Premier League players aged under 21 are spending longer sidelined through injury than ever before, with knee problems on the rise, a study has shown.

New data from global insurance group Howden's 'Men's European Football Injury Index' has revealed similar trends across Europe's top men's leagues.

The revelations come as club and international calendars face increasing scrutiny, with many players arguing congested schedules threaten their welfare.

James Burrows, head of sport at Howden, highlighted the "ever-increasing physical demands" on players as a reason for the spike in injuries.

"As fixture congestion intensifies with expanded competitions domestically and internationally, we are seeing more players sidelined for longer periods," he said.

Players' union Fifpro has made the same argument, external. Its 2024 Player Workload Monitoring Report claims 78% of coaches and 72% of players surveyed support the implementation of a guaranteed rest period in the calendar.

The same report detailed how England and Real Madrid midfielder Jude Bellingham played 251 competitive games before reaching the age of 21 in June, while ex-England captain David Beckham played 54 in comparison.

The Professional Footballers' Association said some players "feel that they are being pushed to, and beyond, their physical limits".

"We can also see that players are absorbing this workload at a younger age than ever before, playing more and more minutes," said a PFA spokesperson.

"We've always said that football's approach to its calendar must be player-led, and based on a proper understanding of how players can physically cope with those demands. That's especially true for young players, who we want to have long as well as successful careers."

According to Howden's report, external, there had been a huge increase in both the total number of injuries suffered by Premier League youngsters and the time they spent sidelined.

In 2023-24, under-21 players in the Premier League spent an average of 43.92 days out per injury, up from 26.5 in 2022-23 and a 187% increase compared to the 2020/21 season.

The overall number of days spent injured rose from 901 to 2,240, while the total number of injuries suffered jumped from 34 to 51.

Increases in all three metrics were largely mirrored across Serie A, Ligue 1, La Liga and the Bundesliga.

Interestingly, young players suffered fewer injuries and spent less time out during a campaign which was elongated by the mid-season 2022 World Cup.

The study showed the total number of knee injuries suffered by players across Europe's top five men's leagues has reached a new high.

There were 367 instances of this in 2023-24, up from 333 the previous season, 352 in 2021-22 and 279 in 2020-21.

While the average number of days spent sidelined with knee problems fell slightly from 52.95 to 51.46, the latest figure is significantly higher than the 33.56 days recorded in 2021-22.

Over the last four seasons, Premier League players have suffered 297 knee injuries. Only players in the Bundesliga (384) have suffered more.

Howden's report used wage data provided by Sporting Intelligence and Football Feeds to calculate the cost of injuries for clubs.

The 915 injuries that occurred during the 2023-24 Premier League season cost clubs 318.8 million euros (£265.6m), up from 288.55m euros (£240.4m) in the previous campaign.

Premier League teams were hit with an injury every 94 minutes of competitive football at a cost of 3,698 euros (£3,081) per minute.

Across Europe's top five leagues, the figures show a 5% increase in overall costs associated with injuries compared to the 2022-23 season.

More and more top-flight players have spoken out about the risk of injuries caused by congested fixture schedules and workloads.

Europe's top leagues and Fifpro filed a legal complaint with the European Commission this week against Fifa over what they claimed was an "abuse of dominance."

The European Leagues - which represents 39 leagues including the Premier League - and the European branch of Fifpro said Fifa had abused its role under European competition law when it came to the international fixture calendar.

Their argument related to Fifa scheduling the new 32-team 2025 Club World Cup next summer, during a period in which players would normally rest.

Fifa said Fifpro and the World Leagues Association were consulted about changes to the overall 2025-30 international match calendar, including the 2025 Club World Cup.

World football's governing body has also accused some leagues of "hypocrisy" and acting "without consideration to everyone else in the world".

"Those leagues apparently prefer a calendar filled with friendlies and summer tours, often involving extensive global travel," added Fifa.

In September, Manchester City and Spain midfielder Rodri - who was included in 72 matchday squads between July 2023 and July 2024 - suggested players could take strike action.

Less than a week later he suffered a season-ending anterior cruciate ligament injury in his side's key Premier League game against Arsenal.

"It's so tough with crazy schedules," said Bellingham, quoted in Fifpro's Player Workload Monitoring Report.

"It's difficult on the body – mentally and physically you are exhausted."