682 FO04 – Growth-related injuries occur in a distal-to-proximal fashion in male youth academy footballers: a two-season prospective cohort study

Background The training loads and competitive match play associated with elite youth football result in injuries. Youth players are uniquely susceptible to apophyseal injuries, which may have consequences for player health and performance. Objective To describe the incidence, severity, and burden of apophyseal injuries in U9-U21 academy football players over two seasons. Setting Elite male academy youth football in England/Wales. Study population Players from 29 (21/22 season) and 31 (22/23 season) Premier League and English Football League academies Assessment of Risk Factors Age group was the independent variable. Results A total of 4,113 match and 4,455 training injuries were reported, including 202 match and 267 training apophyseal injuries. The incidence of match and training apophyseal injuries was 0.2–1.4 and 0.0–0.4 injuries per 1000 player hours, respectively. Apophyseal match injury burden was greatest across U13-U16s (63.4–71.9 days absence per 1000 hours), with the greatest injury severity noted in U15s (median: 53, IQR: 20–147 days). The most common apophyseal injury location, when separated into age groups, was the ankle in U9-U11s (50–60%), the knee in U12-U14s (39–43%), and the hip/groin in U15-U18s (46–70%), displaying a distal-to-proximal trend with age. The majority of apophyseal injuries were non-contact (61%) and gradual onset (59%). Conclusions Apophyseal injuries occur in a distal-to-proximal fashion, which can help inform injury prevention strategies adopted in youth academy football.