Does a major knee injury definitely sideline an elite soccer player?

Injuries occurring in three Swedish elite soccer teams were analyzed during 1 year. A total of 49 of 64 players (75%) sustained 85 injuries. The incidence of injury during games was 13 injuries per 1000 hours, while the incidence during training was 3 injuries per 1000 hours. Twenty percent of the injuries required hospital facilities. The majority of the traumatic injuries (93%) were to the lower extremities, with one third of the total injuries occurring in the knee. Overuse injuries accounted for 35% of all injuries and occurred mainly during preseason training and at the end of each season. Conversely, the majority of traumatic injuries occurred during games, equally distributed between the first and second halves with a predominance toward the end of each half. The position of the player within the team did not influence injury rate. The referee considered 28% of the traumatic injuries to be caused by violation of existing rules. Thirty-four percent of the injuries were major, causing more than 1 month of absence from training and/or games. Eleven knee injuries required surgical intervention revealing seven ruptured ACLs, of which three were chronic. At followup, 9 to 18.5 months after injury, 4 of 12 players with major knee injuries had returned to play at the elite level. The others had either been transferred to lower divisions or were still in rehabilitation.     

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.     

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.     

Injuries among Swedish female elite football players: a prospective population study

Injury occurrence in all 12 female elite senior football teams in premiere league was registered during 1 year. Of 269 players, 129 (48%) sustained 237 injuries. The total injury incidence was 4.6/1000 h of football. The injury incidence during practice was 2.7 and during the game time was 13.9/1000 h. The highest injury incidence during practice was to the knee (0.8/1000 h) and thigh (0.5/1000 h), and during game time was to the knee (4.4/1000 h) and head (2.2/1000 h). In total, the location for the highest injury incidence was the knee with 1.5 injuries/1000 h of football. The majority of injuries (82%) were localized to the lower extremities. Sixty-six injuries (28%) were re-occurring injuries (re-injuries). The incidence of traumatic injuries was 3.3/1000 h of football and for overuse injuries 1.3/1000 h. Overuse injuries occurred mainly during the preseason and at the beginning of the spring season. Thirty-nine percent of the injuries were slight or minor causing absence from practice or game time of less than 1 week, 39% were moderate (absence 7-28 days) and 22% were major (absence more than 28 days). The major injuries occurred often owing to trauma and were mainly to the knee.     

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.     

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.     

Injuries in amateur soccer players on artificial turf: A one-season prospective study

BackgroundEpidemiological studies in soccer are important for injury prevention. However, most of the available information is limited to elite players.ObjectiveTo determine the epidemiology of injuries in amateur soccer players on artificial turf.DesignProspective cohort study during one competitive season (2010–2011).SettingAmateur soccer players. Participants: 231 players (aged 24.7; range: 18–38 years).Main outcome measuresInjury incidence was recorded prospectively according to the consensus statement for soccer.Results213 injuries were recorded; 57% of the players suffered injuries. Injury incidence was 5.1 (95% CI: 4.3–5.9) injuries/1000 h exposure. Injury incidence was higher in matches than in training (32.2 [95% CI: 23.1–41.3] vs. 2.4 [95% CI: 1.8–3.0] injuries/1000 h; p < 0.001). The thigh (22.1%), knee (20.2%), and ankle (19.2%) were the most affected regions. The most frequent diagnoses were thigh strain/muscle rupture (18.3%), and ankle and knee strain/ligament injury (17.3% and 11.3%, respectively). Time-loss due to injury was 20.3 (95% CI: 16.8–23.73) days. Most injuries (79%) were traumatic; 21% were overuse injuries. Re-injuries accounted for 10% of all injuries sustained during the season.ConclusionsInjury incidence in amateur soccer players is higher during matches played on artificial turf than during training sessions.     

Injury risk in female floorball: a prospective one-season follow-up

The purpose of this prospective study was to examine the incidence, nature, causes, and severity of injuries in female floorball. Three hundred and seventy-four licensed female floorball players from Finnish top leagues were observed prospectively for one season (6 months). The practice and game hours of floorball were recorded on an exercise diary. All injuries were registered with a structured questionnaire and verified by a physician. During the study period, 133 out of the 374 (35%) players sustained 172 injuries. The injury incidence was 1.8 per 1000 practice hours and 40.3 per 1000 game hours. Of all injuries, 70% were traumatic and 30% were from overuse. The most common injury type was joint sprain (27%). The most commonly injured sites were the knee (27%) and ankle (22%). Twenty-one of the knee injuries (46%) were serious including 10 anterior cruciate ligament (ACL) ruptures. Eight of ACL ruptures occurred during floorball games, giving an ACL rupture incidence of 3.6 per 1000 game hours. Eleven injuries (6%) needed hospital admission. The study attested that injury rate in floorball game is very high. Injury prevention strategies in female floorball should be targeted at injuries occurring at the knee and ankle.     

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.     

Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland

A prospective study of male soccer injuries among 12 teams playing at the highest competition level was carried out in Finland in 1993. Overall, two out of three players were injured during the whole season. The injury incidence per 1000 playing hours among injured players and all players during games was higher than during practice, 14.2 vs. 11.3 and 2.3 vs. 1.8, respectively. The lower extremity was involved in 76% of the injuries. Thigh injuries were most frequent (22%), whereas overuse injuries were scarce (6%). Eighteen per cent of the injured players needed surgery and in most cases (58%) the reason for surgery was a knee injury. Sixteen per cent of all injured players were absent from soccer for more than 1 month after the injury. The mean absence time was 17 days for all and 84 days for operatively treated players.     

An examination of injuries in major league soccer. The inaugural season

We analyzed the injury data collected from the 10 teams (237 players) that constituted Major League Soccer during its inaugural season. The overall injury rate was 6.2 per 1000 hours of participation. An injury rate of 2.9 per 1000 hours was noted for practice and 35.3 per 1000 hours was found for games. The difference was statistically significant. With regard to severity, 36% of injuries (143 of 399) were categorized as an incident (no time lost from competition). Of the 256 injuries that caused the player to lose playing time, 59% were classified as minor (<7 days lost), 28% as moderate (7 to 29 days lost), and 13% as major (>30 days lost). Seventy-seven percent of the injuries (197 of 256) were to the lower extremity; most frequently affected were the knee (N = 54) and ankle (N = 46). Neither the player's age nor playing position was found to be associated with prevalence or severity of injury. We believe that this information serves to underscore the notion that soccer, as it is played at the professional level, is a sport with a relatively low incidence of injury.     

Soccer injuries and their mechanisms: a prospective study

In order to study the incidence and mechanisms of injury in soccer and to recommend prophylactic measures, 180 players in a senior male soccer division were followed prospectively for 1 yr. Attendance records for games and practice sessions were kept, and all injuries were examined and treated by the same orthopaedic surgeon. One hundred twenty-four players incurred 256 injuries, mostly sprains and strains of the lower extremities. Of these, 62% were considered minor with ankle sprains being the most common (17%), while 11% were considered major with knee ligament sprains being the most frequent (32%). Overuse injuries were most frequent in the preseason training period. Traumatic leg injuries involved players with inadequate or no shin guards. Of the traumatic knee injuries, 11 of 18 (61%) occurred during a collision; non-contact knee injuries were frequently seen in those players with a history of knee injury and existing instability. Study of injury sequence disclosed that a minor injury was often followed within two months by a major one. In addition, with severe injuries incurred during fouls, the individual causing the penalty was injured. This prospective study suggested that those with knee instability and those allowed to resume play with poorly rehabilitated or clinically unhealed injuries are more apt to sustain further injury. Some injuries can be avoided by using better equipment and by observance of the rules.     

Injuries in women's professional soccer

Objective: The injury data from the first two seasons of the Women's United Soccer Association (WUSA) were analysed to determine the injury incidence, anatomic location of injuries, and relation of player position.

Methods: Injury data on 202 players from eight teams during the first two seasons of the WUSA were prospectively collected and analysed.

Results: A total of 173 injuries occurred in 110 players with an overall injury incidence rate of 1.93 injuries per 1000 player hours. The incidence of injury during practice and games was 1.17 and 12.63 per 1000 player hours, respectively. Of the injuries 82% were acute and 16% were chronic. Most of the injuries (60%) were located in the lower extremities. Strains (30.7%), sprains (19.1%), contusions (16.2%), and fractures (11.6%) were the most common diagnoses and the knee (31.8%) and head (10.9%) were the most common sites of injury. Anterior cruciate ligament (ACL) injuries accounted for 4.6% of all injuries and the incidence of ACL tears was 0.09 per 1000 player hours (practice 0.04, game 0.90). Midfielders suffered the most injuries (p<0.007).

Conclusion: We conclude that the injury incidence in the WUSA is lower than the 6.2 injuries per 1000 player hours found in the corresponding male professional league (Major League Soccer); however, knee injuries predominate even in these elite female athletes.

     

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.     

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.     

Injury risk factors in female European football. A prospective study of 123 players during one season

The purpose of this study was to register prospectively the injuries in female soccer and to study their correlation to potential risk factors. A total of 123 senior players from eight teams of different levels were followed during one season. Isokinetic knee muscle strength at 60 and 180 degrees/s, one-leg-hop, vertical jump, square-hop, and continuous multistage fitness test (MFT) were tested at the end of the pre-season. In addition, Body Mass Index (BMI) and general joint laxity were measured. During the season, April-October, all injuries resulting in absence from one practice/game or more were registered. Forty-seven of the 123 players sustained altogether 65 injuries. The total injury rate was 14.3 per 1000 game hours and 3.7 per 1000 practice hours. The knee (26%) was the most commonly injured region followed by the foot (12%), ankle (11%), thigh (11%) and back (11%). The risk of sustaining moderate and major injuries increased in the later part of the game or practice. Significant risk factors for injuries were an increased general joint laxity (odds ratio (OR)=5.3, P<0.001), a high performance in the functional test square-hop (OR=4.3, P=0.002), and an age over 25 years (OR=3.7, P=0.01). The injury rate was not different compared to male soccer, but knee injuries were more common, which is in accordance with previous studies. None of the risk factors identified in this study is easily applicable for future intervention studies in the attempts to reduce the injury rate in female soccer.     

Community level australian football: a profile of injuries

Identification of injuries and their risk factors is required in order to develop risk controls within the context of sports injury prevention. The Australian Football Injury Prevention Project (AFIPP) was a randomised controlled trial (RCT) examining the effects of protective equipment on injury rates in Australian Rules Football. The aim of this paper is to describe the general injury profile of community level Australian Football players over one season, as recorded during this RCT. Players were recruited from the largest community football league in Victoria, Australia, during the 2001 playing season. A total of 301 players participated (64% response rate) and all injuries occurring during training and games were recorded. The overall injury incidence rate was 12.1/1000 player hours. Bruises/soft tissue injuries made up more than a quarter of all injuries (28%) and the leg (lower leg, ankle, thigh/hamstring and knee) was the most commonly injured body region. Most injuries occurred at the beginning of the season (April-May, 53% of injuries), during competition (77%) and through body contact (49.9%). Midfielders (OR = 3.39, 95% CI: 1.13, 10.14) and players aged at least 25 years (OR = 2.15, 95% CI: 1.06, 4.34) were significantly more likely to experience an injury than other playing positions and younger players. Although the injury rate in this study was lower than that in previous studies, the results are consistent with the finding that injuries tend to occur earlier in the season and more commonly during competition. Injury prevention efforts should be particularly targeted at midfielders and older players.     

A retrospective injury analysis of state representative female soccer players

Objectives: A 5-year retrospective injury survey was conducted with 45 female elite soccer players from the Queensland Academy of Sport (QAS), to record the anatomical distribution, diagnosis and incidence of injury and identify possible risk factors in elite female soccer players at the QAS from 1993–1998. Methods: Data were gathered from medical, physiological, coaches and team managers' records. Results: The study recorded 239 injuries. Incidence of injury was highest in 1994 (12·2 per 1000 h) and lowest in 1995 (5·0 per 1000 h). Athletic exposure almost doubled between 1994 and 1995. Incidence of injury per 1000 athletic exposure hours decreased from 12·2 to 5 between 1994 and 1995. The leg accounted for 81·5% of all injuries and 52% of injuries involved the foot, ankle and shin. Strains (35%) and sprains (31%) were the most common diagnoses. Most injuries were of a mild nature (61%), with major injuries accounting for 19% of total injuries over the period 1993–1998. The most common major injuries were stress fractures (29%), with tibial stress fractures being the most common type. Injuries to the ankle, shin or both these areas were sustained by 66% of players. Seventy-six percent of ankle injuries and 100% of shin injuries were recurrent. Twenty-two percent of players had both ankle and shin injuries, in 90% of cases ankle injury was sustained before the shin injury. Conclusions: Ankle and shin were the most common injury in this group of high performance female soccer players with high recurrence. Incidence of injury may be related to athletic exposure.