The Epidemiology of Injury in English Women's Domestic Club Football: A Single Site Prospective Cohort Study

Background
The epidemiology of injury at club level in the English Women’s Domestic Club Football League is unknown. The aim of this study was to estimate the incidence, prevalence, and nature of injury in a single women’s football squad over the course of one season.

Study Design
Prospective single site cohort study

Methods
Twenty-five female footballers competing in the English Women’s Championship were observed. Data collection procedures followed the UEFA consensus guidelines (2006). Individual player exposure was recorded for all football related activity and incidence of injury per 1000h was estimated for total, match, and training activity. Prevalence, site, and type of injury was recorded. Epidemiologic incidence proportions, clinical incidence and severity was calculated to provide measures of injury burden and resource management statistics.

Results
A total of 18 injuries including re-injuries were sustained in 11 players providing a clinical incidence of 0.72 injuries per player. Epidemiological incidence proportion was 0.44 (95% CI: 0.24 – 0.74), thus the average probability that any player would sustain at least one injury was 44% (95% CI: 25% to 63%). The total incidence of injury was 8.0/1000h, 30.6/1000h during match play and 2.2/1000h during training. The most common sites of injury were the knee (5/18, 28%) and thigh (4/18, 22%). There was two (11%) non-time loss and 16 (89%) time-loss injuries recorded. Of the 16 time loss injuries, there were three (19%) severe, five (31%) moderate and six (37%) minor severity injuries. Of the five knee injuries, two (13%) were major severity ruptures of the anterior cruciate ligament. Injury burden was estimated to be 468 days lost/1000h.

Conclusions
This is the first prospective investigation capturing women’s injury incidence data from a cohort of English domestic club players. Total, match, and training incidence rate estimates are comparable to rates of single site cohort studies in Europe. The days lost from knee injuries imposes an increased burden on a squad of this size. Multi-site prospective investigations of injury are required.