Match and Training Injuries in Women’s Football: A Systematic Review and Pooled Analysis of Published Studies - Abstract
Background: The injury risk to female football participants is high with 48% to 70% of all players sustaining at least one injury during a season. The majority (69% to 85%) of these injuries are acute onset.
Objective: To review and calculate pooled data estimates for women’s football injury epidemiology for participation levels in match and training environments.
Methods: A systematic review and pooled analysis for published studies reporting women’s football match and training injuries including estimated costs. Searches were performed in PubMed, CINHAL, Science Direct, Scopus, SPORT Discus, Springer Link and Wiley Online databases. Studies were considered if they reported women’s football match or training injuries between Jan 1990 to Dec 2021. Two authors extracted study characteristics, numerical data and assessed article quality by adhering to the protocols for systematic review of observational studies (MOOSE) and Strengthening and Reporting of Observational studies in Epidemiology (STROBE) statements.
Results: Of 36 articles identified as eligible for the systematic review, there were 363,652 match-hrs with 8,608 injuries and 2,924,138 match-athlete exposures (AE) with 15,470 match injuries resulting in pooled match injury incidence rates (IIR) of 23.7 (95% CI: 23.2 to 24.2) per 1,000 match-hrs and 5.3 (95% CI: 5.2 to 5.4) per 1,000 match-AEs. Of the total estimated female football injury costs (NZD$257,667,307) 63.6% were attributed to match injuries. There were more pooled injuries recorded for the lower limb (20.5 (95% CI: 19.8 to 21.3) per 1,000 match-hrs) than to the chest-back-other (RR: 7.4 (95% CI: 6.6 to 8.2); p<0.0001; d=1.03), upper limb (RR: 7.0 (95% CI: 6.3 to 7.7); p<0.0001; d=1.04) and head-neck (RR: 4.0 (3.7 to 4.3); p<0.0001; d=0.91) body regions. There were significantly more pooled contusions (19.8 (18.6 to 21.0) per 1,000 match-hrs) than sprains (RR: 1.8 (95% CI: 1.3 to 1.5); p<0.0001; d=0.65), strains (RR: 3.4 (95% CI: 3.0 to 3.9); p<0.0001; d=1.07) and concussions (RR: 19.8 (95% CI: 16.4 to 23.9); p<0.0001; d=1.31). Studies on female junior participants reported more training injuries (10.1 (9.5 to 10.7) per 1,000 training-hrs) than studies reporting on female adolescent (RR: 6.6 (95% CI: 5.5 to 7.8); p<0.001; d=0.76), amateur (RR: 3.8 (95% CI: 3.5 to 4.1); p<0.0001; d=0.34) and elite (RR: 2.8 (95% CI: 2.6-3.1); p<0.0001; d=0.48) level participants.
Conclusion: Injury prevention interventions need to focus on female junior football players to reduce lower limb injuries and contusions.
Key Points:
• Based on 35 studies, estimates of pooled injury incidence for female football match-related activities ranged from 20.9 per 1,000 match-hrs (junior) to 29.2 per 1,000 match-hrs (elite).
• Based on 25 studies, estimates of pooled injury incidence for female football training-related activities ranged from 1.6 per 1,000 training-hrs (adolescent) to 10.1 per 1,000 match-hrs (junior).
• The estimated match injury related costs were NZD$58,897,320 for studies reporting per 1,000 match-hrs and NZD$104,997,334 for studies reporting per 1,000 AEs.