Background Published research into injury surveillance at English Premier League club (EPL) academies is scarce.

Objective To investigate the injury incidence rate (IIR) across two EPL U21 seasons.

Design Retrospective observational epidemiological cohort study.

Setting An EPL academy.

Participants Forty-one male professional football players (Age 17.8±1.1 y; Mass 73.7±5.9 kg; Height 178.3±5.3 cm).

Risk factor assessment Over two seasons, 2012–2014, injuries were diagnosed by a qualified physiotherapist. Each season consisted of 42-weeks, with ∼6×1-hour training sessions plus 1-fixture per week, with an accumulated squad total of 8054 hours on-legs exposure. Injury variables included; site, type, contact/non-contact, activity at onset and severity classification (days lost; £7, ³8£14, ³15).

Main Outcome Measurements IIR was defined as the number of injuries per 1000 hours of training and matches. Inter-season comparisons were completed through X² analysis.

Results Eighty-three injuries occurred across two seasons; 2012–13 n=27 and 2013–14 n=56 (10.3 IIR). The ankle (n=26, 3.2 IIR) was the highest recorded injury site. Muscular overuse and sprains both had equivalent IIR (n=16, 2.0 IIR). Over half (57%) of all injuries were sustain in matches (n=47, 5.8 IIR). High severity injuries (n=28) had 7 and 12 times the total days lost of Medium (n=22) and Low (n=33) severity injuries, respectively. Injuries classed as non-contact occurred 8% more often than those involving contact (54% vs. 46%). Statistically significant differences resulted between seasons only for muscle strains (1 vs. 11, P=0.02), training (7 vs. 23, P=0.01) and low severity injuries (10 vs. 23, P=0.01).

Conclusions We recommend cost effective targeted injury prevention programs for ankles, muscular overuse, muscular sprains and high severity injuries.