In today’s football, players compete more and more matches over the season. Apart from the domestic competition, the best footballers play international matches with their national team and also during preseason trips.1 Recovery time between games has also been shortened in recent years. More and more matches are played, and rest is decreasing.2 The probability of injury is increasing, and this can be a great risk for clubs.3 Injuries can negatively affect performance and prevent teams from achieving their objectives. For that reason, one of the objectives of the clubs’ coaching staff is to ensure that the athletes can be at their coach’s disposal for as much of the season as possible. Teams invest a lot of money and time in proposing preventive actions trying to reduce the risks of injury in training and competition. Do footballers get injured more now than before? Has it been possible to reduce the incidence of injuries in elite football despite playing more games?

Recent research has analysed whether the frequency of injuries in top-level football teams has increased or not in recent years.4 The study, published in the British Journal of Sports Medicine in 2021, was based on the analysis of 3,302 players belonging to 49 elite teams from 19 different European countries that participated in the Champions’ League group stage during 18 seasons played between 2000-2001 and 2018-2019. A member of each club’s coaching staff recorded each player’s injuries and participation in training sessions and games. In total, 265 seasons of the teams were evaluated. During this period, 11,820 injuries occurred after 1,784,281 hours of player exposure, accounting for an injury incidence of 6.6 per 1,000 hours. The game injury rate (both in training and competition) was of 23.8/1,000 hours of exposure, while 3.4/1,000 hours in training. Muscle (n = 4,763) and ligamentous (n = 1,971) injuries accounted for 57% of all injuries.

The results suggest three very relevant conclusions: (1) the incidence of injuries in training and competition has decreased over the past 18 years; (2) the relapse injury rate has also decreased and (3) the players’ availability to participate in training and games has increased. More specifically:

• The incidence of injuries in training and competition has gradually fallen during the 18 seasons analysed at 3% per year.
• The frequency of ligamentous injuries has annually decreased by 5% during training and 4% during competition. 
• However, the muscle injury rate has remained constant. 
• The incidence of relapse due to injury has decreased by 5% per year in both training and competition. Throughout the 18 seasons analysed, the value is 10%.
• The player’s availability to train and compete increased by 0.7% and 0.2% per season, respectively.

The decrease in the incidence of injuries observed between 2001 and 2019 may suggest that the injury prevention strategies proposed by the clubs are effective. They should invest effort and money to further professionalize their sports-medical structure. In addition, other aspects such as communication between the coach and the medical team, the individualisation of training load and injury prevention programmes, the coach’s more or less democratic management style or the development of warning systems to control players’ risk of injury could improve intervention in clubs. 

Carlos Lago Peñas

References: 

1 Football FIFPRO.Players Worldwide. Football’s schedule is getting busier, cutting players recovery time 2019. https://www.fifpro.org/en/industry/at-the-limit. Accessed December 29, 2020.

2 Silva JR, Rumpf MC, Hertzog M, Castagna C, Farooq A, Girad, O, Hader K. acute and residual soccer match-related fatigue: a systematic review and meta-analysis. Sports Med. 2018; 48:539-583.

3 Bengtsson H, Ekstrand J, Waldén M, Hägglund M. Muscle injury rate in professional football is higher in matches played within 5 days since the previous match: a 14-year prospective study with more than 130 000 match observations. Br J Sports Med. 2018; 52:1116-1122.

4 Ekstrand J, Sporeco A, Bengtsson H, Bahr R. Injury rates decreased in men’s professional football: an 18-year prospective cohort study of almost 12000 injuries sustained during 1.8 million hours of play. Br J Sports Med 2021; en prensa,