is currently the most popular sport in the world. The competitive
nature of the sport makes it prone to injuries with the estimated
frequency being 10 to 35 per 1000 playing hours (Dvorak and Junge,
The aim of this study was to identify the injury patterns and rehabilitation
periods with specific injuries in a premiership football club.
Player injuries were retrospectively analysed from a local database
(Microsoft Access 2000) at the Blackburn Rovers Football Club, UK
from December 1998 to March 2004. The club physiotherapist and physician
recorded details of all injuries sustained during both training
and matches during that period. Clear distinctions were made between
acute and overuse injuries and rehabilitation times for each injury
were noted (Arnason et al., 2004).
Data was analysed using SPSS (Chicago, Illinois, USA). Differences
between the groups were assessed using the independent samples t-test.
P values of < 0.05 were considered statistically significant.
There were 483 injuries in 91 players. Of these 133 injuries occurred
as a result of overuse and 350 as a result of direct trauma. 440
injuries were treated conservatively while 43 were treated operatively.
Table 1 shows the range and
number of injuries, which occurred during this period along with
the average rehabilitation time for each injury. Injuries grouped
as "Other" in table 1
accounted for less than 1% of all injuries and could not always
be directly attributed to football even though this appeared to
be the precipitating factor in all cases.
There was no statistical difference between rehabilitation times
for acute injuries (18 days, standard deviation 30) as compared
to overuse injuries (20 days, standard deviation 39) (p = 0.640).
The mean rehabilitation time however for injuries treated conservatively
(15 days , standard deviation 24) as compared to injuries treated
surgically (61 days, standard deviation 67) was found to be statistically
significant (p = 0.0001).
The definition of football injuries still remains controversial
The traditional criteria of absence from training or games followed
by the need for medical treatment leads to an underestimation of
the incidence of less severe and overuse injuries(Dvorak and Junge,
In this study a specific attempt was made to include all injuries
including minor and overuse injuries. This closely resembles the
Council of Europe definition of a football injury (Dvorak and Junge,
The knee and ankle joints along with the thigh and calf muscles
were the commonest location of injuries in this group of players.
This pattern has already been documented in professional football
players (Dvorak and Junge, 2000;
Woods et al., 2002).
Four specific injury types were identified as most frequent: hamstring
strains, adductor or groin strains, knee sprains and ankle sprains.
This pattern however does differ from previous studies in that the
incidence of hamstring strains is higher than reported in previous
studies (Nielsen and Yde, 1989).
The disparity between the number of players and injuries in this
study confirms the pattern of repeated injuries associated with
professional football. This has been well documented and previous
injuries have already been identified as one of the major risk factors
for reinjuries amongst professional football players (Dvorak et
Nielsen and Yde, 1989;
Arnason et al., 2004).
In this study 27.5% of all injuries included overuse injuries. These
results differ from those of Arnason et al. (1996) who found a much
lower percentage (9%) of overuse injuries in their study. The importance
these apparently minor injuries should not be underestimated as
the rehabilitation time for these injuries was similar to the acute
injuries in our study. All injuries treated surgically ie anterior
cruciate ligament ruptures, meniscal tears and osteochondral defects
of the femoral condyle had lengthy rehabilitation periods as compared
to the rest of the conservatively treated injuries.
Our study has demonstrated a common pattern of injuries in professional
football players in a
premiership football club. Some of these injuries are serious enough
to cause a premature end to a young player's career. There appears
to be higher incidences of overuse injuries in this study than previously
suggested. The time lost due to overuse injuries in football should
not be underestimated and these injuries should be included in the
definition of football injuries.