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Injury incidence rates in women’s football: a systematic review and meta-analysis of prospective injury surveillance studies
  1. Dan Horan1,2,
  2. Fionn Büttner1,
  3. Catherine Blake1,3,
  4. Martin Hägglund4,5,
  5. Seamus Kelly1,3,
  6. Eamonn Delahunt1,3
  1. 1School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
  2. 2High Performance Department, Football Association of Ireland, Dublin, Ireland
  3. 3Institute for Sport and Health, University College Dublin, Dublin, Ireland
  4. 4Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
  5. 5Football Research Group, Linköping University, Linköping, Sweden
  1. Correspondence to Dan Horan, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin 4, Ireland; danhoran10{at}


Objective To review the literature to establish overall, match and training injury incidence rates (IIRs) in senior (≥18 years of age) women’s football (amateur club, elite club and international).

Design Systematic review and meta-analysis of overall, match and training IIRs in senior women’s football, stratified by injury location, type and severity.

Data sources MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO and Web of Science were searched from earliest record to July 2021.

Eligibility criteria for selecting studies (1) football players participating in a senior women’s football league (amateur club or elite club) or a senior women’s international football tournament; (2) the study had to report IIRs or provide sufficient data from which this outcome metric could be calculated through standardised equations; (3) a full-text article published in a peer-reviewed journal before July 2021; (4) a prospective injury surveillance study and (5) case reports on single teams were ineligible.

Results 17 articles met the inclusion criteria; amateur club (n=2), elite club (n=10), international (n=5). Overall, match and training ‘time-loss’ IIRs are similar between senior women’s elite club football and international football. ‘Time-loss’ training IIRs in senior women’s elite club football and international football are approximately 6–7 times lower than their equivalent match IIRs. Overall ‘time-loss’ IIRs stratified by injury type in women’s elite club football were 2.70/1000 hours (95% CI 1.12 to 6.50) for muscle and tendon, 2.62/1000 hours (95% CI 1.26 to 5.46) for joint and ligaments, and 0.76/1000 hours (95% CI 0.55 to 1.03) for contusions. Due to the differences in injury definitions, it was not possible to aggregate IIRs for amateur club football.

Conclusion Lower limb injuries incurred during matches are a substantial problem in senior women’s football. The prevention of lower limb joint, ligament, muscle and tendon injuries should be a central focus of injury prevention interventions in senior women’s amateur club, elite club and international football.

PROSPERO registration number CRD42020162895.

  • football
  • sporting injuries
  • sports
  • sports medicine
  • women

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  • Twitter @DanHoran10, @peanutbuttner, @Blake_Cath, @MHgglund, @EamonnDelahunt

  • Contributors DH and ED are the guarantors of the review. ED developed the eligibility criteria. DH, FB and ED developed the search strategy. DH and ED performed abstract, title and full-text screening. Any discrepancies in study selection were arbitrated by MH. DH and ED performed data extraction, with any discrepancies arbitrated by MH. Statistical expertise was provided by FB and CB. Contextual expertise on football was provided by DH, SK, and MH. All authors approved the final protocol.

  • Funding DH is the recipient of an Irish Research Council Enterprise Partnership Scheme (Postgraduate) award. This scheme provides funding for PhD students to undertake research with a specified enterprise partner; in this instance the enterprise partner is the Football Association of Ireland. ED is designated as the principal investigator associated with this award. The Irish Research Council was not involved in any aspect of this study, such as the design of the study’s protocol and analysis plan. The Irish Research Council had no input on the interpretation or publication of the study results. The Football Association of Ireland was not involved in any aspect of this review, such as the design of the review’s protocol and analysis plan. The Football Association of Ireland had no input on the interpretation or publication of the study results.

  • 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.