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Communication quality between the medical team and the head coach/manager is associated with injury burden and player availability in elite football clubs
  1. Jan Ekstrand1,2,
  2. Daniel Lundqvist3,
  3. Michael Davison2,4,
  4. Michel D’Hooghe2,5,
  5. Anne Marte Pensgaard6
  1. 1 Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  2. 2 Football Research Group, Linköping, Sweden
  3. 3 Unit of Education and Sociology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
  4. 4 Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
  5. 5 Union of European Football Associations (UEFA), Nyon, Switzerland
  6. 6 Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence to Professor Jan Ekstrand, Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping 582 21, Sweden; jan.ekstrand{at}


Objectives We investigated medical staff interpretations and descriptions of internal communication quality in elite football teams to determine whether internal communication was correlated with injuries and/or player availability at training and matches.

Methods Medical staff from 36 elite football clubs across 17 European countries produced 77 reports at four postseason meetings to provide their perceptions of internal communications in their teams. They also recorded data on individual players’ exposure to football and time-loss injuries.

Results The injury burden and incidence of severe injuries were significantly higher in teams with low quality of communication between the head coach/manager and the medical team (scores of 1–2 on a 5-point Likert scale) compared with teams with moderate or high-quality scores (scores of 3–5; p=0.008 for both). Teams with low scores had 4%–5% lower training attendance (76% vs 83%, p=0.001) and less availability at matches (82% vs 88%, p=0.004) compared with teams with moderate or high communication quality scores.

Conclusions The quality of internal communication within a team was correlated with injury rates, training attendance and match availability.

  • elite performance
  • epidemiology
  • football
  • injury
  • soccer

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  • Contributors JE was responsible for the conception and design of the study and for the data collection over the study period. JE conducted the analyses in collaboration with the biostatistician (HH). All authors contributed to the interpretations of the findings. JE wrote the first draft of the paper, which was critically revised by MD, MD’H, DL and AMP. The final manuscript was approved by all authors. JE is the study guarantor.

  • Funding The Football Research Group was established in Linkoping, Sweden, in cooperation with Linkoping University. It was supported by grants from UEFA, the Swedish Football Association and the Swedish Research Council for Sport Science.

  • Competing interests None declared.

  • Patient consent Not required.

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