Integrating the S&C Professional:
Injury rates are one of the most significant concerns that disrupts the development windows and reduces participation, and in some cases, it can contribute to long-term musculoskeletal complications amongst youth athletes. In both contact and non-contact sports, rates of both acute and overuse injuries amongst youth populations have often attracted scrutiny alongside the increasing demand for the inclusion of structured strength and conditioning provision to reduce them. Whether strength and conditioning provision and generic injury prevention programmes meaningfully impact the injury rates in youth athlete populations and sports remains largely unanswered from the evidence base.
Structured S&C and Injury Reduction
The largest level of evidence concerns the relationship between participation in structured strength and conditioning programmes and its relationship with injury incidents in youth sports. The literature infers that regular participation in pre-season training programmes which incorporated the combination of strength training, plyometrics and education of quality movement patterns might contribute to the reduction of the likelihood of sports related injuries in youth athletes (Faigenbaum & Myer, 2009). These findings have since been quantified, according to a meta-analysis conducted by Lloyd et al. (2013) found that resistance training reduced the chance of sports related injuries such as acute and overuse related injuries in children and adolescence by up to 66%. A separate body of literature surrounding neuromuscular training (NMT) which encompassed a broader range of training modalities such as plyometrics, balance, agility and movement education produced comparable figures. Neuromuscular training in youth athletes where athletes participated in training sessions two or three times per week produced the largest preventative effects with a reduction in injury risk by up to 42% (Steib et al., 2017). More recently, injury prevention programmes that included both strength and flexibility training were able to reduce injury risks by nearly one third with these training modalities being the highlighted as being highly effective risk mitigation strategies (Francisco Javier Robles-Palazón et al., 2024).
The caveat to this body of evidence is that the large majority of these studies were within a controlled environment and delivered under the supervision of professional researchers with programmes designed specifically to mitigate risks. Which poses the question, if these principles were delivered in an uncontrolled environment by a coach within a club environment would yield the same results as. This argument is a lot less well answered by existing literature, which restricts the validity for evaluating specific impact that a dedicated strength and conditioning coach may have as there is limited transfer into evidence for the effectiveness of any particular delivery model.
The Role of Qualified Supervision in Injury Prevention
The most consistent finding within literature regarding youth resistance training concerns the relationship between supervision quality and injury risk. Most of the injuries reported within youth athlete populations occur in unsupervised or poorly supervised settings, which stem from inappropriate loading and the misuse of equipment and not the inherent risk that resistance training might have on an individual (Faigenbaum et al., 2009). These findings were further supported by the 2014 international consensus position statement on youth resistance training (Lloyd et al., 2013), which emphasised that most of the training-related injuries that occur among young athletes are preventable by suitable supervision and education of proper progression based on technical competence. Crucially, around 77% of acute resistance training-related injuries are often accidental, reinforcing the notion that qualified oversight is the most effective way of reducing risk rather than avoiding resistance training altogether.
The primary two factors that have been identified as the two most modifiable risk factors for injuries amongst youth populations are poor exercise technique and a rapid increase in loan (Faigenbaum et al., 2009). Both of these factors directly address the qualified coach who can adjust loads, change movement patterns in response to any technical breakdowns that the athlete might be demonstrating. According to Faigenbaum et al. (2009) only 36% of training sessions that junior high school athletes were supervised by a coach, thus giving an insight into the amount of training sessions that athletes undertake without oversight. Trainers and athletes engaged in supervised resistance training reported vastly lower injury rates than those who trained alone or with a training partner (Fisher et al., 2023).
Dedicated by S&C coaches compared to other supervision models. For example, sport specific coaches doubling as the athletic development lead or peer led training groups have received significantly less research attention. Most research tends to examine the presence or absence of supervision and not the professional quality of this. This gap in the literature could be significant, since the value of the S&C coach compared to an unqualified sports coach is precisely the question that is most relevant and facing for youth sports populations. The research infers that the qualification of the coach has a significant impact to the injury rates amongst youth athletes. However, the evidence base for the specific impact at club levels remains in speculation.
Load Management as a Mechanism for Injury Prevention
Another substantive contribution that an S&C practitioner can contribute to the injury prevention in youth sport is the management of training load on an athlete over a prolonged period. Injuries that arise from an accumulation of repetitive sub-maximal stress over time in comparison to a single traumatic event has one of the largest impacts to injury rates in youth sport clubs. The training-injury prevention paradox demonstrated that the relationship between training load and injury risks are not linear: Meaning, a rapid increase in training load can increase the likelihood of injury, chronic load that is managed week to week is associated with reduced injury incidence compared to irregular or inconsistent training patterns (Gabbett, 2016). This suggests that, how the load is structured over a period of time can be of equal importance than how much load is given during a specific training session.
Principles of load management have also received considerable attention with youth sports literature. It has been noted in the literature that training volume and intensity should increase no more than 10% per week to avoid accumulating any excessive stress and allow the musculoskeletal system to adapt and recover (Brenner, 2016). This guideline is broadly recognised within broader load management literature as being one that requires awareness and deliberate intent within programming to implement correctly. Load increases closer to 15% can increase the risk of injury to up to 50% (Niall Seewang, 2024) highlighting the importance of progressive load increments, opposed to reactive management once symptoms of over training are present. This can be challenging to navigate amongst other factors of youth development, including growth and any physical changes to tissue tolerance and maturation stages that could further impact how an athlete is managed. This requires a level of individualised oversight from a professional rather than an individual trying to manage this on their own.
Evidence within youth football in the US illustrates the limitations of load monitoring at club level. Comprehensive monitoring approaches in elite youth football found that combining subjective wellness measures alongside performance testing and positional tracking data tracked and monitored by a professional practitioner who had a permanent presence at a club was accepted by players of being an effective way to track load management. At a more basic level, evidence given in research on adolescent overuse injuries in soccer, it has been identified that that peak height velocity as the most consistent factor that poses a risk of an overuse injury (Ayoub et al., 2025), which can have direct implications for a practitioner who are better suited in tracking maturation markers and adjusting training loads accordingly than most sport coaches.
Conclusion
Taking all the evidence into account, it consistently supports the idea that structured, supervised provision from a S&C coach can play a vital role in reducing injury rates in youth athlete populations. Findings are consistent, with meaningful effect sizes across a large range of sports and training modalities. Research shows that the way the supervision is delivered and more specifically with the presence of a qualified practitioner is at least as important as the content of the programme itself with poorly supervised or even in the absence of supervision being associated with substantially higher injury rates (Faigenbaum & Myer, 2009). In addition to the findings on professional supervision, load management strategies used by practitioners may reduce risk levels that arise from poorly regulated accumulation of training stress (Gabbett, 2016).
However, there are still limitations within the literature that may conflict with conclusions as they are mainly associated with youth sport specifically. Most of the research in this area either involves controlled conditions or elite level environments with professional support structures already in place, which might not correlate with injury rates that occur in less well-equipped environments. However, the question of whether dedicated S&C coaches within youth club environments reduce injury risk remains largely unexplored as a direct empirical question.
References
Ayoub, A., Ranger, M., Longmire, M., & Bovid, K. (2025). Adolescent soccer overuse injuries: A review of epidemiology, risk factors, and management. International Journal of Environmental Research and Public Health, 22(9), 1388–1388. https://doi.org/10.3390/ijerph22091388
Brenner, J. S. (2016). Sports specialization and intensive training in young athletes. Pediatrics, 138(3), e20162148–e20162148. https://doi.org/10.1542/peds.2016-2148
Faigenbaum, A. D., Kraemer, W. J., Blimkie, C. J. R., Jeffreys, I., Micheli, L. J., Nitka, M., & Rowland, T. W. (2009). Youth resistance training: Updated position statement paper from the national strength and conditioning association. Journal of Strength and Conditioning Research, 23(5), S60–S79. https://doi.org/10.1519/jsc.0b013e31819df407
Faigenbaum, A. D., & Myer, G. D. (2009). Resistance Training among Young athletes: safety, Efficacy and Injury Prevention Effects. British Journal of Sports Medicine, 44(1), 56–63. https://doi.org/10.1136/bjsm.2009.068098
Fisher, J., Androulakis-Korakakis, P., Giessing, J., Helms, E., Schoenfeld, B., Smith, D., & Winett, R. (2023). Supervision during resistance training: A comparison of trainer and trainee perceptions. International Journal of Strength and Conditioning, 3(1). https://doi.org/10.47206/ijsc.v3i1.256
Francisco Javier Robles-Palazón, Desirée Blázquez-Rincón, López-Valenciano, A., Comfort, P., José Antonio López-López, & Ayala, F. (2024). A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. part 1: An analysis by classical training components. Annals of Medicine, 56(1). https://doi.org/10.1080/07853890.2024.2408457
Gabbett, T. J. (2016). The training—injury prevention paradox: Should athletes be training smarter and harder? British Journal of Sports Medicine, 50(5), 273–280. https://bjsm.bmj.com/content/50/5/273
Lloyd, R. S., Faigenbaum, A. D., Stone, M. H., Oliver, J. L., Jeffreys, I., Moody, J. A., Brewer, C., Pierce, K. C., McCambridge, T. M., Howard, R., Herrington, L., Hainline, B., Micheli, L. J., Jaques, R., Kraemer, W. J., McBride, M. G., Best, T. M., Chu, D. A., Alvar, B. A., & Myer, G. D. (2013). Position statement on youth resistance training: the 2014 International Consensus. British Journal of Sports Medicine, 48(7), 498–505. https://doi.org/10.1136/bjsports-2013-092952
Niall Seewang. (2024, February 29). How load management can help reduce injury risk in youth athletes. Science for Sport. https://www.scienceforsport.com/how-load-management-can-help-reduce-injury-risk-in-youth-athletes/?srsltid=AfmBOooSHZquMkh6MpUnl6C90NPGWlAhlJRGJpnlYTfdYiy7XP0a1BBo
Steib, S., Rahlf, A. L., Pfeifer, K., & Zech, A. (2017). Dose-Response relationship of neuromuscular training for injury prevention in youth athletes: A meta-analysis. Frontiers in Physiology, 8(920). https://doi.org/10.3389/fphys.2017.00920
