Objective: To investigate the rate of and risk factors for head and neck injury in male soccer.
Design: Prospective cohort study.
Setting: Professional soccer.
Participants: Twenty-six European teams between 2001/2002 and 2009/2010.
Assessment of Risk Factors: Simple and multiple risk factor analyses were evaluated using Cox regression for player-related variables and logistic regression for match-related variables.
Main Outcome Measures: Injury rate (number of time loss injuries per 1000 hours).
Results: A total of 136 head and neck injuries were recorded (2.2% of all injuries). The head and neck injury rate was 0.17 (0.06 concussions) per 1000 hours. There was a 20-fold higher rate of head and neck injury during match play compared with training (rate ratio [RR], 20.2; 95% confidence interval [CI], 13.3-30.6) and a 78-fold higher rate of concussions (RR, 78.5; 95% CI, 24.4-252.5). Mean layoff for concussion was 10.5 days, but 27% of the concussed players returned to play within 5 days. Defender was the only significant player-related risk factor for head and neck injuries in the multiple analysis (RR, 1.8; 95% CI, 1.0-3.1), whereas no significant variables were identified for concussions.
Conclusions: Head and neck injuries were relatively uncommon in professional soccer. Defender was the playing position most at risk. More than one-quarter of the concussed players returned to play before what is recommended in the consensus statements by the major sports governing bodies.
*Football Research Group, Linköping, Sweden
†Department of Rehabilitation Centre, Ängelholm Hospital, Ängelholm, Sweden
‡Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
§Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Corresponding Author: Michael Nilsson, MD, Department of Rehabilitation Centre, Ängelholm Hospital, 262 81 Ängelholm, Sweden (email@example.com).
Grants were obtained from the Union of European Football Associations, Swedish National Centre for Research in Sports, and Praktikertjänst AB.
J. Ekstrand is the first vice chairman of the Union of European Football Associations Medical Committee. For the remaining authors, no conflicts of interest were declared.
Received July 19, 2012
Accepted November 19, 2012