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F. Aljowair1, P. Newman1, J. Witchalls1, J. Bousie1
1University of Canberra, Faculty of Health, Canberra, Australia
Background: Soccer players experience a high prevalence of injuries to their groin and hamstring areas with a high cost to team outcomes.
Purpose: The current review aimed to collate, evaluate, and synthesise evidence of risk factors that correlate with the most common soft-tissue-related injuries in adult male soccer players.
Methods: A systematic search through the databases CINAHL, SPORTDiscus, MEDLINE, and Scopus was conducted in order to determine relevant research papers. A meta-analysis was undertaken from the study results that reported risk factors with a consistent definition and results. For studies with adequate data, standardised mean differences (SMDs) or risk ratios (RRs) were compared to determine the risk factors’ effect size. Heterogeneity of studies was considered and accounted for, using chi-square and I2 tests.
Results: Thirty-six studies were included (23 in descriptive analysis and 13 in meta-analysis). Twenty-six variables were reported within these papers and pooled for analysis. The following factors were associated significantly with groin injuries: previous groin injury (RR 2.02, 95% CI 1.29 to 3.24, p=0.002); older players (SDM 0.31, 95% CI 0.15 to 0.48, p=0.0002); being a midfielder (RR 1.23, 95% CI 1.01 to 1.09, p=0.04); and participation in a match on natural grass (compared to artificial turf) (RR 1.52, 95% CI 1.04 to 2.23, p=0.03). For hamstrings, significant factors in sustaining injuries were; having a previous hamstring injury (RR 1.69, 95% CI 1.01 to 2.83, p=0.05); older players (SMD 0.44, 95% CI 0.22 to 0.67, p=0.0001); and defenders (RR 1.32, 95% CI 1.13 to 1.55, p=0.0006). Meanwhile, a meta-analysis of other risk factors revealed no significant association with a future hamstring injury for limb dominance, hamstring flexibility, or playing surface; and no significant association with both hamstring and groin injury for height, weight, and BMI.
Conclusion(s): Significant factors associated with a future hamstring injury are: a previous history of injuries; being an older player; and the individual’s playing position. These same factors are all associated with the risk of sustaining groin injuries while playing in a match on natural grass was an additional factor related to groin injuries. Future research should consider multi-variate models incorporating these features when considering preventative strategies.
Implications: By determining injury-factors, players at increased risk can be identified, and a more specific approach in their training or rehabilitation programme can be recommended. While this study identified no modifiable risk factors beyond specific playing surfaces for hamstring or groin injuries, there are sub-populations within the sport that are at greater risk of injury. Such players may need more specific risk reduction management approaches. Further, it would be beneficial for additional research to have the goal of confirming the modifiable risk factors, as well as analysing the factors that present conflicting evidence.
Funding, acknowledgements: The Saudi Arabian Ministry of Defence sponsored Mr Aljowair during the conduct of this review.
Keywords: Injury risk, football, thigh
Topic: Sport & sports injuries
Did this work require ethics approval? No
Institution: N/A
Committee: N/A
Reason: This study is a systematic review.
All authors, affiliations and abstracts have been published as submitted.
