Incidence of Injury for Professional Soccer Players in the United States: A 6-Year Prospective Study of Major League Soccer

Background:

Despite an abundance of injury research focusing on European professional soccer athletes, there are limited injury data on professional soccer players in the United States.

Purpose:

To describe the epidemiology of injury across multiple years in Major League Soccer (MLS) players.

Study Design:

Descriptive epidemiology study.

Methods:

A web-based health management platform was used to prospectively collect injury data from all MLS teams between 2014 and 2019. An injury was defined as an incident that required medical attention and was recorded into the health management platform anytime over the course of the 2014-2019 seasons. Injuries and exposure data were recorded in training and match settings to calculate injury incidence.

Results:

A total of 9713 injuries were recorded between 2014 and 2019. A mean 1.1 injuries per year per player were identified, with midfielders sustaining the largest number of injuries. The most common injuries were hamstring strains (12.3%), ankle sprains (8.5%), and adductor strains (7.6%). The mean time missed per injury was 15.8 days, with 44.2% of injuries resulting in no days missed. Overall injury incidence was 8.7 per 1000 hours of exposure, declining over the course of the investigation, with a 4.1-times greater mean incidence during matches (14.0/1000 h) than training (3.4/1000 h).

Conclusion:

Between 2014 and 2019, the most commonly reported injuries in MLS players were hamstring strains, ankle sprains, and adductor strains. Injury incidence during matches was 4.1 times greater when compared with training, while overall injury incidence was found to decline during the course of the study period.

Injuries during football tournaments in 45,000 children and adolescents

Four percent of the world's population, or 265 million people, play football, and many players are injured every year. The present study investigated more than 1800 injuries in over 45,000 youth players participating in three consecutive international football tournaments in Denmark in 2012-2014. The aim was to investigate the injury types and locations in children and adolescent football players and the differences between genders and age groups (11-15 and 16-19 years of age). An overall injury rate of 15.3 per 1000 player hours was found. The most common injury location was lower extremities (66.7%), and the most common injury type was contusion (24.4%). Girls had a relative risk of injury of 1.5 compared with boys, p < .001, and they had a higher proportion of injuries to knee and lower leg, 23.8%, than boys, 19.0%, p < .01. Boys had a higher proportion of fracture, 6.8%, as opposed to 3.3% among girls, p < .001. In conclusion, we found the youngest girls to have a higher incidence of almost all injury categories than any other group. In general, the incidence of injury decreased with age. The study provides a detailed insight into the injuries that may be expected at a large youth football tournament. These findings are of great value for organizations and healthcare professionals planning similar events and for planning injury prevention strategies, which would be of special interest in the youngest female players in general.

Sports-related concussion increases the risk of subsequent injury by about 50% in elite male football players

BACKGROUND

Little is known about the short-term and long-term sequelae of concussion, and about when athletes who have sustained such injuries can safely return to play.

PURPOSE

To examine whether sports-related concussion increases the risk of subsequent injury in elite male football players.

STUDY DESIGN

Prospective cohort study.

METHODS

Injuries were registered for 46 male elite football teams in 10 European countries in the 2001/2002-2011/2102 seasons. Two survival models were used to analyse whether concussion increased the subsequent risk of an injury in the first year.

RESULTS

During the follow-up period, 66 players sustained concussions and 1599 players sustained other injuries. Compared with the risk following other injuries, concussion was associated with a progressively increased risk of a subsequent injury in the first year (0 to <3 months, HR=1.56, 95% CI 1.09 to 2.23; 3 to <6 months, HR=2.78, 95% CI 1.58 to 4.89; 6-12 months, HR=4.07, 95% CI 2.14 to 7.76). In the second model, after adjustment for the number of injuries in the year preceding the concussion, this injury remained significantly associated with the risk of subsequent injury in the first year (HR=1.47, 95% CI 1.05 to 2.05).

CONCLUSIONS

Concussion was a risk factor for sustaining subsequent injury within the following year. In-depth medical evaluation, which includes neurological and cognitive assessment, is warranted within the concussion management and return-to- play process.

Head and neck injuries in professional soccer

OBJECTIVE

To investigate the rate of and risk factors for head and neck injury in male soccer.

DESIGN

Prospective cohort study.

SETTING

Professional soccer.

PARTICIPANTS

Twenty-six European teams between 2001/2002 and 2009/2010.

ASSESSMENT OF RISK FACTORS

Simple and multiple risk factor analyses were evaluated using Cox regression for player-related variables and logistic regression for match-related variables.

MAIN OUTCOME MEASURES

Injury rate (number of time loss injuries per 1000 hours).

RESULTS

A total of 136 head and neck injuries were recorded (2.2% of all injuries). The head and neck injury rate was 0.17 (0.06 concussions) per 1000 hours. There was a 20-fold higher rate of head and neck injury during match play compared with training (rate ratio [RR], 20.2; 95% confidence interval [CI], 13.3-30.6) and a 78-fold higher rate of concussions (RR, 78.5; 95% CI, 24.4-252.5). Mean layoff for concussion was 10.5 days, but 27% of the concussed players returned to play within 5 days. Defender was the only significant player-related risk factor for head and neck injuries in the multiple analysis (RR, 1.8; 95% CI, 1.0-3.1), whereas no significant variables were identified for concussions.

CONCLUSIONS

Head and neck injuries were relatively uncommon in professional soccer. Defender was the playing position most at risk. More than one-quarter of the concussed players returned to play before what is recommended in the consensus statements by the major sports governing bodies.

Mechanisms and consequences of head injuries in soccer: a study of 451 patients

Object

The goal of this study was to evaluate the incidence and mechanisms of head injury during soccer games and to describe the results after spontaneous resolution of symptoms or after treatment.

Methods

In a retrospective study from 2005, records on 451 players from the German Soccer Association who had suffered various injuries were collected. The study used a questionnaire in which the player described the accident and the playing situation as well as the clinical course after trauma. This questionnaire also included information about the physical symptoms of the players and the length of their rehabilitation. Two groups were formed: one with head injuries (case group), and the other with injuries of other body parts (control group).

Results

Of the injuries reported, 108 (23.9%) were related to the head, 114 (25.3%) to the knee, 58 (13%) to the ankle, 56 (12%) to the calf, and 30 (7%) to the shoulder. The areas of the head most frequently involved were the facial and occipital regions. In the head injury group, the head duel was the most common playing action to lead to trauma. In those cases, the body part that hit the injured player was the elbow, arm, or head of the opponent. The most common playing situation was combat in the penalty area. The median hospitalization time after the trauma was 2 days for the case group and 5 days for the control group. The rehabilitation time for the case group was also shorter (median 6.5 days) than for the control group (median 30 days).

Conclusions

Trivial head injuries in soccer can have a long and complicated course. Nevertheless, the temporary disability is shorter in most cases than for players with injuries to other parts of the body. Modifying the rules of play would be necessary to reduce the incidence of head trauma.

Sport-related concussion

Sport-related concussion is a common injury in children and adolescents. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. The management of sport-related concussion has changed significantly over the last several years. The previously used grading systems and return-to-play guidelines have been abandoned in favor of more individualized assessment and management. Neuropsychological testing is being used more frequently to assist in management. After recovery, it is recommended that an athlete's return-to-play progress in a gradual, stepwise fashion while being monitored by a health care provider. Proper assessment and management of a sport-related concussion is crucial, because repeat concussions can result in decreased neurocognitive functioning, increased symptomatology, and, at times, catastrophic outcomes.

Injuries in young elite female soccer players: an 8-season prospective study

BACKGROUND

Epidemiologic data on injuries in young female soccer players at elite levels are scarce.

PURPOSE

The aim of the present study is to investigate the incidence of soccer-related injuries in young elite female French players.

STUDY DESIGN

Cohort study; Level of evidence, 2.

METHODS

Injuries sustained by players between 15 and 19 years of age, during 8 seasons, were diagnosed and documented by a sports physician according to type, location, severity, the date the injury occurred, and playing position.

RESULTS

Altogether 619 injuries were documented for 110 players (92.4%). Of these injuries, 64.6% (4.6/1000 training hours; 95% confidence interval [CI], 4.2-5.0) and 35.4% (22.4/1000 match hours; 95% CI, 19.4-25.4) were sustained during training and matches, respectively. The risk of injury was greater in the youngest (under age 15) group compared with the oldest (under 19) group (relative risk 1.7; 95% CI, 1.3-2.3). Traumatic injuries amounted to 536 (86.4%) and 83 (13.4%) were overuse injuries. There were 51.9% minor injuries, 35.7% moderate injuries, and 12.4% major injuries. Most injuries were located at the lower extremities (83.4%), with the majority affecting the ankle (n = 157). The most commonly diagnosed injury was ankle sprain (16.8%). Twelve anterior cruciate ligament ruptures were sustained, with the majority occurring during matches (n = 10; 1.0/1000 match hours; 95% CI, 0.4-1.6). Reinjuries accounted for 4.4% of total injuries, and September was the predominant month for injury (14.2%).

CONCLUSIONS

The results, when compared with those of other investigations on female soccer players, revealed high rates of both traumatic injury and match injury, whereas recurrence of injury was low. Injuries, notably sprains, to the ankle were common, suggesting a need for the implementation of specific injury prevention strategies for this joint.