Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players

Abstract Background Youth football players are at high risk of lower limb injuries, which can affect performance and long-term career development. However, epidemiological data on injury patterns in German elite youth football remain limited. This study aims to (1) provide an overview of lower limb...

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Main Authors: Sebastian Viktor Waldemar Schulz, Lynn Matits, Eric Schwarz, Achim Jerg, Moritz Otte, Patrick Wiedemann, Daniel Alexander Bizjak, Johannes Kirsten, Alexander-Stephan Henze
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Sports Science, Medicine and Rehabilitation
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Online Access:https://doi.org/10.1186/s13102-025-01190-7
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author Sebastian Viktor Waldemar Schulz
Lynn Matits
Eric Schwarz
Achim Jerg
Moritz Otte
Patrick Wiedemann
Daniel Alexander Bizjak
Johannes Kirsten
Alexander-Stephan Henze
author_facet Sebastian Viktor Waldemar Schulz
Lynn Matits
Eric Schwarz
Achim Jerg
Moritz Otte
Patrick Wiedemann
Daniel Alexander Bizjak
Johannes Kirsten
Alexander-Stephan Henze
author_sort Sebastian Viktor Waldemar Schulz
collection DOAJ
description Abstract Background Youth football players are at high risk of lower limb injuries, which can affect performance and long-term career development. However, epidemiological data on injury patterns in German elite youth football remain limited. This study aims to (1) provide an overview of lower limb injuries in German elite youth football academies and (2) investigate the association between anthropometric factors, particularly genu varum, and injury risk. Methods This cross-sectional study included 381 healthy male football players (aged 10–23 years) from two German elite youth academies between 2021 and 2023. Injury history from the most recent full league season, including pre-season and regular season matches, was recorded. Anthropometric assessments included body composition and intercondylar distance of the knee (ICD) to evaluate genu varum. Results A total of 140 lower limb injuries were documented, resulting in a cumulative injury frequency of 0.39 and an incidence of 1.2 injuries per 1,000 h. Most injuries were muscle-tendon injuries in the thigh (36.4%) and ligament injuries in the ankle (35.0%). Injury hot spots included lateral ligament tears in the ankle (30.0%) and muscle injuries within a triangle of the hamstrings (12.9%), quadriceps (10.7%), and adductors (11.4%) in the thigh. Injury frequency significantly increased from age 13 (p =.013; OR = 2.29), particularly in the thigh (p =.027; OR = 3.28). Regression analysis revealed a significant correlation between age (p =.038; coefficient of variation (COV) = -0.07) and ICD (p =.003; COV = -0.01) on the number of injuries, suggesting a potential link between genu varum and increased injury risk. Conclusion This study provides the first structured overview of lower limb injuries in two German elite youth football academies and their association with anthropometric data. The findings highlight age-related injury patterns and suggest a potential link between genu varum and injury risk, underlining the need for targeted injury prevention strategies. Establishing a systematic, long-term injury surveillance system in youth football is essential for developing evidence-based interventions to reduce injury risk and support player development.
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spelling doaj-art-8ff2b780650844dbb3c8f4ea914379472025-08-20T03:10:35ZengBMCBMC Sports Science, Medicine and Rehabilitation2052-18472025-06-0117111210.1186/s13102-025-01190-7Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football playersSebastian Viktor Waldemar Schulz0Lynn Matits1Eric Schwarz2Achim Jerg3Moritz Otte4Patrick Wiedemann5Daniel Alexander Bizjak6Johannes Kirsten7Alexander-Stephan Henze8Sports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmSports and Rehabilitation Medicine, University Hospital UlmAbstract Background Youth football players are at high risk of lower limb injuries, which can affect performance and long-term career development. However, epidemiological data on injury patterns in German elite youth football remain limited. This study aims to (1) provide an overview of lower limb injuries in German elite youth football academies and (2) investigate the association between anthropometric factors, particularly genu varum, and injury risk. Methods This cross-sectional study included 381 healthy male football players (aged 10–23 years) from two German elite youth academies between 2021 and 2023. Injury history from the most recent full league season, including pre-season and regular season matches, was recorded. Anthropometric assessments included body composition and intercondylar distance of the knee (ICD) to evaluate genu varum. Results A total of 140 lower limb injuries were documented, resulting in a cumulative injury frequency of 0.39 and an incidence of 1.2 injuries per 1,000 h. Most injuries were muscle-tendon injuries in the thigh (36.4%) and ligament injuries in the ankle (35.0%). Injury hot spots included lateral ligament tears in the ankle (30.0%) and muscle injuries within a triangle of the hamstrings (12.9%), quadriceps (10.7%), and adductors (11.4%) in the thigh. Injury frequency significantly increased from age 13 (p =.013; OR = 2.29), particularly in the thigh (p =.027; OR = 3.28). Regression analysis revealed a significant correlation between age (p =.038; coefficient of variation (COV) = -0.07) and ICD (p =.003; COV = -0.01) on the number of injuries, suggesting a potential link between genu varum and increased injury risk. Conclusion This study provides the first structured overview of lower limb injuries in two German elite youth football academies and their association with anthropometric data. The findings highlight age-related injury patterns and suggest a potential link between genu varum and injury risk, underlining the need for targeted injury prevention strategies. Establishing a systematic, long-term injury surveillance system in youth football is essential for developing evidence-based interventions to reduce injury risk and support player development.https://doi.org/10.1186/s13102-025-01190-7SoccerAthletic injuriesEpidemiologyGenu varumPrimary prevention
spellingShingle Sebastian Viktor Waldemar Schulz
Lynn Matits
Eric Schwarz
Achim Jerg
Moritz Otte
Patrick Wiedemann
Daniel Alexander Bizjak
Johannes Kirsten
Alexander-Stephan Henze
Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
BMC Sports Science, Medicine and Rehabilitation
Soccer
Athletic injuries
Epidemiology
Genu varum
Primary prevention
title Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
title_full Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
title_fullStr Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
title_full_unstemmed Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
title_short Lower limb injuries and their association with anthropometrics - an observational study of 381 German elite youth football players
title_sort lower limb injuries and their association with anthropometrics an observational study of 381 german elite youth football players
topic Soccer
Athletic injuries
Epidemiology
Genu varum
Primary prevention
url https://doi.org/10.1186/s13102-025-01190-7
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