Soccer injuries research study

“Injuries intensity and representation in FIFA World Cups”

Dr Miodrag Mladenovic, Serbia soccer national team doctor

Science congress ”Experiences and perspectives – World Cup in South Africa 2010”

Faculty of sports and physical education, Belgrade, 2010

Last ten years, a huge attention has been ascribed to UEFA and FIFA medical comitees on injury prevention and safetiness at professional soccer players. Research medical center(F-MARC), which main areas are injury risk,number and frequency assessments; and creating unique injury profile in soccer , set up at FIFA. The studies shew how big risk of injurying in professional football is. Injury risk in professional soccer is 1000 times, for example, bigger than in industry job.

Injury definition

To be able to match different studies, term injury has to be defined. Lots of researches about soccer injuries use term “wasted time” as an injury definition, and describe it as one of causes for competition absence. Other injury definition represents player need to treat injuries and that is “medical help” definition. If injury is present, nevermind caused or not training or match absence, it is described as “tissue injury” definition. Some studies are using combinations of definitions written above.

Injury classification

1)      Traumatic injuries

-          Acute ligaments or joint capsulas;

-          Acute muscles and tendons sprains;

-          Contusions;

-          Fractures;

-          Partial or complete joint dislocations

-          Other injuries( abrasions, concussions…)

2)      Overfatique injuries, followed with painful muscle-skeletal system syndromes, with dangerous starting symptoms, but without any sign of injury or illness

Chronic injury

Term chronic injury is usually defined as injury that comes up after previous injury at the same place and at the same type inside two months after the last day of rehabilitation from previous injury. It has to be considered that injuries create proprioception deficit and structural damages, like muscle scars, that is present longer than two months after an initial injury. Other injuries never grow up completely, so risk from repeated injury, like reconstructed ligamentum cruciata anterior(ACL) injury or condition after partial meniscectomia.

When is thought that player is completely rehabilitated?

The question when it is thought that player is capable for activities returnal, depends on injury seriousness and chronic injury rate. Is it when player should start warming up with the team, and not capable for complete training? Actually, it is thought that player should return once an injury is completely rehabilitated. Some autors suggest that player is thought to be injured until he is capable to play the whole game with all coach demands, including sprint running, forced counter running, kicking and full rhythm playing during the whole game.

Due to all written, it is completely clear that seriousness of injury defining has to be completely respected, and on the way with standard forms that were defined by FIFA Research center.

Soccer World championship is the biggest and the most viewed competition in the world. Number of spectators is enormous and it is estimated to 40 milliards during the whole competition, and final is followed by 1,5 million spectators. In the background is found good organized group of medicine experts that worries about health, and not only to the players, but to the administrative personel, referees and others. On that big competition FIFA and local medical personel cooperation is extremely important before and during the competition.

FIFA research center has started serious injury analysis since World Cup ’98 in France till today, including Olympic games tournaments. Obligations of the medical teams from all countries competitors is to do players examination; which includes complete anamnesys, physical examination, with special attention to heart function. It is also obligated to do blood findings, EKG in peace, stress test, just as ultrasound heart examination that has to be done by cardiologist.

On World Cup ’06 in Germany have also been done researches that were described previously, and compared with the World Cup ’02 in Korea/Japan(shown in the table 1).

Comparing to injury number on World Cups ’02 and ’06 conclusion is that it was come to overall injury number decrease year 2006., and, of course, significant decrease by the game from 2,7 to 2,3. There is few objective reasons for that; and these are: preparation time for ’06 was significantly longer than ’02 when preparations started right after the end of championships. Other reason is that judges by rules changing contributed to overall injuries decrease.

According to injury region and injury type on World Cups ’02 and ’06; representation is shown in the table 2.

Doping control

FIFA does anti-doping control from the World Cup in Mexico, year 1970. Positive doping tests in FIFA competitions are rare. In period 1994-2005 it was 4 positive tests, 1994 one positive test on ephedrine, one on cannabis and on nandrolon on World Cup for youth national teams 2003., and one of ephedrine in Angola on qualification match for world championship, year 2006. During 12 years, along with 480 tests during the world cup championship, in year 2006. 3811 tests was done, from which positive was 0,1%. Different from soccer, during Olympic Games in Athens there were 27 positive findings in individual sports and not a single one in team sports. Result of small number of findings in soccer is a result of common work on education FIFA Medical committee in cooperation with team and club doctors and players that were completely informed about prohibited substances and action “no space for doping in soccer”.

Table 1

Competition	World Cup 2002. Korea/ Japan	World Cup 2006. Germany
Match number	64	64
Hour number(games played)	2112	2112
Injury number	171	145
Injury number/1000 hours	80,96	68,7
Injuries per game	2,7	2,3
Conditions of injuries income
Non- contact injuries	27%(45)	27%(38)
Contact injuries	73%(122)	73%(104)
Contact injuries - foul	51%(59)	61%(57)
Fouls penalized by referee	52%(28)	57%(32)
Time
First halftime	54%(88)	50%(66)
Second halftime	46%(72+3)	50%(64+2)
Injury difficulty
0 days	33%(53)	30%(39)
1-3 days	37%(59)	33%(43)
4-7 days	17%(27)	15%(19)
1 week-1 month	11%(18)	18%(23)
>1 month	2%(3)	5%(7)

Table 2

Location and diagnosis	World Cup 2002. Korea/ Japan		World Cup 2006. Germany
	Total	Absence	Total	Absence

Head	25	5	13	4
Concussion	4	1	1	1
Nasal bone fracture	1	1	0	0
Contusion	11	1	7	2
Laceration	9	2	5	1
Hand	8	3	12	5
Fracture	1	1	1	1
Dislocation	0	0	2	1
Muscular distension/rupture	1	1	0	0
Sprain	1	1	2	1
Contusion	4	0	7	2
Laceration	1	0	0	0
Torso	6	6	15	11
Muscular distension/rupture	1	1	2	2
Sprain	1	1	0	0
Tendinitis	1	1	0	0
Contusion	3	3	12	8
Muscular pain	0	0	1	1
Hip	2	2	1	1
Distension	1	1	0	0
Contusion	1	1	1	1
Groin	9	8	6	4
Muscular distension/rupture	8	8	3	1
Tendinitis	1	0	0	0
Labial impidgement	0	0	1	1
Contusion	0	0	1	1
Tension	0	0	1	1
Thigh	30	26	21	16
Muscular distension/rupture	18	18	10	10
Tendinitis	2	2	0	0
Contusion	10	6	9	4
Spasms	0	0	2	2
Knee	22	15	18	17
Ligament rupture	1	1	1	1
Menisci lesion	1	1	2	2
Sprain	5	3	7	7
Tendinitis	1	1	2	1
Tendon rupture	0	0	1	1
Contusion	13	8	5	5
Deep wound	1	1	0	0
Leg	29	15	30	19
Muscular distension/rupture	5	5	4	3
Contusion	24	10	19	13
Tendinitis	0	0	1	0
Laceration	0	0	1	0
Rest	0	0	5	3
Articulatio talocruralis	25	19	24	16
Sprain	16	13	16	12
Contusion	8	6	8	4
Laceration	1	0	0	0
Foot	14	8	6	5
Fracture	1	0	0	0
Dislocation	1	1	0	0
Sprain	1	1	0	0
Contusion	9	6	5	4
Laceration	1	0	0	0
Not clear(possible fracture)	1	0	0	0
Rest(calluses)	0	0	1	1
Not clear	1	0	0	0
Contusion	1	0	0	0