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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.

Background: The association between injury risk and skeletal maturity in youth soccer has received little attention. Purpose: To prospectively investigate injury patterns and incidence in relation to skeletal maturity in elite youth academy soccer players and to determine the injury risks associated with the skeletal maturity status, both overall and to the lower limb apophysis. Study Design: Descriptive epidemiology study. Methods: All injuries that required medical attention and led to time loss were recorded prospectively during 4 consecutive seasons in 283 unique soccer players from U-13 (12 years of age) to U-19 (18 years). The skeletal age (SA) was assessed in 454 player-seasons using the Fels method, and skeletal maturity status (SA minus chronological age) was classified as follows: late, SA >1 year behind chronological age; normal, SA ±1 year of chronological age; early, SA >1 year ahead of chronological age; and mature, SA = 18 years. An adjusted Cox regression model was used to analyze the injury risk. Results: A total of 1565 injuries were recorded; 60% were time-loss injuries, resulting in 17,772 days lost. Adjusted injury-free survival analysis showed a significantly greater hazard ratio (HR) for different status of skeletal maturity: early vs normal (HR = 1.26 [95% CI, 1.11-1.42]; P < .001) and early vs mature (HR = 1.35 [95% CI, 1.17-1.56]; P < .001). Players who were skeletally mature at the wrist had a substantially decreased risk of lower extremity apophyseal injuries (by 45%-61%) compared with late ( P < .05), normal ( P < .05), and early ( P < .001) maturers. Conclusion: Musculoskeletal injury patterns and injury risks varied depending on the players’ skeletal maturity status. Early maturers had the greatest overall adjusted injury risk. Players who were already skeletally mature at the wrist had the lowest risk of lower extremity apophyseal injuries but were still vulnerable for hip and pelvis apophyseal injuries.

ObjectiveInvestigate the incidence and burden of injuries by age group in youth football (soccer) academy players during four consecutive seasons.MethodsAll injuries that caused time-loss or required medical attention (as per consensus definitions) were prospectively recorded in 551 youth football players from under 9 years to under 19 years. Injury incidence (II) and burden (IB) were calculated as number of injuries per squad season (s-s), as well as for type, location and age groups.ResultsA total of 2204 injuries were recorded. 40% (n=882) required medical attention and 60% (n=1322) caused time-loss. The total time-loss was 25 034 days. A squad of 25 players sustained an average of 30 time-loss injuries (TLI) per s-s with an IB of 574 days lost per s-s. Compared with the other age groups, U-16 players had the highest TLI incidence per s-s (95% CI lower-upper): II= 59 (52 to 67); IB=992 days; (963 to 1022) and U-18 players had the greatest burden per s-s: II= 42.1 (36.1 to 49.1); IB= 1408 days (1373 to 1444). Across the cohort of players, contusions (II=7.7/s-s), sprains (II=4.9/s-s) and growth-related injuries (II=4.3/s-s) were the most common TLI. Meniscus/cartilage injuries had the greatest injury severity (95% CI lower-upper): II= 0.4 (0.3 to 0.7), IB= 73 days (22 to 181). The burden (95% CI lower-upper) of physeal fractures (II= 0.8; 0.6 to 1.2; IB= 58 days; 33 to 78) was double than non-physeal fractures.SummaryAt this youth football academy, each squad of 25 players averaged 30 injuries per season which resulted in 574 days lost. The highest incidence of TLI occurred in under-16 players, while the highest IB occurred in under-18 players.

It is well established that differences in injury definition and recording methodology restrict comparisons between injury surveillance programmes. There is, however, little documentation of the variation that can exist between data recorders. The aim of this study was, therefore, to explore the effect on reported injuries when team recorders or supervisors are involved in research. Injury data collected prospectively over five seasons for the U16, U17, and U18 age groups in a youth football (soccer) academy were used to compare different recording settings based on the research involvement of the clinicians. A research-invested team physiotherapist reported an 8.8 times greater incidence (P < 0.001) of non-time-loss injuries and a 2.5 times greater incidence (P < 0.001) of minimal injuries (1-3 days lost) compared to a setting where neither the team physiotherapists nor the supervisor relied on the collected data for research purposes. When team physiotherapists were not invested in research themselves but were supervised by a researcher, the incidence of non-time-loss injuries and minimal injuries was 2.5 times (P < 0.001) and 2.0 times greater (P < 0.01) than in the non-invested setting, respectively. However, there were no differences between recording settings for overall incidence of time-loss injuries. The results from this study demonstrate that involving clinicians that are relying on the collected data for research purposes can significantly affect the reported rates of non-time-loss and minimal injuries. Time-loss injuries overall were not affected by research investment, and should therefore be preferred for comparisons between teams and seasons.

Although substance P (SP) has been implicated as a mediator of neurogenic inflammation in the small intestine, little information is available regarding the role of SP in the pathogenesis of chronic ulcerative colitis. In this study, our aim was to investigate whether the intraperitoneal administration of a nonpeptide neurokinin-1 (NK-1) antagonist, CP-96345, which antagonizes the binding of SP to its NK-1 receptor, results in the attenuation of colonic inflammation induced in rats by 5% dextran sodium sulfate (DSS) in drinking water for 10 days compared with an inactive enantiomer, CP-96344. Disease activity was assessed daily for 10 days, after which colonic tissue damage was scored and myeloperoxidase activity and colon and urinary 8-isoprostanes were measured. Animals receiving DSS exhibited marked physical signs of colitis by day 5 compared with controls. Chronic administration of the NK-1 antagonist significantly reduced the disease activity index, mucosal myeloperoxidase activity, colonic tissue damage score, and mucosal and urinary levels of 8-isoprostanes compared with inactive enantiomer- or vehicle-injected (saline) animals receiving DSS alone. These data indicate that the administration of an NK-1 antagonist can attenuate colonic inflammation and oxidative stress and suggest a novel therapeutic approach in the treatment of chronic ulcerative colitis.