Incidence of sports-related musculoskeletal injuries in 683 students during physical education classes in Austrian schools: a one-year prospective observational study

Objective This study aimed to examine the incidence of musculoskeletal time-loss injuries during physical education (PE) classes and their association with non-modifiable risk factors. Methods A 1 year prospective study was conducted in four Austrian schools, involving 683 individuals (290 boys, 393 girls; mean age 13.4 +/- 2.0 years). During follow-up, weekly exposure (participation in PE classes) and injury characteristics (eg, type and location) were registered. Injury incidence was calculated per 1000 hours of PE participation, and binary logistic regression was used to examine associations with non-modifiable risk factors (age, sex, weight, Body Mass Index, activity level, membership in a sports club, history of previous injury, maturity status). Results Over 48 162.5 hours of PE, 77 injuries were recorded (1.60 injuries per 1000 hours, 95% CI 1.35 to 1.89). Injuries primarily affected the lower limb (49.35%), with ligament and joint capsule lesions being most common (31.17%). Non-contact injuries made up 57.14% of the total, and acute injuries constituted 94.81% of cases. There was a strong association between maturity offset and injury incidence (p<0.001), demonstrating a higher risk at the pre-peak height velocity (PHV) stage when compared with the at-PHV (OR=0.48, 95% CI 0.24 to 0.94, p=0.03) and the post-PHV stage (OR=0.13, 95% CI 0.06 to 0.24, p<0.001). Conclusion This study highlights a notable incidence of sports-related musculoskeletal time-loss injuries during PE classes, emphasising the need for targeted preventive measures that account for the influence of biological maturation, particularly maturity offset, on injury risk in schoolchildren.