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Injury Profile in Women’s Football: A Systematic Review and Meta-Analysis

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A Letter to the Editor to this article was published on 27 August 2021

A Letter to the Editor to this article was published on 27 August 2021

Abstract

Background

Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women.

Objective

The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football.

Methods

A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model.

Results

The overall incidence of injuries in female football players was 6.1 injuries/1000 h of exposure. Match injury incidence (19.2 injuries/1000 h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1–3 days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6–1.7) whereby on average players sustained more than one injury per season.

Conclusions

Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play.

Registration

This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).

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Data availability

The authors declare that data supporting the findings of this study are available within the article and its supplementary information files.

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Acknowledgements

This study is part of the project entitled “Estudio del riesgo de lesion en jóvenes deportistas a través de redes de inteligencia artificial”, funded by the Spanish Ministry of Science and Innovation (DEP2017-88775-P), the State Research Agency (AEI), and the European Regional Development Fund (ERDF). Alba Aparicio-Sarmiento was supported by the Spanish Ministry of Education, Culture and Sports for the Training of University Teaching Staff (Grant Number: FPU18/00702). Francisco Ayala was supported by postdoctoral grant given by Seneca Foundation (postdoctoral fellowships funded by the regional sub program focuses on the postdoctoral development, 20366/PD/17) from Spain.

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Authors and Affiliations

  1. Centre for Sport Studies, King Juan Carlos University, Madrid, Spain

    Alejandro López-Valenciano

  2. Faculty of Health Sciences, Universidad Isabel I , Burgos, Spain

    Javier Raya-González

  3. Infectious Diseases Unit, Hospital General Universitario de Elche, Elche, Spain

    Jose Alberto Garcia-Gómez

  4. Department of Physical Activity and Sport, Faculty of Sport Sciences, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, 30100, Murcia, Spain

    Alba Aparicio-Sarmiento & Pilar Sainz de Baranda

  5. Sports and Musculoskeletal System Research Group (RAQUIS), University of Murcia, 30100, Murcia, Spain

    Alba Aparicio-Sarmiento & Pilar Sainz de Baranda

  6. School of Sport and Exercise, University of Gloucestershire, Gloucester, UK

    Mark De Ste Croix & Francisco Ayala

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  1. Alejandro López-Valenciano
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  2. Javier Raya-González
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  3. Jose Alberto Garcia-Gómez
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  4. Alba Aparicio-Sarmiento
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  5. Pilar Sainz de Baranda
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  6. Mark De Ste Croix
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  7. Francisco Ayala
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Contributions

AL, JR and FA were responsible for the conception and design of the study. AL and JR were involved in data collection over the study periods. MD conducted the analyses together with the biostatistician (AG) and they were planned and checked with PS and AA. All authors contributed to the interpretation of findings and had full access to all data. AL wrote the first draft of the paper, which was critically revised by FA, MD and PS. The final manuscript was approved by all authors.

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Correspondence to Francisco Ayala.

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López-Valenciano, A., Raya-González, J., Garcia-Gómez, J.A. et al. Injury Profile in Women’s Football: A Systematic Review and Meta-Analysis. Sports Med 51, 423–442 (2021). https://doi.org/10.1007/s40279-020-01401-w

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