This edition of the FastFact highlights more interesting insights out of the UEFA Elite Club Study.1 This prospective cohort study has shown that the rate of injuries sustained by players participating in the study has reduced over the past 18 seasons. The study is an open source article that has been published in the BJSM.
This prospective cohort study involved a total of 3302 elite male players from 49 teams and 19 countries. Data was collected over 18 consecutive seasons from the 2000-01 to 2018-19 seasons. Participating players were members of teams that had qualified for the UEFA Champions League group stages. Exposures and injuries from both training sessions and matches were recorded by a designated member of each team. The study evaluated four injury measures. These were (1) injury incidence in training, (2) injury incidence in matches, (3) injury burden for training injuries, and (4) injury burden for match injuries. Three injury ‘types’ were included: all injuries, ligament injuries and muscles injuries.
A total of 265 ‘team seasons’ from 49 teams were included in the analyses. During these seasons, a total of 11 820 injuries were reported during 1 784 281 hours of exposure, representing a total injury incidence of 6.6/1000 hours (95% CI 6.5 to 6.7). The majority of the reported injuries occurred during match play (6785 match injuries and 5035 training injuries), representing a match injury incidence of 23.8/1000 hours. The injury incidence in training was 3.4/1000 hours. It is worth highlighting that the risk of injury during matches is around seven times higher than it is during training. Muscle injuries (n=4763) and ligament injuries (n=1971) comprised 57% of all injuries reported.
Over the 18-year period there were some significant trends that potentially suggest that football medicine strategies are having a positive effect. The most significant were that injury incidence decreased during the study period (both during training and matches) and that re-injury rates also decreased. As a result of these improvements, player availability for training and match play also increased. This reduction in injury risk is particularly impressive as this has occurred despite the intensity of football matches, and the resulting physical demands on players, having increased during the same period.
While the study’s authors note that the design of the study did not allow them to determine causative factors for these changes, they have presented some interesting observations. Possible reasons for the reduced injury risk include a more skilled medical workforce, better educated coaches (who are more aware of injury risk factors and injury prevention strategies) and access to improvement technology (like GPS data or video analysis). Whether this reduced injury risk has also occurred in youth football, women’s football, lower-level leagues and in leagues in other Confederations is not known.
1. Ekstrand J, Spreco A, Bengtsson H, et al Injury rates decreased in men’s professional football: an 18-year prospective cohort study of almost 12 000 injuries sustained during 1.8 million hours of play. British Journal of Sports Medicine Published Online First: 05 February 2021. doi: 10.1136/bjsports-2020-103159