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Prevention of Injuries Among Male Soccer Players

A Prospective, Randomized Intervention Study Targeting Players With Previous Injuries or Reduced Function

Anders H. Engebretsen^,*, Grethe Myklebust, PT, PhD, Ingar Holme, PhD, Lars Engebretsen, MD, PhD^, and Roald Bahr, MD, PhD

From Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo Norway, and the Department of Orthopaedic Surgery, Ulleval University Hospital, University of Oslo, Oslo, Norway

^* Address correspondence to Anders H. Engebretsen, Oslo Sports Trauma Research Center, Norwegian School of Sports Science, PO Box 4014 Ullevål Stadion, N-0806 Oslo, Norway (e-mail: Anders.Engebretsen{at}nih.no).

Background: This study was conducted to investigate whether the most common injuries in soccer could be prevented, and to determine if a simple questionnaire could identify players at increased risk.

Hypothesis: Introduction of targeted exercise programs to male soccer players with a history of previous injury or reduced function in the ankle, knee, hamstring, or groin will prevent injuries.

Study Design: Randomized controlled trial; Level of evidence, 2.

Methods: A total of 508 players representing 31 teams were included in the study. A questionnaire indicating previous injury and/or reduced function as inclusion criteria was used to divide the players into high-risk (HR) (76%) and low-risk (LR) groups. The HR players were randomized individually into an HR intervention group or HR control group.

Results: A total of 505 injuries were reported, sustained by 56% of the players. The total injury incidence was a mean of 3.2 (95% confidence interval [CI], 2.5–3.9) in the LR control group, 5.3 (95% CI, 4.6–6.0) in the HR control group (P = .0001 vs the LR control group), and 4.9 (95% CI, 4.3–5.6) in the HR intervention group (P = .50 vs the HR control group). For the main outcome measure, the sum of injuries to the ankle, knee, hamstring, and groin, there was also a significantly lower injury risk in the LR control group compared with the 2 other groups, but no difference between the HR intervention group and the HR control group. Compliance with the training programs in the HR intervention group was poor, with only 27.5% in the ankle group, 29.2% in the knee group, 21.1% in the hamstring group, and 19.4% in the groin defined as having carried out the minimum recommended training volume.

Conclusion: The players with a significantly increased risk of injury were able to be identified through the use of a questionnaire, but player compliance with the training programs prescribed was low and any effect of the intervention on injury risk could not be detected.

Key Words: football • injury prevention • ankle injuries • knee injuries • hamstring injuries • groin injuries • risk factors • randomized controlled trial

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