Oslo Sports Trauma Research Center

BACKGROUND: Elite youth athletes participate in intense and structured training programmes to realise their performance potential, but their development may be interrupted by injuries. To reduce the impact of injuries we first need to know which injuries affect participation the most and what the risk factors are. Growth and maturation represent two potential non-modifiable intrinsic risk factors that are unique to adolescent athletes. The literature published on this topic is, however, considered of low quality and findings in earlier studies are inconsistent.

AIM: The aim of this thesis was to identify the most common and burdensome injuries in elite male youth athletes participating in football (soccer) and athletics (track and field) and to explore growth and maturation as risk factors.

WHAT IS THE PROJECT ABOUT: All studies were based on data from routine monitoring of athletes at Aspire Academy, a national elite sports academy in Doha, Qatar. Participants were males aged 11 to 18 years participating in the football or athletics programmes. The first study (Paper I) was a methodological study where we investigated the effect on injury incidence when a broad medical-attention definition was used and recorders/supervisors were invested in research projects relying on the data. Papers II and III were descriptive epidemiological studies in athletics and football, respectively. In Papers IV and V, subsamples of athletes from the epidemiological studies with complete growth (anthropometric measures, i.e. height, leg length and body mass) and maturity (skeletal age, using the Fels method) assessments were included. Growth rates, maturity status and maturity tempo were then examined as risk factors for specific injury types.

CONCLUSION AND IMPLICATIONS: Based on our findings, time-loss incidence should be used when multiple medical staff recorders are involved in the data collection. Injuries patterns in elite male youth athletes are specific to the sport, event group and age group; tailoring injury reduction programmes may therefore be possible. A large proportion of lost training and competition days were attributed to bone injuries; these should be targeted to a larger degree in risk factor studies and in injury reduction programmes. Skeletal maturity appears to affect the risk of sustaining certain injury types in football and athletics, while growth rates were only related to injury risk in athletics. Practitioners and researchers may need to consider the full growth and maturity process, rather than analysing short isolated periods, to better understand the relationship between growth, maturation and injury risk.

SUPERVISORS:

Main supervisor: Roald Bahr – Professor, Oslo Sports Trauma Research Center, NIH.

Warren Gregson – Head of Football Physiology, Aspire Academy, Doha

Professor, Dep. of Sport and Exercise Sciences, Liverpool John Moores University.

Amanda Johnson – Lead Physiotherapist, Aspire Academy Sports Medicine Centre, Aspetar Orthopaedic and Sports Medicine Hospital.

THE THESIS IS BASED ON THE FOLLOWING ARTICLES:

I. Wik EH, Materne O, Chamari K, Duque JDP, Horobeanu C, Salcinovic B, Bahr R, Johnson A. Involving research-invested clinicians in data collection affects injury incidence in youth football. Scandinavian Journal of Medicine and Science in Sports. 2019;29(7):1031-1039.

II. Martinez-Silvan D, Wik EH, Alonso JM, Jeanguyot E, Salcinovic B, Johnson A, Cardinale M. Injury characteristics in male youth athletics: a five-season prospective study in a full-time sports academy. British Journal of Sports Medicine. 2020:bjsports-2020-102373.

III. Wik EH, Lolli L, Chamari K, Materne O, Di Salvo V, Gregson W, Bahr R. Injury patterns differ with age in male youth football: a four-season prospective study of 1111 time-loss injuries in an elite national academy. British Journal of Sports Medicine. 2020:bjsports-2020-103430.

IV. Wik EH, Martinez-Silvan D, Farooq A, Cardinale M, Johnson A, Bahr R. Skeletal maturation and growth rates are related to bone and growth plate injuries in adolescent athletics. Scandinavian Journal of Medicine and Science in Sports. 2020;30(5):894-903.

V. Wik EH, Lolli L, Chamari K, Tabben M, Di Salvo V, Gregson W, Bahr R. Main and combined effects of growth rate and skeletal maturity status on injury risk in elite male youth football players. Manuscript submitted to Scandinavian Journal of Medicine and Science in Sports, February 2021.