Extrinsic factors

The majority of this module discusses how to mitigate various intrinsic risk factors for injury. It is also important to consider extrinsic risk factors. There are some good examples in football where external risk factors (including other players and the environment) have been addressed to some extent.

Click on the following tabs to read more about some of the extrinsic factors which impact on the risk of injury.

Playing surface
One of the factors which is frequently cited as a risk factor for injury is playing on an artificial, rather than grass, pitch. F-MARC’s studies have not shown any increased risk associated with playing on synthetic pitches. There is, however, some evidence which suggests that frequently swapping between artificial and grass pitches may be associated with an increased risk of injury.

The type of grass, especially the tightness of the thatch, has been implicated as a risk factor for ACL injury. Cooch and Kikuyu grasses typically have a thick weave which increases shoe-surface traction. This may increase the risk of injury. Rye grass has a less thick weave and may be a safer surface.

Rule changes
One of the most effective ways to prevent injury is through rule changes. There are good examples of this being effective across multiple sports. In football, perhaps the best example is the outlawing of the tackle from behind. This has been associated with a substantially reduced risk of injury. In a similar way, preventing players from leading with their arms and elbows during heading duels has reduced the incidence of head injuries.
Playing equipment
The use of shin guards, appropriate boots and goalkeeping gloves all likely reduce the risk of injury. Mouthguards also clearly reduce the risk of dental and facial injury. Headgear, despite its increasing popularity, has not been shown to reduce the risk of concussion.
Mouthguards have been shown to dramatically reduce the risk of sustaining an oral or facial injury. A properly fitted mouthguard can still allow the player to talk and breath without restriction and are very well tolerated. To learn more about mouthguards complete the dental module.

Dr Mark Fulcher

Sport and Exercise Physician