Adolescent female soccer players may be experiencing injury rates much higher than previously believed, and for at least 1 subgroup of these athletes, the secret to prevention could be to play more soccer.
A new study of 498 female soccer players aged 15-18 in Denmark used a text message-based self-reporting system to track injuries related to the sport and found substantially higher rates than had been established through previous studies, which were based on reports from coaches or medical staff. Differences varied by rate of exposure, but on average the Danish study found a time-loss injury rate of 9.7 per 1,000 hours of exposure-previous studies reported time-loss rates between 2.4 and 5.3.
For severe injuries, the differences were even more dramatic, with a 1.1 per 1,000 hours rate that is "3 times that previously reported in a female adolescent population, and identical to or higher than ... that reported in elite male and female soccer," according to the authors. The article appears in the July 2 edition of the American Journal of Sports Medicine (abstract only available for free).
The study involved 4 weekly questions sent via text message to all participants, with subsequent messages sent immediately depending on how participants responded to the initial set of questions. The weekly questions asked whether the participants experienced any discomfort during a match or practice during the past week, whether they missed training or games during the last week and why, how many hours of soccer training they participated in during the past week, and how many minutes of game play they participated in during the past week. Participants who reported pain or discomfort were contacted by telephone and briefly interviewed further. Information-gathering was conducted for a full Danish soccer season, from February to June 2012.
Researchers then categorized all reported injuries into time-loss and no time-loss injuries, with "time loss" being defined as an injury that resulted in a loss of playing/training time of 1 week or more. From there, they separated time-loss injuries into overuse and acute injuries, and further divided acute injuries into injuries sustained in a match or in training. Injury severity was linked to the time lost from soccer, with time-loss of 4 weeks or more being categorized as "severe." The most common severe injuries involved the knee, ankle, groin, and lumbar spine.
In addition to the higher overall incidence rates, authors noted a strong correlation between risk of time-loss injuries and lower amount of play and training time. In the lowest-exposure group (less than 1 hour per week of play or training), the predicted incidence of time-loss injuries was 71 per 1,000 hours of exposure-significantly higher than even the second-to-lowest exposure group (1 to 2 hours per week of play or training), whose time-loss injury rate was about 24 per 1,000 hours. Authors write that the "obvious first measure" of prevention for this group would be to increase regular training, and they warn that if the rates hold true, occasional soccer players "may represent a population exhibiting unsafe behavior and a possible major cost to society in terms of medical expenses."
Overall, authors write, the findings of the study are "highly alarming and suggest that previously reported injury rates in adolescent female soccer may be substantially underestimated, and estimates of injury distribution may be inaccurate."
Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.
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