Background Although descriptions of injury inciting events are of key importance to understand the causes of any particular injury type, systematic analysis of inciting events remain rare.

Objective Identification and description of recurrent injury patterns in professional football.

Design Prospective video analysis of moderate and severe match injuries.

Setting Two highest divisions in German professional male football (Bundesliga, 2. Bundesliga).

Patients (or Participants) All players who played at least one competitive club match within the seasons 2014/15, 15/16 and 16/17 were included (n=1,449).

Interventions (or Assessment of Risk Factors) Systematic video analysis of all moderate and severe match injuries (time-loss ≥ 8 days) that were registered by clubs or physicians with the VBG (German statutory accident insurance for professional athletes) as part of the occupational accident reporting.

Main Outcome Measurements An observation form was developed and evaluated containing five categories: (I) general match and player information, (II) localisation of the injury on the pitch, (III) game situation and player/opponent behaviour, (IV) injury mechanism and (V) injured body location.

Results Of the 857 moderate and severe match injuries, 345 (40.3%) were clearly identified in the video footage and included to the analysis. Of these, almost half were contact injuries (49.3%), 23.2% non-contact injuries and the remaining 27.5% indirect-contact injuries. Most contact injuries were caused by collisions with the opponent (46.5%); non-contact injuries were commonly caused by structural overexertion (71.3%). Finally, nine recurrent comprehensive injury patterns were identified and described.

Conclusions Future preventive approaches should prepare players for the identified recurrent injury situations to reduce injury burden in professional football. One of the main findings was that own tackles are football-specific actions with a high risk for injuries, particularly for knee injuries. Thus, player behaviour and technique skills might present areas with considerable preventive potential. The resulting video database can be used in coaching education to demonstrate recurrent match situations with a high risk for injuries.