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Lower Injury Rates for Newcomers to Professional Soccer: a Prospective Cohort Study over Nine Consecutive Seasons
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0002-6883-1471
2013 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 41, no 6, 1419-1425 p.Article in journal (Refereed) Published
Abstract [en]

Background: No study has investigated whether newcomers to professional soccer have a different injury rate than established players.                     

Purpose: The primary objective was to investigate whether being a newcomer to professional soccer influences injury rates. The secondary objective was to evaluate whether playing position and player age influence injury rates.                     

Study Design: Cohort study; Level of evidence, 2.                     

Methods: Twenty-six soccer clubs, with 1401 players, were followed prospectively over 9 consecutive seasons between 2001 and 2010. Club medical staff recorded time-loss injuries and soccer exposure on an individual level. Cox regression analyses were used to evaluate associations between time-loss injuries and time in professional soccer, playing position, and age.                     

Results: In total, 6140 injuries and 797,389 hours of exposure were registered. A decreased general injury rate was observed for newcomers (n = 116) compared with established players (n = 3091) (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.99). In contrast, newcomers had a higher rate of fractures (rate ratio [RR], 1.77; 95% CI, 1.05-2.97), especially stress-related bone injuries (RR, 2.68; 95% CI, 1.08-6.69). Using goalkeepers as a reference, all outfield playing positions had significantly higher adjusted injury rates: defenders with an HR of 1.91 (95% CI, 1.64-2.24), midfielders with an HR of 1.78 (95% CI, 1.53-2.07), and forwards with an HR of 1.82 (95% CI, 1.55-2.14). Using players aged ≤21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30 years (HR, 1.44; 95% CI, 1.24-1.68).                     

Conclusion: Newcomers to professional soccer had a lower general injury rate than established players but a higher rate of stress-related bone injuries. Being a goalkeeper was associated with lower injury rates than all outfield playing positions. Injury rates increased with age, a pattern that persisted after adjusting for playing position and match exposure.

Place, publisher, year, edition, pages
2013. Vol. 41, no 6, 1419-1425 p.
Keyword [en]
age; soccer; playing position; risk factor
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-103813DOI: 10.1177/0363546513485358ISI: 000330523500026OAI: oai:DiVA.org:liu-103813DiVA: diva2:691664
Available from: 2014-01-28 Created: 2014-01-28 Last updated: 2017-12-06
In thesis
1. Risk factors for injury in men´s professional football
Open this publication in new window or tab >>Risk factors for injury in men´s professional football
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis includes four papers based on three different prospective cohort studies on injury characteristics in men’s professional football. The same general methodology was used in all papers. Time-loss injuries and player individual exposure was registered for match and training separately. The general aim was to investigate potential internal and external risk factors for injury, with a focus on age, playing position, time in professional football, playing surface (artificial turf and natural grass), changes between surfaces and climate; and to evaluate the study methodology.

Paper I was based on data collected between 2001 and 2010 from 26 top professional clubs in Europe; the UCL injury study. In total, 6140 injuries and 797 389 hours of exposure were registered. A decreased general injury rate was observed for newcomers compared with established players (hazard ratio (HR), 0.77; 95% CI 0.61-0.99). Using goalkeepers as a reference, all outfield playing positions had significantly higher age-adjusted injury rates. Using players aged ≤ 21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30  years (HR, 1.44; 95% CI, 1.24-1.68).

Paper II and Paper III are based on data collected during two consecutive seasons, 2010 and 2011, in the Swedish and Norwegian male first leagues. In total, 2186 injuries and 367 490 hours of football exposure were recorded. No statistically significant differences were found in acute injury rates on artificial turf (AT) compared with natural grass (NG) during match play (rate ratio, 0.98, 99% CI 0.79-1.22) or training (rate ratio 1.14, 99% CI 0.86-1.50) when analysing at the individual player level. However, when analysing at the club level, clubs with AT installed at their home arena had a significantly higher acute training injury rate (rate ratio 1.31, 99% CI 1.04-1.63) and overuse injury rate (rate ratio 1.38, 99% CI 1.14-1.65) compared to clubs with NG installed at their home venue. No association was found between frequent surface shifts and subsequent overuse injury risk (risk ratio 1.01, 95% CI 0.91-1.12). Analyses on the total cohort showed no difference in injury rates between clubs in the two climate zones (total rate ratio 1.01, 95% CI 0.92-1.10).

Data included in Paper IV were collected during two consecutive seasons 2008 and 2009. During this period, two Norwegian elite football clubs were concurrently included in two research groups’ surveillance systems. The capture rate for match injuries was similar between the two audits, while the capture rate for training injuries was slightly higher with individual-based exposure recording. The inter-rater agreement in injury variable categorisations was in most aspects very high.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 94 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1445
Keyword
Age, artificial turf, cohort study, elite, epidemiology, overuse injury, soccer, surface, sporting injuries, playing position
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Sciences
Identifiers
urn:nbn:se:liu:diva-117170 (URN)10.3384/diss.diva-117170 (DOI)978-91-7519-126-3 (ISBN)
Public defence
2015-05-29, Berzeliussalen, Campus US, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2015-04-21Bibliographically approved

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Kristenson, KarolinaWaldén, MarkusEkstrand, JanHägglund, Martin

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