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Epidemiology of head and neck injuries in elite football – a prospective survey of fifa tournaments between 1998 and 2015
  1. Annika Prien1,
  2. Jiri Dvorak2,3,4,
  3. Astrid Junge1,3,4
  1. 1Medical School Hamburg (MSH), Hamburg, Germany
  2. 2FIFA Medical Assessment and Research Centre (F-MARC), Zurich, Switzerland
  3. 3Schulthess Clinic, Zurich, Switzerland
  4. 4Fédération Internationale de Football Association (FIFA), Zurich, Switzerland


Objective Recently the potential long-term effect of sports-related head injuries has been discussed. To develop effective injury prevention strategies, epidemiological information is required. The aim of this study was to analyse the incidence and characteristics of head and neck match injuries.

Design Prospective cohort study.

Setting FIFA tournaments and Olympic Games.

Participants All football teams participating in FIFA tournaments and Olympic Games between 1998 and 2015 were included in the study. The team physicians reported injuries from 2106 matches from 65 outdoor tournaments (20 women’s and 45 men’s). The average response rate was 96%.

Outcome measures Incidence rates per match and a variety of injury characteristics (type, severity, cause, gender) of head/neck injuries compared to other football injuries were analysed.

Main results 4756 injuries (2.4 injuries/match) were reported. Most injuries affected the lower extremity (70%), followed by the head/neck (15%), trunk (8%) and upper extremity (7%). Head injuries (n=674; 14.4%) were more frequent than neck injuries (n= 34;0.7%), and the incidence was higher in female (18%) than in male (14%) players. Most head/neck injuries were contusions (n=362; 50.3%) and non-time-loss injuries (n= 164;22.8%). Of the 108 (15%) reported concussions, 62% resulted in time-loss. Only one head injury (fracture) had an estimated time-loss of more than four weeks.

Conclusion While neck injuries are rare, head injuries are more frequent, and particularly concussions often result in time-loss. No career-ending injuries of the head or neck were reported. Potential long-term effects of head/neck injuries warrant further evaluation in clinical studies.

Competing interests None.

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