Associations Between Growth, Maturation and Non-Contact Injury Risk in Scottish Male Academy Football: A Prospective Multi-Academy Study

Background
Biological maturation significantly influences injury risk in youth footballers, yet evidence from male Scottish academies remains limited. Variability in maturity timing means players do not reach peak height velocity (PHV) at the same chronological age, potentially creating disparities in injury vulnerability within age-grouped squads.

Aim
To investigate the relationship between biological maturation, growth, and non-contact injury risk in male academy football players.

Subjects and Methods
A prospective cohort study was conducted across five Club Academy Scotland (CAS) academies during the 2024–2025 season, including 392 male players aged 9–17 years (U10–U18). Anthropometric assessments were performed quarterly to estimate growth rate and biological maturity status (pre-, circa-, and post-PHV) and timing (early-, on-time-, and late-maturing) using percentage of predicted adult height (%PAH). Non-contact injury incidence (per 1000 h) and burden (days lost per 1000 h) were recorded throughout the season.

Results
Injury incidence was highest in post-PHV players, as well as in early- and late-maturing individuals. A non-linear relationship was observed between %PAH and injury incidence, with dual peaks at approximately 90% and 100% PAH, corresponding to circa- and post-PHV periods. Growth velocity was positively associated with injury incidence, with a marked increase observed at rates exceeding 10 cm/year.

Conclusions
These findings highlight the importance of monitoring growth and maturation in academy football and support the implementation of individualised, maturity-informed approaches to load management to mitigate injury risk.