Shedding light on incidence and burden of physeal injuries in a youth elite football academy: A 4-season prospective study

Olivier Materne*, Karim Chamari, Abdulaziz Farooq, Montassar Tabben, Adam Weir, Per Holmich, Roald Bahr, Matt Greig, Lars R. McNaughton

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

16 Citations (Scopus)


Introduction: Physeal 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. Methods: In total, 551 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). Results: There 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 U-17 for hip–pelvis (II: 6.4; 95% CI: 4.2–9.3). Conclusion: Physeal 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.

Original languageEnglish
Pages (from-to)165-176
Number of pages12
JournalScandinavian Journal of Medicine and Science in Sports
Issue number1
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
The authors would like to thank all academy football players, plus the team of football physiotherapists from Aspire Academy for their highly professional injury recording commitments. We would also like to acknowledge all from the imaging department of Aspetar for their continued support. Finally, the authors are extremely grateful to the artist, Mr. Rapha?l Demarteau, for his artwork and drawings.

Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


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