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Injury and illness epidemiology in professional Asian football: lower general incidence and burden but higher ACL and hamstring injury burden compared with Europe
  1. Montassar Tabben1,
  2. Cristiano Eirale1,
  3. Gurcharan Singh2,
  4. Abdulaziz Al-Kuwari1,
  5. Jan Ekstrand1,3,
  6. Hakim Chalabi1,
  7. Roald Bahr1,4,
  8. Karim Chamari1
  1. 1 Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
  2. 2 Sports Medicine Unit, Asian Football Confederation, Kuala Lumpur, Malaysia
  3. 3 Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  4. 4 Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence to Dr Montassar Tabben, ASPREV, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Montassar.Tabben{at}


Background While football injury and illness epidemiology surveillance at professional club level in Europe is available, epidemiological data from other continents are lacking.

Purpose Investigating injury and illness epidemiology in professional Asian football.

Study design Descriptive prospective study.

Methods Professional teams from the Asian Football Confederation (AFC) league were followed prospectively for three consecutive AFC seasons (2017 through 2019, 13 teams per season, 322 team months). Time-loss injuries and illnesses in addition to individual match and training exposure were recorded using standardised digital tools in accordance with international consensus procedures.

Results In total, 232 665 hours of exposure (88.6% training and 11.4% matches) and 1159 injuries were recorded; 496 (42.8%) occurred during matches, 610 (52.6%) during training; 32 (2.8%) were reported as ‘not applicable’ and for 21 injuries (1.8%) information was missing. Injury incidence was significantly greater during match play (19.2±8.6 injuries per 1000 hours) than training (2.8±1.4, p<0.0001), resulting in a low overall incidence of 5.1±2.2.

The injury burden for match injuries was greater than from training injuries (456±336 days per 1000 hours vs 54±34 days, p<0.0001). The two specific injuries causing the greatest burden were complete ACL ruptures (0.14 injuries (95% CI 0.9 to 0.19) and 29.8 days lost (29.1 to 30.5) per 1000 hours) and hamstring strains (0.86 injuries (0.74 to 0.99) and 17.5 days (17.0 to 18.1) lost per 1000 hours).

Reinjuries constituted 9.9% of all injuries. Index injuries caused 22.6±40.8 days of absence compared with 25.1±39 for reinjuries (p=0.62). The 175 illnesses recorded resulted in 1.4±2.9 days of time loss per team per month.

Conclusion Professional Asian football is characterised by an overall injury incidence similar to that reported from Europe, but with a high rate of ACL ruptures and hamstring injury, warranting further investigations.

  • soccer
  • epidemiology
  • injury mechanism
  • longitudinal study

Data availability statement

No data are available. Data are confidential and not available upon request.

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Data availability statement

No data are available. Data are confidential and not available upon request.

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  • Contributors MT, CE and KC lead the project, were responsible for data collection, project management and for writing the initial version of the manuscript. MT was responsible for the statistical analysis. MT, CE, RB and KC were involved in the analysis and interpretation of the results. All authors have revised the manuscript critically for important intellectual content and approved the final version. In doing so, we agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.