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  1. A Nilstad,
  2. TE Andersen,
  3. R Bahr,
  4. IM Holme,
  5. K Steffen
  1. Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway


Background The incidence of lower extremity injuries in female football players is high, but their risk factors are poorly understood.

Objective To investigate risk factors for lower extremity injuries in elite female football players.

Design Prospective cohort study.

Study setting Elite football league.

Participants Norwegian elite female football players.

Risk factor assessment Baseline screening tests were conducted prior to the 2009 competitive football season and included tests assessing maximal lower extremity strength, balance, knee valgus angles in a drop jump landing, knee joint laxity, generalized joint laxity and foot pronation. We also included a questionnaire to collect information on demographic data, elite level experience and injury history. Time-loss injuries and exposure in training and match were recorded prospectively during the subsequent football season using weekly text messaging. Players reporting an injury were contacted to collect data regarding injury circumstances. Univariate and multivariate regression analyses were used to calculate odds ratios (OR) and 95% confidence intervals (CI) for one standard deviation change.

Main outcome measurements New lower extremity injuries.

Results In total, 173 players provided complete screening tests and registrations of injuries and exposure throughout the season. A total of 171 injuries in 107 players (62%) were recorded. Multivariate analyses showed that greater BMI (OR 1.51, CI 1.21–1.90, P=.001) was the only factor significantly associated with new lower extremity injuries. Greater BMI was associated with new thigh injuries (OR 1.51, CI 1.08–2.11, P=.01), lower knee valgus angles in a drop jump landing was associated with ankle injuries (OR 0.64, CI 0.41–1.00, P=.04) and a previous knee injury with lower leg and foot injuries (OR 3.57, CI 1.27–9.99, P=.02), whereas neither of the factors investigated influenced the risk of knee injuries.

Conclusion Greater BMI was associated with lower extremity injuries in elite female football players.

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