## 3 Injury Incidence
[34] highlighted a wide range of injury incidences in female players (1.1-7.2 injuries per 1000 h), with match-specific rates ranging from 2.88 to 30.59 injuries per 1000 h and training sessions rates ranging from 0.74 to 3.47 injuries per 1000 h of exposure. Variability in these findings may be attributed to differences in match formats, training loads, skill levels, and age-related maturity. Similarly, in 12 female soccer teams with players ages 11-14 years, the injury incidence rate was 2.2 per 1000 soccer exposure hours (95% CI 1.5-3.1), with an injury incidence rate of 6.1 (95% CI 3.5-9.9) during games and 1.0 (95% CI 0.5-1.8) during training sessions [35]. The higher variability in injury incidence may be due to several factors. It has been indicated that young players (children aged 6-12 years) participating in five- or seven-a-side soccer show a lower incidence of injuries compared to adolescents aged 13-16 years playing regular 11-a-side soccer [25]. Furthermore, the physical fitness level of the players can influence injury risk, as higher levels of physical fitness have been associated with a greater rate of all injuries (1.3 times higher injury rate) compared to players with lower fitness levels [36]. Several potential reasons, such as increased exposure, higher training loads, more frequent competition, playing with older junior teams, and greater involvement in the game, might explain why more fit players sustain a higher injury rate than their less fit counterparts. Lastly, players with higher soccer skills are at a greater risk of sustaining injuries--particularly contact injuries--than their less skilled teammates [37]. It is possible that skilled players, with more ball possession and active involvement in the game, are more susceptible to tackles and foil play, leading to a heightened risk of injury. These players are consequently more exposed to collisions and other physical duels [37; 38]. Adolescence is marked by significant psychological and physiological transformations, resulting in players of the same chronological age being at varying stages of puberty. Consequently, some research has explored the relationship between biological age and injury risk. [PERSON] et al. [39] reported the highest overall injury risk among early maturers. Conversely, [PERSON] et al. [12] observed no significant differences in overall injury incidence but noted that early and late maturers might be predisposed to different types of injuries. Similarly, [PERSON] et al. [40] found a greater number of injuries in early maturers compared to normal or late maturers, but these differences disappeared after accounting for variables such as training volume, playing time, height, and playing position. Stronger consensus exists in studies that used the maturity offset method to assess timing of maturation [41]. There is a heightened injury incidence during the circa-PHV phase--a period of rapid growth spurt often referred to as \"adolescent awkwardness\". During this stage, motor control strategies are disrupted [42], and the accelerated growth of anatomical structures like bones, tendons, and ligaments increases injury risk in soccer players. While it is well-recognized that female athletes are more prone to ACL injuries [43] due to hormonal, anthropometric, and biomechanical factors, it remains unclear whether sex differences affect susceptibility to other types of injuries compared to male soccer players. Some studies have found no significant differences between males and females in overall injury rates [25; 44; 45], although others have reported higher injury rates in females [5; 9; 46]. A greater injury incidence rate during matches compared to training is a consistent finding in research on female soccer players [6; 9; 23].