Injuries in adolescent female players in European football: a prospective study over one outdoor soccer season

In this prospective study, injuries in 153 adolescent female soccer players were recorded during one outdoor season (April-October). The overall injury incidence rate was 6.8 per 1000 h soccer (games and practice) and the incidence rate of traumatic injury 9.1 and 1.5 per 1000 player-hours in games and practice, respectively. Sixty-three players (41%) sustained 79 injuries. Sixty-six percent of the injuries were traumatic and 34% were overuse injuries. Most of the traumatic injuries occurred during games. Eighty-nine percent of the injuries were located in the lower extremities and 42% occurred in the knee or ankle. The most frequent type of injury was ankle sprain (22.8%). Forty-one percent of the traumatic injuries and 56% of the ankle sprains were re-injuries. Most of the injuries were of moderate severity (52%), while 34% were minor and 14% were major. Most of the major injuries were traumatic such as knee ligament injuries and ankle sprains.     

The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study

To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P = 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P = 0.05) and 4.8 times higher than male athletes (P = 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P = 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P = 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.     

Injuries in Norwegian female elite soccer: a prospective one-season cohort study

Female soccer has become increasingly popular during the last two decades. According to the International Football Association (FIFA) there are approximately 40 million registered female soccer players in the world. Three studies in elite soccer have shown an injury incidence during games ranging from 12.6 to 23.3 injuries per 1,000 h. A very high incidence of ACL-injuries ranging from 0.31 to 2.2 per 1,000 game hours has also been shown. We followed the Norwegian female elite series during the 2001 season to estimate the incidence and characteristics of injuries. A total of 181 female soccer players on ten teams were followed during the 2001 elite season in Norway. We recorded baseline data, match and training exposure and injury data as type of injury, location and severity of injury. The mean age of the players was 23 years (range 17–34). A total of 189 injuries were recorded and 19 (10%) of these were overuse injuries; 89 (47%) occurred during games and 100 (53%) during training sessions. The incidence of acute injuries was 23.6 per 1,000 game hours and 3.1 per 1,000 training hours. The majority of the injuries occurred in the lower extremities (81%), but there were also a significant number of head injuries (6.3%). The most common injury type was ankle sprain (17.2%). Half of the injuries were minor, with training or game absence of less than 7 days. Midfielders sustained the most injuries (32.6%) with an incidence of 42.4 per 1,000 game hours. We recorded two ACL-injuries and two PCL-injuries during the season. They all occurred during games, and the incidence was therefore calculated to 0.6 per 1,000 game hours for both injury types. The incidences of injuries reported for female soccer varies considerably, with the highest numbers reported from Germany and the present study. These studies have also the highest incidence of minor injuries registered. The location of the injuries is quite similar compared to other reports, but the number of ankle sprains seems to be higher in our study, whereas the number of knee and thigh injuries is lower. There has been much attention to ACL injuries in team handball and hamstring injuries in soccer in Norway, and this could have influenced the team’s pre-season training, resulting in a reduction in the incidence of these injury types. The high number of ankle injuries has to be addressed to see whether this is a result of inadequate rehabilitation routines leading to re-injuries, or other factors. The high number of ACL-injuries in these reports is alarming and needs special attention in the future.     

Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players?

This prospective randomized intervention investigated whether training on a balance board could reduce the amount of traumatic injuries of the lower extremities in female soccer players. A total of 221 female soccer players from 13 different teams playing in the second and third Swedish divisions volunteered to participate in the study. Seven teams (n = 121) were randomized to an intervention group and six teams (n = 100) to a control group and were followed during one outdoor season (April-October). Before and after the season muscle flexibility and balance/postural sway of the lower extremities were measured in the players. There were no significant differences in age, height, weight, muscle flexibility and balance/postural sway of the lower extremities between the intervention and the control group. During the season the players in the intervention group performed a special training program consisting of 10-15 min of balance board training in addition to their standard soccer practice and games. After a 37% drop-out the intervention group consisted of 62 players and the control group of 78 players. The results showed no significant differences between the groups with respect either to the number, incidence, or type of traumatic injuries of the lower extremities. The incidence rate of "major" injuries was higher in the intervention group than in the control group. Four of five anterior cruciate ligament injuries occurred in the intervention group, which means that we could not prevent severe knee injuries in female soccer players with balance board training. However, among the players who had been injured during the 3-month period prior to this investigation there were significantly more players from the control group than from the intervention group who sustained new injuries during the study period.     

Prevention of soccer injuries: a prospective intervention study in youth amateur players

BACKGROUND: Risk factors for soccer injuries and possibilities for prevention have been discussed by several authors, but only a few have investigated the effectiveness of preventive interventions. PURPOSE: The aim of the present study was to evaluate the effects of a prevention program on the incidence of soccer injuries in male youth amateur players. STUDY DESIGN: Prospective controlled intervention study. METHODS: Seven soccer teams took part in a prevention program that focused on education and supervision of coaches and players, while seven other teams were instructed to train and play soccer as usual. Over 1 year all injuries were documented weekly by physicians. Complete weekly injury reports were available for 194 players. RESULTS: The incidence of injury per 1000 hours of training and playing soccer was 6.7 in the intervention group and 8.5 in the control group, which equates to 21% fewer injuries in the intervention group. The greatest effects were observed for mild injuries, overuse injuries, and injuries incurred during training. The prevention program had greater effects in low-skill than in high-skill teams. CONCLUSIONS: The incidence of soccer injuries can be reduced by preventive interventions, especially in low skill level youth teams. Coaches and players need better education regarding injury prevention strategies and should include such interventions as part of their regular training.     

Incidence of injuries in elite French youth soccer players: a 10-season study

BACKGROUND: Research on age-related injury incidence in elite youth soccer is needed to identify high-risk groups. PURPOSE: To investigate the incidence of soccer-related injuries in elite French youth players based at the Clairefontaine Football Center. STUDY DESIGN: Cohort study (Prevalence); Level of evidence, 1. METHODS: Injuries sustained by players in the younger than 14-, 15-, and 16-year-old age groups during 10 seasons were diagnosed and documented by a sports physician according to type, location, severity, the date the injury occurred, and playing position. RESULTS: Altogether, 1152 injuries were documented across all age groups with 69.1% and 30.9% sustained during training and matches, respectively. A total of 4.8 injuries per 1000 hours' exposure time were recorded and 11.2 and 3.9 injuries per 1000 hours for matches and training, respectively. There was no significant difference in injury frequency between age groups. The youngest group sustained more training injuries (P < .05) and osteochondroses (P < .05) and fewer match injuries than did the oldest group. Injury incidence varied throughout the season, peaking in September in all groups. The majority of injuries lasted less than 1 week (60.2%), contusions were the predominant injury type (30.6%, P < .05), and the upper leg was the site most often injured (24.5%, P < .05). CONCLUSION: Those players younger than 14 years incurred more injuries in training and sustained more growth-related overuse disorders. Older players were more often injured during matches. Injury incidence and the frequency of overuse disorders were highest early in the season.     

Injuries among young soccer players

We registered all new injuries among 496 male youth soccer players, aged 12 to 18 years, during the course of one year. The incidence of injury was 3.7 injuries per 1000 hours of soccer per player. The incidence increased with age, and at the higher ages within the youth players, approached the incidence rate of senior players (age greater than or equal to 18 years). Seventy percent of the injuries were located in the lower extremities, particularly the knee (26%) and ankle (23%). Back pain occurred in 14% of players. Fractures, which accounted for 4% of injuries, were most often in the upper extremities. We conclude that youth soccer is a relatively low-risk sport with an injury pattern that differs slightly from that of senior players.     

Soccer injuries among elite female players

Injuries occurring in two female elite soccer teams were recorded during 1 year. Of 41 players, 33 (80%) sustained 78 injuries. The incidence of injury during games was 24/1000 hours, while the incidence during training was 7/1000 hours. The majority (88%) of injuries were localized to the lower extremities, with equal occurrence in the left and right legs. Forty-nine percent of the injuries occurred in the knee or ankle. Most of the injuries were minor (49%), while 36% were moderate and 15% were major. Of the major injuries (N = 12), 10 were due to trauma and 7 (58%) were knee ligament or meniscal tears. Overuse injuries constituted 28% of all injuries and occurred mainly during preseason training and at the beginning and end of the competitive season. Traumatic injuries (72%) occurred mainly during games with a predominance at the beginning of the competitive season. Almost 80% of the traumatic injuries occurred during physical contact with an opponent. Extrinsic factors such as weather, playing surface, temperature, or the position of the player within the team did not influence the injury rate. We conclude that female elite soccer players sustain a high incidence of injury. Few injuries were major, but 17% of the players sustained a major knee injury during the year.     

The epidemiology of knee injuries in Iranian male professional soccer players

Detailed injury epidemiology is an invaluable tool for minimising risk associated with sporting injuries. The aim of this study was to investigate epidemiology of knee injuries in Iranian male professional soccer players. In total, 390 soccer players of 16 clubs were studied during one season. A total of 43 injured soccer players were interviewed and 16 team physicians were consulted. All information was collected through standard questionnaires. Furthermore, medical personal prospectively reported time-loss injuries sustained by players over one season and the knee injuries were evaluated. The results showed that in total, from 390 players, 43 of them suffered knee injuries (14.9 per 100 players). The anterior cruciate ligament was the most commonly injured ligament of the knee, in which 12.5% were accompanied by injuries to the medial meniscus and medial collateral ligament. There was a significant difference in incidence of injury between the preferred (62.9%) and non-preferred leg (37.1%). Most injuries were characteristically severe (82.3%). Most injuries occurred in away games (52.94%), mostly in the second half and most commonly in the final 15 min (35.3%). The incidence of non-contact injuries (66.12%) was significantly higher than contact injuries (33.87%). It can be concluded that the incidence of knee injury was high (0.12 injuries per team per match). Injury tends to be more common in match play and mostly at the end of season. Midfielders suffered more knee injuries. Most injuries occurred in the losing teams.     

Incidence,burden, and pattern of injuries in Spanish male youth soccer players: A prospective cohort study

ObjectivesTo explore the incidence, burden, and pattern of injuries in Spanish male youth soccer players during a 9-month competitive season (from September to May–June).DesignProspective cohort study.Participants314 young (10–19 years) soccer players.Main outcome measuresIncidence, burden, location, type, severity, mechanism, and circumstance of injuries, as well as potential differences by tactical position, month of the year, age group, and maturity status.ResultsA total of 146 time-loss injuries were sustained by 101 different players. This resulted in an overall injury incidence of 3.1 injuries per 1000 h, a training injury incidence of 1.8 injuries per 1000 h, and a match injury incidence of 11.2 injuries per 1000 h. The probability of injury over the season was 34%. Most of the injuries affected the lower extremity and were classified as muscle/tendon injuries, with hamstring muscle injuries representing the most burdensome diagnosis. The incidence of injuries increased with age and maturation, but a heightened risk of overuse injuries during periods around peak height velocity was also identified.ConclusionsThese findings suggest a need for implementing specific injury prevention measures. Due to the high burden shown, these measures should mainly focus on reducing the number and severity of hamstring muscle injuries.     

No effect of a video-based awareness program on the rate of soccer injuries

BACKGROUND: The injury rate in soccer is high, and effective injury prevention methods are needed. PURPOSE: To test the effect of a video-based awareness program on the incidence of acute injuries in soccer. STUDY DESIGN: Randomized control trial; Level of evidence, 1. METHODS: Participants were elite male soccer players from the top 2 divisions in Iceland. Fifteen of 20 teams completed the study: 7 intervention teams (127 players) and 8 control teams (144 players) chosen by random. Just before the start of the 2000 soccer season, the intervention teams were visited with an intervention program. The program included a 15-minute presentation with information on the injury risk of playing elite soccer, typical injuries, and their mechanisms. Then the players worked together in pairs and analyzed video sequences to develop preventive strategies. The 12 video sequences were selected from the previous Icelandic soccer season, representing 3 typical injury mechanisms that accounted for more than half of all incidents recorded. During the season, team physical therapists prospectively recorded all acute injuries, and coaches recorded training exposure on a special form. Injury incidence was compared between groups and between the 1999 and 2000 seasons for teams that participated in both seasons. RESULTS: No difference was observed in injury incidence between the intervention (6.6 +/- 0.7 injuries per 1000 player hours) and control groups (6.6 +/- 0.7 injuries per 1000 player hours). Furthermore, there was no difference in injury location or type. CONCLUSION: The video-based injury awareness program showed no effect on injury rate.     

Epidemiology and traumatology of injuries in soccer

A prospective investigation of soccer injuries among 123 players participating at various competition levels was undertaken in a Danish soccer club. The injury incidence during games was highest at division level (18.5/1000 hours) and lowest at series level (11.9/1000 hours), whereas the distribution of the incidences during practice was reversed. The youth section (16 to 18 years) had incidences that could be compared to the highest senior level. The lower extremity was involved in 84% of the injuries, including 34% of overuse injuries. Ankle sprains were most common (36%) and equally found at all levels, whereas half of all overuse injuries were seen among division players. Contact injuries during tackling occurred most often in lower series and youths (45%). Players participating at high levels had only 30% of the injuries during tackling and 54% during running. More than half of 20 knee injuries were caused by tackling. Thirty-five percent of injured players were absent from soccer for more than 1 month; 28% had complaints 12 months after the end of the season with knee injuries the most serious. The study shows that the injury incidence, the pattern of injury, and the traumatology varied between players participating at different levels of soccer competition.     

Soccer injuries in childhood

A prospective study of soccer injuries, involving 287 male youth players, from the ages of 12-15 was conducted in 24 Greek soccer clubs, during the course of one year. A total of 193 players sustained 209 injuries. The incidence of injuries was 4.0 injuries per 1000 h of soccer time per player, and the most common types of injuries were sprains and strains. Surprisingly, it was found that an increase of injury incidences occurred during practice. Fifty-eight injuries required medical assistance. The majority of injuries (80%) were located in the lower extremities. Collision with other players was the most common activity at the time of injury, accounting for 40% of all injuries. The conclusion of this study and the evidence from other studies suggests that youth soccer is a relatively low risk sport. However, a substantial amount of injuries could be prevented. It is necessary to identify the risk factors, which are associated with these types of injuries.     

Type of sport is related to injury profile: A study on cross country skiers,swimmers, long‐distance runners and soccer players. A retrospective 12‐month study

This 12‐month retrospective questionnaire compared the occurrence of sports injuries in 149 cross country skiers, 154 swimmers, 143 long‐distance runners and 128 soccer players aged 15–35 years. Soccer had significantly more injuries (5.1 injuries/1000 exposure hour) than other sports (2.1–2.8, P<0.001). More runners than soccer players reported overuse injuries (59% vs 42%, P=0.005), locating typically in the foot in runners, soccer players and skiers. Swimmers reported overuse injuries in the shoulder more commonly than skiers (40% vs 1%, P<0.001), who also intensively load shoulders. Acute injuries in skiers (80%) and in swimmers (58%), and overuse injuries in skiers (61%), occurred during exercise other than own event. In soccer and running the absence time from sport because of injuries was significantly longer than in skiing and swimming. No severe permanent disabilities occurred due to injury but seven women quit sports because of injury. In conclusion, type of loading is strictly associated with the anatomical location of an overuse injury as shown by the difference in shoulder injury incidence between swimmers and cross country skiers. In some sports, a significant proportion of acute injuries occur in other than the main event.     

Incidence of injuries in French professional soccer players

In this prevalence cohort study, injuries sustained during 15 seasons in a professional soccer team were investigated according to the different soccer seasons, number of matches per season, month the injury occurred, location, severity, playing position and the team's rank at the end of the French professional championship. Altogether, 903 injuries in 173 professional soccer players were reported. Injury incidence per 1?000?h of exposure during matches and training was 4.7±5. This incidence did not vary significantly between seasons. However, injury incidence increased after the year 2003 and constantly exceeded 4.2. In the same way, after 2002 muscle injury incidence always exceeded 2 per 1?000?h of exposure. Injury incidence peaked during the month of January. Hamstring muscle injury represented the most frequent injury. No difference in injury incidence was found according to the playing position or to the season whether the team participated or not in the European cup. No correlation was found with the team's rank at the end of the French championship. This study highlighted no significant variation on injury incidence over a 15-season period except for the muscle injury rate in high level soccer players.     

Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: A review of prevention programs aimed to modify risk factors and to reduce injury rates

Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players participating in the game as on 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes a significant loss of time from competition in soccer, which has served as the strong impetus to conduct research that focuses to determine the risk factors for injury, and more importantly, to identify and teach techniques to reduce this injury in the sport. This research emphasis has afforded a rapid influx of literature aimed to report the effects of neuromuscular training on the risk factors and the incidence of non-contact ACL injury in high-risk soccer populations. The purpose of the current review is to sequence the most recent literature relating the effects of prevention programs that were developed to alter risk factors associated with non-contact ACL injuries and to reduce the rate of non-contact ACL injuries in soccer players. To date there is no standardized intervention program established for soccer to prevent non-contact ACL injuries. Multi-component programs show better results than single-component preventive programs to reduce the risk and incidence of non-contact ACL injuries in soccer players. Lower extremity plyometrics, dynamic balance and strength, stretching, body awareness and decision-making, and targeted core and trunk control appear to be successful training components to reduce non-contact ACL injury risk factors (decrease landing forces, decrease varus/valgus moments, and increase effective muscle activation) and prevent non-contact ACL injuries in soccer players, especially in female athletes. Pre-season injury prevention combined with an in-season maintenance program may be advocated to prevent injury. Compliance may in fact be the limiting factor to the overall success of ACL injury interventions targeted to soccer players regardless of gender. Thus, interventional research must also consider techniques to improve compliance especially at the elite levels which will likely influence trickle down effects to sub-elite levels. Future research is also needed for male soccer athletes to help determine the most effective intervention to reduce the non-contact ACL injury risk factors and to prevent non-contact ACL injuries.     

Predictors of moderate and severe injuries in Italian major leagues soccer teams: results from a cohort study

AIM: The possible consequences of injury in soccer players could be a relevant public health issue, due the large diffusion of this sport around the world. We have evaluated the predictive value of both personal and professional characteristics on the occurrence of injuries and their severity in a prospective cohort study. METHODS: A cohort of 1 041 professional soccer players from the two Italian major Leagues was assembled during the season 2003-2004: 743 out of 785 subjects available the day of the interview (94.6%) answered an epidemiological questionnaire. A validation study was performed to assess if participating subjects were representative of the whole cohort. The risk of injuries and their severity according to several variables were assessed. RESULTS: A total of 157 subjects suffered 177 injuries during the season 2002-2003. Differences exist between injured and non-injured players according to both the number of matches played during the season and the League. A trend in risk of injury with anthropometric measures was observed, although not significant. The type of tissue and the type of injury were significantly associated with the duration of the stop. CONCLUSION: Anthropometric measures and career history (such as type of League and number of played matches) could require further attention, since they seem to be predictive of injury occurrence in soccer players.     

Injuries in youth amateur soccer and rugby players--comparison of incidence and characteristics

OBJECTIVES: In reviewing the literature on sports injuries, few studies could be found in which exposure related incidences of injury in different types of sport were compared. These studies indicated that ice hockey, handball, basketball, soccer, and rugby are popular team sports with a relatively high risk of injury. The aim of the study was to compare the characteristics and incidence of injuries in male youth amateur soccer and rugby players. METHODS: This prospective cohort study comprised an initial baseline examination to ascertain the characteristics of the players and their level of performance, and a one season observation period during which a physician visited the team weekly and documented all occurring injuries. Twelve soccer and 10 rugby school teams with male amateur players aged 14-18 years were selected for the study. 145 soccer and 123 rugby players could be followed up over one season. RESULTS: Comparison of the incidence of soccer and rugby injuries indicated that rugby union football was associated with a significantly higher rate of injury than soccer. The differences were pronounced for contact injuries, injuries of the head, neck, shoulder, and upper extremity, as well as for concussion, fractures, dislocations, and strains. Rugby players incurred 1.5 times more overuse and training injuries in relation to exposure time, and 2.7 times more match injuries than soccer players. Three rugby players but no soccer players had to stop their participation in sport because of severe injury. CONCLUSION: The incidence of injury in New Zealand school teams playing soccer or rugby union is high, probably in part because of the low ratio of hours spent in training relative to hours spent playing matches. The development and implementation of preventive interventions to reduce the rate and severity of injury is recommended.     

Sex-related injury patterns among selected high school sports

This cohort observational study was undertaken to test the hypothesis that the incidence of injuries for girls participating in high school sports is greater than that for boys. From 1995 through 1997, players were included in our study if they were listed on the school's varsity team roster for boys' or girls' basketball, boys' or girls' soccer, boys' baseball, or girls' softball. Injuries and opportunities for injury were recorded daily. Certified athletic trainers reported injury and exposure data. Based on 39,032 player-seasons and 8988 reported injuries, the injury rates per 100 players for softball (16.7) and for girls' soccer (26.7) were higher than for baseball (13.2) and boys' soccer (23.4). The knee injury rates per 100 players for girls' basketball (4.5) and girls' soccer (5.2) were higher than for their male counterparts. Major injuries occurred more often in girls' basketball (12.4%) and soccer (12.1%) than in boys' basketball (9.9%) and soccer (10.4%). Baseball players (12.5%) had more major injuries than softball players (7.8%). There was a higher number of surgeries, particularly knee and anterior cruciate ligament surgeries, for female basketball and soccer players than for boys or girls in other sports.