Background: Published training recommendations exist for youth athletes aimed at reducing injury risk. No studies have assessed the impact of counselling interventions using training recommendations on risk of injury in young athletes., Objectives: To determine if online training counselling regarding safe sport participation can reduce injury risk in youth athletes and to assess recommendation compliance, including barriers to compliance., Methods: A multicentre randomised intervention trial was performed at two Midwestern academic institutions with expertise in treating young athletes. Enrolled subjects ages 8-17 completed a baseline risk assessment survey and were randomised to a control or intervention group. Both groups completed exposure surveys every 3 months for 1 year. The intervention group also received online training counselling on safe sport participation every 3 months. Training characteristics including training volume, degree of specialisation and adherence to recommendations were captured. Differences in self-reported injury between groups, compliance to recommendations and barriers to compliance were evaluated., Results: At baseline, n=357 subjects were enrolled (n=172 control and n=185 intervention). Controls were nearly twice as likely to be injured during the intervention period after controlling for age, sex, baseline injury and level of specialisation. No improvement in recommendation compliance was detected among intervention subjects. Primary barriers to compliance were no prior knowledge of recommendations, personal choice and following coaches' recommendations., Conclusions: In this convenience sample of youth athletes, electronic training counselling surrounding safe sports participation was not determined to affect injury risk. Lack of knowledge and adherence to appropriate training recommendations is evident and barriers to compliance exist., Competing Interests: Competing interests: NJ reports grants from Loyola University Medical Center Intramural Research Grant, personal fees from University of Hawaii, personal fees from Young Athlete Foundation (YAF) and personal fees from United States Tennis Association (USTA), outside the submitted work., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)