Epidemiology and Prevention Programs on Football Injuries in Children and Adolescent Players: Systematic Review

Document Type : Research Paper

Authors

1 Assistant Professor, Health and Sport Rehabilitation Department, Faculty of Sport Sciences and Health, Shahid Beheshti University

2 Assistant Professor, Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute

Abstract

More than half of football players are under 18. The risk of injury to these players is high, but there are few studies in the field of epidemiology and prevention of injuries. Thus, the purpose of this systematic review was to evaluate scientific studies on the prevalence, incidence, mechanism, and prevention of injuries to children and adolescents. Scientific data bases including MEDLINE, EMBASE, SCOPUS and MAGIRAN were searched using the keywords "football" or "soccer", "youth", "junior ", "adolescent ", "pediatric,", '' child '' '' 'injury ‘,' injury prevention'. 989 studies were identified, of which 62 studies satisfied the inclusion criteria to enter the review.
The results showed that the incidence of injury in training for children and adolescents varied from 1 to 5 injuries per 1000 hours of training. The incidence of injuries in the competition increases with age. On average, this was about 15 to 20 injuries per 1000 hours. 60 to 90 percent of injuries were acute. Most injuries affected the lower extremities. Strain and sprain were the most common types of injuries in children and adolescents.

Keywords


 1.  Count, F.B., 270 million people active in football. FIFA Communications Division, Information Services, 2006. 31: p. 2007.
2.   Krustrup, P., et al., Recreational soccer is an effective health-promoting activity for untrained men. British journal of sports medicine, 2009. 43(11): p. 825-831.
3.   Krustrup, P., et al., Recreational football as a health promoting activity: a topical review. Scandinavian journal of medicine & science in sports, 2010. 20(s1): p. 1-13.
4.   Majewski, M., H. Susanne, and S. Klaus, Epidemiology of athletic knee injuries: A 10-year study. The knee, 2006. 13(3): p. 184-188.
5.   Giannotti, M., et al., Epidemiology of acute soccer injuries in Canadian children and youth. Pediatric emergency care, 2011. 27(2): p. 81-85.
6.   Leininger, R.E., C.L. Knox, and R.D. Comstock, Epidemiology of 1.6 million pediatric soccer-related injuries presenting to US emergency departments from 1990 to 2003. The American journal of sports medicine, 2007. 35(2): p. 288-293.
7.   Waldén, M., et al., The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective. Knee surgery, sports traumatology, arthroscopy, 2011. 19(1): p. 3-10.
8.   Ekstrand, J., M. Hägglund, and M. Waldén, Injury incidence and injury patterns in professional football: the UEFA injury study. British journal of sports medicine, 2009: p. bjsports60582.
9.   Hägglund, M., M. Waldén, and J. Ekstrand, UEFA injury study–an injury audit at European Championships 2006 to 2008. British journal of sports medicine, 2009.
10. Fuller, C.W., et al., Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union. British journal of sports medicine, 2007. 41(5): p. 328-331.
11. Giza, E. and L. Micheli, Soccer injuries, in Epidemiology of Pediatric Sports Injuries. 2005, Karger Publishers. p. 140-169.
12. Fuller, C.W., et al., Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scandinavian journal of medicine & science in sports, 2006. 16(2): p. 83-92.
13. Rössler, R., et al., Soccer Injuries in Players Aged 7 to 12 Years A Descriptive Epidemiological Study Over 2 Seasons. The American journal of sports medicine, 2015: p. 0363546515614816.
14. Khodaee, M., et al., Nine-year study of US high school soccer injuries: data from a national sports injury surveillance programme. British journal of sports medicine, 2016: p. bjsports-2015-095946.
15. Clausen, M.B., et al., High Injury Incidence in Adolescent Female Soccer. The American Journal of Sports Medicine, 2014. 42(10): p. 2487-2494.
16. Tourny, C., et al., Epidemiologic study of young soccer player's injuries in U12 to U20. The Journal of sports medicine and physical fitness, 2014. 54(4): p. 526-535.
17. Renshaw, A. and P.C. Goodwin, Injury incidence in a Premier League youth soccer academy using the consensus statement: a prospective cohort study. BMJ Open Sport & Exercise Medicine, 2016. 2(1): p. e000132.
18. Zarei, M., et al., Comparison of Injury in Iran national junior and youth football players. British Journal of Sports Medicine, 2010. 44(Suppl 1): p. i6-i6.
19. Aoki, H., et al., Incidence of injury among adolescent soccer players: a comparative study of artificial and natural grass turfs. Clinical Journal of Sport Medicine, 2010. 20(1): p. 1-7.
20. Backous, D.D., et al., Soccer injuries and their relation to physical maturity. American Journal of Diseases of Children, 1988. 142(8): p. 839-842.
21. Brito, J., et al., Injuries in Portuguese youth soccer players during training and match play. Journal of athletic training, 2012. 47(2): p. 191-197.
22. De Loes, M. and I. Goldie, Incidence rate of injuries during sport activity and physical exercise in a rural Swedish municipality: incidence rates in 17 sports. International journal of sports medicine, 1988. 9(06): p. 461-467.
23. Elias, S.R., 10-year trend in USA Cup soccer injuries: 1988-1997. Medicine and science in sports and exercise, 2001. 33(3): p. 359-367.
24. Emery, C.A., W.H. Meeuwisse, and S.E. Hartmann, Evaluation of risk factors for injury in adolescent soccer implementation and validation of an injury surveillance system. The American journal of sports medicine, 2005. 33(12): p. 1882-1891.
25. Froholdt, A., O.E. Olsen, and R. Bahr, Low risk of injuries among children playing organized soccer: a prospective cohort study. The American journal of sports medicine, 2009. 37(6): p. 1155-1160.
26. Inklaar, H., et al., Injuries in male soccer players: team risk analysis. International journal of sports medicine, 1996. 17(03): p. 229-234.
27. Johnson, A., P.J. Doherty, and A. Freemont, Investigation of growth, development, and factors associated with injury in elite schoolboy footballers: prospective study. Bmj, 2009. 338: p. b490.
28. Junge, A., et al., Injuries in youth amateur soccer and rugby players—comparison of incidence and characteristics. British journal of sports medicine, 2004. 38(2): p. 168-172.
29. Junge, A., et al., Prevention of soccer injuries: a prospective intervention study in youth amateur players. The American Journal of Sports Medicine, 2002. 30(5): p. 652-659.
30. Junge, A., J. Chomiak, and J. Dvorak, Incidence of football injuries in youth players comparison of players from two European regions. The American journal of sports medicine, 2000. 28(suppl 5): p. S-47-S-50.
31. Kakavelakis, K., et al., Soccer injuries in childhood. Scandinavian journal of medicine & science in sports, 2003. 13(3): p. 175-178.
32. Kibler, W.B., Injuries in adolescent and preadolescent soccer players. Medicine and science in sports and exercise, 1993. 25(12): p. 1330-1332.
33. Le Gall, F., C. Carling, and T. Reilly, Injuries in young elite female soccer players an 8-season prospective study. The American journal of sports medicine, 2008. 36(2): p. 276-284.
34. Le Gall, F., C. Carling, and T. Reilly, Biological maturity and injury in elite youth football. Scandinavian journal of medicine & science in sports, 2007. 17(5): p. 564-572.
35. Le Gall, F., et al., Incidence of Injuries in Elite French Youth Soccer Players A 10-Season Study. The American journal of sports medicine, 2006. 34(6): p. 928-938.
36. Maehlum, S., E. Dahl, and O.A. Daljord, Frequency of injuries in a youth soccer tournament. The Physician and Sportsmedicine, 1986. 14(7): p. 73-79.
37. McNoe, B.M. and D.J. Chalmers, Injury in Community-Level Soccer Development of an Injury Surveillance System. The American journal of sports medicine, 2010. 38(12): p. 2542-2551.
38. Müller-Rath, R., et al., The injury pattern following the introduction of the junior premier league in Germany compared to professional senior football (soccer). Sportverletzung Sportschaden: Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin, 2006. 20(4): p. 192-195.
39. Nielsen, A.B. and J. Yde, Epidemiology and traumatology of injuries in soccer. The American Journal of Sports Medicine, 1989. 17(6): p. 803-807.
40. Nilsson, S. and A. Roaas, Soccer injuries in adolescents. The American journal of sports medicine, 1978. 6(6): p. 358-361.
41. Peterson, L., et al., Incidence of football injuries and complaints in different age groups and skill-level groups. The American Journal of Sports Medicine, 2000. 28(5_suppl): p. 51-57.
42. Rosenbaum, D.A., et al., Variation in injury risk over the course of a two-day youth club soccer tournament. Injury prevention, 2009. 15(4): p. 266-269.
43. Schmidt-Olsen, S., et al., Injuries among young soccer players. The American journal of sports medicine, 1991. 19(3): p. 273-275.
44. Schmidt-Olsen, S., et al., Soccer injuries of youth. British journal of sports medicine, 1985. 19(3): p. 161-164.
45. Söderman, K., et al., Injuries in adolescent female players in European football: a prospective study over one outdoor soccer season. Scandinavian journal of medicine & science in sports, 2001. 11(5): p. 299-304.
46. Soligard, T., et al., Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. Bmj, 2008. 337: p. a2469.
47. Spinks, A.B., et al., Injury risk from popular childhood physical activities: results from an Australian primary school cohort. Injury Prevention, 2006. 12(6): p. 390-394.
48. Steffen, K., T.E. Andersen, and R. Bahr, Risk of injury on artificial turf and natural grass in young female football players. British journal of sports medicine, 2007. 41(suppl 1): p. i33-i37.
49. Timpka, T., O. Risto, and M. Björmsjö, Boys soccer league injuries: a community-based study of time-loss from sports participation and long-term sequelae. The European Journal of Public Health, 2008. 18(1): p. 19-24.
50. Yde, J. and A. Nielsen, Sports injuries in adolescents' ball games: soccer, handball and basketball. British Journal of Sports Medicine, 1990. 24(1): p. 51-54.
51. Junge, A. and J. Dvorak, Soccer injuries. Sports medicine, 2004. 34(13): p. 929-938.
52. Emery, C.A. and W.H. Meeuwisse, Risk factors for injury in indoor compared with outdoor adolescent soccer. The American journal of sports medicine, 2006. 34(10): p. 1636-1642.
53. Lindenfeld, T.N., et al., Incidence of injury in indoor soccer. The American journal of sports medicine, 1994. 22(3): p. 364-371.
54. Hoff, G.L. and T.A. Martin, Outdoor and indoor soccer: injuries among youth players. The American journal of sports medicine, 1986. 14(3): p. 231-233.
55. Ekstrand, J., T. Timpka, and M. Hägglund, Risk of injury in elite football played on artificial turf versus natural grass: a prospective two-cohort study. British journal of sports medicine, 2006. 40(12): p. 975-980.
56. Ekstrand, J., M. Hägglund, and C. Fuller, Comparison of injuries sustained on artificial turf and grass by male and female elite football players. Scandinavian journal of medicine & science in sports, 2011. 21(6): p. 824-832.
57. Williams, S., P.A. Hume, and S. Kara, A review of football injuries on third and fourth generation artificial turfs compared with natural turf. Sports medicine, 2011. 41(11): p. 903-923.
58. Baxter-Jones, A., N. Maffulli, and P. Helms, Low injury rates in elite athletes. Archives of Disease in Childhood, 1993. 68(1): p. 130-132.
59. Yard, E.E., et al., The epidemiology of United States high school soccer injuries, 2005–2007. The American Journal of Sports Medicine, 2008. 36(10): p. 1930-1937.
60. Price, R., et al., The Football Association medical research programme: an audit of injuries in academy youth football. British journal of sports medicine, 2004. 38(4): p. 466-471.
61. Lüthje, P., et al., Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland. Scandinavian journal of medicine & science in sports, 1996. 6(3): p. 180-185.
62. van Mechelen, W., The severity of sports injuries. Sports Med, 1997. 24(3): p. 176-80.
63. Engebretsen, A.H., et al., Prevention of injuries among male soccer players. Am J Sports Med, 2008. 36(6): p. 1052-1060.
64. Morgan, B.E. and M.A. Oberlander, An Examination of Injuries in Major League Soccer The Inaugural Season. Am J Sports Med, 2001. 29(4): p. 426-430.
65. Heidt Jr, R.S., et al., Avoidance of soccer injuries with preseason conditioning. Am J Sports Med, 2000. 28(5): p. 659-662.
66. Soligard, T., Injuries in youth female football: risk factors, prevention and compliance, in Oslo Sports Trauma Research Center. 2011, Department of Sports Medicine Norwegian School of Sport Sciences: Norway. p. 157.
67. Chomiak, J., et al., Severe injuries in football players influencing factors. Am J Sports Med, 2000. 28(suppl 5): p. S-58-S-68.
68. Wong, P. and Y. Hong, Soccer injury in the lower extremities. Br J Sports Med, 2005. 39(8): p. 473-82.
69. Woods, C., et al., The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of preseason injuries. British journal of sports medicine, 2002. 36(6): p. 436-441.
70. CSCSD, G.D.M.P.F., Soccer-specific warm-up and lower extremity injury rates in collegiate male soccer players. Journal of athletic training, 2013. 48(6): p. 782.
71. Soligard, T., et al., Compliance with a comprehensive warm-up programme to prevent injuries in youth football. British journal of sports medicine, 2010. 44(11): p. 787-793.
72. Steffen, K., et al., High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. British journal of sports medicine, 2013. 47(12): p. 794-802.
73. Hammes, D., et al., Injury prevention in male veteran football players–a randomised controlled trial using “FIFA 11+”. Journal of sports sciences, 2015. 33(9): p. 873-881.
74. Steffen, K., et al., Preventing injuries in female youth football–a cluster‐randomized controlled trial. Scandinavian journal of medicine & science in sports, 2008. 18(5): p. 605-614.
75. LaBella, C.R., et al., Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: cluster randomized controlled trial. Arch Pediatr Adolesc Med, 2011. 165(11): p. 1033-40.
76. Heidt, R., et al., Avoidance of soccer injuries with preseason conditioning. Am J Sports Med, 2000. 28: p. 659-62.
77. Junge A, et al., Prevention of soccer injuries: aprospective intervention study in youth amateur players. Am J Sports Med, 2002. 30(5): p. 652-9.
78. Emery, C. and W. Meeuwisse, The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. Br J Sports Med 2010. 44: p. 555-562.
79. Zarei M, Johari K. The Effect of FIFA 11+ Kids Warm-Up Program on Injuries Incidence Rate and Motor Performance in Iranian Children Male Soccer Players. Studies in Sport Medicine. in press. (Article in Persian)