSP injury risk is maturation-dependent. Minimal differences in type and location between high-level YSP from four different countries suggest injury rates in this population are geographically similar.

Genetic Variants and Hamstring Injury in Soccer: An Association and Validation Study.

PURPOSE: This study aimed to investigate the association of candidate single nucleotide polymorphisms (SNP) with noncontact hamstring muscle injuries in elite soccer players and to create and validate a model to assess the risk of hamstring injury. METHODS: A total of 107 elite male outfield players were prospectively followed for six seasons. Players were genotyped for 37 SNP previously investigated in relation to musculoskeletal injuries. The association of SNP, previous injury, age, level of play, position, and anthropometric data with 129 hamstring injuries (413 observations) was investigated in the discovery phase (2010-2015), and a multivariable Cox frailty model was created using forward selection. The model's discriminative ability was tested in the validation phase (2015-2016, 31 injuries, 98 observations) using Harrell's C index. RESULTS: Five SNP were found to be significantly associated with hamstring injury in a multivariable model: matrix metalloproteinase 3 rs679620 (A vs G, hazard ratio [HR] = 2.06, 95% confidence interval [CI] = 1.51-2.81), tenascin C rs2104772 (A vs T, HR = 1.65, 95% CI = 1.17-2.32), interleukin 6 rs1800795 (GG vs GC + CC, HR = 1.68, 95% CI = 1.11-2.53), nitric oxide synthase 3 rs1799983 (G vs T, HR = 1.35, 95% CI = 1.01-1.79), and hypoxia-inducible factor-1α rs11549465 (CC vs CT, HR = 2.08, 95% CI = 1.00-4.29). Age also entered the model (≥24 vs <24 yr, HR = 2.10, 95% CI = 1.29-3.42). The model showed acceptable discrimination in the discovery phase (C index = 0.74), but not in the validation phase (C index = 0.52). CONCLUSION: Genetic variants appear to be involved in the etiology of hamstring injuries but were not found to have predictive value by themselves. Further research, increasing the number of genetic variants and including environmental factors in complex multifactorial risk models, is necessary.