Injury rates decreased in men's professional football: an 18-year prospective cohort study of almost 12 000 injuries sustained during 1.8 million hours of play

Abstract

Background: The UEFA Elite Club Injury Study is the largest and longest running injury surveillance programme in football.

Objective: To analyse the 18-season time trends in injury rates among male professional football players.

Methods: 3302 players comprising 49 teams (19 countries) were followed from 2000-2001 through 2018-2019. Team medical staff recorded individual player exposure and time-loss injuries.

Results: A total of 11 820 time-loss injuries were recorded during 1 784 281 hours of exposure. Injury incidence fell gradually during the 18-year study period, 3% per season for both training injuries (95% CI 1% to 4% decrease, p=0.002) and match injuries (95% CI 2% to 3% decrease, p<0.001). Ligament injury incidence decreased 5% per season during training (95% CI 3% to 7% decrease, p<0.001) and 4% per season during match play (95% CI 3% to 6% decrease, p<0.001), while the rate of muscle injuries remained constant. The incidence of reinjuries decreased by 5% per season during both training (95% CI 2% to 8% decrease, p=0.001) and matches (95% CI 3% to 7% decrease, p<0.001). Squad availability increased by 0.7% per season for training sessions (95% CI 0.5% to 0.8% increase, p<0.001) and 0.2% per season for matches (95% CI 0.1% to 0.3% increase, p=0.001).

Conclusions: Over 18 years: (1) injury incidence decreased in training and matches, (2) reinjury rates decreased, and (3) player availability for training and match play increased.

Keywords: elite performance; epidemiology; hamstring; injury prevention; soccer.

Figure 1

Training injuries. Time course of injury incidence, injury severity, injury burden and reinjury rate for all injuries, muscle injuries and ligament injuries over the study period. Injury incidence is defined as the number of injuries per 1000 hours of training exposure with 95% CI. Injury severity is defined as the average number of absence days following training injuries with 95% CI. Injury burden is defined as the number of absence days caused per 1000 hours of training exposure with 95% CI. Reinjury rate is defined as the number of reinjuries per 1000 hours of training exposure with 95% CI.

Figure 2

Match injuries. Development of injury incidence, injury severity, injury burden and reinjury rate for all injuries, muscle injuries and ligament injuries in matches over the study period. Injury incidence is defined as the number of injuries per 1000 hours of match exposure with 95% CI. Injury severity is defined as the average number of absence days following match injuries with 95% CI. Injury burden is defined as the number of absence days caused per 1000 hours of match exposure with 95% CI. Reinjury rate is defined as the number of reinjuries per 1000 hours of training exposure with 95% CI.

Figure 3

Development of player availability and injury absence in training and in matches over the study period. Player availability is defined as the average proportion of training sessions and matches when players were available to participate with 95% CI. Injury absence is defined as the average proportion of training sessions and matches when players were unavailable to participate due to injury with 95% CI.