Advertisement

Injury Incidence, Prevalence and Severity in High-Level Male Youth Football: A Systematic Review

  • Steven JonesEmail author
  • Sania Almousa
  • Alistair Gibb
  • Nick Allamby
  • Rich Mullen
  • Thor Einar Andersen
  • Morgan Williams
Systematic Review

Abstract

Background

At a young age, high-level youth footballers enter structured practice where they engage in regular training and matches. The academy system is considered fundamental to a young footballer’s tactical, technical and physical development. Yet, with regular training and matches, high-level youth footballers may be exposed to the risk of injury.

Objective

This systematic review analyses and summarises published scientific information on high-level youth football injury characteristics and calculates the risk of them sustaining an injury over the course of a typical season.

Methods

The search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Of the 1346 studies found, 23 fulfilled the inclusion criteria.

Results

Quality assurance scores for the selected research articles ranged between two and five out of eight. A high degree of heterogeneity between studies was observed. The probability of sustaining a time-loss injury during a high-level youth season ranged between < 1% and 96% for under 9- to under 16-year age groups and 50% and 91% for under 18- to under 21-year age groups. Pooled estimates for total (training and match) incidence per 1000 h was 5.8 for youth players aged under 9 to under 21 years, 7.9 for older players (under 17–under 21 years) and 3.7 for younger aged players (under 9–under 16 years). Training injury incidence rate ranged from 0.69 to 7.9 per 1000 h for all age groups in youth football. Match injury incidence rate for high-level youth players ranged from 0.4 to 80.0 per 1000 h. Close to one-fifth (18%) of all high-level youth football injuries were classified as severe and required > 28 days recovery time. Muscle strain injury accounted for 37% of all injuries reported in youth football. High probabilities (> 90%) of sustaining a time-loss injury over one typical high-level football season were found.

Conclusion

High-level youth players lose large portions of the seasonal development to injury, with players seemingly suffering long absences from training and matches, consequently affecting health and well-being and possibly burdening club/parental finances and healthcare systems.

Notes

Acknowledgements

The authors would like to thank all of the researchers who responded, in particular Andy Renshaw, Tania Nilsson and Hans Jan Bult for their assistance.

Authors’ Contributions

Steven Jones was primarily responsible for determining the review design, data analysis and writing the manuscript. Sania Almousa, Alistair Gibb, Nick Allamby, Rich Mullen, Thor Einar Andersen and Morgan Williams were involved in review design and contributed to the writing the manuscript.

Compliance with Ethical Standards

Funding

We used no sources of funding to assist in the preparation of this article.

Conflict of interest

Steven Jones, Sania Almousa, Alistar Gibb, Nick Allamby, Rich Mullen, Thor Einar Andersen and Morgan Williams declare they have no competing interests relevant to the content.

References

  1. 1.
    Calvin M. No hunger in paradise.The players. The journey. The dream. London: Century; 2017.Google Scholar
  2. 2.
    Ward P, Hodges NJ, Starkes JL, et al. The road to excellence: deliberate practice and the development of expertise. High Abil Stud. 2007;18:119–53.Google Scholar
  3. 3.
    Demopoulos P. Optimising the use of GPS technology to quantify biomechanical load in elite level soccer. [dissertation]. Edge Hill University; 2016.Google Scholar
  4. 4.
    Russell M, Sparkes W, Northeast J, et al. Responses to a 120 min reserve team soccer match: a case study focusing on the demands of extra time. J Sports Sci. 2015;33:2133–9.Google Scholar
  5. 5.
    Tierney PJ, Young A, Clarke ND, et al. Match play demands of 11 versus 11 professional football using Global Positioning System tracking: variations across common playing formations. Hum Mov Sci. 2016;49:1–8.Google Scholar
  6. 6.
    Gleim GW, McHugh MP. Flexibility and its effects on sports injury and performance. Sports Med. 1997;24:289–99.Google Scholar
  7. 7.
    Sole G, Milosavljevic S, Nicholson H, et al. Altered muscle activation following hamstring injuries. Br J Sports Med. 2012;46:118–23.Google Scholar
  8. 8.
    Rowland TW. Effect of prolonged inactivity on aerobic fitness of children. J Sports Med Phys Fit. 1994;34:147–55.Google Scholar
  9. 9.
    Røksund OD, Kristoffersen M, Bogen BE, et al. Higher drop in speed during a repeated sprint test in soccer players reporting former hamstring strain injury. Front Physiol. 2017;8:25.Google Scholar
  10. 10.
    Fyfe JJ, Opar DA, Williams MD, et al. The role of neuromuscular inhibition in hamstring strain injury recurrence. J Electromyogr Kinesiol. 2013;23:523–30.Google Scholar
  11. 11.
    Drawer S, Fuller CW. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med. 2001;35:402–8.Google Scholar
  12. 12.
    Maffulli N, Longo UG, Gougoulias N, et al. Long-term health outcomes of youth sports injuries. Br J Sports Med. 2010;44:21–5.Google Scholar
  13. 13.
    Leventer L, Eek F, Hofstetter S, et al. Injury patterns among elite football players: a media-based analysis over 6 seasons with emphasis on playing position. Int J Sports Med. 2016;37:898–908.Google Scholar
  14. 14.
    Ekstrand J, Hägglund M, Waldén M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011;45:553–8.Google Scholar
  15. 15.
    Bengtsson H, Ekstrand J, Waldén M, et al. Match injury rates in professional soccer vary with match result, match venue, and type of competition. Am J Sports Med. 2013;41:1505–10.Google Scholar
  16. 16.
    Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011;39:1226–32.Google Scholar
  17. 17.
    Bengtsson H, Ekstrand J, Hägglund M. Muscle injury rates in professional football increase with fixture congestion: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013;47:743–7.Google Scholar
  18. 18.
    Hägglund M, Waldén M, Ekstrand J. UEFA injury study–an injury audit of European Championships 2006 to 2008. Br J Sports Med. 2009;43:483–9.Google Scholar
  19. 19.
    Giza E, Mithöfer K, Farrell L, et al. Injuries in women’s professional soccer. Br J Sports Med. 2005;39:212–6.Google Scholar
  20. 20.
    Junge A, Dvorak J. Injuries in female football players in top-level international tournaments. Br J Sports Med. 2007;41:i3–7.Google Scholar
  21. 21.
    Clausen MB, Zebis MK, Møller M, et al. High injury incidence in adolescent female soccer. Am J Sports Med. 2014;42:2487–94.Google Scholar
  22. 22.
    Giza E, Micheli LJ. Soccer injuries. Med Sport Sci. 2005;49:819–37.Google Scholar
  23. 23.
    Faude O, Rößler R, Junge A. Football injuries in children and adolescent players: are there clues for prevention? Sports Med. 2013;43:819–37.Google Scholar
  24. 24.
    Pfirrmann D, Herbst M, Ingelfinger P, et al. Analysis of injury incidences in male professional adult and elite youth soccer players: a systematic review. J Athl Train. 2016;51:410–24.Google Scholar
  25. 25.
    Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.Google Scholar
  26. 26.
    Freckleton G, Pizzari T. Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. Br J Sports Med. 2013;47:351–8.Google Scholar
  27. 27.
    Loney PL, Chambers LW, Bennett KJ, et al. Critical appraisal of the health research literature: prevalence or incidence of a health problem. Chronic Dis Can. 1998;19:170–6.Google Scholar
  28. 28.
    Higgins JPT, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analyses. Br Med J. 2003;327:557–60.Google Scholar
  29. 29.
    Parekh N, Hodges SD, Pollock AM, et al. Communicating the risk of injury in schoolboy rugby: using Poisson probability as an alternative presentation of the epidemiology. Br J Sports Med. 2012;46:611–3.Google Scholar
  30. 30.
    Freitag A, Kirkwood G, Scharer S, et al. Systematic review of rugby injuries in children and adolescents under 21 years. Br J Sports Med. 2015;49:511–9.Google Scholar
  31. 31.
    Nevill M, Atkinson G, Hughes MD, et al. Statistical methods for analysing discrete and categorical data recorded in performance analysis. J Sports Sci. 2002;20:829–44.Google Scholar
  32. 32.
    UEFA Youth Rules ‘Regulations of the UEFA European Under-17 Championship 2016/17’. https://www.uefa.com/MultimediaFiles/Download/Regulations/uefaorg/Regulations/02/39/19/17/2391917_DOWNLOAD.pdf. Accessed 11 Apr 2018.
  33. 33.
    Deehan DJ, Bell K, McCaskie AW. Adolescent musculoskeletal injuries in a football academy. J Bone Joint Surg. 2007;89:5–8.Google Scholar
  34. 34.
    Merron R, Selfe J, Swire R, et al. Injuries among professional soccer players of different age groups: a prospective four-year study in an English Premier League Football Club. Int Sports Med J. 2006;7:266–76.Google Scholar
  35. 35.
    Read PJ, Oliver JL, De Ste Croix MBA, et al. An audit of injuries in six English professional soccer academies. J Sports Sci. 2018;36:1542–8.Google Scholar
  36. 36.
    Renshaw A, Goodwin PC. Injury incidence in a Premier League youth soccer academy using the consensus statement: a prospective cohort study. BMJ Open Sport Exerc Med. 2016;2:e000132.Google Scholar
  37. 37.
    Johnson A, Doherty PJ, Freemount A. Investigation of growth, development, and factors associated with injury in elite schoolboy footballers: prospective study. BMJ. 2009;338:b490.Google Scholar
  38. 38.
    Tears C, Chesterton P, Wijnbergen M. The elite player performance plan: the impact of a new national youth development strategy on injury characteristics in a Premier League football academy. J Sports Sci. 2018;36:2181–8.Google Scholar
  39. 39.
    Price RJ, Hawkins RD, Hulse MA, et al. The Football Association medical research programme: an audit of injuries in academy youth football. Br J Sports Med. 2004;38:466–71.Google Scholar
  40. 40.
    Bacon CS, Mauger AR. Prediction of overuse injuries in professional u18-u21 footballers using metrics of training distance and intensity. J Strength Cond Res. 2017;31:3067–76.Google Scholar
  41. 41.
    Bowen L, Gross AS, Gimpel M, et al. Accumulated workloads and the acute:chronic workload ratio relate to injury risk in elite youth football players. Br J Sports Med. 2017;51:452–9.Google Scholar
  42. 42.
    Hawkins RD, Fuller CW. A prospective epidemiological study of injuries in four English professional football clubs. Br J Sports Med. 1999;33:196–203.Google Scholar
  43. 43.
    Brink MS, Visscher C, Arends S, et al. Monitoring stress and recovery: new insights for the prevention of injuries and illnesses in elite youth soccer players. Br J Sports Med. 2010;44:809–15.Google Scholar
  44. 44.
    Bult HJ, Barendrecht M, Tak IJR. Injury risk and injury burden are related to age group and peak height velocity among talented male youth soccer players. Orthop J Sports Med. 2018;6:232596711881104.Google Scholar
  45. 45.
    van der Sluis A, Elferink-Gemser MT, Coelho-e-Silva MJ, et al. Sport injuries aligned to peak height velocity in talented pubertal soccer players. Int J Sports Med. 2014;35:351–5.Google Scholar
  46. 46.
    Kemper GL, van der Sluis A, Brink MS, et al. Anthropometric injury risk factors in elite-standard youth soccer. Int J Sports Med. 2015;36:1112–7.Google Scholar
  47. 47.
    Le Gall F, Carling C, Reilly T, et al. Incidence of injuries in elite French youth soccer players: a 10-season study. Am J Sports Med. 2006;34:928–38.Google Scholar
  48. 48.
    Le Gall F, Carling C, Reilly T. Biological maturity and injury in elite youth football. Scand J Med Sci Sports. 2007;17:564–72.Google Scholar
  49. 49.
    Tourny C, Sangnier S, Cotte T, et al. Epidemiologic study of young soccer player’s injuries in U12 to U20. J Sports Med Phys Fit. 2014;54:526–35.Google Scholar
  50. 50.
    Nilsson T, Östenberg AH, Alricsson M. Injury profile among elite male youth soccer players in a Swedish first league. J Exerc Rehab. 2016;12:83–9.Google Scholar
  51. 51.
    Timpka T, Risto O, Björmsjö M. Boys soccer league injuries: a community-based study of time-loss from sports participation and long-term sequelae. Eur J Public Health. 2008;18:19–24.Google Scholar
  52. 52.
    Peterson LJ, Chomiak A, Graf-Baumann J, et al. Incidence of football injuries and complaints in different age groups and skill-level groups. Am J Sports Med. 2000;28:S47–50.Google Scholar
  53. 53.
    Bianco A, Spedicato M, Petrucci M, et al. A prospective analysis of the injury incidence of young male professional football players on artificial turf. Asian J Sports Med. 2016;7:e28425.Google Scholar
  54. 54.
    Ergun M, Denerel NH, Binnet MS, et al. Injuries in elite youth football players: a prospective three-year study. Acta Orthop Traumatol Turc. 2013;47:339–46.Google Scholar
  55. 55.
    Junge A, Chomiak J, Dvorak J. Incidence of football injuries in youth players comparison of players from two European regions. Am J Sports Med. 2000;28:47.Google Scholar
  56. 56.
    Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Clin J Sports Med. 2006;16:97–106.Google Scholar
  57. 57.
    Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports. 2006;16:83–92.Google Scholar
  58. 58.
    Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med. 2006;40:193–201.Google Scholar
  59. 59.
    Brukner P, Khan K. Sports injuries: overuse, Chapter 5 in Clin Sports Med. Sydney: McGraw-Hill; 2012. p. 25–40.Google Scholar
  60. 60.
    Read PJ, Oliver JL, De Ste Croix MBA, et al. A prospective investigation to evaluate risk factors for lower extremity injury risk in male youth soccer players. Scand J Med Sci Sports. 2018;28:1244–51.Google Scholar
  61. 61.
    Eirale C, Tol JL, Farooq A, et al. Low injury rate strongly correlates with team success in Qatari professional football. Br J Sports Med. 2013;47:807–8.Google Scholar
  62. 62.
    Williams S, Trewartha G, Kemp SP, et al. Time loss injuries compromise team success in elite Rugby Union: a 7-year prospective study. Br J Sports Med. 2016;50:651–65.Google Scholar
  63. 63.
    Calman KC. Communication of risk: choice, consent, and trust. Lancet. 2002;360:166–8.Google Scholar
  64. 64.
    Soligard T, Myklebust G, Steffen K, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ. 2008;337:a2469.Google Scholar
  65. 65.
    Bizzini M, Dvorak J. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide-a narrative review. Br J Sports Med. 2015;49:577–9.Google Scholar
  66. 66.
    Rössler R, Junge A, Bizzini M, et al. A multinational cluster randomised controlled trial to assess the efficacy of ‘11+ Kids’: a warm-up programme to prevent injuries in Children’s Football. Sports Med. 2018;48:1493–504.Google Scholar
  67. 67.
    Rössler R, Verhagen E, Rommers N, et al. Comparison of the ‘11+ Kids’ injury prevention programme and a regular warmup in children’s football (soccer): a cost effectiveness analysis. Br J Sports Med. 2019;53:309–14.Google Scholar
  68. 68.
    Pierpoint L, Comstock RD. Field hockey injuries among high school girls in the United States, 2008/09–2015/16. Br J Sports Med. 2017;51:374.Google Scholar
  69. 69.
    Bathgate A. A prospective study of injuries to elite Australian rugby union players * Commentary. Br J Sports Med. 2002;36:265–9.Google Scholar
  70. 70.
    Waldén M, Hägglund M, Ekstrand J. UEFA Champions League study: a prospective study of injuries in professional football during the 2001–2002 season. Br J Sports Med. 2005;39:542–6.Google Scholar
  71. 71.
    Waldén M, Hägglund M, Ekstrand J. Injuries in Swedish elite football: a prospective study on injury definitions, risk for injury and injury pattern during 2001. Scand J Med Sci Sports. 2005;15:118–25.Google Scholar
  72. 72.
    Eirale C, Hamilton B, Bisciotti G, et al. Injury epidemiology in a national football team of the Middle East. Scand J Med Sci Sports. 2012;22:323–9.Google Scholar
  73. 73.
    Rössler R, Junge A, Chomiak J, et al. Soccer injuries in players Aged 7 to 12 years: a descriptive epidemiological study over 2 seasons. Am J Sports Med. 2016;44:309–17.Google Scholar
  74. 74.
    Gastin PB, Fahrner B, Meyer D, et al. Influence of physical fitness, age, experience, and weekly training load on match performance in elite Australian football. J Strength Cond Res. 2013;27:1272–9.Google Scholar
  75. 75.
    Philippaerts RM, Vaeyens R, Janssens M, et al. The relationship between peak height velocity and physical performance in youth soccer players. J Sports Sci. 2006;24:221–30.Google Scholar
  76. 76.
    Malina RM. Maturity status and injury risk in youth soccer players. Clin J Sports Med. 2010;20:132.Google Scholar
  77. 77.
    Bridge MW, Toms MR. The specialising or sampling debate: a retrospective analysis of adolescent sports participation in the UK. J Sports Sci. 2013;31:87–96.Google Scholar
  78. 78.
    Bradley PS, Sheldon W, Wooster B, et al. High-intensity running in English FA Premier League soccer matches. J Sports Sci. 2009;27:159–68.Google Scholar
  79. 79.
    Barnes C, Archer DT, Hogg B, et al. The evolution of physical and technical performance parameters in the English Premier League. Int J Sports Med. 2014;35:1095–100.Google Scholar
  80. 80.
    Dvorak J, George J, Junge A, et al. Age determination by magnetic resonance imaging of the wrist in adolescent male football players. Br J Sports Med. 2007;41:45–52.Google Scholar
  81. 81.
    Malina RM. Skeletal age and age verification in youth sport. Sports Med. 2011;41:925–47.Google Scholar
  82. 82.
    Malina RM, Rogol AD, Cumming SP, et al. Biological maturation of youth athletes: assessment and implications. Br J Sports Med. 2015;49:852–9.Google Scholar
  83. 83.
    Swain M, Kamper SJ, Maher CG, et al. Relationship between growth, maturation and musculoskeletal conditions in adolescents: a systematic review. Br J Sports Med. 2018;52:1246–52.Google Scholar
  84. 84.
    Bahr R. Demise of the fittest: are we destroying our biggest talents? Br J Sports Med. 2014;48:1265–7.Google Scholar
  85. 85.
    Tak I, Weir A, Langhout R, et al. The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players. Br J Sports Med. 2015;49:630–4.Google Scholar
  86. 86.
    Thorborg K, Branci S, Stensbirk F, et al. Copenhagen hip and groin outcome score (HAGOS) in male soccer: reference values for hip and groin injury-free players. Br J Sports Med. 2014;48:557–9.Google Scholar
  87. 87.
    Werner J, Hägglund M, Waldén M, et al. UEFA injury study: a prospective study of hip and groin injuries in professional football over seven consecutive seasons. Br J Sports Med. 2009;43:1036–40.Google Scholar
  88. 88.
    Ekstrand J, Waldén M, Hägglund M. Hamstring injuries have increased by 4% annually in men’s professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. Br J Sports Med. 2016;50:731–7.Google Scholar
  89. 89.
    Timmins R, Bourne MN, Shield AJ, et al. Short biceps femoris fascicles and eccentric knee flexor weakness increase the risk of hamstring injury in elite football (soccer): a prospective cohort study. Br J Sports Med. 2015;50:1624–35.Google Scholar
  90. 90.
    Petersen J, Thorborg K, Nielsen MB, et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011;39:2296–303.Google Scholar
  91. 91.
    Ishøi L, Hölmich P, Aagaard P, et al. Effects of the Nordic hamstring exercise on sprint capacity in male football players: a randomized controlled trial. J Sports Sci. 2018;36:1663–72.Google Scholar
  92. 92.
    Harøy J, Clarsen B, Wiger EG, et al. The adductor strengthening programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med. 2019;53:150–7.Google Scholar
  93. 93.
    Timmins R, Porter K, Williams M, et al. Biceps femoris muscle architecture—the influence of previous injury. Br J Sports Med. 2014;48:665–6.Google Scholar
  94. 94.
    Gabbe BJ, Bailey M, Cook JL, et al. The association between hip and groin injuries in the elite junior football years and injuries sustained during elite senior competition. Br J Sports Med. 2010;44:799–802.Google Scholar
  95. 95.
    Hickey J, Shield AJ, Williams MD, et al. The financial cost of hamstring strain injuries in the Australian Football League. Br J Sports Med. 2014;48:729–30.Google Scholar
  96. 96.
    Ekstrand J, Spreco A, Davison M. Elite football teams that do not have a winter break lose on average 303 player-days more per season to injuries than those teams that do: a comparison among 35 professional European teams. Br J Sports Med. 2018.  https://doi.org/10.1136/bjsports-2018-099506.Google Scholar
  97. 97.
    Hunkin SL, Fahrner B, Gastin PB. Creatine kinase and its relationship with match performance in elite Australian Rules football. J Sci Med Sport. 2014;17:332–6.Google Scholar
  98. 98.
    Fünten KAD, Faude O, Lensch J, et al. Injury characteristics in the German professional male soccer leagues after a shortened winter break. J Athl Train. 2014;49:786–93.Google Scholar
  99. 99.
    Cortes N, Greska E, Kollock R, et al. Changes in lower extremity biomechanics due to a short-term fatigue protocol. J Athl Train. 2013;48:306–13.Google Scholar
  100. 100.
    Alentorn-Geli E, Myer GD, Silvers HJ, et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: mechanisms of injury and underlying risk factors. Knee Surg Sports Traumatol Arthrosc. 2009;17:705–29.Google Scholar
  101. 101.
    Alentorn-Geli E, Myer GD, Silvers HJ, et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to reduce injury rates. Knee Surg, Sports Traumatol, Arthrosc. 2009;17:859–79.Google Scholar
  102. 102.
    Orchard J. Is there a relationship between ground and climatic conditions and injuries in football? Sports Med. 2002;32:419–32.Google Scholar
  103. 103.
    Faude O, Rössler R, Petushek EJ, et al. Neuromuscular adaptations to multimodal injury prevention programs in youth sports: a systematic review with meta-analysis of randomized controlled trials. Front Physiol. 2017;8:791.Google Scholar
  104. 104.
    Steib S, Rahlf AL, Pfeifer K, et al. Dose-response relationship of neuromuscular training for injury prevention in youth athletes: a meta-analysis. Front Physiol. 2017;8:920.Google Scholar
  105. 105.
    LaPrade RF, Agel J, Baker J, et al. AOSSM Early sport specialization consensus statement. Orthop J Sports Med. 2016;4:1–8.Google Scholar
  106. 106.
    Brenner JS. Sports Specialization and intensive training in young athletes. Pediatrics. 2016;138:e1–8.Google Scholar
  107. 107.
    Bergeron MF, Mountjoy M, Armstrong N, et al. International Olympic Committee consensus statement on youth athletic development. Br J Sports Med. 2015;49:843–51.Google Scholar
  108. 108.
    Lloyd S, Cronin JB, Faigenbaum AD, et al. National Strength and Conditioning Association position statement on long-term athletic development. J Strength and Cond Res. 2016;30:1491–509.Google Scholar
  109. 109.
    Valovich McLeod TC, Decoster LC, Loud KJ, et al. National Athletic Trainers’ Association position statement: prevention of pediatric overuse injuries. J Athl Train. 2011;46:206–20.Google Scholar
  110. 110.
    Bell DR, Post EG, Biese K, et al. Sport specialization and risk of overuse injuries: a systematic review with meta-analysis. Pediatrics. 2018;142:e20180657.Google Scholar
  111. 111.
    Wilhelm A, Choi C, Deitch J. Early sport specialization: effectiveness and risk of injury in professional baseball players. Orthop J Sports Med. 2017;5:1–5.Google Scholar
  112. 112.
    Jayanthi NA, LaBella CR, Fischer D, et al. Sports-specialized intensive training and the risk of injury in young athletes: a clinical case-control study. Am J Sports Med. 2015;43:794–801.Google Scholar
  113. 113.
    Mostafaviar AM, Best TM, Myer GD. Early sport specialization, does it lead to long-term problems? [editorial]. Br J Sports Med. 2013;47(17):1060.Google Scholar
  114. 114.
    Hägglund M, Waldén M, Ekstrand J. Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. Br J Sports Med. 2006;40(9):767–72.Google Scholar
  115. 115.
    Waldén M, Hägglund M, Ekstrand J. High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury. Br J Sports Med. 2006;40:158–62.Google Scholar
  116. 116.
    Grimmer KA, Jones D, Williams J. Prevalence of adolescent injury from recreational exercise: an australian perspective. J Adolesc Health. 2000;27:266–72.Google Scholar
  117. 117.
    Von Rosen P, Kottorp A, Fridén C, et al. Young, talented and injured: injury perceptions, experiences and consequences in adolescent elite athletes. Eur J Sport Sci. 2018;18:731–40.Google Scholar
  118. 118.
    Merkel DL. Youth sport: positive and negative impact on young athletes. Open Access J Sports Med. 2013;4:151–60.Google Scholar
  119. 119.
    Malina RM. Early sport specialization. Curr Sports Med Rep. 2010;9:364–71.Google Scholar
  120. 120.
    Bleakley C, Tully M, O’Connor S. Epidemiology of adolescent rugby injuries: a systematic review. J Athl Train. 2011;46:555–65.Google Scholar
  121. 121.
    Orchard J, Hoskins W. For debate: consensus injury definitions in team sports should focus on missed playing time. Clin J Sports Med. 2007;17:192–6.Google Scholar
  122. 122.
    Clarsen B, Bahr R, Heymans MW, et al. The prevalence and impact of overuse injuries in five Norwegian sports: application of a new surveillance method. Scand J Med Sci Sports. 2015;25:323–30.Google Scholar
  123. 123.
    Clarsen B, Myklebust G, Bahr R. Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med. 2013;47:495–502.Google Scholar
  124. 124.
    Clarsen B, Bahr R. Matching the choice of injury/illness definition to study setting, purpose and design: one size does not fit all. Br J Sports Med. 2014;48:510–2.Google Scholar
  125. 125.
    Bjørneboe J, Flørenes TW, Bahr R, et al. Injury surveillance in male professional football; is medical staff reporting complete and accurate? Scand J Med Sci Sports. 2011;21:713–20.Google Scholar
  126. 126.
    Wik EH, Materne O, Chamari K, et al. Involving research-invested clinicians in data collection affects injury incidence in youth football. Scand J Med Sci Sports. 2019.  https://doi.org/10.1111/sms.2018-13427.Google Scholar
  127. 127.
    Finch C, Valuri G, Ozannw-Smith J. Sport and active recreation injuries in Australia: evidence from emergency department presentation. Br J Sports Med. 1998;32(3):220–5.Google Scholar
  128. 128.
    Bahr R, Clarsen B, Ekstrand J. Why we should focus on the burden of injuries and illnesses, not just their incidence. [editorial]. Br J Sports Med. 2018;52(16):1018.Google Scholar
  129. 129.
    Müller-Rath R, Schmidt C, Mumme T, et al. The injury pattern following the introduction of the junior premier league in Germany compared to professional senior football (soccer). Sportverletz Sportschaden. 2006;20(4):192–5.Google Scholar
  130. 130.
    Morrison A, Polisena J, Husereau D, et al. The effect of English-language restriction on systematic review-based meta-anayses: a system review of empirical studies. Int J Technol Assess Health Care. 2012;28(4):138–44.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019
, corrected publication 2019

Authors and Affiliations

  • Steven Jones
    • 1
    • 3
    Email author
  • Sania Almousa
    • 1
  • Alistair Gibb
    • 3
  • Nick Allamby
    • 3
  • Rich Mullen
    • 1
  • Thor Einar Andersen
    • 2
  • Morgan Williams
    • 1
  1. 1.School of Health, Sport and Professional Practice, Faculty of Life Sciences and EducationUniversity of South WalesPontypriddUK
  2. 2.Department of Sports Medicine, Oslo Sports Trauma Research CenterNorwegian School of Sport SciencesOsloNorway
  3. 3.Bolton Wanderers Football ClubBoltonUK

Personalised recommendations