Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis

Abstract

Background: To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players.

Methods: Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model.

Results: Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play.

Conclusion: The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.

Keywords: Incidence; Muscle injuries; Severity; Soccer; Young athletes.

Graphical abstract

Fig. 1

Flow chart of the selection of studies for the meta-analysis. ^a No injury definition (n = 2), full-text not available (n = 2), and incidence for football players reported jointly with other sports (n = 1). ED = emergency departments.

Fig. 2

Training injury incidence in male youth football players, with 95%CI. a, b, c, d, e, and f indicate different cohorts in the same study. 95%CI = 95% confidence interval.

Fig. 3

Match injury incidence in male youth football players, with 95%CI. a, b, c, d, e, and f indicate different cohorts in the same study. 95%CI = 95% confidence interval.

Fig. 4

Training injury incidence in female youth football players, with 95%CI. g, h, and i indicate different cohorts in the same study. 95%CI = 95% confidence interval.

Fig. 5

Match injury incidence in female youth football players, with 95%CI. g, h, and i indicate different cohorts in the same study. 95%CI = 95% confidence interval.

Fig. 6

Location of injuries in male (left side) and female (right side) youth football players. The upper boxes (with solid lines extending from them) represent the incidence of injury for main groups (head and neck, upper limbs, trunk, lower limbs), whereas the lower boxes (with dashed lines extending from them) represent the incidence of injury for lower extremities categories (hip/groin, thigh, knee, lower leg/Achilles tendon, ankle, foot/toe).