Summary
Current knowledge about the aetiology of soccer injuries is limited. The presumed complex interaction of various risk factors requires in-depth statistical analysis of techniques to identify dependent and independent variables, and to describe the extent, direction and strength of the relationship between the independent predictor variables and soccer injuries. However, in the majority of the studies, the application of statistical analysis was restricted to descriptive and univariate analysing techniques. Moreover, the results of studies on the aetiology of soccer injuries are biased by selection according to age, gender and level of competition.
Identified intrinsic risk factors are joint flexibility including pathological ligamentous laxity and muscle tightness, functional instability, previous injuries and inadequate rehabilitation.
Extrinsic risk factors include the exercise load in soccer (competition and practice), inadequate equipment (shinguards, taping, shoes), playing field conditions and foul play. Also, the number of well controlled experimental studies on the prevention of soccer injuries is very limited. In different selected homogenous subgroups of the soccer population in Sweden and Denmark, different types of prevention proved to be successful in reducing the incidence and severity of soccer injuries. Selection bias should be considered in the interpretation of these results.
Generally, the epidemiological information of the sport medical aspects of soccer injuries appears to be inconsistent and far from complete. The aetiology of soccer injuries may differ between different subgroups of the soccer population. As a consequence, different subgroups of soccer players may need different prophylactic programmes to achieve a major reduction in incidence and severity of soccer injuries.
More research is needed to identify high risk groups and independent predictor variables of injury within those subgroups. The outcome of these studies must lead to the development of effective prophylactic programmes. Preferably, such studies should include uniform definitions of injury and should be based on sound epidemiological methodological principles.
References
Inklaar H. Soccer injuries: incidence and severity. Sports Med 1994; 18: 55–73
Segesser B. Etiologie und Prophylaxe von Sportschäden. Schweiz Zeitschr Sportmed 1977; 25: 99–104
Lysens RJJ, Steverlynck A, van den Auweele Y, et al. The predictability of sports injuries. Sports Med 1984; 1: 6–10
Nigg BM. Biomechanics, load analysis, and sports injuries in the lower extremities. Sports Med 1985; 2: 367–9
Walter SD, Sutton JR, McIntosh JM, et al. The aetiology of sports injuries. A review of methodologies. Sports Med 1985; 2: 47–58
Lorentzen R. Causes of injuries, intrinsic factors. In: Dirix A, Knuttgen G, Tittel K., editors. The Olympic book of sports medicine. Vol 1. Oxford: Blackwell Scientific Publications, 1988: 376–90
Nigg BM. Causes of injuries, extrinsic factors. In: Dirix A, Knuttgen G, Tittel K, editors. The Olympic book of sports medicine. Vol 1. Oxford: Blackwell Scientific Publications, 1988: 363–75
Ekstrand J, Nigg B. Surface related injuries in soccer. Sports Med 1989; 8: 56–62
Backx FJG, Erich WBM, Kemper ABA, et al. Sports injuries in school aged children. An epidemiologic study. Am J Sports Med 1989; 17: 234–9
Taimela S, Kujala UM, Õsterman K. Intrinsic risk factors and athletic injuries. Sports Med 1990; 9: 205–15
Kok G, Bouter LM. On the importance of planned health education: prevention of ski injury as an example. Am J Sports Med 1990; 18: 600–5
Meeuwisse WM. Predictability of sports injuries. What is the epidemiological evidence? Sports Med 1991; 12: 8–15
Bol E, Schmikli SL, Backx FJG, et al. Sportblessures onder de knie. Programmering van toekomstig onderzoek. Oosterbeek: Nationaal Instituut voor de Sportgezondheidszorg, 1991
Lysens RJJ, de Weert W, Nieuwboer A. Factors associated with injury proneness. Sports Med 1991; 12: 281–9
van Mechelen W, Hlobil H, Kemper HCG. Incidence, severity, aetiology and prevention of sports injuries. Sports Med 1992; 14: 82–99
Fletcher RH, Fletcher SW, Wagner EH. Clinical epidemiology, the essentials. London: Williams and Wilkins, 1992
Kleinbaum DG, Kupper LL, Muller KE. Applied regression analysis and other multivariable methods. Boston: PWS Kent Publishing Co, 1988
Jackson DW, Jarrett H, Biley D, et al. Injury prediction in the young athlete, a preliminary report. Am J Sports Med 1978; 6: 6–14
Schlatmann H, Hlobil H, van Mechelen W, et al. Naar een registratiesysteem van sportblessures in Nederland. Geneesk Sport 1987; 20 (5): 179–84
Backx FJG, Inklaar H, Koornneef M, et al. Draft FIMS position statement on the prevention of sports injuries. Geneesk Sport (special issue FIMS) 1990; 23: 22–7
Ekstrand J, Gillquist J. The frequency of muscle tightness and injuries in soccer players. Am J Sports Med 1982; 10: 75–8
Mangine RE, Noyes FR, Mullen MP, et al. A physiological profile of the elite soccer athlete. J Orthop Sports Phys Ther 1990; 12 (4): 147–52
Ekstrand J, Gillquist J. The avoidability of soccer injuries. Int J Sports Med 1983; 4: 124–8
Lysens RJJ. Epidemiological study of soccer injuries in the 18 teams of the first national division of the Royal Belgium Soccer Association (RBSA) during the season 1980–1981. In: van der Togt CR, Kemper ABA, Koornneef M, editors. Proceedings 2nd Meeting Council of Europe: sports injuries and their prevention. Oosterbeek: National Institute for Sports Health Care, 1987: 16–7
Schmidt-Olsen S, Jörgensen U, Kaalund S, et al. Injuries among young soccer players. Am J Sports Med 1991; 19: 273–5
Brynhildsen J, Ekstrand J, Jeppson A, et al. Previous injuries and persisting symptoms in female soccer players. Int J Sports Med 1990; 11: 489–92
Tropp M, Askling C, Gillquist J. Prevention of ankle sprains. Am J Sports Med 1985; 13: 259–62
Nielsen AB, Yde J. Epidemiology and traumatology of injuries in soccer. Am J Sports Med 1989; 17: 803–7
Ekstrand J, Gillquist J. Soccer injuries and their mechanisms: a prospective study. Med Sci Sports Exerc 1983; 15 (3): 267–70
Ekstrand J, Tropp H. Incidence of ankle sprains in soccer. Foot Ankle 1990; 11 (1): 41–3
Barrack RL, Skinner HB, Buckley SL. Proprioception in the anterior cruciate deficient knee. Am J Sports Med 1989; 17: 1–6
Lysens RJJ, Lefevre J, Ostyn MS, et al. Study of evaluation of joint flexibility as a risk factor in sports injuries. The Cilag Award of the Belgian Society of Sports Medicine and Sports Science. Leuven: University Press, 1984
Poulmedis P. Muscular imbalance and strains in soccer. In: van der Togt CR, Kemper ABA, editors. Proceedings 3rd Meeting Council of Europe: sports injuries and their prevention. Oosterbeek: National Institute for Sports Health Care, 1988: 53–7
Engström B, Forssblad M, Johansson C, et al. Does a major knee injury definitely sideline an elite soccer player?. Am J Sports Med 1990; 18: 101–5
Ekstrand J, Gillquist J, Liljedahl SO. Prevention of soccer injuries. Supervision by doctor and physiotherapist. Am J Sports Med 1983; 11: 116–20
Backous DD, Friedl KE, Smith NJ, et al. Soccer injuries and their relation to physical maturity. Am J Dis Child 1988; 142: 839–42
Möller-Nielsen J, Hammar M. Women’s soccer injuries in relation to the mentrual cycle and oral contraceptive use. Med Sci Sports Exerc 1989; 21 (2): 126–9
Eriksson LI, Jorfeldt L, Ekstrand J. Overuse and distorsion soccer injuries related to the players estimated maximal aerobic work capacity. Int J Sports Med 1986; 7: 214–6
Taimela S, Õsterman L, Kujala UM, et al. Motor ability and personality with reference to soccer injuries. J Sports Med Physical Fitness 1990; 30 (2): 194–201
Wisman JGJ. Voetbalvaardigheden en blessurerisico. Janus Jongbloed Research Centre, University of Utrecht, 1991
Taerk GS. The injury prone athlete: a psychosocial approach. J Sports Med Phys Fitness 1977; 17: 187–92
Crossman J Psychosocial factors and athletic injury. J Sports Med Phys Fitness 1985; 25: 151–3
van Vulpen AV. Sports for all, sports injuries and their prevention, scientific report. Oosterbeek: Council of Europe, National Institute for Sports Health Care, 1989
Kelly MJ. Psychological risk factors and sports injuries. J Sports Med Phys Fitness 1990; 30 (2): 202–21
Jörgensen U. Epidemiology of injuries in typical Scandinavian team sports. Br J Sports Med 1984; 18 (2): 59–63
Minarovjech V. Knowledge of anti-injury in the league football soccer in Czechoslovakia. In: Vecchiet L, editor. Proceedings 1st International Congress on Sports Medicine Applied to Football. Vol II. Rome: D Guanella, 1980: 871–8
de Geus GH. Voetbalblessures, een exploratief onderzoek naar de achtergronden van blessures bij voetbalspelers. Amsterdam: Consumer Safety Institute, 1988
Høy K, Lindblad BE, Juhl Terkelsen CJ, et al. European soccer injuries. Am J Sports Med 1992; 20: 318–22
Ekstrand J, Gillquist J, Möller M, et al. Incidence of soccer injuries and their relation to training and team success. Am J Sports Med 1983; 11: 63–7
Engström B, Johansson C, Törnkvist H. Soccer injuries among elite female players. Am J Sports Med 1991; 19: 273–5
Nilsson S, Roaas A. Soccer injuries in adolescents. Am J Sports Med 1978; 6: 358–61
Sullivan JA, Gross RH, Grana WA, et al. Evaluation of injuries in youth soccer. Am J Sports Med 1980; 8: 325–7
Schmidt-Olsen S, Bünemann LKH, Lade V, et al. Soccer injuries of youth. Int J Sports Med 1985; 19 (3): 161–4
Maehlum S, Dahl E, Daljord OA. Frequency of injuries in a youth soccer tournament. Physician Sportsmed 1986; 14 (7): 73–9
Hoff GL, Martin ThA. Outdoor and indoor soccer: injuries among youth players. Am J Sports Med 1986; 14: 231–3
Cahill BR, Griffith EH. Exposure to injury in major college football. A preliminary report of data collection to determine injury exposure rates and activity risk factors. Am J Sports Med 1979; 7: 183–5
von Laack W. Untersuchungen über die Druckverteilung durch Schienbeinschoner im Fussballsport. Dtsch Zeitschr Sport-med 1985; 7: 203–8
Philippens M. Skin guards impact performance. Delft: TNO Road Vehicles Research Institute, 1988
Philippens M. Framework for a standard for skin guards. Delft: TNO Road Vehicles Research Institute, 1991
Garrick JG, Requa RK. Role of external support in prevention of ankle sprains. Med Sci Sports Exerc 1973; 5 (3): 200–3
Rovere GD, Clarke ThJ, Yates CS, et al. Retrospective comparison of taping and ankle stabilizers in preventing ankle injuries. Am J Sports Med 1988; 16: 228–33
Glick JM, Gordon RB, Nishimoto D. The prevention and treatment of ankle injuries. Am J Sports Med 1976; 4: 136–41
Delacerda FG. Effect of underwrap conditions on the supportive effectiveness of ankle strapping with tape. J Sports Med Phys Fitness 1978; 18: 77–81
Myburgh K, Vaughan CL, Isaacs SK. The effect of ankle guards and taping on joint motion before, during and after a squash match. Am J Sports Med 1984; 12 (6): 441–6
Bunch RP, Bednarski K, Holland D, et al. Ankle joint support: a comparison of reusable lace-on brace with taping and wrapping. Physician Sportsmed 1985; 13 (5): 59–62
Pope MH, Renstrom P, Donnermeyer D, et al. A comparison of ankle taping methods. Med Sci Sports Exerc 1987; 19 (2): 143–7
Greene TA, Wight CR. A comparative support evaluation of three ankle orthoses before, during and after exercise. J Orthop Sports Phys Ther 1990; 11 (10): 453–66
Monto RR. Time to redesign the trusty football boot? New Scientist 1993; April: 15
Berbig R, Biener K. Sportunfälle bei Fussballtorhuettern. Schweiz Zeitschr Sports Med 1983; 31: 73–9
Berger-Vachon C, Gabard G, Moyen B. Soccer accidents in the French Rhône-Alpes Soccer Association. Sports Med 1986; 3: 69–77
Nigg BM, Segesser B. The influence of playing surface on the load on the locomotor system and on football and tennis injuries. Sports Med 1988; 5: 375–85
Torg JS, Quedenfeld T. Effect of shoe type and cleat length on incidence and severity of knee injuries among high school football players. Res Q 1971; 42 (2): 203–11
Blyth CS, Mueller FD. Football injury survey. Physician Sportsmed 1974; 9: 45–52
Nigg BM, Yeadon MR. Biomechanical aspects of playing surfaces. J Sports Sci 1987; 5: 117–45
McMaster W. Injuries in soccer. Am J Sports Med 1978; 6 (6): 354–7
Napravnik C. Prevention of accidents in football. In: Vecchiet K, editor. Proceedings 1st International Congress on Sports Medicine Applied to Football. Vol II. Rome: D Guanella, 1980: 879–82
Renstrom P, Petterson L, Edberg B. Valhalla artificial pitch at Gothenburg 1975–1977. A two year evaluation. Gothenburg: Rapport Naturvardsverket, 1977
Stanway A. Cited in Caldwell R. Soccer players prefer astro turf to grass field. Physician Sportsmed 1981; 9: 22–4
Albert M. Descriptive three year data study of outdoor and indoor professional soccer injuries. Athletic Training 1983; 18: 218–20
Burke MJ, Sanitato JJ, Vinger PF, et al. Soccerball induced eye injuries. JAMA 1983; 249 (19): 2682–5
Kristiansen B. Association football injuries in schoolboys. Scand J Sports Sci 1983; 5 (1): 1–2
Ekstrand J. Soccer injuries and their prevention. Linköping University, medical dissertation no. 130, Linköping, 1982
Jörgensen U, Sörensen J. Free substitution in soccer: a prospective study. In: Togt van der CR, Kemper ABA, Koornneef M, editors. Proceedings 3rd Meeting Council of Europe. Sports injuries and their prevention. Oosterbeek: National Institute for Sports Health Care, 1988: 155–8
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Inklaar, H. Soccer Injuries. Sports Med. 18, 81–93 (1994). https://doi.org/10.2165/00007256-199418020-00002
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DOI: https://doi.org/10.2165/00007256-199418020-00002