Original research
Differences in injury risk and characteristics between Dutch amateur and professional soccer players

https://doi.org/10.1016/j.jsams.2014.02.004Get rights and content

Abstract

Objectives

To compare the incidence and characteristics of injuries between Dutch amateur and professional male soccer players during one entire competition season.

Design

A prospective two-cohort design.

Methods

During the 2009–2010 season, 456 Dutch male amateur soccer players and 217 professional players were prospectively followed. Information on injuries and individual exposure to all soccer activities were recorded in both cohorts. Injuries were recorded using the time-loss definition.

Results

In total, 424 injuries were recorded among 274 of the amateur players (60.1% injured players) and 286 injuries were sustained by 136 (62.7% injured players) of the professional players (p = 0.52). Compared to the professionals, the injury incidence during training sessions was higher among amateurs (p = 0.01), but the injury incidence among professionals was higher during matches (p < 0.001). Professional players also had a higher incidence of minimal injuries (p < 0.001), whereas the incidence of moderate and severe injuries was higher for amateurs (all p < 0.001). Lastly, professional players sustained more overuse injuries (p = 0.02), whereas amateurs reported more recurrent injuries (p < 0.001).

Conclusions

The above-mentioned differences in injury rates between amateur and professional players in the Netherlands might be explained by the difference in the level at which they play, since factors like the availability of medical support and/or the team size may influence the injury risk and characteristics.

Introduction

Soccer is one of the most popular sports worldwide. In the Netherlands, there are more than 1.2 million licensed members of the Royal Netherlands Football Association (KNVB) and 900 of them have been contracted by a professional soccer club (www.knvb.nl). The incidence rate of outdoor injuries in soccer is among the highest of all sports, particularly for adult male players.1 International studies have observed large differences in the injury incidences. Injury risks range from 2.0 to 44.6 injuries/1000 soccer hours.2, 3

Soccer injuries result from a complex interaction of multiple intrinsic and extrinsic risk factors.4 There is general consensus that the incidence of injuries is higher during matches than in training sessions.5 However, several studies describing soccer injuries in male players have produced contradictory results with regard to the relation between injuries and the skills levels. The majority of these results have been summarized in two reviews, but the studies included in them have considerable limitations, like small study populations, no exposure registration and only focusing on severe injuries.5, 6 In addition, since the studies were published before 2006, they did not follow the guidelines of the consensus statement on injury definitions and data collection procedures for such studies by Fuller and colleagues.7 The two reviews describe the results of six studies. One showed a higher overall injury incidence at higher levels of play.8 Two other studies reported that players competing at higher levels have a higher injury rate during matches and a lower injury rate during training sessions, compared to players at a lower level.9, 10 One of these studies specifically stated that the total injury incidence was similar between different skills levels.9 In contrast, the fourth study concluded that the total injury incidence was significantly different between low-skilled and high-skilled players with the former showing a higher overall injury rate. However, specific incidences for matches and training sessions were not different between the two groups.11 The last two studies showed that low-skilled players run a higher risk of suffering (time-loss or severe) injuries than high-skilled players.12, 13

Comparing characteristics and risk of injury between soccer players participating at different levels has been difficult due to differences between studies in research populations and methodology. To our knowledge, there have been no studies comparing the epidemiology of soccer injuries in professional and amateur soccer during the same season and using the same study design. Therefore, the aim of this study was to compare the incidences and characteristics of injuries between Dutch amateur and professional male soccer players, using data obtained with one consistent method during an entire competition season.

Section snippets

Methods

A prospective two-cohort design was used to study soccer injuries in Dutch male amateur soccer players and male professional soccer players. The data for the amateur cohort were obtained from a cluster-randomized controlled trial (RCT) comparing the injury incidences between an intervention group that used a training program (called “The 11”) during warm-up and a control group training as usual. Teams from two districts in the second highest Dutch amateur soccer league were invited to

Results

The final amateur cohort consisted of 456 players from 23 teams (one team declined to participate). The mean team size was 20 (±2), ranging from 16 to 23 players per team. On average, the amateurs had played soccer for 17.5 (±4.5) years. Nearly seven out of ten amateur players (n = 300, 69.0%) reported having sustained a soccer injury in the year prior to the start of this study, and 52 players (11.4%) were injured at the start of the season.

Six professional teams declined to participate and four

Discussion

The principal findings of this study were that the injury incidence during training sessions was higher in the amateur cohort than in the professional cohort. In contrast, the injury incidence during matches was significantly higher for professional players. The injury incidences in training sessions and matches for the amateur cohort are consistent data from previous studies.18, 19, 20 Using the same methodology, the overall incidence rate for the professional cohort is lower than that found

Conclusion

The incidence during training sessions was significantly higher in the amateur cohort. In contrast, the injury incidence during matches was significantly higher among the professional players. The professional players had a significantly higher incidence of minimal injuries, whereas the incidence of moderate and severe injuries was significantly higher among the amateurs. The professional players sustained significantly more overuse injuries, whereas amateurs reported significantly more

Practical implications

  • Comparing the epidemiology of soccer injuries in professional and amateur soccer provide valuable information about the relation between injury characteristics and the skills levels of players.

  • The above-mentioned differences in soccer injuries between Dutch amateurs and professionals can be explained by the different game level, since factors like differences in the availability of medical support or the team size may have influenced the risk and characteristics of injuries.

  • Staff of soccer

Funding

The study among amateurs was funded by the Netherlands Organization for Health Research and Development (ZonMw) and the Royal Netherlands Football Association (KNVB).

Contributors

In accordance with the Vancouver Protocol, all five authors have substantially contributed to conception and design, acquisition of data or analysis and interpretation of data, drafting the article or revising it critically for important intellectual content and final approval of the version to be published.

Conflicts of interest

The authors declare that they have no conflicts of interest in the authorship or publication of this contribution.

Acknowledgements

We are grateful to the district managers of the Royal Netherlands Football Association (KNVB), representatives of the participating soccer clubs (board members, coaches, and medical staff) and the soccer players involved, for their cooperation.

The authors wish to thank Mark Krist MSc and Jasper Stege MSc, for their assistance in collecting the data, and Sissi van der Knaap MSc for her contribution in data analysis.

References (30)

  • S.L. Schmikli et al.

    Injury prevention target groups in soccer: injury characteristics and incidence rates in male junior and senior players

    J Sci Med Sport

    (2011)
  • A. Junge et al.

    Sports injuries during the Summer Olympic Games 2008

    Am J Sports Med

    (2009)
  • J. Ekstrand et al.

    Injury incidences and injury patterns in professional football: the UEFA-injury study

    Br J Sports Med

    (2011)
  • R. Bahr et al.

    Understanding injury mechanisms: a key component of preventing injuries in sport

    Br J Sports Med

    (2005)
  • D.F. Murphy et al.

    Risk factors for lower extremity injury: a review of the literature

    Br J Sports Med

    (2003)
  • J. Dvorak et al.

    Football injuries and physical symptoms. A review of the literature

    Am J Sports Med

    (2000)
  • C.W. Fuller et al.

    Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries

    Clin J Sport Med

    (2006)
  • H. Inklaar et al.

    Injuries in male soccer players: team risk analysis

    Int J Sports Med

    (1996)
  • J. Ekstrand et al.

    The incidence of ankle sprains in soccer

    Foot Ankle

    (1990)
  • A.B. Nielsen et al.

    Epidemiology and traumatology of injuries in soccer

    Am J Sports Med

    (1989)
  • T.D. Poulsen et al.

    Injuries in high-skilled and low-skilled soccer: a prospective study

    Br J Sports Med

    (1991)
  • J. Chomiak et al.

    Severe injuries in football players. Influencing factors

    Am J Sports Med

    (2000)
  • L. Peterson et al.

    Incidence of football injuries and complaints in different age groups and skill-level groups

    Am J Sports Med

    (2000)
  • A.M.C. van Beijsterveldt et al.

    Effectiveness and cost-effectiveness of an injury prevention programme for adult male amateur soccer players: design of a cluster-randomised controlled trial

    Inj Prev

    (2011)
  • A.M.C. van Beijsterveldt et al.

    Effectiveness of an injury prevention programme for adult male amateur soccer players: a cluster-randomized controlled trial

    Br J Sports Med

    (2012)
  • Cited by (0)

    View full text