Injuries according to sexual maturity status: a three-season observational study with male academy players of a professional Spanish football club

The current literature suggests that football (soccer) players' age and maturity status affect the likelihood of sustaining certain injuries; however, few studies have used indicators of sexual maturity. By retrospectively analysing prospectively collected data, we therefore aimed to describe injury patterns among young football players in a Spanish academy over three seasons and investigate associations with sexual maturity status. Participants included 354 male youth players aged 7 to 18, categorised into five age groups. Maturity assessments were conducted annually, utilising pubertal stages for genitalia and pubic hair, alongside testicular volume measurements. Time-loss injuries were recorded by medical staff and associations with pubertal stages were examined using Generalized Estimating Equations (GEE). Results indicated an overall incidence of 2.2 injuries per 1000 hours. Higher injury rates were observed for more advanced maturational stages (p < 0.05). Common injury types included muscle injuries (23%), joint sprains (20%), and growth-related injuries (16%), with specific injuries varying by maturity stage. For instance, growth-related injuries peaked during mid-puberty, while muscle and joint injuries were more frequent in advanced maturity stages (p < 0.05). Our findings suggest that sexual maturity status was significantly associated with injury occurrence in youth football. This emphasises the importance of understanding the interplay between biological maturity and injury occurrence. In addition to considering players' age or playing level, coaches and clinicians may consider tailoring training and injury prevention strategies according to players' maturity levels to better mitigate injury risks.