Background Absolute numbers of head injuries in football (soccer) are considerable because of its high popularity and the large number of players. In 2006 a rule was changed to reduce head injuries. Players were given a red card (sent off) for intentional elbow-head contact.
Aims To describe the head injury mechanism and examine the effect of the rule change.
Methods Based on continuously recorded data from the German football magazine “kicker”, a database of all head injuries in the 1st German Male Bundesliga was generated comprising seasons 2000/01-2012/13. Injury mechanisms were analysed from video recordings. Injury incidence rates (IR) and 95% confidence intervals (95% CI) as well as incidence rate ratios (IRR) to assess differences before and after the rule change were calculated.
Results 356 head injuries were recorded (IR 2.22, 95% CI 2.00 to 2.46 per 1000 match hours). Contact with another player caused most head injuries, more specifically because of head-head (34%) or elbow-head (17%) contacts. After the rule change, head injuries were reduced by 29% (IRR 0.71, 95% CI 0.57 to 0.86, p=0.002). Lacerations/abrasions declined by 42% (95% CI 0.39 to 0.85), concussions by 29% (95% CI 0.46 to 1.09), contusions by 18% (95% CI 0.43 to 1.55) and facial fractures by 16% (95% CI 0.55 to 1.28).
Conclusions This rule change appeared to reduce the risk of head injuries in men’s professional football.
- traumatic brain injury
- injury patterns
- head impact
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Contributors TM, FB and CR were responsible for the conception and design of the study. FB was responsible for data collection over the study period. FB conducted the statistical analyses. FB, TT and KadF conducted the video analyses. FB wrote the paper. The draft of the paper was critically revised by CR, KadF and TM.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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