British Journal of Sports Medicine, Vol 33, Issue 3 196-203, Copyright © 1999 by British Association of Sport and Medicine

A prospective epidemiological study of injuries in four English professional football clubs

RD Hawkins and CW Fuller
Centre for Hazard and Risk Management, Loughborough University, Leics, United Kingdom.

OBJECTIVE: To define the causes of injuries to players in English professional football during competition and training. METHOD: Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. RESULTS: In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p < 0.01) higher than that during training (3.5). The IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p < 0.01) injuries in competition in the 15 minute periods at the end of each half. Strains (41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p < 0.01) more injuries to the dominant body side. Reinjury counted for 22% of all injuries. Only 12% of all injuries were caused by a breach of the rules of football, although player to player contact was involved in 41% of all injuries. CONCLUSIONS: The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition.
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• (2009). BASEM Annual Congress 2008 8-10 October 2008, Brighton, UK. Br. J. Sports. Med. 43: 875-882 [Full Text]  
• Frisch, A., Croisier, J.-L., Urhausen, A., Seil, R., Theisen, D. (2009). Injuries, risk factors and prevention initiatives in youth sport. Br Med Bull 0: ldp034v1-ldp034 [Abstract] [Full Text]  
• Rosenbaum, D A, Silvis, M L, Williams, J E, Davis, S W (2009). Variation in injury risk over the course of a two-day youth club soccer tournament. Inj. Prev. 15: 266-269 [Abstract] [Full Text]  
• Azubuike, S O, Okojie, O H (2009). An epidemiological study of football (soccer) injuries in Benin City, Nigeria. Br. J. Sports. Med. 43: 382-386 [Abstract] [Full Text]  
• Sankey, R. A., Brooks, J. H. M., Kemp, S. P. T., Haddad, F. S. (2008). The Epidemiology of Ankle Injuries in Professional Rugby Union Players. Am J Sports Med 36: 2415-2424 [Abstract] [Full Text]  
• Fuller, C W, Ward, C J (2008). An empirical approach for defining acceptable levels of risk: a case study in team sports. Inj. Prev. 14: 256-261 [Abstract] [Full Text]  
• Engebretsen, A. H., Myklebust, G., Holme, I., Engebretsen, L., Bahr, R. (2008). Prevention of Injuries Among Male Soccer Players: A Prospective, Randomized Intervention Study Targeting Players With Previous Injuries or Reduced Function. Am J Sports Med 36: 1052-1060 [Abstract] [Full Text]  
• Kernozek, T. W., Torry, M. R., Iwasaki, M. (2008). Gender Differences in Lower Extremity Landing Mechanics Caused by Neuromuscular Fatigue. Am J Sports Med 36: 554-565 [Abstract] [Full Text]  
• Le Gall, F., Carling, C., Reilly, T. (2008). Injuries in Young Elite Female Soccer Players: An 8-Season Prospective Study. Am J Sports Med 36: 276-284 [Abstract] [Full Text]  
• Lohmander, L. S., Englund, P. M., Dahl, L. L., Roos, E. M. (2007). The Long-term Consequence of Anterior Cruciate Ligament and Meniscus Injuries: Osteoarthritis. Am J Sports Med 35: 1756-1769 [Abstract] [Full Text]  
• Hagglund, M., Walden, M., Ekstrand, J. (2007). Lower Reinjury Rate With a Coach-Controlled Rehabilitation Program in Amateur Male Soccer: A Randomized Controlled Trial. Am J Sports Med 35: 1433-1442 [Abstract] [Full Text]  
• Junge, A., Dvorak, J. (2007). Injuries in female football players in top-level international tournaments. Br. J. Sports. Med. 41: i3-i7 [Abstract] [Full Text]  
• Tscholl, P, O'Riordan, D, Fuller, C W, Dvorak, J, Gutzwiller, F, Junge, A (2007). Causation of injuries in female football players in top-level tournaments. Br. J. Sports. Med. 41: i8-i14 [Abstract] [Full Text]  
• Tscholl, P, O'Riordan, D, Fuller, C W, Dvorak, J, Junge, A (2007). Tackle mechanisms and match characteristics in women's elite football tournaments. Br. J. Sports. Med. 41: i15-i19 [Abstract] [Full Text]  
• Fuller, C. W, Dick, R. W, Corlette, J., Schmalz, R. (2007). Comparison of the incidence, nature and cause of injuries sustained on grass and new generation artificial turf by male and female football players. Part 1: match injuries. Br. J. Sports. Med. 41: i20-i26 [Abstract] [Full Text]  
• Wilson, F, Caffrey, S, King, E, Casey, K, Gissane, C (2007). A 6-month prospective study of injury in Gaelic football. Br. J. Sports. Med. 41: 317-321 [Abstract] [Full Text]  
• Dallalana, R. J., Brooks, J. H. M., Kemp, S. P. T., Williams, A. M. (2007). The Epidemiology of Knee Injuries in English Professional Rugby Union. Am J Sports Med 35: 818-830 [Abstract] [Full Text]  
• Wong, P.-l., Chamari, K., Mao, D. W., Wisloff, U., Hong, Y. (2007). Higher plantar pressure on the medial side in four soccer-related movements. Br. J. Sports. Med. 41: 93-100 [Abstract] [Full Text]  
• Deehan, D. J., Bell, K., McCaskie, A. W. (2007). Adolescent musculoskeletal injuries in a football academy. J Bone Joint Surg Br 89-B: 5-8 [Abstract] [Full Text]  
• Ekstrand, J, Timpka, T, Hagglund, M, Karlsson, J (2006). Risk of injury in elite football played on artificial turf versus natural grass: a prospective two-cohort study * Commentary. Br. J. Sports. Med. 40: 975-980 [Abstract] [Full Text]  
• Scase, E, Cook, J, Makdissi, M, Gabbe, B, Shuck, L, Payne, W (2006). Teaching landing skills in elite junior Australian football: evaluation of an injury prevention strategy * COMMENTARY. Br. J. Sports. Med. 40: 834-838 [Abstract] [Full Text]  
• Faude, O, Junge, A, Kindermann, W, Dvorak, J (2006). Risk factors for injuries in elite female soccer players. Br. J. Sports. Med. 40: 785-790 [Abstract] [Full Text]  
• Hagglund, M, Walden, M, Ekstrand, J (2006). Previous injury as a risk factor for injury in elite football: a prospective study over two consecutive seasons. Br. J. Sports. Med. 40: 767-772 [Abstract] [Full Text]  
• Le Gall, F., Carling, C., Reilly, T., Vandewalle, H., Church, J., Rochcongar, P. (2006). Incidence of Injuries in Elite French Youth Soccer Players: A 10-Season Study. Am J Sports Med 34: 928-938 [Abstract] [Full Text]  
• Fuller, C W, Walker, J, Drawer, S (2006). Quantifying the functional rehabilitation of injured football players * Commentary. Br. J. Sports. Med. 40: 151-157 [Abstract] [Full Text]  
• Walden, M, Hagglund, M, Ekstrand, J, Karlsson, J (2006). High risk of new knee injury in elite footballers with previous anterior cruciate ligament injury * Commentary. Br. J. Sports. Med. 40: 158-162 [Abstract] [Full Text]  
• Faude, O., Junge, A., Kindermann, W., Dvorak, J. (2005). Injuries in Female Soccer Players: A Prospective Study in the German National League. Am J Sports Med 33: 1694-1700 [Abstract] [Full Text]  
• Brooks, J H M, Fuller, C W, Kemp, S P T, Reddin, D B (2005). Epidemiology of injuries in English professional rugby union: part 1 match injuries. Br. J. Sports. Med. 39: 757-766 [Abstract] [Full Text]  
• Brooks, J H M, Fuller, C W, Kemp, S P T, Reddin, D B (2005). Epidemiology of injuries in English professional rugby union: part 2 training Injuries. Br. J. Sports. Med. 39: 767-775 [Abstract] [Full Text]  
• Wong, P, Hong, Y (2005). Soccer injury in the lower extremities. Br. J. Sports. Med. 39: 473-482 [Abstract] [Full Text]  
• Walden, M, Hagglund, M, Ekstrand, J (2005). UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season. Br. J. Sports. Med. 39: 542-546 [Abstract] [Full Text]  
• Fuller, C W, Junge, A, Dvorak, J (2005). A six year prospective study of the incidence and causes of head and neck injuries in international football. Br. J. Sports. Med. 39: i3-i9 [Abstract] [Full Text]  
• Krosshaug, T, Andersen, T E, Olsen, O-E O, Myklebust, G, Bahr, R (2005). Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities. Br. J. Sports. Med. 39: 330-339 [Abstract] [Full Text]  
• Hagglund, M, Walden, M, Bahr, R, Ekstrand, J (2005). Methods for epidemiological study of injuries to professional football players: developing the UEFA model. Br. J. Sports. Med. 39: 340-346 [Abstract] [Full Text]  
• Verrall, G M, Slavotinek, J P, Barnes, P G (2005). The effect of sports specific training on reducing the incidence of hamstring injuries in professional Australian Rules football players. Br. J. Sports. Med. 39: 363-368 [Abstract] [Full Text]  
• Brooks, J H M, Fuller, C W, Kemp, S P T, Reddin, D B (2005). A prospective study of injuries and training amongst the England 2003 Rugby World Cup squad. Br. J. Sports. Med. 39: 288-293 [Abstract] [Full Text]  
• Giza, E, Mithofer, K, Farrell, L, Zarins, B, Gill, T, Drawer, S (2005). Injuries in women's professional soccer * Commentary. Br. J. Sports. Med. 39: 212-216 [Abstract] [Full Text]  
• Arnason, A., Engebretsen, L., Bahr, R. (2005). No Effect of a Video-Based Awareness Program on the Rate of Soccer Injuries. Am J Sports Med 33: 77-84 [Abstract] [Full Text]  
• Andersen, T E, Arnason, A, Engebretsen, L, Bahr, R (2004). Mechanisms of head injuries in elite football. Br. J. Sports. Med. 38: 690-696 [Abstract] [Full Text]  
• Andersen, T E, Tenga, A, Engebretsen, L, Bahr, R (2004). Video analysis of injuries and incidents in Norwegian professional football. Br. J. Sports. Med. 38: 626-631 [Abstract] [Full Text]  
• Arnason, A., Tenga, A., Engebretsen, L., Bahr, R. (2004). A Prospective Video-Based Analysis of Injury Situations in Elite Male Football: Football Incident Analysis. Am J Sports Med 32: 1459-1465 [Abstract] [Full Text]  
• Dadebo, B, White, J, George, K P (2004). A survey of flexibility training protocols and hamstring strains in professional football clubs in England. Br. J. Sports. Med. 38: 388-394 [Abstract] [Full Text]  
• Price, R J, Hawkins, R D, Hulse, M A, Hodson, A (2004). The Football Association medical research programme: an audit of injuries in academy youth football. Br. J. Sports. Med. 38: 466-471 [Abstract] [Full Text]  
• Ekstrand, J, Walden, M, Hagglund, M (2004). A congested football calendar and the wellbeing of players: correlation between match exposure of European footballers before the World Cup 2002 and their injuries and performances during that World Cup. Br. J. Sports. Med. 38: 493-497 [Abstract] [Full Text]  
• Halasi, T., Kynsburg, A., Tallay, A., Berkes, I. (2004). Development of a New Activity Score for the Evaluation of Ankle Instability. Am J Sports Med 32: 899-908 [Abstract] [Full Text]  
• Arnason, A., Sigurdsson, S. B., Gudmundsson, A., Holme, I., Engebretsen, L., Bahr, R. (2004). Risk Factors for Injuries in Football. Am J Sports Med 32: 5S-16S [Abstract] [Full Text]  
• Junge, A., Dvorak, J., Graf-Baumann, T. (2004). Football Injuries During the World Cup 2002. Am J Sports Med 32: 23S-27S [Abstract] [Full Text]  
• Fuller, C. W., Smith, G. L., Junge, A., Dvorak, J. (2004). An Assessment of Player Error as an Injury Causation Factor in International Football. Am J Sports Med 32: 28S-35S [Abstract] [Full Text]  
• Yoon, Y. S., Chai, M., Shin, D. W. (2004). Football Injuries at Asian Tournaments. Am J Sports Med 32: 36S-42S [Abstract] [Full Text]  
• Fuller, C. W., Smith, G. L., Junge, A., Dvorak, J. (2004). The Influence of Tackle Parameters on the Propensity for Injury in International Football. Am J Sports Med 32: 43S-53S [Abstract] [Full Text]  
• Andersen, T. E., Engebretsen, L., Bahr, R. (2004). Rule Violations as a Cause of Injuries in Male Norwegian Professional Football: Are the Referees Doing Their Job?. Am J Sports Med 32: 62S-68S [Abstract] [Full Text]  
• Andersen, T. E., Floerenes, T. W., Arnason, A., Bahr, R. (2004). Video Analysis of the Mechanisms for Ankle Injuries in Football. Am J Sports Med 32: 69S-79S [Abstract] [Full Text]  
• Giza, E., Fuller, C., Junge, A., Dvorak, J. (2003). Mechanisms of Foot and Ankle Injuries in Soccer. Am J Sports Med 31: 550-554 [Abstract] [Full Text]  
• Andersen, T E, Larsen, O, Tenga, A, Engebretsen, L, Bahr, R (2003). Football incident analysis: a new video based method to describe injury mechanisms in professional football. Br. J. Sports. Med. 37: 226-232 [Abstract] [Full Text]  
• Drawer, S, Fuller, C W (2002). Evaluating the level of injury in English professional football using a risk based assessment process. Br. J. Sports. Med. 36: 446-451 [Abstract] [Full Text]  
• Conaghan, P G (2002). Update on osteoarthritis part 1: current concepts and the relation to exercise. Br. J. Sports. Med. 36: 330-333 [Abstract] [Full Text]  
• Rahnama, N, Reilly, T, Lees, A (2002). Injury risk associated with playing actions during competitive soccer. Br. J. Sports. Med. 36: 354-359 [Abstract] [Full Text]  
• Junge, A., Rosch, D., Peterson, L., Graf-Baumann, T., Dvorak, J. (2002). Prevention of Soccer Injuries: A Prospective Intervention Study in Youth Amateur Players. Am J Sports Med 30: 652-659 [Abstract] [Full Text]  
• Drawer, S, Fuller, C., Waddington, I (2002). Perceptions of retired professional soccer players about the provision of support services before and after retirement. Br. J. Sports. Med. 36: 33-38 [Abstract] [Full Text]  
• Drawer, S, Fuller, C W (2001). Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br. J. Sports. Med. 35: 402-408 [Abstract] [Full Text]  
• Waddington, I. (2001). Commentary. Br. J. Sports. Med. 35: 408-408 [Full Text]  
• Hawkins, R D, Hulse, M A, Wilkinson, C, Hodson, A, Gibson, M (2001). The association football medical research programme: an audit of injuries in professional football. Br. J. Sports. Med. 35: 43-47 [Abstract] [Full Text]  
• Dvorak, J., Junge, A. (2000). Football Injuries and Physical Symptoms: A Review of the Literature. Am J Sports Med 28: S-3-S-9 [Abstract] [Full Text]  
• Junge, A., Dvorak, J. (2000). Influence of Definition and Data Collection on the Incidence of Injuries in Football. Am J Sports Med 28: S-40-S-46 [Abstract] [Full Text]