Increased Lower Extremity Injury Risk Associated With Player Load and Distance in Collegiate Women’s Soccer

Abstract

Background: There is limited research regarding the impact of workload on injury risk specific to women’s soccer. Wearable global positioning system (GPS) units can track workload metrics such as total distance traveled and player load during games and training sessions. These metrics can be useful in predicting injury risk. Purpose: To examine the relationship between injury risk and player workload as collected from wearable GPS units in National Collegiate Athletic Association (NCAA) Division I women’s soccer players. Study Design: Case-control study; Level of evidence, 3. Methods: Lower extremity injury incidence and GPS workload data (player load, total distance, and high-speed distance) for 65 NCAA Division I women’s soccer players were collected over 3 seasons. Accumulated 1-, 2-, 3-, and 4-week loads and acute-to-chronic workload ratios (ACWR) were classified into discrete ranges by z-scores. ACWR was calculated using rolling averages and exponentially weighted moving averages (EWMA) models. Binary logistic regression models were used to compare the 7:28 rolling average and EWMA ACWRs between injured and noninjured players for all GPS/accelerometer variables. The prior 1-, 2-, 3-, and 4-week accumulated loads for all GPS/accelerometer variables were compared between the injured and uninjured cohorts using 2-sample t tests. Results: There were a total of 53 lower extremity injuries that resulted in lost time recorded (5.76/1000 hours “on-legs” exposure time; 34 noncontact and 19 contact injuries). The prior 2-week (7242 vs 6613 m/s2; P = .02), 3-week (10,533 vs 9718 m/s2; P = .02), and 4-week (13,819 vs 12,892 m/s2; P = .04) accumulated player loads and 2-week (62.40 vs 57.25 km; P = .04), 3-week (90.97 vs 84.10 km; P = .03), and 4-week (119.31 vs 111.38 km; P = .05) accumulated total distances were significantly higher for injured players compared with noninjured players during the same time frames. There were no significant differences in player load, total distance, or high-speed distance ACWR between injured and noninjured players for both the rolling averages and EWMA calculations. Conclusion: Higher accumulated player load and total distance, but not ACWR, were associated with injury in women’s soccer players.

In-Season Internal Load and Wellness Variations in Professional Women Soccer Players: Comparisons between Playing Positions and Status

“…It is important to note that, despite ACWR derived from s-RPE not being a good predictor of injury [ 42 ], our outcomes observed across the in-season period did not reach the suggested “danger zone” (ACWR ≥ 1.5) [ 43 ]. This result is in line with another study performed with 65 players from Division I in the United States, which reported this ratio was not associated with injury [ 44 ], although some studies reported associations between ACWR and non-contact injury occurrences [ 42 , 45 , 46 , 47 , 48 ]. In fact, ACWR score has also been related to perceived effort in women athletes [ 49 ].…”

Injury Incidence Increases after COVID-19 Infection: A Case Study with a Male Professional Football Team

“…European reports did not acknowledge the potential complicating factor of the effects of increases in the acute-to-chronic workload ratio (ACWR). Periods of inactivity followed by higher demand activity increases the ACWR and the subsequent risk of injury, founded in several sports [ 25 ], including football [ 26 , 27 ], according to data presented in this pilot study with professional football players.…”

Increased Risk of ACL Injury for Female but Not Male Soccer Players on Artificial Turf Versus Natural Grass: A Systematic Review and Meta-Analysis

“… 36 , 47 It has been shown that 18.3% of current collegiate and professional women’s soccer players have a history of at least 1 ACL injury. 50 Risk factors associated with ACL injury in female athletes include neuromuscular imbalances, 21 hormonal fluctuations, 11 , 20 narrower intercondylar notch width, 39 , 40 , 42 joint laxity, 32 , 43 workload, 51 and landing mechanics. 24 , 33 Our investigation demonstrated that playing soccer games on AT may be an additional risk factor for ACL injury specifically for female athletes.…”