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004 Increased injury risk in youth athletics when growth rates are high and skeletal maturation is low
  1. Eirik Halvorsen Wik1,2,
  2. Daniel Martínez-Silván1,
  3. Abdulaziz Farooq1,
  4. Marco Cardinale3,4,
  5. Amanda Johnson1,
  6. Roald Bahr1,2
  1. 1Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Norwegian School of Sport Sciences, Oslo, Norway
  3. 3Aspire Academy, Doha, Qatar
  4. 4University College London, London, UK


Background Studies addressing risk factors for injuries in youth athletics are scarce and although growth and maturation represent potential risk factors for adolescent athletes, the available literature is inconclusive.

Objective The aim of this study was to examine if growth rate, maturity status and maturity tempo are associated with injury risk in adolescent athletics.

Design Anthropometric, skeletal maturity and injury data collected prospectively over four seasons were included.

Setting The data collection was part of the ongoing monitoring of athletes at the Aspire Academy in Qatar.

Patients (or Participants) Participants were student-athletes, not yet specialized to event groups. Of the 129 athlete-seasons eligible for inclusion, 117 athlete-seasons (74 athletes) were included in the final sample.

Interventions (or Assessment of Risk Factors) Anthropometric measures were taken at the start and end of each season, while skeletal maturity was assessed at the start of each season using hand radiographs.

Main Outcome Measurements Time-loss injuries were recorded by medical staff and associations were assessed using generalized estimating equations.

Results Growth rate for stature was associated with greater risk of bone (Incidence rate ratio (IRR): 1.5 per SD above the mean, 95% CI: 1.1 to 1.9) and growth plate injuries (2.1, 1.5 to 3.1). Growth rate for leg length was associated with greater risk of overall (1.3, 1.0 to 1.7), bone (1.4, 1.0 to 1.9) and growth plate injuries (2.1, 1.4 to 3.0). Athletes with greater maturity status (0.6 per skeletal age year, 0.5 to 0.9; 0.8 per percent of mature height; 0.7 to 1.0) were less prone to growth plate injuries. Annual change in skeletal age was associated with an increased risk of bone injuries (1.5 per SD above the mean; 1.0 to 2.3).

Conclusions The results of this study suggest that rapid growth in stature and leg length, skeletal maturity status and maturity tempo represent risk factors for certain injury types in adolescent athletics. Regular monitoring therefore seems warranted.

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