Injuries in football – an overview

Injury rates are high in modern football, and is the most common reason for player unavailability in training and matches (1). Every season there are discussions regarding injuries in football, and especially when key players are out for a prolonged period. It has been shown a relationship between increased performance and lower injury rates for professional football teams in domestic league and European cup tournaments (1), which highlights the importance of player availability. In addition, lower injury rates can save clubs for unnecassary expences. This article will in short go through the current information on injuries in football.

Injury rates

Injury incidence in elite football is fairly consistent, with incidence reported to to range between 25 to 30 injuries/1000 hours match play, and 3 to 5 injuries/1000 hours training (2). It has been reported from the UEFA injury study on elite European football that a typical squad of 25 players could expect 50 injuries a season, resulting in 2 injuries per player on average (3). Of these, 57% of all injuries occur during matches, and 43% during training (3).

During matches, it has been shown that there is an increased tendency for injuries over time in both the first and second halves (3, 4). Statistically, the greatest injury rates have been shown to occur in the final 15 min of the two halves, with significantly more injuries in the second half (4). An example of injuries over time in match is shown in figure 1.

Figure 1. Number of non-contact and contact injuries over time in match. Example from an elite Norwegian football team.

Skaderovertid

The risk of sustaining an injury seems to be relatively stable over a season (3).

Several studies have investigated injuries in period with congested fixtures, with contradictory results (5-7). However, the tendency seems to point towards higher injury rates in periods with a congested match schedule and short recovery time, typical for teams who participate in domestic or international tournaments, or the hectic Christmas period in English football.

Most frequent injuries

Most of the injuries in football are to the lower extremities, where the most frequent locations are thigh, knee, ankle and groin (3, 4). Thigh strain is the single most common injury type, where posterior strains to the hamstring musculature are most frequent (3), and it has been suggested that a squad of 25 players could expect 10 thigh strains each season (3).

In regard to mechanisms behind injuries, 58% are linked to non-contact mechanisms, while contact injuries has been reported to account for 38% of all injuries, and are mostly caused by tackles or collisions (4).

Risk factors for injuries

Several risk factors has been proposed in studies for non-contact injuries. The most documented risk factors is previous injury (3, 8), where the main reason often is that players are not fully fit prior to playing matches. In addition, it has been proposed that high age, poor warm-up, strenght difference between quadriceps/hamstring musculature, muscular fatigue, poor mobility at the hip region and poor fitness can affect the risk for injuries (8).

 

References
  1. Hägglund M, Waldén M, Magnusson H, Kristenson K, Bengtsson H, Ekstrand J. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British journal of sports medicine. 2013.
  2. Walden M, Hagglund M, Ekstrand J. UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season. British journal of sports medicine. 2005;39(8):542-6.
  3. Ekstrand J, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. British journal of sports medicine. 2011;45(7):553-8.
  4. Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. British journal of sports medicine. 2001;35(1):43-7.
  5. Carling C, Le Gall F, Dupont G. Are physical performance and injury risk in a professional soccer team in match-play affected over a prolonged period of fixture congestion? International journal of sports medicine. 2012;33(1):36-42.
  6. Bengtsson H, Ekstrand J, Hagglund M. Muscle injury rates in professional football increase with fixture congestion: an 11-year follow-up of the UEFA Champions League injury study. British journal of sports medicine. 2013;47(12):743-7.
  7. Dupont G, Nedelec M, McCall A, McCormack D, Berthoin S, Wisloff U. Effect of 2 soccer matches in a week on physical performance and injury rate. The American journal of sports medicine. 2010;38(9):1752-8.
  8. Arnason A, Sigurdsson SB, Gudmundsson A, Holme I, Engebretsen L, Bahr R. Risk Factors for Injuries in Football. The American journal of sports medicine. 2004;32(1 suppl):5S-16S.
  9. Van Winckel J, Helsen W, McMillan K, Tenney D, Meert JP, Bradley P. Fitness in Soccer. Moveo Ergo Sum/Klein Gelmen. 2014

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