Injury Burden in Professional European Football (Soccer): Systematic Review, Meta-Analysis, and Economic Considerations

Objective:We performed a systematic review and meta-analysis to evaluate the injury burden and the related economic cost in European professional male football players.Data Sources:Multiple database research was performed up to August 5, 2022 (PubMed, EMbase, Scopus, Cochrane Library), including only studies that reported severity in the number of days of absence for each injury, incidence reported in the number of injuries/1000 hours, or reported number of injuries and exposure time and adult male football players, professionals from European clubs. Two reviewers extracted data and assessed paper quality with the Strengthening the Reporting of Observational Studies in Epidemiology statement and the Newcastle-Ottawa Scale.Main Results:Twenty-two studies have reported incidence, severity, and burden of injuries in professional football. The highest injury burden was found for ligament-joint injuries (37.9 days/1000 hours; 222 397 euro/1000 hours) and for muscle injuries (34.7 days/1000 hours; 203 620 euro/1000 hours). Injury locations with high burden were knee injuries (34.8 days/1000 hours; 20 4206 euro/1000 hours)-mainly anterior cruciate ligament injuries (14.4 days/1000 hours; 84 499 euro/1000 h)-followed by thigh injuries (25.0 days/1000 hours; 146 700 euro/1000 hours), hamstrings injuries (15.4 days/1000 hours; 90 367 euro/1000 hours), hip-and-groin injuries (16.1 days/1000 hours; 94 475 euro/1000 hours), primarily adductor muscles injuries (9.4 days/1000 hours; 55 159euro/1000 hours), and ankle injuries (13.1 days/1000 h; 76 871 euro/1000 hours) with ankle sprains (7.4 days/1000 hours; 43 423 euro/1000 hours).Conclusions:Being exposed to injury risk has serious consequences for individual and club performance and economy. This review identified the most relevant targets in injury management, compared their injury data with reference values, and provided economic evidence when trying to gain buy-in from the key decision makers.