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Overuse injuries are prevalent in children’s competitive football: a prospective study using the OSTRC Overuse Injury Questionnaire
  1. Mari Leppänen1,
  2. Kati Pasanen1,2,
  3. Benjamin Clarsen3,
  4. Pekka Kannus4,
  5. Roald Bahr3,
  6. Jari Parkkari1,
  7. Heidi Haapasalo5,
  8. Tommi Vasankari4
  1. 1 Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
  2. 2 Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
  3. 3 Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
  4. 4 UKK Institute for Health Promotion Research, Tampere, Finland
  5. 5 Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
  1. Correspondence to Dr Mari Leppänen, Tampere Research Center of Sports Medicine, UKK Institute, Tampere, FI-33501, Finland; mari.leppanen{at}


Objectives To investigate the prevalence and burden of overuse injuries in children’s football as well as player characteristics and their association with overuse injury risk.

Methods This investigation is based on the control arm (10 clubs) of a randomised controlled trial investigating prevention of injuries in youth football. We conducted a prospective 20-week follow-up study on overuse injuries among Finnish football players (n=733, aged 9–14 years). Each week, we sent a text message to players’ parents to ask if the player had sustained any injury during the past week. Players with overuse problem were interviewed over the phone using an overuse injury questionnaire. The main outcome measures were prevalence of all overuse injuries and substantial overuse injuries (those leading to moderate or severe reductions in participation or performance) and injury severity.

Results The average response rate was 95%. In total, 343 players (46.8%) reported an overuse problem while in the study. The average weekly prevalence of all overuse problems and substantial overuse problems was 12.8% and 6.0%, respectively. Injuries affecting the knee had the highest weekly prevalence (5.7% and 2.4% for all and substantial knee problems, respectively). Girls had a higher likelihood of knee problems (OR 2.70; 95% CI 1.69 to 4.17), whereas boys had a higher likelihood of heel problems (OR 2.82; 95% CI 1.07 to 7.44). The likelihood of reporting an overuse problem increased with age (OR 1.21; 95% CI 1.00 to 1.47).

Conclusion Overuse injuries are prevalent in children’s competitive football. Knee overuse injuries represent the greatest burden on participation and performance.

Trial registration number ISRCTN14046021.

  • sporting injuries
  • adolescent
  • soccer
  • overuse injury

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  • Contributors All authors contributed to project planning and manuscript preparations. ML and KP were responsible for the data collection. ML was responsible for the data analysis and drafting of the manuscript. All authors critically revised the manuscript and approved the final version of the manuscript. ML is the guarantor.

  • Funding This study was financially supported by the Finnish Ministry of Education and Culture, by the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (grant 9S049) and by the Palloilu Säätiö, Tammela.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethics Committee of Pirkanmaa Hospital District (ETL-code R13110).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data are available upon request.