Injury recurrence is lower at the highest professional football level than at national and amateur levels: does sports medicine and sports physiotherapy deliver?

Abstract

Background: Previous injury is a well-documented risk factor for football injury. The time trends and patterns of recurrent injuries at different playing levels are not clear.

Aim: To compare recurrent injury proportions, incidences and patterns between different football playing levels, and to study time trends in recurrent injury incidence.

Methods: Time-loss injuries were collected from injury surveillance of 43 top-level European professional teams (240 team-seasons), 19 Swedish premier division teams (82 team-seasons) and 10 Swedish amateur teams (10 team-seasons). Recurrent injury was defined as an injury of the same type and at the same site as an index injury within the preceding year, with injury <2 months defined as an early recurrence, and >2 months as a delayed recurrence. Seasonal trend for recurrent injury incidence, expressed as the average annual percentage of change, was analysed using linear regression.

Results: 13 050 injuries were included, 2449 (18.8%) being recurrent injuries, with 1944 early (14.9%) and 505 delayed recurrences (3.9%). Recurrence proportions were highest in the second half of the competitive season for all cohorts. Recurrence proportions differed between playing levels, with 35.1% in the amateur cohort, 25.0% in the Swedish elite cohort and 16.6% in the European cohort (χ(2) overall effect, p<0.001). A decreasing trend was observed in recurrent injury incidence in the European cohort, a -2.9% average annual change over the 14-year study period (95% CI -5.4% to -0.4%, p=0.026). Similarly, a decreasing tendency was also seen in the Swedish premier division.

Conclusions: Recurrence proportions showed an inverse relationship with playing level, and recurrent injury incidence has decreased over the past decade.

Keywords: Cohort study; Football; Injury; Recurrent; Soccer.

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