Background Injuries have a negative impact on the development of young football players. The percentage of predicted adult height is being used as an indicator of maturity status for bio-banding, yet no study has investigated its association with injury risk in football.

Objective To establish the percentage of adult height at which the most relevant football injuries occur.

Design Prospective cohort study.

Setting Elite male football players from a Spanish LaLiga club’s academy.

Patients (or Participants) 63 players were followed between 1998 and 2019, since they were on average 10.7 years old (80.8% of adult height) until they reached their final height (one full season at 100%).

Assessment of Risk Factors The medical staff recorded injuries following the FIFA consensus and measured height every 3–6 months.

Main Outcome Measurements The percentage of adult height at which each injury occurred was calculated using the player’s closest height to the injury and his final adult height. Injuries were classified in maturity bands, Pre-peak height velocity (Pre-PHV) <88%, Peak heigh velocity (PHV) 88–95% and Post-peak height velocity (Post-PHV) >95%.

Results Sever’s disease occurred at a median 87.8% of adult height (interquartile range: 82.3–91.5%, band with the highest frequency: 58.8% pre-PHV), Osgood-Schlatter disease at 87.2% (85.9–91.2%, 54.2% pre-PHV) and anterior inferior iliac spine injuries at 91.0% (88.9–93.8%, 69.2% PHV). Spondylolysis occurred at 98.7% of adult height (97.5–99.5%, 92.3% post-PHV). Similarly, muscle and joint/ligament injuries were more common Post-PHV: hamstring injuries at 98.4% (96.6–99.4%, 77.8% post-PHV), quadriceps injuries at 98.5% (94.8–99.5%, 72.4% post-PHV), knee joint/ligament injuries at 98.9% (98.0–99.9%, 87.5% post-PHV), anterior cruciate ligament ruptures at 98.6% (98.0–100%, 100% post-PHV) and ankle joint/ligament injuries at 98.3% (89.4–99.3%, 65.7% post-PHV).

Conclusions The percentage of predicted adult height could be determined to detect high-risk periods for specific injuries and guide preventive strategies in young footballers.