Injuries in Youth Football: What Is Special About a Growing Body
A child is not a small adult, even when injured. Why overuse injuries appear, which typical growing pains are worth recognising, and what a coach can do to prevent them.
Linkalde · 2026-10-19
The more children play sport, and the more they train, the more injuries appear. This is pointed out by Jon Warner and Lyle Micheli, doctors specialising in young athletes, in a review of injuries in children and teenagers. And they stress something every academy coach needs to know: children don't get injured in the same way as adults.
This article helps you spot warning signs and prevent injuries. It is no substitute for a doctor: if a pain won't go away or makes the player limp, the player stops and the family gets it checked.
Two ways of getting injured
| Knock or twist | Overuse | |
|---|---|---|
| How it happens | A single action with a lot of force: a tackle, a bad landing, a twist. | Many small repeated impacts: running, jumping, kicking. |
| How you notice it | Immediate pain on one particular play. | Pain that appears gradually and gets worse with training. |
| What causes it | Contact and chance, partly. | Mostly how you train: load, repetition, rest. |
| What the coach can do | Warm up well, teach how to fall, fair play. | A lot: it is the type that depends most on the coach. |
Overuse injuries are increasingly common among young athletes, according to the authors. And they are precisely the ones that can best be avoided from the bench.
Why a child is not a small adult
- A child's bone is more porous than an adult's and copes worse with compression and tension.
- The weak point is the growth plate, the part of the bone that is still growing, near joints such as the knee, the ankle or the heel. It is more vulnerable than an adult's to both knocks and overload.
- In a child, the ligaments are usually stronger than that cartilage. That's why cruciate ligament tears are rare before the age of 14: when the knee twists, what often suffers is the growth plate.
- Until the growth plates of the tibia and fibula close, around 15-16, a sprained ankle can actually be a fracture in that area.
Practical consequence: a “sprain” in a 12-year-old player is not the same as in a 25-year-old. If there is severe pain, swelling or they can't put weight on it, get a doctor to look at it before they train again.
What causes overuse injuries
Warner and Micheli suggest going through a list of risk factors to find the cause and prevent it. The first is the most common, and it is in the coach's hands:
- Training errors. This is the most frequently repeated factor. Intensive summer camps and programmes that raise the load suddenly put young players at risk. As a guide, increasing intensity and duration by more than 10% a week can already predispose to these injuries.
- Muscle-tendon imbalance after a growth spurt. The bone grows, the muscle falls behind and flexibility is lost. Carrying on with intense, repetitive training without regaining it is asking for an injury.
- Strength imbalances: for example, strong quadriceps and weak, short hamstrings.
- The shape of the legs and feet: legs of different lengths, knees turning in or out, feet that collapse inwards.
- Footwear: it should cushion, support and compensate.
- A lack of basic fitness. A very sedentary child isn't ready to withstand the repeated impacts of a sport.
Raising the load without going over 10% a week
Typical growing pains worth recognising
Some pains turn up again and again in players of growing age. The coach doesn't diagnose them, but recognising them helps avoid saying “it's nothing, carry on”:
| Pain | Where | What we know | What usually helps |
|---|---|---|---|
| Osgood-Schlatter | Below the kneecap, at the bump of the shin bone | Small tears where the patellar tendon attaches. More common in boys and at puberty. | Less jumping and running, stretching and strength work, always with a doctor. |
| Sever's | The heel | Irritation of the heel's growth area. | Stretch the calves and Achilles tendon, strengthen the ankle and check the boots. |
| Pain at the front of the knee | Around the kneecap | Usually due to leg alignment, often with no damage to the cartilage. | Leg strength and stretching. More than 90% of the authors' patients improve with this programme. |
| Groin pain | Groin and lower abdomen | Overload of the abdominals and adductors, typical of playing a lot of football. | Rest, stretching and strengthening. |
What the coach can do
FIFA's youth manuals turn these ideas into training guidelines:
- Strength early, but with bodyweight. From age 9-10, core exercises (abs and back). Building a solid muscle base is also preventing injuries.
- Balance opposing muscles. If you work the quadriceps, work the hamstrings too. Muscle balance is especially important between the ages of 13 and 15.
- Flexibility in every session, through games and exercises, especially for adductors, hip flexors, ankles and knees.
- Stretch after strength work, jumps and speed, even more so with players who are growing. Combine static stretching with dynamic mobility.
- Basic aerobic endurance. As well as being good for health, it prevents accidents and injuries and helps recovery.
- A good warm-up before every session and every match.
When to stop
- The pain shows up in every training session or gets worse.
- The player limps or changes the way they run.
- There is swelling or they can't put weight on it normally.
- After a growth spurt, the player suddenly loses flexibility or always complains about the same spot.
In these cases the sensible thing is to cut the load, talk to the family and have a doctor take a look. To return, it's better to first regain the flexibility and strength they had.
Bibliography
- Warner, J. J. P. y Micheli, L. J.. Lesiones músculo-esqueléticas en niños y adolescentes. PubliCE.
- FIFA. Fútbol juvenil. Manual para entrenadores. Fédération Internationale de Football Association.
- FIFA. Manual para entrenadores. Fédération Internationale de Football Association.