The Association Between Biological Maturity and Injury in Young Females Participating in Sport: A Systematic Review

Background: Injuries in youth sport remain a concern. Biological maturity has been linked to injury risk but there is limited female specific evidence.

Aim: To evaluate the evidence for an association between biological maturity and injury in young females participating in sport.

Methods: A systematic search was conducted using EBSCO Health database from inception until April 2025. Studies were included if they investigated females in any sport and reported an assessment of biological maturity status and either injury rate or potential factors associated with injury. Study quality and risk of bias and the strength of evidence for findings was determined based on the consistency and quality of studies.

Finding: 31 studies (n=10 reporting injury; n=21 reporting risk factors) were included in the review. Evidence supporting an association between injury and maturation was limited. There is moderate evidence of an association between potential injury risk factors and maturation. Most evidence is in the context of lower limb biomechanics during jump/landing tasks and potential risk of knee injury.

Conclusion: Current evidence for a link between maturity status and sport related injury in young females is limited, however there is moderate evidence that maturity status is associated with potential knee injury risk factors.