Background: The aim was to investigate the association of injuries with male football player continuity, progression and chances of reaching the First team in an elite academy. Methods: Injuries and exposure time were prospectively recorded, following the FIFA guidelines, over 6 seasons (2011-2017) in Under (U)12, U14, U16, U19, 2nd/3rd team and First team players from the same professional football club. Results: U19 and 2nd/3rd team players progressing to the next level had a lower injury burden and higher match availability compared to players that did not progress. Injury burden was lower in players progressing from U12 to U14. All players progressing from the 2nd/3rd teams to the First team had a match availability higher than 84% and did not suffer an anterior cruciate ligament (ACL) rupture or an injury requiring over 200 (+200) days to return to play. In U19 and 2nd/3rd team players, injuries requiring +100 and +200days to return to play, ACL ruptures and groin pain, but not hamstring and ankle ligament injuries, were associated with lower odds of continuing in the academy each season. Conclusion: Injuries were negatively associated with player progression, and injury prevention and return-to-play strategies should be a priority for football academies.
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