Background Engaging in competitive sports as a youth can have many health benefits, but recent studies also report a disquieting high injury risk. The long-term purpose of a Swedish research program is to develop a framework for safe athletics training among youth athletes (aged 12–15 years).

Objective To establish a national consensus of what causes injuries in youth athletics by compiling the best available experiential knowledge about the underlying causes of injuries sustained by young athletics athletes.

Design Qualitative study using focus groups and in-depth interviews for data collection.

Setting The Swedish Athletics community divided into seven administrative regions.

Participants 79 individuals representing all levels of the sport; officials from the Swedish Athletics Association, coaches, athletes, sports medicine professionals, clubs representatives, and parents.

Assessment of Risk Factors Qualitative research methods were used to categorize data, perform a thematic analysis, and execute repeated feed-back cycles to the community to corroborate preliminary results.

Main Outcome Measurements Categories resulting from the qualitative analysis were used to construct an explanatory model.

Results Injuries in youth athletes were not considered to be strictly the result of discrete causal factors but rather the result of the interactions between factors at different levels. Three major areas of injury causes emerged; the evidence-in-situ for application in daily practice, attitudes among coaches and parents about long-term strategies in youth athletics, and the setting and conditions for participating in the sport. In response, an ecological model for implementation of interventions was outlined that has its focal point in the young athlete's personal zone of athletic development.

Conclusions A national consensus process established that if effective and sustainable injury prevention processes are to be introduced in youth athletics, an ecological approach is needed. Such an approach allows a longitudinal development-focused strategy for prevention that spans over an entire athletic career.