Monday, January 31, 2011

Injuries and Illness at the 2010 World Cup

Unfortunately injuries are far too common in the sport of soccer. In many cases, injuries are a nagging inconvenience. In others, careers can be changed. In either case, injuries often have a major influence on the outcome of the match. Monitoring the incidence and nature of injuries is important. Innovations in training and equipment along with key rule changes are designed to reduce the risk and incidence of injury. But do they really impact the health and fitness of the athlete? The FIFA Medical Assessment and Research Centre (F-MARC), in conjunction with chief physicians from all 32 finalists teams, collected injury data throughout the 2010 FIFA World Cup. The results, just published in the British Journal of Sports Medicine, suggest that the reduction in injuries compared to previous World Cups reflects a growing emphasis on injury prevention, less foul play and stricter officiating.

A total of 125 injuries were reported for the 64 matches played, an incidence rate of 2 per match. The number of injuries increased as the match progressed. Only a third occurred in the first period while the remaining two-thirds occurred after intermission. Approximately 35% of the match injuries were non-contact while the remaining 65% occurred from contact with another player. Less than one-quarter of the contact injuries resulted from foul play.

During training, an additional 104 injuries occurred. By comparison to match play, there were 7.9 injuries per 1000 training hours and 61.1 per 1000 hours of match play. About 24% of the training injuries resulted from overuse and 12% from a prior injury. 23% of the injuries were non-contact in nature and 40% resulted from player contact.

For both matches and training, injuries to the thigh were the most common – contusions (bruises) and strains (muscle pulls). There was only a single ligament rupture (ankle) and a few (7) knee ligament sprains. Five fractures occurred, two to the head/face, two at the ankle and one of the arm. Two concussions were reported, one during match play and one during training.

Approximately half of the match and training injuries caused the player to miss at least 1 day of participation in ether a match or training session.

Illnesses affected 12% of all players. The most common were upper respiratory infections and gastrointestinal problems. The most common prescribed treatments were antibiotics and oral analgesics (pain medications).

The researchers compared their results with the results of previous World Cup competitions. They found that the incidence of match injuries (2 per match) has steadily decreased from 2002. The average of the three previous competitions was higher at 2.4 injuries per match. There was also a large drop in the number of injuries attributed to foul play. In 2002 and 2006 well over half of the player contact injuries were due to foul play. In 2010, this value dropped to 23%.

The investigators attributed these declines to the contributions made by medicine and sports science to “development of the game”. Over the past decade, key advances have been made in the area of training ad injury prevention. Perhaps athletes are arriving at the World Cup better prepared to avoid injury. In addition, emphasis on “fair play” and several key rule changes designed to eliminate tackles from behind and elbows to the head may have lead to the decline in injuries caused by foul play.

A source of concern was the high incidence of over use injuries and the large proportion of injuries occurring in the later stages of the match. The researchers suggested that this might reflect the large number of matches played each year, especially during the run up to the World Cup. An earlier study suggests that the congested football calendar and too many matches may lead to fatigue and raise the risk of injury as well as under-performance.

In summary, this study reports that the incidence of injuries during the 2010 World Cup Finals declined compared to the previous three competitions. This is especially true for injuries resulting form foul play. However, the large numbers of overuse injuries and late-match injuries raise concern over too many matches played by professionals. Also, given that there remain a considerable number of player-to-player contact injuries, continued focus on injury prevention, fair play and stricter refereeing remain top priorities.

Reference:

Dvorak J, Junge A, Derman W, Schwellnus M (2011) Injuries and illness of football players during the 2010 FIFA World Cup. British Journal of Sports Medicine, DOI: 10.1136/bjsm.2010.079905

See Also:

Dvorak J (2009) Give Hippocrates a jersey: promoting heath through football/sport. British Journal of Sports Medicine, 43:317-322.