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Lower limb MSK injuries among school-aged rugby and football players: a systematic review
  1. David Stewart Anderson1,
  2. John Cathcart2,
  3. Iseult Wilson3,
  4. Julie Hides4,
  5. Felix Leung4,
  6. Daniel Kerr2
  1. 1 Life and Health Sciences, Ulster University - Jordanstown Campus, Newtownabbey, UK
  2. 2 Institute of Nursing and Health Research, School of Health Sciences, Ulster University - Jordanstown Campus, Newtownabbey, UK
  3. 3 School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
  4. 4 School of Allied Health Sciences, Griffith University, Nathan, Australia
  1. Correspondence to David Stewart Anderson; anderson-d24{at}


Objective The objective of this systematic review was to explore the incidence of lower limb musculoskeletal (MSK) injuries sustained by rugby union, rugby league, soccer, Australian Rules and Gaelic football players under 18 years. The review sought to identify the mechanisms and types of injury sustained and to compare between sports.

Design This systematic review focused on the incidence of lower limb injury in adolescent team sports that involved running and kicking a ball. A literature search of studies published prior to January 2020 was conducted using SportDiscus, Medline and PubMed databases. The Standard Quality Assessment Criteria appraisal tool was used to assess the quality of each article included in the review. Two or more authors independently reviewed all papers.

Results Sixteen papers met the inclusion criteria; prospective cohort (N=14), retrospective (n=1) and longitudinal (n=1). These studies investigated injuries in rugby union and rugby league (n=10), football (soccer) (n=3), Australian Rules (n=2) and Gaelic football (n=1). There were a total of 55 882 participants, aged 7–19 years old, who reported 6525 injuries. The type, site and mechanisms of injury differed across sports.

Summary Lower limb injuries were common in adolescent rugby, soccer, Gaelic football and Australian Rules football players, however these studies may not fully reflect the true injury burden where recurrent and overuse injuries have not been considered. There were differences between sports in the mechanisms, types and severity of injury.

  • Epidemiology
  • Sporting injuries
  • Adolescent
  • Football
  • Australian football

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  • Twitter David Anderson @DSAnderson001.

  • Contributors DSA (doctoral researcher)—primary author; JC (supervisor)—co-author; IW (supervisor)—co-author; JH (external reviewer)—co-author; FL (external reviewer)—co-author; DK (chief investigator)—co-author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval None required.

  • Provenance and peer review Not commissioned; externally peer-reviewed.

  • Data availability statement Yes.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.