Foot & ankle injuries in elite professional footballers: The findings of one English Premier League team
D Murray1, NPM Jain1, S Kemp2, T McEvoy3 Specialist Registrar, North West Deanery, Manchester, United Kingdom 2 Wolverhampton Wanderers Football Club, Wolverhampton, United Kingdom 3 Royal Preston Hospital, Preston, United Kingdom 1
INTRODUCTION
Introduction • Foot and ankle injuries are a common occurrence amongst all footballers • Awareness as to how common these injuries are would have many benefits to the football club and the players
Introduction • The aim of this study was to: – establish the frequency and variation of foot and ankle injuries within one English Premier League (EPL) professional football club over the course of a season
– attempt to identify any factors associated with the injuries
MATERIALS AND METHODS
Materials & Methods • Data was collected prospectively for all foot and ankle injuries suffered by first team players over the 2008-09 and 2009-10 EPL season at one EPL club • Note – the injuries recorded are only those bad enough that it caused a player to miss a game
Materials & Methods • Each player’s demographics were recorded along with various factors concerning or influencing the injury including: – playing surface - type and side of injury – recovery time - ability to continue playing – pitch condition - type of footwear – foot posture index score (FPIS) - mechanism of injury – dominant side
Materials and Methods
RESULTS
Results FREQUENCY • 12 players within the squad of 38 sustained a foot ankle injury during a match over the 2 seasons – 12/38 = 32%
• Therefore the risk of injury per season is 16% – 32/2 = 16% – Or 12/2 = 6 – 6/38 = 16%
Results
Results 5.5% of all injuries were foot injuries and 14.4% ankle
Results • The commonest injury was 5th metatarsal fracture seen in 33% • Lateral ligament sprain was seen in 28% • Syndesmosis injury in 17%
Results Mean time (days) to return to play by injury 80
70 60
• The mean recovery time following 5th metatarsal fractures was 69 days
50 40 30 20 10 0 Syndesmosis 5th Metatarsal fracture Lateral Ligament Sprain
Results • 67% of all injuries (100% of 5th metatarsal fractures) were sustained while wearing blade footwear
• 55% in wet conditions
• Supination was the most common foot posture (43%)
Results • 52% of injuries were sustained in the tackle
• 56% of injuries were in the dominant (kicking) foot
• There were no ankle fractures observed
Results • Injury per 1000 hours – 8333 minutes per injury – 1000 hours = 60 000 minutes – 60 000 / 8333 = 7.2
• Therefore 7.2 foot & ankle injuries per 1000 hours
DISCUSSION
Discussion • Ekstrand et al – UEFA study Br J Sp Med 2011 – 25.7 total injuries per 1000 hours played in a match – 20% were foot & ankle injuries
• 5.1 F&A injury every 1000 hours – Compared to our study 7.2
Discussion
Discussion • Prediction of F&A injuries is beneficial to club – Can estimate need for treatment – Can predict and prepare for absences – Affects insurance – Can invest in prevention • Evidence in the NBA • Modification of equipment
CONCLUSIONS
Conclusions • Foot and ankle injuries
sustained in a game are common in elite professional footballers (16% in a season)
• Injuries that are not serious
enough to cause missed games are even more common (48%)
Conclusions •
Our findings suggest that 5th metatarsal fractures are the most common foot & ankle injury amongst professional footballers
•
Ankle fractures are relatively rare in comparison
•
Injuries appear to occur more frequently with blade footwear as opposed to traditional studded footwear
Thank you
E-mail: npmjain@hotmail.com NB – There are no disclosures or conflicts of interest with this study