Injuries in team sport tournaments during the 2004 Olympic Games

BACKGROUND: Several authors have analyzed the incidence of injuries in a given sport, but only a few have examined the exposure-related incidence of injuries in different types of sports using the same methodology. PURPOSE: Analysis of the incidence, circumstances, and characteristics of injuries in different team sports during the 2004 Olympic Games. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: During the 2004 Olympic Games, injuries in 14 team sport tournaments (men's and women's soccer, men's and women's handball, men's and women's basketball, men's and women's field hockey, baseball, softball, men's and women's water polo, and men's and women's volleyball) were analyzed. After each match, the physician of the participating teams or the official medical representative of the sport completed a standardized injury report form. The mean response rate was 93%. RESULTS: A total of 377 injuries were reported from 456 matches, an incidence of 0.8 injuries per match (95% confidence interval, 0.75-0.91) or 54 injuries per 1000 player matches (95% confidence interval, 49-60). Half of all injuries affected the lower extremity; 24% involved the head or neck. The most prevalent diagnoses were head contusion and ankle sprain. On average, 78% of injuries were caused by contact with another player. However, a significantly higher percentage of noncontact (57%) versus contact injuries (37%) was expected to prevent the player from participating in his or her sport. Significantly more injuries in male players (46%) versus female players (35%) were expected to result in absence from match or training. The incidence, diagnosis, and causes of injuries differed substantially between the team sports. CONCLUSION: The risk of injury in different team sports can be compared using standardized methodology. Even if the incidence and characteristics of injuries are not identical in all sports, prevention of injury and promotion of fair play are relevant topics for almost all team sports.     

Epidemiology of injuries in the Australian Football League, seasons 1997-2000

OBJECTIVE: To describe the epidemiology of injuries in the Australian Football League (AFL) over four seasons. METHODS: An injury was defined as "any physical or medical condition that caused a player to miss a match in the regular season." The rationale for this definition was to eliminate a previously noted tendency of team recorders to interpret injury definitions subjectively. Administrative records of injury payments to players who did not play matches determined the occurrence of an injury. RESULTS: The seasonal incidence of new injuries was 39 per club (of 40 players) per season (of 22 matches). The match injury incidence for AFL games was 25.7 injuries per 1000 player hours. The injury prevalence (percentage of players missing through injury in an average week) was 16%. The recurrence rate of injuries was 17%. The most common and prevalent injury was hamstring strain (six injuries per club per season, resulting in 21 missed matches per club per season), followed in prevalence by anterior cruciate ligament and groin injuries. CONCLUSIONS: The injury definition of this study does not produce incidence rates that are complete for all minor injuries. However, the determination of an injury is made by a single entity in exactly the same manner for all teams, which overcomes a significant methodological flaw present in other multiteam injury surveillance systems.     

UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season

Background: No previous study on adult football involving several different countries has investigated the incidence and pattern of injuries at the highest club competitive level. Objective: To investigate the risk exposure, risk of injury, and injury pattern of footballers involved in UEFA Champions League and international matches during a full football season. Method: Eleven top clubs (266 players) in five European countries were followed prospectively throughout the season of 2001–2002. Time-lost injuries and individual exposure times were recorded during all club and national team training sessions and matches. Results: A total of 658 injuries were recorded. The mean (SD) injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5 (11.0) injuries per 1000 match hours and 5.8 (2.1) injuries per 1000 training hours). The risk of match injury was significantly higher in the English and Dutch teams than in the teams from France, Italy, and Spain (41.8 (3.3) v 24.0 (7.9) injuries per 1000 hours; p = 0.008). Major injuries (absence >4 weeks) constituted 15% of all injuries, and the risk of major injury was also significantly higher among the English and Dutch teams (p = 0.04). National team players had a higher match exposure, with a tendency towards a lower training injury incidence than the rest of the players (p = 0.051). Thigh strain was the most common injury (16%), with posterior strains being significantly more common than anterior ones (67 v 36; p<0.0001). Conclusions: The risk of injury in European professional football is high. The most common injury is the thigh strain typically involving the hamstrings. The results suggest that regional differences may influence injury epidemiology and traumatology, but the factors involved are unclear. National team players have a higher match exposure, but no higher risk of injury than other top level players.     

Injuries to athletes with disabilities: identifying injury patterns

Participation in sport activities for people with disabilities continues to gain in popularity. With participation in sports, there is an inherent risk of injury. A review of current sport epidemiological studies was used and we concluded that injury patterns for this population are similar to those for athletes without disabilities. Injury data from Paralympic competitions dating back to 1976 indicate that most elite athletes with disabilities seek medical care for illness and musculo-skeletal injuries. However, there are very limited injury data regarding Winter Paralympic events or skiing injuries. For those athletes who participate in Summer Paralympic events, abrasions, strains, sprains and contusions are more common than fractures and dislocations. However, location of injuries appears to be disability and sport dependent. Lower extremity injuries are more common in ambulatory athletes (visually impaired, amputee, cerebral palsy) and upper extremity injuries are more frequent in athletes who use a wheelchair. While it appears that the majority of the injuries occurring in this population are minor in nature, inconsistencies in the definition of injury in the literature make this conclusion tenuous. When injuries are expressed as time lost in participation, 52% of injuries resulted in 7 days lost or less, 29% in 8 to 21 days lost and 19% in greater than 22 days lost. The only prospective study addressing injury rates of athletes with disabilities in a manner consistent with other sport epidemiological studies found an injury rate of 9.3 injuries per 1000 athlete-exposures (AE). This injury rate is less than American football (10.1 to 15/1000 AE) and soccer (9.8/1000 AE), and greater than basketball (7.0/1000 AE). It is unclear whether comparative statistics such as these take into consideration the number of illness and injury episodes that resulted from the disability. Further complicating epidemiological studies for athletes with disabilities is the definition of the population and samples of convenience which are frequently used. These samples are often not representative of the multiplicity of disability conditions, levels of competition and range of sport activities available. Prospective studies comparing athletes to sedentary control individuals to measure differences in injury rates, type and frequency between and within disability groups, sports and levels of competition are desperately needed to further the knowledge of injury trends and develop and establish accurate injury prevention programmes.     

Incidence, severity, aetiology and prevention of sports injuries. A review of concepts.

Notwithstanding the healthy influence of sporting activities on risk factors, in particular those of cardiovascular disease, it is becoming increasingly apparent that sports can present a danger to health in the form of sports injuries. The extent of the sports injury problem calls for preventative action based on the results of epidemiological research. For the interpretation of these facts uniform definitions are needed and limitations of research designs should be known. Measures to prevent sports injuries form part of what is called the 'sequence of prevention'. Firstly the extent of the sports injury problem must be identified and described. Secondly the factors and mechanisms which play a part in the occurrence of sports injuries have to be identified. The third step is to introduce measures that are likely to reduce the future risk and/or severity of sports injuries. This measure should be based on the aetiological factors and the mechanism as identified in the second step. Finally the effect of the measures must be evaluated by repeating the first step. In this review some aspects of the first and second step of the sequence of prevention are discussed. The extent of the sports injury problem is often described by injury incidence and by indicators of the severity of sports injuries. Sports injury incidence should preferably be expressed as the number of sports injuries per exposure time (e.g. per 1000 hours of sports participation) in order to facilitate the comparability of research results. However, one should realise that the outcome of research applying this definition of sports injury incidence is highly dependent on the definitions of 'sports injury' and 'sports participation'. The outcome of such research also depends on the applied research design and research methodology. The incidence of sports injuries depends on: the method used to count injuries (e.g. prospective vs retrospective); the method used to establish the population at risk; and on the representativeness of the sample. Severity of sports injuries can be described on the basis of 6 criteria: the nature of the sports injury; the duration and nature of treatment; sporting time lost; working time lost; permanent damage; and cost. Here also uniform definitions are important and necessary in order to enhance the comparability of research data. In the second step of the 'sequence of prevention' the aetiological factors that play a role in the occurrence of a sports injury have to be identified by epidemiological studies. Epidemiological research on the aetiology of sports injuries requires a conceptual model.(ABSTRACT TRUNCATED AT 400 WORDS)     

For debate: consensus injury definitions in team sports should focus on encompassing all injuries.

OBJECTIVE: The purpose of this paper is to highlight the most effective method of collecting injury data by using a definition that encompasses all injuries into the data collection system. The definition provides an accurate picture of injury incidence and also allows filtering of records so that data can be reported in a variety of comparable ways. DATA SOURCES/SYNTHESIS: A qualitative review of literature in team sports, plus expert opinion, served as the basis for data collection strategies. Articles were retrieved from SportsDiscus and PubMed using the terms "sports injury definition" and "injury definition." These terms were searched for the period 1966 to November 2006. RESULTS: One of the major results (from this paper) that supports the use of an all-encompassing injury definition is that 70% to 92% of all injuries sustained fall into the transient category--that is, by only recording injuries that result in missed matches, the majority of injuries are missed and therefore injury rates are underreported. CONCLUSION: An injury definition should be the most encompassing definition that enables a true, global picture of injury incidence to be seen in participation in any team sport.     

Incidence, risk, and prevention of hamstring muscle injuries in professional rugby union

BACKGROUND: The incidence of hamstring muscle injuries in professional rugby union is high, but evidence-based information on risk factors and injury-prevention strategies in this sport is limited. PURPOSE: To define the incidence, severity, and risk factors associated with hamstring muscle injuries in professional rugby union and to determine whether the use of hamstring strengthening and stretching exercises reduces the incidence and severity of these injuries. STUDY DESIGN: Cohort study (prevention); Level of evidence, 3. METHODS: Team clinicians reported all hamstring muscle injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury; loss of time from training and match play was used as the definition of an injury. Players' match and training exposures were recorded on a weekly basis. RESULTS: The incidence of hamstring muscle injuries was 0.27 per 1000 player training hours and 5.6 per 1000 player match hours. Injuries, on average, resulted in 17 days of lost time, with recurrent injuries (23%) significantly more severe (25 days lost) than new injuries (14 days lost). Second-row forwards sustained the fewest (2.4 injuries/1000 player hours) and the least severe (7 days lost) match injuries. Running activities accounted for 68% of hamstring muscle injuries, but injuries resulting from kicking were the most severe (36 days lost). Players undertaking Nordic hamstring exercises in addition to conventional stretching and strengthening exercises had lower incidences and severities of injury during training and competition. CONCLUSION: The Nordic hamstring strengthening exercise may reduce the incidence and severity of hamstring muscle injuries sustained during training and competition.     

Epidemiology of injury in male collegiate Gaelic footballers in one season

Despite the popularity of collegiate Gaelic football in Ireland and the recent expansion into the United Kingdom and United States, no previous study has examined injury incidence. A prospective epidemiological study was implemented to establish injury incidence in 217 (19.3 ± 1.9 years) male collegiate Gaelic footballers from two collegiate institutions in one season. An injury was defined as any injury sustained during training or competition resulting in time lost from play or athlete reported restricted performance. Athletic therapy and training students, alongside a certified athletic and rehabilitation therapist, attended all training/matches over one season, and injuries were recorded using a standardized injury report form. The match injury rate was 25.1 injuries per 1000 h, with a significantly higher match injury rate noted in fresher players (players in their 1st year of higher education) (41.6 injuries per 1000 h) than senior players (12.7 injuries per 1000 h). Lower limb injuries were predominant (71.1%), particularly in the hamstring (15.5%), knee (14.1%), and ankle (11.3%). Soft‐tissue injuries predominated, particularly strains (32.4%) and sprains (27.5%). A scan and surgery was required in 31% and 12% of injuries, respectively. Thus, injuries are prevalent in male collegiate Gaelic football, and injury prevention programs are required.     

Epidemiology of injuries in Australian junior rugby league players

ObjectivesConduct a large-scale epidemiological study of injury characteristics (location, type, mechanism, severity, burden) and incidence in community junior rugby league.DesignProspective cohort epidemiology study.MethodsInjury surveillance was conducted in three district leagues (Penrith, Canberra, Melbourne) in under 6 (U6) to under 18 years (U18) age groups across the 2016 season. Club sports trainers recorded all match/training medical-attention injuries using a commercial electronic application which recorded injury circumstances and characteristics.ResultsA total of 13,169 players from 897 teams participated and 408 (89% male) players sustained 485 injuries, 94% of which were match related. The overall injury incidence was 5.9 injuries/1000 player hours and highest in U13–U18 female players (22.2 injuries/1000 player hours). The mean injury severity of 16 ± 31 days missed training/match-play caused an overall injury burden of 94.2 days missed/1000 player hours). Tackles accounted for 84% of injuries. Joint and contusion injuries were the most prevalent injury type and the head (35% total injuries, primarily bruising and bleeding) was the most injured body site.ConclusionsThis is the first study to report injuries across a large cohort of all-age Australian community junior rugby league players over one season. Injury prevalence was lower than previously reported in junior rugby league suggesting the sport has not become more dangerous for junior players. These findings provide an evidence-base to inform or revise policy, training and injury prevention programs and athlete development pathways in relation to game-wide safety and develop best-practice protocols in injury management for rugby league athlete support personnel.     

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.     

For debate: consensus injury definitions in team sports should focus on missed playing time.

OBJECTIVE: To compare the most commonly used and proposed injury definitions for surveillance systems in team sports and attempt to assess their suitability for consensus definitions in terms of reliability and functionality. DATA SOURCES: The PubMed and SportDiscus databases were searched for papers on team sports that discussed consensus definitions or compared various definitions of injury. DATA SYNTHESIS: A continuum between the most broad "tissue damage" definition and the most narrow "match time loss only" definition was developed. RESULTS: A "match time loss only" injury definition can be reliably and accurately applied but only captures a small percentage of the total pool of all "tissue damage" injuries. There are some inherent biases in using a match time loss only definition (late season matches, matches with unequal breaks between games), but these are clearly visible. All other definitions improve the volume of data captured but suffer serious theoretical and/or practical flaws with respect to accuracy and reliability. No study using a broad definition has demonstrated good reliability to date (eg, using 2 independent recorders at the same team). CONCLUSION: A "match time loss only" injury definition is the most accurate and reliable of those commonly used in team sports. Other injury definitions are broader and may be more appropriate for individual team and specific injury studies. However, a match time loss definition is the most accurate and reliable tool for comparing injury rates at different teams and between different seasons within teams. Hence, we recommend this as the basis for the injury definition in a consensus statement.     

Risk for injury when playing in a national football team

The Swedish male senior national football team was followed prospectively between 1991 and 1997. During these 6 years, the team played 73 official matches and had three training camps. The senior author (J. E.) attended 57 of these matches and the three training camps and these matches and training camps, are included in the present study. Exposure to football was recorded individually for each player. The team physician examined all injuries. Total exposure was 7245 h (6235 training and 1010 match hours) and there were 71 injuries (40 training and 31 match injuries). Five (16%) of the match injuries were major, with more than 4 weeks of absence from football. The injury incidence during training was 6.5/1000 h and the injury risk during matchplay was 30.3/1000 h. A significantly higher injury incidence was found for matches lost compared to matches won or drawn (52.5 vs. 22.7/1000 h, P=0.026). No statistically significant difference for injury was found between competitive matches and friendly matches. No difference was found between home and away matches or matches on neutral ground. The risk for injury when playing in a national team compares with previously reported figures for professional football at a high level.     

Injury epidemiology in a national football team of the Middle East

Many football epidemiological studies have been performed but only two of them have investigated injury risk in a national football team. In the present study, the senior male Qatar national football team was followed prospectively for two seasons. All injuries that were incurred during training and matches were recorded, together with match and training exposure time. Principal findings were (i) a higher injury incidence during matches than during training, (65.9 vs 4.3/1000 h, P<0.001), (ii) a high incidence of muscular strain during matches (23.2/1000 h) and (iii) a greater severity of injury in games than in regular training or camp situations (19.5 vs 8.4 vs 6.7 days, P<0.05). Despite the unique environmental, social and cultural setting in the Middle East, these findings are consistent with previous data from European football, suggesting that international guidelines on injury prevention and management may be applied in this region.     

Epidemiology and traumatology of injuries in track athletes

During one year 4398 injured athletes were treated at the casualty wards of Aarhus, Denmark; 156 were practicing track and field disciplines. In the same period 54 track athletes of a Danish sport club were followed in order to register any lesion incurred during sports activity. Thirty-one athletes (57%) had 35 injuries, giving an injury incidence of 1.8 per 1000 hours of practice. At follow-up after 1 year, 13% of all athletes still had complaints, and none of them had returned to former sports activity. Jumpers had overuse symptoms correlated to take-off, and sprains or fractures related to downstrokes. Runners had a higher risk of overuse injuries than jumpers, especially involving the Achilles tendon and the plantar aponeurosis. Young athletes had a higher injury incidence per time than older participants; and women had higher injury risk than men.     

Beach handball is safer than indoor team handball: injury rates during the 2017 European Beach Handball Championships

Purpose

Beach handball is a relatively new type of sports, which was derived from team handball. Medical issues such as frequency and severity of injury are yet unknown. The purpose of this study was to investigate the injury pattern and injury rates of this new type of sports.

Methods

This study investigated the injury incidence of 30 national teams (10 senior and 20 u-17 teams, 16 men’s and 14 women’s teams) participating in the 2017 European Beach Handball Championships. Reports on injuries sustained during the senior and u-17 youth tournaments were provided by the medical staff of each team. Injury incidence was differentiated between age and sex, and between the five field positions (goalkeeper, wing, central defender, pivot, and specialist).

Results

During the tournaments, 87 injuries were recorded yielding an overall injury incidence of 286.1 per 1000 match hours. Time-loss due to injury was 49.3 per 1000 match hours. Senior players had a higher overall injury incidence with 395.3 injuries than u-17 players with 205.7 injuries per 1000 h match hours (p?<?0.01). Comparison of the injury incidence between the two sexes showed 330.23 injuries per 1000 h handball exposure for male players and 234.9 injuries for female players (n.s.). The most frequent injury type was sprains (21 injuries, 24.1%) followed by contusions (19 injuries, 21.8%) and skin abrasions with (15 injuries, 17.2%). Central defenders and specialists had the highest injury incidence. Thighs, ankles, as well as foot and toes (altogether 12 injuries, all 13.8%) were the three most frequently injured anatomic sites.

Conclusions

Beach handball seems to have a lower incidence of time-loss injuries than that reported for indoor team handball. This study is an important basis for developing injury prevention strategies in this sports that should focus on thighs, ankles, feet and toes. Further research into this new type of sports is essential to identify risk factors and to develop adequate injury prevention measures.

Level of evidence

II.

     

A unique insight into the incidence of rugby injuries using referee replacement reports

OBJECTIVES: To obtain further information the incidence of injuries and playing positions affected in club rugby in Scotland. METHODS: Routine reports of injury (permanent) and blood (temporary) replacements occurring in competitive club rugby matches by referees to the Scottish Rugby Union during seasons 1990-1991 to 1996-1997 were analysed. RESULTS: A total of 3,513 injuries (87 per 100 scheduled matches) and 1,000 blood replacements (34 per 100 scheduled matches) were reported. Forwards accounted for 60% of the injury and 72% of the blood replacements. Flankers and the front row were the most commonly replaced forwards while wing and centre three quarters were the most vulnerable playing positions among backs. The incidence of injury replacements increased as the match progressed up until the last 10 minutes when the trend was reversed. Blood replacements showed a different pattern with 60% occurring during the first half of the match. CONCLUSION: The most important finding of the study was reliability of referees in documenting the vulnerability of certain playing positions, and the timing when injuries took place, thus assisting coaches and team selectors when choosing replacement players for competitive club and representative rugby matches. This study re-emphasises the need for continuing epidemiological research.     

The epidemiology of injuries in powerlifting at the London 2012 Paralympic Games: An analysis of 1411 athlete‐days

Sport injury epidemiology has received increased recognition as a field of sport medicine research that can improve the health and safety of athletes. Injuries among Paralympic powerlifters have not previously been systematically studied. The purpose of this prospective cohort study was to characterize injuries among Paralympic powerlifters. Athletes competing in the sport of powerlifting were followed over the 7‐day competition period of the 2012 London Paralympic Games. The main outcome measurements were injury incidence rate (IR; number of injuries per 1000 athlete‐days) and injury incidence proportion (IP; injuries per 100 athletes). A total of 38 injuries among 163 powerlifters were documented. The overall IR was 33.3 injuries/1000 athlete‐days (95% CI 24.0–42.6) and the overall IP was 23.3 injuries per 100 athletes (95% CI 16.8–29.8). The majority of injuries were chronic overuse injuries (61%). The most commonly injured anatomical region was the shoulder/clavicle (32% of all injuries), followed by the chest (13%) and elbow (13%). The information obtained in this study opens the door for future study into the mechanisms and details of injuries into powerlifters with physical impairments.     

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.     

Injuries in England and Wales elite men’s domestic cricket: A nine season review from 2010 to 2018

ObjectivesThis study primarily aimed to explore injury incidence rates in the three main domestic competition formats in England and Wales (First-Class, One-Day and Twenty20 [T20]). For the first time, the study also describes the epidemiology of elite men’s domestic cricket injuries across nine seasons (2010–2018 inclusive).DesignProspective cohort analysis.MethodsInjury incidence and prevalence from all injuries calculated according to the updated international consensus statement on injury surveillance in cricket, with statistical process control charts (SPC) used to detect trends in the data.ResultsThe average match injury incidence was 102 injuries/1000 days of play, with highest incidence in One-Day (254 injuries/1000 days of play), followed by T20 (136 injuries/1000 days of play) and First-Class Cricket (68 injuries/1000 days of play). Most match injuries were sustained during bowling (41.6 injuries/1000 days of play), followed by fielding (26.8 injuries/1000 days of play) and batting (22.3 injuries/1000 days of play). The thigh was the body area most commonly injured (7.4 injuries/100 players per season), with lumbar spine injuries the most prevalent (1.3% of players unavailable on any given day during the season). On average, 7.5% of players were unavailable on any given day during the domestic season when all injuries were considered (match and training). The SPC charts showed relatively consistent match injury incidence for all competitions, reproduced across all nine seasons.ConclusionThese findings provide a robust empirical base for the extent of the injury problem in domestic cricket played in England and Wales, with similar injury profiles across the three formats.     

Epidemiology of football injuries

Aim

The overall aim of this on-going injury study is to increase the safety in football.

Study design

Prospective cohort survey.

Methods

The study population consisted of two cohorts: the Union of European Football Associations (UEFA) Champions League (UCL) cohort and the Swedish Superleague cohort. The UEFA Champions League cohort with 17 teams from nine countries was followed over five consecutive seasons (2001 to 2006). The Swedish Superleague with 14 teams was followed for two full consecutive seasons (2001 and 2002). Exposure for training and matches in the club and in national teams was registered in minutes for each player. The team doctor reported all injuries causing the player to miss at least one match or training session. The study follows the consensus on methods for studies on football injuries agreed upon by the Federation of International Football Associations (FIFA) and UEFA.

Results

Overall 6300 injuries have been registered during 800,000 h of exposure. The incidence of injury at top-level football is six to nine injuries per 1000 h of total exposure (three to five injuries per 1000 training hours and 24 to 30 injuries per 1000 match hours). As a mean, a team of 25 players can expect 40 to 50 injuries per season, half of them causing absence less than a week but six players of them causing absence more than a month. The risk of injury has not increased during the five-year period. Thigh muscle injury is the most common injury at top-level with an injury incidence of 1.6/1000 h of exposure, which means that a team can expect 10 such injuries each season. The risk of ankle sprain has been reduced by 50%, probably due to the thorough knowledge in top-level teams about optimal treatment and prevention. A correlation has been found between major injuries (causing absence > 4 weeks) and performance. There is a considerable variation in the number of matches played per season in European professional leagues. Top-level players are obliged to play many matches, especially during the final period of the season. A correlation was found between many matches at the end of a season and an increased injury risk and/or underperformance during subsequent world tournaments.

Conclusion

The injury risk has not increased in male professional football during recent years. At elite level, the risk of ankle sprain has been lowered and thigh muscle strain is the most common injury. A period with a congested match calendar can lead to fatigue increasing the risk of injury and poor performance during the following period.