Injuries among female football players

Abstract: Background: Football is a popular female team sport played by approximately 40 million women in over 100 countries all over the world. In Sweden football is the largest female team sport with more than 56,000 players over 15 years of age. Aim: The aims of this thesis were to investigate injuries and injury incidences among female non-elite players in second division as well as elite football players in the premiere league in Sweden over an entire football season with special emphases on regional and level differences; to investigate range of motion (ROM) at the beginning of the football season in relationship to upcoming joint (sprain) and muscle-tendon (strain) injuries; to investigate if the injury incidence varied during the different phases of the menstrual cycle and if there was a difference in injury incidence according to oral contraceptive (OC) pill usage. Material and methods: Thirty teams (n=522 players) from two different league levels in Sweden, the second division (9 teams from the most Northern league and 9 teams from the most Southern league, comprising 18 teams) and the premiere league (12 teams), were studied during an entire football season. Baseline information was obtained and ROM was measured. During the season menstruation and OC usage, football exposure and injuries were registered. Result: A total of 466 injuries were studied. The overall injury incidence was 9.6 injuries/1000 hours of football in the second division and 4.6 injuries/1000 hours of football in the premiere league. Traumatic injuries were in majority (59-69%), and the most common type of traumatic injury was sprain, mainly to the ankle. The distribution of injuries varied between regions; the number of total injuries as well as the total injury incidence was higher in the northern than southern region in the second division. Both traumatic and overuse injuries occurred mainly during the early preseason and at the beginning of the competitive spring season. Increased/decreased ROM in the lower extremity did not appear to be apredisposing risk factor for joint (sprain) or muscle-tendon (strain) injuries of the lower extremity. More than half the players began their football season with physical complaints, which in most cases disturbed their football activity. A total of 2 586 menstrual cycles were studied. An increased injuries incidence was noted during the menstrual phase compared to the pre- ovulatory phase as well as during the post-ovulatory phase compared to the pre-ovulatory phase for non-OC users. An increased incidence of traumatic injuries was also noted during the menstrual phase compared to the pre- ovulatory phase for non-OC users. There were no differences between the OC/non-OC groups concerning injury incidence during practice, game or total football. Conclusion: Evidence is presented in this thesis that regional factors as well as play- level are associated with injury incidence. Preseason ROM measurements cannot identify players at risk for upcoming sprain or strain injuries. An increased injury incidence duringthe menstrual phase was found, however, no significant difference in injury incidence between OC-users and non- users were found.