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Few training sessions between return to play and first match appearance are associated with an increased propensity for injury: a prospective cohort study of male professional football players during 16 consecutive seasons
  1. Håkan Bengtsson1,2,
  2. Jan Ekstrand2,3,4,
  3. Markus Waldén2,4,
  4. Martin Hägglund1,2
  1. 1Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  2. 2Football Research Group, Linköping University, Linköping, Sweden
  3. 3Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  4. 4Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  1. Correspondence to Håkan Bengtsson, Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping SE-581 83, Sweden; info.frg{at}telia.com

Abstract

Background It has been hypothesised that injury risk after return to play following an injury absence is influenced by the amount of training completed before return to competition.

Aim To analyse if the number of completed training sessions between return to play and the first subsequent match appearance was associated with the odds of injury in men’s professional football.

Methods From a cohort study, including 303 637 individual matches, 4805 first match appearances after return to play following moderate to severe injuries (≥8 days absence) were analysed. Rate ratios (RRs) were used to compare injury rates in the first match appearances with the average seasonal match injury rate. Odds ratios (ORs) were used to analyse associations between the number of completed training sessions and general (all injuries), muscle, and non-muscle injury odds.

Results Injury rate in the first match after return to play was increased by 87% compared with the average seasonal match injury rate (46.9 vs 25.0/1000 hours, RR=1.87; 95% CI 1.64 to 2.14). The odds of injury dropped 7% with each training session before the first match (OR 0.93; 95% CI 0.87 to 0.98). The same association was found for muscle injuries (OR 0.87; 95% CI 0.79 to 0.95) but not for non-muscle injuries (OR 0.99; 95% CI 0.91 to 1.07).

Conclusions Injury rates in the first match after injury are higher than the average seasonal match injury rate, but the propensity for player injury is decreased when players complete more training sessions before their first match.

  • cohort study
  • epidemiology
  • football
  • muscle injury
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Footnotes

  • Twitter @HockanB, @janekstrand, @MarkusWalden, @MHgglund, @frgsweden.

  • Contributors HB was responsible for the conception and design of the study. HB, AS and HH conducted the analyses which were planned and checked with MH, JE and MW. All authors contributed to the interpretation of the findings and had full access to all data. HB wrote the first draft of the paper, which was critically revised by JE, MW and MH. The final manuscript was approved by all authors. MH is the study guarantor.

  • Funding The Football Research Group was established in Linköping, Sweden, in cooperation with Linköping University, using grants from the Union of European Football Associations (UEFA), the Swedish Football Association and the Swedish Research Council for Sport Science.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Written informed consent was collected from all participating players. The study protocol was approved by the Union of European Football Associations (UEFA) Football Development Division and the UEFA Medical Committee.

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

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