## 4 Discussion  
The aim of this study was to comprehensively examine the prevalence and associated risk factors of knee injuries among youth football players in Saudi Arabia. Our investigation, encompassing 104 male players from five teams, revealed that 37.5% of participants had experienced prior knee injuries, predominantly characterized by muscle injuries occurring during training sessions. This study provides a novel and detailed exploration of injury distribution, encompassing severity, timing, and mechanisms, shedding light on the prevalence of multiple injuries. In contrast, existing studies have often focused on specific types of knee injuries, such as ligaments or menisci, or have been limited to specific populations like university students. To the best of our knowledge, the current study is the first attempt to assess the prevalence of muscle injuries among youth football players in Saudi Arabia. In the current study, muscle injuries constituted the most prevalent type, making up 61.5% of all reported injuries, with quadriceps and hamstring injuries being equally common and predominantly occurring during training sessions. The results of the current study are consistent with previous studies [11,12] that found that knee injuries caused the highest burden among injuries and that muscular injuries in general were the most common in youth football players. However, no direct comparison can be conducted because these studies do not specifically address the incidence of knee muscle injuries in this population. In the same context, [PERSON] et al. [9] found that almost one third of all injuries in professional football are muscle injuries. The reason for the high prevalence of muscle injuries in youth football players may be the nature of the sport; it features high-intensity activities such as accelerations during running, jumping, and kicking and the predominant use of pelvic muscles rather than core abdominal muscle stabilizers [13]. Furthermore, incomplete muscular development and the limited shock absorption of developing muscles in adolescents are major concerns [14]. This is consistent with the findings of [PERSON] et al. [15], who reported that muscle injuries were the most common type of injury (61.4%) and that the majority of muscle injuries and all ligament injuries occurred during training. In general, knee injuries in youth football players predominantly occur during training sessions. The higher incidence of knee injuries in youth football players during training compared to matches can be attributed to factors such as training intensity, physical contact, individual focus, fatigue, and age and maturation status [11,15,16]. These factors contribute to the increased risk of knee injuries during training sessions, while matches may provide a less intense and more varied environment that reduces the risk of knee injuries. In the current investigation, ligamentous injuries had the second-highest prevalence at 25.6%, with the ACL emerging as the most frequently affected. These findings closely align with the research of [PERSON] et al. [17] who reported that the prevalence of knee ligament injury was 48.8% and the ACL was implicated in 46.2% of the cases. Likewise, the