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Sports injuries aligned to predicted mature height in highly trained Middle-Eastern youth athletes: a cohort study
  1. Abdallah Rejeb1,2,
  2. Amanda Johnson1,
  3. Abdulaziz Farooq3,
  4. Ruth Verrelst2,
  5. Samuel Pullinger4,
  6. Roel Vaeyens5,
  7. Erik Witvrouw2
  1. 1 Aspire Academy Sports Medicine Center, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2 Rehabilitation Sciences and Physiotherapie, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
  3. 3 Athlete Health and Performance Research, Aspetar, Orthopaedic and Sports Medicine Department, Doha, Qatar
  4. 4 Department of Sports Sciences, ASPIRE Academy for Sports Excellence, Doha, Ad Dawhah, Qatar
  5. 5 Department of Movement and Sports Sciences, Universiteit Gent Faculteit Geneeskunde en Gezondheidswetenschappen, Gent, Belgium
  1. Correspondence to Abdallah Rejeb; abdallah.rajeb{at}


Objectives To investigate the association of maturity status with injury incidence in Middle-Eastern youth athletes.

Design Prospective cohort study.

Setting Four consecutive seasons (2010–2014), Aspire Academy, Qatar.

Participants Male athletes (age range: 11–18 years) representing four disciplines enrolled and grouped into two categories: individual sports and racquet sports.

Outcome measures Injury data collected over four seasons. Athletes’ anthropometric characteristics assessed to calculate age at peak height velocity. Predicted mature heights (PMHs) collected and categorised into four quartiles. Athletes had wrist and hand radiographs for assessment of skeletal age (SA). Early and late maturers with an SA of >1 year older or younger than their chronological age (CA).

Results For the sample (n=67) across all groups, 43 (64%) athletes had one or more injuries: total of 212 injuries, 4.9 injuries per athlete across study. Survival analysis of maturity status using SA found early maturing athletes had two-fold greater injury risk compared with late maturers (HR 2.04, 95% CI 1.15 to 3.61, p=0.015). PMH associated with injury risk (HR 1.05, 95% CI 1.01 to 1.08, p=0.006).

Athletes in fourth quartile (≥184 cm) had up to two-fold injury risk (HR 2.41, 95% CI 1.42 to 4.08, p=0.001). Racquet and individual sports involved similar injury risk (HR 1.14, 95% CI 0.86 to 1.52, p=0.37).

Conclusion SA early maturity and PMH gradient were significant predictors of injury in youths.

  • youth
  • biological maturation
  • skeletal age
  • anthropometrics
  • sports injury
  • mature height

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  • Contributors AR designed and developed the research question and wrote the original version of the manuscript as part of his doctoral thesis. EW (doctoral supervisor) reviewed, designed and provided expertise to the study. AJ (doctoral committee member) was involved in study design. AF supervised and provided expertise with respect to the data analyses. RVe, SP and RVa (doctoral committee member) reviewed and provided expertise to the study. All authors have contributed to and edited the manuscript and have approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

  • Patient consent for publication Parental/guardian consent obtained.

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