ArticlePDF Available

Abstract

Background: Medical illnesses and sports-related injuries both have an effect on athlete health and performance. Epidemiology of injury and illness has been extensively researched during international soccer tournaments and the European soccer season. Reports on injury location and severity differ across geographical regions, and there is limited information on injury epidemiology in African soccer leagues. No studies have investigated the illness burden in soccer in Africa. Methods: This was a prospective cohort study involving two soccer teams over the 10-month duration of the 2015/16 Premier Soccer League in South Africa. Team medical staff recorded daily soccer exposure, illness and injuries. Team-based match and training exposure was calculated and used to determine injury and illness incidence and burden over the soccer season. Results: Overall injury incidence was 2.2/1000 hours, with match injury incidence of 24.8/1000 hours and training injury incidence of 0.9/1000 hours. Time loss injuries accounted for 33 of the 44 injuries recorded. The most common time loss injury location was the knee (14 injuries, 42%). There were 7 minimal, 4 mild, 12 moderate and 10 severe injuries. Sprain/ligament injury (8 injuries) was the most common type, followed by meniscus/cartilage injury (7 injuries). Eleven illnesses were reported during the season, with an incidence of 0.7/1000 player days, and most were minimal in severity (8/11). The illness burden was 1.7/1000 player days. The respiratory (46%) and gastrointestinal (36%) systems were most commonly affected. Conclusions: The incidence of injury was comparable with data reported internationally and mirrors the increased risk of injury during matches versus training. The nature of injury differed in that the knee was more frequently affected than the ankle or thigh, joint injuries were more common than muscle injuries, and there was a larger proportion of severe injuries. The illness burden was very low.
THE JOURNAL OF SPORTS MEDICINE
AND PHYSICAL FITNESS
A Journal on Applied Physiology, Biomechanics, Preventive Medicine,
Sports Medicine and Traumatology, Sports Psychology
Indexed/Abstracted in: Chemical Abstracts, CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation
Index Expanded (SciSearch), Scopus
Impact Factor 1,215
eTOC
The Journal of Sports Medicine and Physical Fitness 2017 May 09
DOI: 10.23736/S0022-4707.17.07452-7
Copyright © 2017 EDIZIONI MINERVA MEDICA
language: English
Incidence of injury and illness in South African professional male football players: a prospective cohort study
Helen BAYNE 1, 2, Martin SCHWELLNUS 1, Dina, JANSE Van RENSBURG 1, Jhano BOTHA 3, Lervasen PILLAY 1
1 Institute for Sport, Exercise Medicine and Lifestyle Research & Section Sports Medicine, Faculty of Health Sciences, University of
Pretoria, Pretoria, South Africa; 2 High Performance Centre, University of Pretoria, Pretoria, South Africa; 3University of Pretoria Football
Club, Pretoria, South Africa
PDF
BACKGROUND: Medical illnesses and sports-related injuries both have an effect on athlete health and performance. Epidemiology of
injury and illness has been extensively researched during international football tournaments and the European football season. Reports on
injury location and severity differ across geographical regions, and there is limited information on injury epidemiology in African football
leagues. No studies have investigated the illness burden in football in Africa.
METHODS: This was a prospective cohort study involving two football teams over the 10- month duration of the 2015/16 Premier Soccer
League in South Africa. Team medical staff recorded daily football exposure, illness and injuries. Team-based match and training exposure
was calculated and used to determine injury and illness incidence and burden over the football season.
RESULTS: Overall injury incidence was 2.2 / 1000 h, with match injury incidence of 24.8 / 1000 h and training injury incidence of 0.9 / 1000
h. Time loss injuries accounted for 33 of the 44 injuries recorded. The most common time loss injury location was the knee (14 injuries,
42%). There were 7 minimal, 4 mild, 12 moderate and 10 severe injuries. Sprain/ligament injury (8 injuries) was the most common type,
followed by meniscus/cartilage injury (7 injuries). Eleven illnesses were reported during the season, with an incidence of 0.7 / 1000 player
days, and most were minimal in severity (8/11). The illness burden was 1.7 / 1000 player days. The respiratory (46%) and gastrointestinal
(36%) systems were most commonly affected.
CONCLUSIONS: The incidence of injury was comparable with data reported internationally and mirrors the increased risk of injury during
matches versus training. The nature of injury differed in that the knee was more frequently affected than the ankle or thigh, joint injuries
were more common than muscle injuries, and there was a larger proportion of severe injuries. The illness burden was very low.
KEY WORDS: Football - Sports injury - Illness - Epidemiology
... A study conducted among South African players corroborates the finding. 39 Although the knee was the most commonly injured body part during both training and matches, there was only one injury to the knee among the U16 players during a match. The U16 players reported the hip/ groin as the most commonly injured body region, with 80% occurring during training. ...
... One study has reported similar findings among South African players. 39 However, previous studies among youth and academy players in Portugal, 42 New Zealand 43 and England 44 have reported muscle strains as the most common type of injury. The assertion that growth-related injuries are sometimes mistakenly diagnosed as muscle injuries among younger players 45 might explain the difference between studies. ...
Article
Full-text available
Objective To determine the epidemiology and clinical characteristics of match and training injuries among football players at an academy in Ghana. Methods In this prospective observational study, we followed 80 youth and adult football players at a Ghanaian academy over a season of 39 weeks. Medical attention and time-loss injuries, as well as exposure times of players, were recorded by resident physiotherapists using a standardised injury surveillance form. The average weekly injury prevalence was calculated. Injury incidence rates were calculated per 1000 exposure hours, with significance indicated as 95% CIs. Results 126 injuries were recorded during the season, with an average weekly injury prevalence of 4.1%. The overall injury incidence was 4.5 (95% CI 3.8 to 5.4) injuries per 1000 hours with under 14 (5.8 (3.3 to 10.2)/1000 hours) and under 18 players (5.7 (4.4 to 7.4)/1000 hours) recording a higher incidence than under 16 (5.1 (3.5 to 7.4)/1000 hours) and senior players (2.7 (1.9 to 3.9)/1000 hours). Match injury incidence was 13 times higher than training injury incidence (27.4 (21.5 to 34.9) vs 2.3 (1.8 to 3.0) injuries/1000 hours). Injuries to the lower extremities had the highest incidence (3.9 (2.1 to 7.2) injuries/1000 hours), with the knee being the most commonly injured site (n=30, 23.8%). The most common type of injury was a joint sprain (1.9 (1.5 to 2.5) injuries/1000 hours), and the most common injury mechanism was direct contact with another player (1.5 (1.1 to 2.0) injuries/1000 hours). Most injuries were moderately severe (2.0 (1.5 to 2.6) injuries/1000 hours). Conclusion Ghanaian academy football players have a substantial risk of sustaining injuries, especially among younger players. Further studies should focus on developing specific injury prevention programmes in under-researched football-playing populations.
... In Tables 1 and 2 are inscribed the values of total incidences at training and at matches for professional men football players [4,11,13,14,16,17,19,23, and amateur football players, respectively [19,[25][26][27][28][29][30][62][63][64][65]. In professional football players, thirty-six studies reported the overall incidence, which varied widely from 1.60, 95% confidence interval, injuries/1000 h [37] and 25.6, 95% confidence interval injuries/1000 h of exposure [38]. The mean overall incidence was 7.75 ± 2.28/lesions/1000 h. ...
... As with total incidence, training incidence was also reported for all 36 eligible studies. The mean value was 3.97 ± 1.35 injuries/1000 h, with a range of variation between 0.8 [37] and 11.8 injuries/1000 h [16]. The mean incidence per match was 30.64 ± 10.28 injuries/1000 h, with limits of variation between 6.16 injuries/1000 h [14] and 97.7 injuries/1000 h [38]. ...
Article
Full-text available
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short-and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
... For instance, the rate is 32.3 injuries per 1000 hours of exposure in national leagues, whereas it rises to 41.1 in international tournaments. 8 Even within Africa, there is significant variability; the South African league reports 24.8 injuries per 1000 match hours, 9 in contrast to 113.4 in the Nigerian league. 10 The study of Zerguini et al. 11 investigating the EPFKIN league in Congo RDC revealed an alarming six injuries per game, equivalent to 182 injuries per 1000 hours of competition. ...
Article
Background Understanding the epidemiology of soccer injuries during specific international competitions is essential for customizing preventive strategies. Several studies have reported outcomes related to international competitions but, to the best of our knowledge, there has been no investigation into the injury patterns during any African Cup of Nations (AFCON) tournaments. This study aimed to analyse the incidence and the characteristics of soccer injuries during the 2021 African Cup of Nations (AFCON), which took place in Cameroon from January 9 to February 6, 2022. Methods A video-based analysis covering 52 matches was conducted by two independent consultant physicians. They reviewed injury replays to determine incidence and characteristics ( i.e. ; mechanisms, body location, match moment, player substitution, absence in the next match, and referee decisions). Results The tournament involved 519 male players, comprising 275 African (ALP) and 244 Non-African (NALP) league players. Eighty-seven injuries occurred, with incidences of 1.7 and 48.8 injuries per match and per 1000 match hours, respectively. Injury incidence rose with competition stages, particularly contact mechanism injuries. Non-contact injuries (23/87) predominantly occurred after 60 minutes of play (19/23), with the thigh being the most frequently affected body part (18/87). Older age and playing time significantly correlated with injury occurrence (p=0.032 and p<0.001, respectively). NALP midfielders and forwards were notably injured by contact mechanisms (36/45) in the attacking zone. Although non-contact mechanisms were more common in ALP than NALP (13/42 vs. 9/45), the difference lacked statistical significance (p=0.240), with a higher rate of muscle injuries (13/42 vs. 10/45, p=0.001). Conclusion Muscle injuries prevailed among professional soccer players in the 2021 AFCON, with older age and playing time identified as key associated factors. Muscle injuries were more prevalent in ALP compared to NALP.
... More specifically, variations have naturally been shown to occur in incidence and burden figures when utilising time-loss (≥ 1 day absent) and medical attention definitions (all injuries including 0 days absent), or a combination of both. For example, within the same study in South African men's professional soccer players, a match injury incidence of 24.8/1000h was reported, while the incidence of time-loss injuries was reported to be 16.5/1000h (Bayne et al. 2018). Another example showed a large difference in match injury incidence between two single season investigations utilising the same number of teams in the men's professional soccer in the USA (Morgan and Oberlander 2001) and England (Jones et al. 2019), whereby a medical attention (Morgan and Oberlander 2001) and a time-loss (Jones et al. 2019) injury definitions were utilised. ...
Article
Full-text available
Background Sport-related injuries and illnesses can negatively impact athlete welfare at all standards of participation in team sports. Injury and illness surveillance (IIS), and the development of monitoring systems, initiates the sequence of injury and illness prevention. Operational IIS monitoring systems help to appraise epidemiological estimates of injury and illness incidence and burden in various athlete populations. However, the methodological underpinnings of various monitoring systems are not harmonized or widely documented, with the presence of efficient and successful programmes rarely showcased at non-elite levels. The aim is to provide a framework that guides the development of IIS, which will enhance overall surveillance, to indirectly inform injury prevention strategies. Methods The process involved all members of the research group initially discussing the research gaps, scope of the project, and the aims of the article. Unique experiences were shared, and specific and global challenges and barriers to IIS at all standards of team sport participation were identified. A tiered system of data collection with corresponding content were produced, with experiences and guidance provided throughout the article. Results The literature has been reviewed and using first-hand experience in conducting IIS programmes in complex and diverse sport settings, the authors have identified key enablers and barriers for best practise as time, technological and human resources, reporter/practitioner training, and medical expertise. Areas of greatest importance regarding the conducting of IIS have been outlined, providing guidance and recommendations across all levels of team sport participation. These areas include definitions, data context, collection procedures, handling, security, ethics, storage, dissemination, quality, compliance, and analysis. Given the barriers to IIS, 3-tiered levels of data collection and content have been proposed. The levels indicate data collection variables, with a focus on sufficiency and achievability, aiming to support the successful conducting of IIS in team sports across all standards of participation. Future opportunities in IIS have been discussed, with several predictive measures and analytical techniques expanded upon. Conclusions The framework provides universal guidance for implementing IIS monitoring systems, facilitating athletes, coaches, parents/guardians, governing bodies and practitioners to implement IIS processes, identify challenges, complete analysis, and interpret outcomes at all standards of participation.
... For instance, the rate is 32.3 injuries per 1000 hours of exposure in national leagues, whereas it rises to 41.1 in international tournaments. 8 Even within Africa, there is significant variability; the South African league reports 24.8 injuries per 1000 match hours, 9 in contrast to 113.4 in the Nigerian league. 10 The study of Zerguini et al. 11 investigating the EPFKIN league in Congo RDC revealed an alarming six injuries per game, equivalent to 182 injuries per 1000 hours of competition. ...
Article
Full-text available
Background Understanding the epidemiology of soccer injuries during specific international competitions is essential for customizing preventive strategies. Several studies have reported outcomes related to international competitions but, to the best of our knowledge, there has been no investigation into the injury patterns during any African Cup of Nations (AFCON) tournaments. This study aimed to analyse the incidence and the characteristics of soccer injuries during the 2021 African Cup of Nations (AFCON), which took place in Cameroon from January 9 to February 6, 2022. Methods A video-based analysis covering 52 matches was conducted by two independent consultant physicians. They reviewed injury replays to determine incidence and characteristics ( i.e. ; mechanisms, body location, match moment, player substitution, absence in the next match, and referee decisions). Results The tournament involved 519 male players, comprising 275 African (ALP) and 244 Non-African (NALP) league players. Eighty-seven injuries occurred, with incidences of 1.7 and 48.8 injuries per match and per 1000 match hours, respectively. Injury incidence rose with competition stages, particularly contact mechanism injuries. Non-contact injuries (23/87) predominantly occurred after 60 minutes of play (19/23), with the thigh being the most frequently affected body part (18/87). Older age and playing time significantly correlated with injury occurrence (p=0.032 and p<0.001, respectively). NALP midfielders and forwards were notably injured by contact mechanisms (36/45) in the attacking zone. Although non-contact mechanisms were more common in ALP than NALP (13/42 vs. 9/45), the difference lacked statistical significance (p=0.240), with a higher rate of muscle injuries (13/42 vs. 10/45, p=0.001). Conclusion Muscle injuries prevailed among professional soccer players in the 2021 AFCON, with older age and playing time identified as key associated factors. Muscle injuries were more prevalent in ALP compared to NALP.
... Data on injury severity in professional football players are presented in Table 5. Twenty-seven studies reported injury severity as a percentage or reported the data needed to calculate it. Calculated values have been marked with an asterix [7,14,18,19,26,27,30,40,43,47]. The most frequent lesions were moderate, with a mean value of 33.57 ...
Article
Full-text available
Background (1): Men's football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men's football game remain the highest of all sports. Objective: The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. Methods (2): A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men's football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries-21.13%, contusions-17.86%, and fractures-3.27%, and for amateur football players, the prevalence's were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Conclusions (4): Football-related injuries have a significant impact on professional and amateur football players and their short-and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the J. Clin. Med. 2023, 12, 6293. https://doi.org/10.3390/jcm12196293 https://www.mdpi.com/journal/jcm J. Clin. Med. 2023, 12, 6293 2 of 24 thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries.
... Research has found that the knee joint is the most common football-related injured region among professional footballers in South Africa, Germany, and the United Kingdom [4][5][6]. Predisposing factors such as previous injuries [7], high workload [2], surface type, and poor pelvic control increase the risk of injury [8,9]. It has been proposed that football-specific movements [10] may increase the risk of lower limb joint-related trauma and that excessive joint load contributes to earlier joint degeneration compared to the general population [11]. ...
Article
Full-text available
Objective: To comment on and explore (1) the prevalence of clinical knee and hip osteoarthritis (OA); (2) the association between pain or function and clinical knee or hip OA; (3) the association between injury or surgery and clinical knee or hip OA. Methods: Participants were recruited from FIFPRO members. A total of 101 footballers consented to answer (1) a developed questionnaire, (2) patient-reported outcome measures, and (3) be evaluated by their team physician for clinical knee or hip OA. Results: Of the 53% evaluated for clinical knee and hip OA, a prevalence of 9.43% and 7.55% of knee and hip OA, respectively, was found. There was a significant and strong association between knee (p = 0.033; Cramers v Value = 0.523) and hip pain (p = 0.005; Cramers v Value = 0.602) and clinical OA. A significant association existed between Hip dysfunction and Osteoarthritis Outcome short form Scores and clinical OA of the hip (p = 0.036). The odds of clinical knee OA were 1.5 and 4.5 times more after one or more injuries or surgeries, respectively. There was no association between playing position and clinical OA. Conclusion: There is a low prevalence of a clinical knee or hip OA in the active professional male footballer. Pain may be a valid symptom to predict or monitor knee or hip OA. Validated assessment tools should be utilised to identify a negative effect on function. The odds of developing clinical OA in the knee with the number of injuries or surgeries. The hip presents with earlier clinical signs of OA compared to the knee.
Article
Full-text available
OBJECTIVE: To summarize the existing evidence regarding the effectiveness of interventions to manage early hip, knee, and ankle osteoarthritis in active elite or professional athletes. DESIGN: Scoping review. DATA SOURCES: Medline (PubMed), SPORTDiscus, ScienceDirect, and Epistomonikos. ELIGIBILITY CRITERIA: Peer-reviewed publications from 2012 to 2023 in English, Dutch, or French that included active elite/professional athletes with osteoarthritis and/or cartilage injury to the hip, knee, and/or ankle joints and outcomes measured using validated tools. OUTCOME MEASURES: Patient-reported outcome scores relating to function and return to sports. RESULTS: Twenty-seven studies were included from 414 identified: two on exercise and rehabilitation, four on joint injections, and twenty-one on surgery. For the “Exercise and rehabilitation” category, the evidence was insufficient to recommend conventional training or whole-body vibration training for patellofemoral pain. For the “Joint injections” category, hip and knee hyaluronic acid injections appear safe and effective for improving symptoms, delaying hip joint degeneration and return to sport in 50% to 100% of athletes. Platelet-rich plasma was not as effective as hyaluronic acid in the knee joint. Strong evidence supported corticosteroids and/or local anaesthetic in relieving knee joint symptoms allowing short-term return to sport but hastening the development of knee osteoarthritis. For the “Surgery” category, there was insufficient evidence to support surgical interventions as effective interventions in the hip, knee, and ankle joints of athletic populations for managing early osteoarthritis and precursor pathology. CONCLUSION: There was insufficient evidence to provide clear recommendations about which interventions are best for managing lower limb osteoarthritis in the elite or professional athlete.
Article
Full-text available
Background The outbreak of the 2019 novel coronavirus disease (COVID-19) led to an enforced quarantine period and limited training and match activities for athletes. Purpose To report the influence of the COVID-19 pandemic on the occurrence of injury in Japanese male professional soccer players. Study Design Descriptive epidemiology study. Methods In total, 21 clubs in the 2019 season and 28 clubs in the 2020 season from the Japan Professional Football League were prospectively followed, and 16 clubs in 2019 and 24 clubs in 2020 were analyzed in this study. Individual training, match exposure, and time-loss injuries were recorded using an electronic data capture system. The influence of COVID-19–related suspension during the 2020 season was retrospectively investigated via comparisons with the 2019 season. Results Total activity time included 114,001 hours in training and 16,339 hours in matches in 2019 and 170,798 hours in training and 25,411 hours in matches in 2020. The mean training interruption period caused by COVID-19 in 2020 was 39.9 days (range, 3-65 days), and the mean game-interruption period was 70.1 days (range, 58-79 days). The total number of injuries was 1495 in 2019 and 1701 in 2020. The overall injury incidence per 1000 hours of exposure was 5.7 in 2019 and 5.8 in 2020. The overall injury burden per 1000 hours of exposure was 155.5 days in 2019 and 130.2 days in 2020. The muscle injury incidence was highest in May 2020, immediately after the suspension period. Conclusion The overall injury incidence did not differ between 2019 and 2020. However, muscle injury incidence notably increased in the 2 months after the COVID-19 pandemic suspension period.
Article
Full-text available
Background. Data on the incidence of football injuries and exposure time of players during matches and training in the South African (SA) Premier Soccer League (PSL) are lacking. Objective. To calculate the incidence of injuries and the exposure time (practice and match) of the players of a PSL team over a full season. Methods. Injury and training data of the players in the squad (N=32) were recorded on a daily basis by the medical support staff, according to the methods of the Football Medical Assessment and Research Centre (F-MARC) protocol. Results. One hundred and thirty injuries were recorded in the season. The most affected body parts were the thigh (n=27, 21%) and ankle (n=27, 21%). The overall incidence was 13.4 injuries per 1 000 player-hours. The incidence during training was 6.6 injuries/1 000 player-hours and during matches 88.9 injuries/1 000 player-hours. The most frequent injury was haematoma/contusion/bruising (n=43, 33%). Of the total injuries, 12% were recurrent. Injury through contact with another player was high (62%). Seventy-six per cent of the injuries were not associated with any violation of the laws of the game. The average time off due to injury was 8 days. The total exposure time over the full season resulted in a combined average of 18 162 minutes (~303 hours). Conclusion. These data differ from the data in European studies. Injury and exposure data measured throughout the season have the potential to identify risks and mechanisms of injuries. This study highlights the necessity for all clubs in the PSL to adopt a standardised injury monitoring programme, using standardised methodology, so that the management of professional players in SA may be improved.
Article
Full-text available
Background. Association football, otherwise known as soccer, is the most popular sport in the world. The increase in the popularity of the game and the expectations from players make injury risk in football high. Objective. To describe the types, severity, prevalence and mechanism of injuries among professional footballers in the Nigeria Premier League (NPL). Methods. The Union of European Football Association (UEFA) Injury Study Questionnaire was used for data collection. A total of 240 footballers from 11 clubs, who participated in the 2011/2012 NPL premiership season, was selected through proportionate stratified random sampling technique, and the participants were studied using a prospective cohort study design for 6 months. Descriptive statistics of means, percentages and frequency distributions were used to answer the research questions. Results. The mean (standard deviation) age, height and weight of the injured footballers was 22.9 (3.4) years, 1.69 (0.05) m and 71.3 (3.9) kg, respectively. There was a high injury prevalence (78%) associated with actual league games, whereas the incidence rate per 1 000-hour exposure was 300.2 exposure-hours from 19 games within 6 months. Sprain (32%) was the predominant type of injury recorded. The tackle event (34%) was the predominant mechanism of injury recorded, and 63% of the injuries led to 1-3 days of player absence from football activities. Most of the injuries were recurrent injuries (63%). Conclusion. This study showed a high occurrence of injuries in the NPL, in particular associated with league (competitive) games. The findings of this study will serve to guide the development and implementation of injury prevention strategies in the NPL.
Article
Full-text available
In 1994 Joseph S Blatter, President of the Federation Internationale de Football Association (FIFA), asked: “What can medicine and science do to improve the game of football?” Although a simple question, it led to the founding of the FIFA Medical Assessment and Research Centre (F-MARC) during the 1994 FIFA World Cup USA. The objective of F-MARC was to reduce football injuries at all levels of play, and to promote football as a health enhancing leisure activity improving social behaviour. In 1994, epidemiological data on the incidence of injuries during major football competitions were scarce. Thus, F-MARC established an injury surveillance system at the 1998 FIFA World Cup France, and has routinely implemented it at all subsequent FIFA competitions.1 This database now enables comparison of the incidence and characteristics of injury between competitions for different age, gender and skill-levels and over time. From the 2002 to the 2014 FIFA World Cup, the incidence of injuries decreased by 37%.2 Reasons for the decrease might be the better preparation of the players for the competition, the strict application of the Laws of the Game by the referees, and also the improved approach of the players towards Fair-Play. Since the large majority of the 300 million football players around the world are recreational players, F-MARC developed an injury prevention programme for these players based on scientific evidence and best practice. The ‘FIFA 11+’ programme was rigorously tested using randomised controlled studies jointly with the Oslo Sports Trauma Centre (Norway),3 and jointly with the NCAA and the Santa Monica Medical Centre (USA).4 Bizzini and Dvorak5 summarise the scientific evidence of the effectiveness of ‘FIFA 11+’ in reducing injuries by up to 50% if performed regularly. Since 2009, FIFA has disseminated the ‘FIFA 11+’ through the network of its 209 Member …
Article
Full-text available
Background: The influence of injuries on team performance in football has only been scarcely investigated. Aim: To study the association between injury rates and team performance in the domestic league play, and in European cups, in male professional football. Methods: 24 football teams from nine European countries were followed prospectively for 11 seasons (2001-2012), including 155 team-seasons. Individual training and match exposure and time-loss injuries were registered. To analyse the effect of injury rates on performance, a Generalised Estimating Equation was used to fit a linear regression on team-level data. Each team's season injury rate and performance were evaluated using its own preceding season data for comparison in the analyses. Results: 7792 injuries were reported during 1 026 104 exposure hours. The total injury incidence was 7.7 injuries/1000 h, injury burden 130 injury days lost/1000 h and player match availability 86%. Lower injury burden (p=0.011) and higher match availability (p=0.031) were associated with higher final league ranking. Similarly, lower injury incidence (p=0.035), lower injury burden (p<0.001) and higher match availability (p<0.001) were associated with increased points per league match. Finally, lower injury burden (p=0.043) and higher match availability (p=0.048) were associated with an increase in the Union of European Football Association (UEFA) Season Club Coefficient, reflecting success in the UEFA Champions League or Europa League. Conclusions: Injuries had a significant influence on performance in the league play and in European cups in male professional football. The findings stress the importance of injury prevention to increase a team's chances of success.
Article
Full-text available
Background Little information exists on the illness and injury patterns of athletes preparing for the Olympic and Paralympic Games. Among the possible explanations for the current lack of knowledge are the methodological challenges faced in conducting prospective studies of large, heterogeneous groups of athletes, particularly when overuse injuries and illnesses are of concern. Objective To describe a new surveillance method that is capable of recording all types of health problems and to use it to study the illness and injury patterns of Norwegian athletes preparing for the 2012 Olympic and Paralympic Games. Methods A total of 142 athletes were monitored over a 40-week period using a weekly online questionnaire on health problems. Team medical personnel were used to classify and diagnose all reported complaints. Results A total of 617 health problems were registered during the project, including 329 illnesses and 288 injuries. At any given time, 36% of athletes had health problems (95% CI 34% to 38%) and 15% of athletes (95% CI 14% to 16%) had substantial problems, defined as those leading to moderate or severe reductions in sports performance or participation, or time loss. Overuse injuries represented 49% of the total burden of health problems, measured as the cumulative severity score, compared to illness (36%) and acute injuries (13%). Conclusions The new method was sensitive and valid in documenting the pattern of acute injuries, overuse injuries and illnesses in a large, heterogeneous group of athletes preparing for the Olympic and Paralympic Games.
Article
Objectives: To investigate the incidence, characteristics and patterns of football injuries at club level in Qatar. Design: Prospective cohort study. Methods: Data were prospectively collected from the first division football league clubs in Qatar, in accordance with the international consensus statement on football injury epidemiology. An injury was defined as any physical complaint sustained during football activity resulting in the inability to participate fully in the next training or match. Individual injuries and exposure of each player were recorded by the medical staff of each team over one season. Results: A total of 217 injuries were recorded, with an injury rate during matches of 14.5/1000 h (95% CI: 11.6-18.0) compared with 4.4/1000 h during training sessions (95% CI: 3.7-5.2). More than one third of all injuries were muscle strains (36.4%). Hamstring strains (54.4% of all muscle strains) exhibited a higher incidence than all other injury types (p < 0.001). The thigh was the most frequent injury location (41.9%, p < 0.001). Re-injuries (15% of total injuries) were mainly comprised of muscle strains associated with a higher severity compared with new injuries. Conclusions: Despite the different environmental, social and cultural setting, our findings are comparable with previous data from a European club football, confirming the previous finding at national team level that there are no regional peculiarities of football injuries in this part of the Asiatic continent. The relatively high overuse injury incidence rate and the high recurrence rate for (severe) thigh muscle strains, especially during games, warrants prevention strategies.
Article
Background There are limited data on the nature, type and incidence of illness in football. Previous studies indicate that gastrointestinal and respiratory tract illnesses are most common. Aim To describe the incidence and burden of illness in male professional football. Methods Over the 4-year study period, 2011-2014, 73 professional football teams in Europe participated, with a total of 1 261 367 player-days recorded. All timeloss illnesses were recorded by the medical staff of each club. A recordable illness episode was any physical or psychological symptom (not related to injury) that resulted in the player being unable to participate fully in training or match play. Results A total of 1914 illness episodes were recorded. The illness incidence was 1.5 per 1000 player-days, meaning that, on average, a player experienced an illness episode every second season, with a median of 3 days absence per illness episode. Severe illness (absence <4 weeks) constituted 2% of all illnesses. Respiratory tract illness was the most common (58%), followed by gastrointestinal illness (38%). Respiratory tract illness, gastrointestinal illness and cardiovascular illness caused the highest illness burden. Conclusions The illness incidence among male professional football players is low compared with the injury incidence. We found that the highest illness burden was caused by illness to the respiratory tract, gastrointestinal tract and cardiovascular system.
Article
Variations in definitions and methodologies have created differences in the results and conclusions obtained from studies of football (soccer) injuries, making interstudy comparisons difficult. Therefore an Injury Consensus Group was established under the auspices of Fédération Internationale de Football Association Medical Assessment and Research Centre. A nominal group consensus model approach was used. A working document on definitions, methodology, and implementation was discussed by the group. Iterative draft statements were prepared and circulated to members of the group for comment before the final consensus statement was produced. Definitions of injury, recurrent injury, severity, and training and match exposures in football together with criteria for classifying injuries in terms of location, type, diagnosis, and causation are proposed. Proforma for recording players’ baseline information, injuries, and training and match exposures are presented. Recommendations are made on how the incidence of match and training injuries should be reported and a checklist of issues and information that should be included in published reports of studies of football injuries is presented.
Article
Objective: The incidence of injury during elite-level football tournaments has been well documented, but the incidence of illness and medical conditions has not been well studied. The main objective was to analyze the incidence and nature of medical illnesses and injuries in football players. Design: Prospective cohort study. Setting: 2009 Fédération Internationale de Football Association Confederations Cup soccer tournament. Participants: One hundred eighty-four soccer players (8 teams of 23 players). Main outcome measures: Incidence (per 1000 player days) of illnesses and injuries. Each team physician was requested to complete a daily report of injury (match and training) and medical illness of their players during the tournament (2070 player days). A total of 63 daily reports were obtained (70% response rate). Results: A total of 56 injuries and 35 illness incidents were recorded, resulting in an overall rate of 16.9 illnesses per 1000 player days and 27.0 injuries (match and training) per 1000 player days. The overall injury rate was 64.4 per 1000 match hours or 2.1 per match. About 0.88 days were lost per injury, and 0.46 days were lost per illness. Thirteen (37%) illnesses were because of conditions of the ear, nose, and throat, and 7 (20%) illnesses were because of other respiratory tract symptoms. The lower limb was the most commonly injured body part, with thigh (20%) being the most frequent location, and contusion (44%) the most frequent type of injury. Conclusions: Illnesses are as common but less severe compared with match and training injuries during an international football tournament. Illnesses comprise an important component in the day-to-day medical care of a traveling football team. Medical illness therefore needs to be considered by the team physicians when planning for and managing the medical needs of elite football teams.
Article
Illness accounts for a significant proportion of consultations with a team physician travelling with elite athletes. To determine the incidence, type, cause and consequences of illness in Rugby Union players participating in a 16-week tournament. 8 teams participating in the 2010 Super 14 Rugby tournament Participants A cohort of 259 elite rugby players from eight teams was recruited. All players were followed daily over the 16-week competition period (22 676 player days). Each day, team physicians completed an illness log with 100% compliance. Information included the daily squad size and illness details including system affected, final diagnosis, type and onset of symptoms, training/match days lost and suspected cause. Incidence of illness (illness per 1000 player days). The incidence of illness in the cohort was 20.7/1000 player days (95% CI 18.5 to 23.1) with the highest incidence of illness in the respiratory system (6.4: 95% CI 5.5 to 7.3), gastrointestinal system (5.6: 95% CI 4.9 to 6.6) and the skin and subcutaneous tissue (4.6; 95% CI 4.0 to 5.4). Infections accounted for 54.5% of all illness and 26.1% of illness resulted in time loss of ≥1 day. In over 50% of illnesses, symptoms were present for ≥1 day before being reported to the team physician. Infective illness involving the respiratory tract and gastrointestinal tract together with dermatological illness was common in elite rugby players participating in this international tournament. A delay in reporting of symptoms >24 h could have important clinical implications in player medical care.