How Do Age Factors Impact Youth Soccer Injuries?
We know injuries can strike at any age, but in youth soccer age differences can define the choice of treatment selected and also influence the nature of injuries sustained.
There’s a big difference between injuries affecting the younger children playing the sport and the older adolescents whose injuries often resemble those of the adult population. There’s an even bigger difference, though, in how injuries are managed between the two groups.
Injuries to the older age group are similar to adult injuries. An eighteen-year old adolescent with a knee ligament sprain is managed in much the same way as a young adult with the same injury. The older adolescents with injuries aren’t really any different from adults in that respect. When late adolescents leave their comfort zone of playing in the under-age competitions and enter the world of open age soccer, playing against adults can frequently lead to injury - usually as a result of physical mismatching. When talking about injuries in the younger age groups, however, the injury risk due to physical mismatching is often far greater.
The Effect of Physique on Injuries
The larger, more mature youngsters not only stand out on the field in terms of physical presence, they quickly learn to be able to use their increased height and weight to their own advantage. Using a phrase associated with other contact sports, the more physically mature youngsters will “dominate the collision”; often leading to injury to opponents as a result.
At under-age level, challenges for the ball in soccer can often be won by the larger children purely as a result of their stronger physique.
The expression ‘larger children’ in this article refers to the increased physical maturity and development of youngsters compared to others of the same age. Adolescents and children develop physically at different rates (Malina et al, 1982), and I think most of us have seen how the stronger physique of the more-developed children makes them stand out in terms of the contact aspect of the game.
Often, at under-age levels these more mature players will be the match-winners simply because of their size and the way they can easily brush aside challenges from opponents. As far as the actual soccer-side of the game is concerned, though, these early developers can often struggle once they reach their middle to late teenage years. It’s at this stage that reality often strikes and they discover that the kids whose challenges they used to shrug off easily have overtaken them in terms of ability.
This doesn’t just happen in soccer either; the same can be seen in other sports where individual skill gives the smaller, more lithe, player the edge in terms of skill as opposed to just physical advantage. Until that stage arrives, however, physical mismatches can result in injury.
Injuries specific to children arising from uneven physical attributes are difficult to quantify. A straight-forward tackle can result in ligamentous damage, muscle injury, and even fractures or dislocations. The difference in physical maturity is perhaps the single most identifiable common factor for injury risk in children’s and under-age soccer; and this is highlighted mainly by injuries sustained as a direct result of direct contact with an opponent.
Direct Contact Injuries
Direct contact injuries in youth and adolescent soccer have been shown to account for a large proportion of all injuries in the open-age adult game (Price et al, 2004), with the greater proportion of these being to the lower limb.
In soccer, injuries sustained in the younger age groups are frequently of the contact type and these are the injuries that are difficult to legislate for and even harder to prevent.
The younger players are at a disadvantage compared to older teenagers simply because by the time the older players have reached the ages of fifteen / sixteen they’re well versed in the basics of soccer; while the younger players are still learning about the game and finding their own limitations.
It’s at this stage where education is so important. Teaching the practical techniques of tackling correctly at an early age for example can make a huge difference to how youngsters approach the physical side of the game. Soccer is supposed to be fun; and tackling is part of that fun but like all other skills in the game needs to be taught correctly in order to minimize the risk of injury. It’s not only injury to opponents that’s a risk but also injury to the tackler, since poor techniques are an injury risk in themselves.
Tackling is a skill; and learning how to tackle correctly needs to be taught like all other aspects of the game.
Injuries and Age Factors in Younger Players
Parents have specific worries with younger children and the potential for injury is always uppermost in the mind.
Although injuries in soccer are part and parcel of the game and occur at all ages, it’s the injuries to the younger children that can be more of a worry to parents. Children cry when they get hurt and this is the one thing that highlights the age differences between the under-tens and the under-sixteens more than anything else. It’s a natural reaction at that age and reassurance plays a big part in not only the treatment process but in immediately dealing with the injury.
Boys and girls have also been shown to be susceptible to different injuries, and we highlighted in an earlier article the statistics illustrating this. However, with younger age groups the immediate reaction is often just the same whatever the injury might be; and crying is a natural part of that process.
The research shows that the majority of injuries sustained in the younger age group are of the contact type, and a great deal of these can be attributed to the different rates at which children develop.
Girls are known to get more ankle and knee injuries than boys, while boys have been shown to have a higher risk of sustaining concussions and facial injuries (Leininger et al, 2007).This is reflected in the number of contact injuries sustained in the younger age-groups where the majority of these injuries are sustained by tackling mechanisms; many of which are likely to be the result of less-refined techniques or poorly-timed challenges as opposed to deliberately late challenges.
In addition to the obvious aspects of this such as in size, strength, and speed; coordination can be a big factor in terms of injury risk. It’s important to remember that often a late tackle can simply be the end product of a lack of co-ordination as opposed to a lack of discipline; but that matters can be made worse if physical mismatching results in the less physically mature or underdeveloped player coming off worse.
The physical differences aren’t helped by the qualifying dates for the under-age leagues; where children born on either side of the cut-off date find themselves physically mismatched as a result. There is a difference in the various rates in growth, development, and skeletal maturity between adolescents of the same age.
Therefore if we remember that a year’s difference in terms of age can manifest itself in greater physical differences, that’s where the child playing in the same competition as a youngster several months older can be at a significant disadvantage.
Stages of physical maturation are better assessed by biological age as opposed to chronological age. Chronological age can be described as the number of years a person has lived, with the biological age of an individual human often clinically different from the characteristics expected of an individual of that chronological age. Differences between chronological age and biological ages have been identified through studies of wrist MRI scans taken in young footballers, with significant differences noted in the skeletal maturity of footballers in the 14 – 19 age group (Dvorak et al, 2007).
At professional level, coaches are also known to favor those youngsters born early in the selection year. Mujika et al (2007), and Jullien et al (2008) noted that in professional soccer, the percentage of players born early in the selection year is particularly high because talent identification and selection processes within elite youth academies tend to show a bias towards this. They suggest that athletes may be perceived as being more ‘‘talented’’, and selected purely because of maturity related advantages in body size, strength, speed, and endurance as acknowledged by Sherar et al, (2007).
How to Properly Manage Injuries
We’ve spoken before about the actual injury management of sports injuries but the most important stage of the whole process undoubtedly remains in the immediate period just after the injury has been sustained. The very moment that knock, pull, strain, etc takes place is when the treatment actually starts; and the very first principle of that treatment is to minimize not only the damage that’s taken place, but also to address the risks of further damage being sustained. The injury management at that point is vital; and it follows that the basic first aid principles are the ones that are the most important.
When dealing with injuries then, it’s often a good idea to think in terms of providing ‘First AIDE’. “Accurate Immediate Diagnosis is Essential” is an old acronym used in soccer medicine to emphasize why the importance of getting the diagnosis right affects the whole treatment process. However, in legal terms the diagnosis remains the prerogative of the medical profession, therefore most pitch-siders aren’t allowed to physically diagnose injuries as such. Legally, most pitch-side immediate responders can only recognize the signs and symptoms presenting and advise the players – and parents – to seek an opinion from a physician.
With children, the golden rule is to seek appropriate advice right away. Injuries seen in the early stages nearly always do better than those left until no improvement appears to be taking place before they’re taken to a doctor. The important thing is to have the injury assessed as soon as possible, either in the physician’s office or in the Emergency Department of the local hospital.
Parents always worry about the long term effects of injury, the quality of care given throughout, and the accuracy of the diagnosis. It’s essential to be aware of how younger children react when they’re injured as opposed to the older ones - the older adolescents are young adults and need to be managed as such.
At the other end of the scale, the younger players are children; and with that comes an awareness of the different approach required.
Reassurance, understanding, and taking appropriate advice to ensure that any injuries sustained are properly diagnosed are the key principles of injury management in the younger age groups.
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Sherar LB, Baxter-Jones ADG, Faulkner RA, Russell KW (2007). Do physical maturity and birth dates predict talent in male youth ice hockey players? Journal of Sports Science. Vol. 25: 879 – 886.