Timing return-to-competition: a prospective registration of 45 different types of severe injuries in Germany’s highest football league

Abstract

Introduction Many professional football players sustain at least one severe injury over the course of their career. Because detailed epidemiological data on different severe injuries in professional football have been missing so far, this study describes the frequency and return-to-competition (RTC) periods of different types of severe football injuries. Material and methods This epidemiological investigation is a prospective standardised injury analysis based on national media longitudinal registration. Injuries were classified according to the consensus statement by Fuller et al. (2006). The analysis includes injuries sustained by players of the first German football league during the seasons 2014–2015 to 2017–2018. Level of evidence: II. Results Overall, 660 severe injuries were registered during the four seasons (mean 165 per season; 9.2 per season per team; incidence in 1000 h: 0.77). The body region most frequently affected by severe injury was the knee (30.0%; 49.5 injuries per season/SD 13.2) followed by the thigh (26.4%; 43.5 injuries/SD 4.2) and the ankle (16.7%; 27.5 injuries/SD 5.0). The distribution of injuries over the course of a season showed a trend for ACL ruptures to mainly occur at the beginning of a season (45.8%), overuse syndromes such as achillodynia (40.9%) and irritation of the knee (44.4%) during the winter months and severe muscle and ankle injuries at the end of a season. ACL ruptures showed the longest RTC durations (median 222 days). Conclusion This study presents detailed epidemiological data on severe injuries in professional football. The body region most frequently affected by severe injuries was the knee. Several types of severe injuries showed a seasonal injury pattern. The appropriate timing of RTC after an injury is one of the most important and complex decisions to be made. This study provides information on the typical time loss due to specific severe football injuries, which may serve as a guideline.

Predictive Modeling of Injury Risk Based on Body Composition and Selected Physical Fitness Tests for Elite Football Players

“…The quadriceps and hamstrings were the next most afflicted muscles, followed by the ankles. These results are consistent with the previous findings in the literature [ 10 , 12 , 13 , 14 , 16 ]. In reality, the lower limbs are under more pressure in this activity because of the tactical–technical maneuvers needed, which justifies their increased risk of damage.…”

“…From the clinical standpoint, the literature describes the lower limbs as the most affected body zone by sports injuries [ 4 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ], particularly for muscle injuries in the thigh area, the quadriceps, and the groin [ 4 , 10 , 15 , 16 ]. Since injuries in professional soccer are an increasingly problem, it is crucial that the work done in training sessions reflects the demands of competition, aiming at the development of athletes’ performance, which includes injury prevention [ 17 , 18 , 19 ].…”

Time‐loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta‐analysis

“…We determined an average time‐loss of 15.92 days (MD: 14.95; Min: 9.55; Max: 52.9) following lateral ankle ligament injury. Even though only one of the included studies 58 explicitly investigated severe injuries (ruptures), it should be critically noted that wound healing of the ligaments is still incomplete with time losses of about 15 days, 44 especially for higher grade ankle sprains with structural damage. Ligaments need adequate tissue loading in rehabilitation training sessions for remodeling and maturation to attain adequate stability 64 .…”

“…The overall sample size derived from 12 studies is 7736 participants. Two studies do not provide clear information on the sample size 57,58 . Of the 7736 participants, 7701 were male, 35 were female.…”

“…None of the included studies were of low quality. While 4 out of 12 (33%) were of moderate quality, 25,50,59,60 8 out of 12 (66%) were of high quality 24,49,51,57,58,61–63 …”