Mitigating the Risks of Lower Extremity Injuries in Soccer: A Comprehensive Analysis of Lower Extremity Injury Rates in Soccer Between 2014 and 2023

Abstract

Objective: With events such as the Copa America 2024, the 2026 World Cup, and the arrival of European stars in Major League Soccer (MLS), the already observed and forecasted rise of soccer in the United States (US) seems to be an inevitable outcome. Although regular participation in soccer features several benefits, including increasing cardiovascular health, decreasing stress, and promoting interpersonal relationships, the risk of injury, as is the case in any sport, is ever present. Although many sports that are popular in America feature high rates of concussion, rotator cuff injuries, and general upper extremity injuries, soccer, being more strenuous on the lower-half of the body, features a disproportionate rate of lower extremity injuries. An analysis of the frequencies of these injuries, relative to factors such as year of injury, age, gender, location of injury, and diagnosis of injury, may help organizational bodies and soccer leagues implement new regulations regarding the usage of protective equipment and rules regarding gameplay. This study aims to illuminate these takeaways in an effort to better patient care outcomes in soccer-related injuries.

Method: This paper utilized the National Electronic Injury Surveillance System Database (NEISS) to compile data on lower extremity soccer-related injuries within the defined study period, 2014-2023. Inclusion criteria for the study involved all patients presenting to the emergency department (ED) within the study period and within the defined age range of 0 to 69 years old, with injuries sustained from or related to soccer. Using NEISS, trends were elucidated discriminating based on year of injury, sex, age group, location of injury, and diagnosis group of injury.

Results: Within the defined study period of 10 years, from 2014-2023, there were approximately 843,063 total soccer-related lower extremity injuries which presented to various EDs across the US. Regarding majorities, the most injuries were sustained in 2014 (12.84% of total injuries), most patients sustaining injuries were male (66.6% of all patients), and within the age range of 10-19 years old (63.24% of all patients), with the most instances occurring at age 15. Lower extremity injuries were most reported to be affecting the ankle with 306,797 incidences (36.39% of total injuries seen) and the most frequent diagnosis group was reported to be strains/sprains with 396,420 (47.02% of total injuries seen) total occurrences.

Conclusion: This study analyzes the incidents of lower extremity injuries while participating in soccer for the last 10 years, 2014-2023. The study provides new data regarding the frequency of injuries and their relative rate with respect to year of injury, age group, sex, location of injury, and diagnosis. The results of this study show injury majorities and trends which can be used to dictate changes in regulation regarding gameplay and the utilization of protective equipment in order to mitigate injuries related to the lower extremities in soccer.

Keywords: National Electronic Injury Surveillance System Database (NEISS); soccer; soccer injuries.

Figure 1.. Pie chart comparing the proportions of soccer-related lower extremity injuries sustained by males and females.

Figure 2.. Bar graph, with error bars and trendlines, showing incidence of injury by age group pertaining to soccer-related lower extremity injuries

Figure 3.. Pie chart showing relative frequencies of injury by age group subcategories pertaining to soccer-related lower extremity injuries

Figure 4.. Bar chart, with error bars, showing incidence of injuries by location on body pertaining to soccer-related lower extremity injuries

Figure 5.. Pie chart showing relative frequencies of injury location subcategories pertaining to soccer-related lower extremity injuries

Figure 6.. Pie chart showing relative frequencies of diagnosis subcategories pertaining to soccer-related lower extremity injuries

Figure 7.. Bar graph, with error bars, showing incidence of each subcategory of diagnosis pertaining to soccer-related lower extremity injuries

Figure 8.. Line graph showing trend regarding injury incidences and year of lower extremity soccer-related injuries

Figure 9.. Bar graph, error bars, showing injury incidences pertaining to soccer-related lower extremity injuries per year within the defined study period