Background The first step on the way to developing preventive measures is the description of epidemiology within the target group. This is not known for German Men's Professional Football so far.

Objective Analysis of injury risk and description of injury patterns.

Design Prospective observational cohort study of the season 2014–15.

Setting Two highest leagues in German men's football (i.e. Bundesliga, 2. Bundesliga).

Patients (or Participants) All first and second division football players who played at least one competitive club match (n=1,358) during the 2014–15 season were included.

Interventions (or Assessment of Risk Factors) Analysis of all injuries of the participants that were registered by clubs or physicians with the VBG as part of the occupational accident reporting and that either led to the player's short-term disability (time-loss) or to medical treatment costs (medical-attention).

Main Outcome Measurements Prevalence rate and injury incidence, injured body regions, type of injury, medical costs and time loss.

Results 1,076 of the 1,358 players (79.2%) were injured. A total of 3,385 injuries were recorded (training: 62.3%, match: 37.3%) which led to a cumulative incidence rate of 2.5 injuries per player and season. Goalkeeper had lower overall risk of injury (2.1 inj./season), but a 3.7 times higher relative risk of concussions than field players. 70.7% of all injuries were lower extremity injuries. Thigh injuries (21.3%) and knee injuries (15.8%) were the most frequent injuries. However, knee injuries caused 37.0% of overall time-loss and 48.4% of overall medical-attention.

Conclusions German men's professional football shows a high risk of injury. Injury risk and injury patterns differ by playing position, probably reflecting the specific performance profiles of the respective playing position. Thus prevention needs to be individualised and at least must consider different characteristics of playing positions. For development of expedient preventive measures, injury mechanisms need to be analysed.