Evaluating the level of injury in English professional football using a risk based assessment process

Objectives: To show how epidemiological data can be presented and analysed in frequency based and risk based formats and how risk based information can simplify management decisions on injury prevention strategies in professional football. Methods: The club physiotherapists at four English professional football clubs prospectively recorded players' injuries over the period November 1994 to May 1997, The nature, location, and mechanism of each injury and the specific numbers of days that players were unavailable to train or play as a result of injuries were recorded. The rates of injury were evaluated on a risk matrix using the number of days and the estimated costs of absence as measures of injury consequences. Results: There was a significant difference in the time lost through injury as a function of injury severity (p<0.001). Slight and minor injuries accounted for 51% of all injuries but represented only 17% of the risk from injury, whereas major injuries accounted for only 12% of the number of injuries and 47% of the risk. Player to player contact injuries accounted for 39% of the risk of injury, and football specific activities accounted for 47% of the risk. The risks of acute injury in professional football were three orders of magnitude greater than those in the construction, manufacturing, and service sectors of industry. Conclusions: The risks associated with minor, moderate, and major acute injuries and osteoarthritis in lower limb joints of professional footballers were found to be unacceptable when evaluated against work based risk criteria used by the Health and Safety Executive, All stakeholders within professional football were shown to have an important contribution to make in reducing the overall level of risk to players through the provision of risk prevention strategies.