Injury Trends in Men’s English Professional Football: An 11-year Case Series

Background
There is a paucity of longitudinal epidemiological injury data in football players competing in the English Football League (EFL). The aim of this study was to report the incidence, site and nature of injury in professional male football players over 11 seasons.

Study Design
Retrospective case series.

Methods
Three-hundred and sixty-three professional football players from four squads competing in the EFL. Data collection procedures followed the guidelines set out in the Union of European Football Associations (UEFA) consensus for all 11 seasons. Injury incidence per 1000 hours was estimated from match and training exposure.

Results
Overall injury incidence was 6.5/1000 hours (95% CI 5.6-7.5). Incidence of injury in match play was significantly higher than training (58/1000 hours, 95% CI 38.4-83.8 v 2.8/1000 hours, 95% CI 1.8-5.2, P<0.001). Re-injuries constituted 6.1% (55/907) of all injuries and caused longer absences than initial injury (15 vs 9). A total of 907 injuries were recorded. No significant differences were found between overall (P=0.935), training (P=0.752) and match (P=0.882) incidence and muscle (P=0.728) and ligament (P=0.991) injuries between seasons. There was a significant increase in the number of hamstring injuries occurring during match play across seasons (R2=0.450, b=0.575, 95% CI 0.1 to 1.1, P=0.024). Moderate severity injuries accounted for 32.6% of all injuries (21-45.5%, 296/907), with a mean (SD) time loss of 18 (33) days per injury.

Conclusions
Whilst overall incidence rates remain stable; the incidence of hamstring injuries remains high and re-injuries had a higher severity than initial injuries. Moderate injuries were the most frequent and on average you can expect injury burden of 18 days per injury per season.