Contrary to the previous studies (2,3) which did not show any decrease in injury incidence in professional soccer over the last decade, the present study, the most complete ever published shows a decrease. Thus, the work ongoing for injury prevention is beneficial, but it may be improved, especially in expanding and better analyzing de databases.

Coaching style, internal communication, data for players’ external and internal loads are all key factors in injury prevention.

Decrease in ligament injuries, but not in muscle injuries

11.820 injuries were analyzed in total, showing an incidence higher in game (23.8 injuries for 1000 hours of play) than in training (3.4 injuries for 1000 hours of training). The great majority of injuries were to ligaments and muscles, representing more than half the total number of injuries. The incidence of injuries decreased by 3% each season between the 2000/2001 season and the 2018/2019 season. Among the injuries, ligament injuries decreased by 4 to 5% while muscle injuries did not decrease.

The severity of injury did not change…

Globally, the number of days of players’ absence did not change over the 18 years of the study, however, the severity of ligament injury increased in training (+4% per season) and in match (+1% per season) resulting in potentially longer absence for these injuries.

… but relatively to the risk it decreased

The number of matches and training sessions increased over the 18 years of the study, thus increasing the risk of injury. Comparing the players’ availability to the increase in matches and training, the authors of the study observed a decrease of 2% per season for injury severity, resulting in an increased availability of the players. However, this improvement did not concern the ligament and muscle injuries which resulted in players absence always the same duration. Globally, players’ availability only increased by 0.7% each season in training and 0.2% in matches.

The next steps in injury prevention

During those 18 years, the intensity of matches and training increased, especially the repeated sprints, which strongly increased the risk of injury. In spite, the prevention strategies succeeded in decreasing injury incidence. Among those multifactorial strategies, data about the external load of the players certainly played a key role, all clubs being equipped with a GPS tracking system and the corresponding softwares for analyzing each player, individually.

However, very few are the clubs evaluating the internal load the same way they do for the external load, individually, objectively, and automatically. The first clubs who will enter the era of physiological individual data, thereby improving internal communications, information sharing and knowledge of each player physiology will have a key advantage in injury prevention, performance improvement on the field and financially (4).

Scientific references

(1)          Ekstrand, J.; Spreco, A.; Bengtsson, H.; Bahr, R. 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. Br. J. Sports Med. 2021.

(2)          Ekstrand, J.; Hägglund, M.; Waldén, M. Injury Incidence and Injury Patterns in Professional Football: The UEFA Injury Study. Br. J. Sports Med. 2011, 45 (7), 553–558.

(3)          Waldén, M.; Hägglund, M.; Magnusson, H.; Ekstrand, J. ACL Injuries in Men’s Professional Football: A 15-Year Prospective Study on Time Trends and Return-to-Play Rates Reveals Only 65% of Players Still Play at the Top Level 3 Years after ACL Rupture. Br. J. Sports Med. 2016, 50 (12), 744–750.

(4)          Eliakim, E.; Morgulev, E.; Lidor, R.; Meckel, Y. Estimation of Injury Costs: Financial Damage of English Premier League Teams’ Underachievement Due to Injuries. BMJ Open Sport Exerc. Med. 2020, 6 (1), e000675.

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Nicolas Bourdillon
Chief Research Officer – PhD in Physiology