Females Sustain more Ankle Injuries than Males in Youth
                    Football

Taru Sokka; Matias Hilska; Tommi Vasankari; Mari Leppänen; Pekka Kannus; Jari Parkkari; Heidi Haapasalo; Hannele Forsman; Jani Raitanen; Kati Pasanen

doi:10.1055/a-1192-5399

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2020; 41(14): 1017-1023
DOI: 10.1055/a-1192-5399

Training and Testing

Females Sustain more Ankle Injuries than Males in Youth Football

Authors

Taru Sokka

¹UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
Matias Hilska

¹UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
Tommi Vasankari

²The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland
Mari Leppänen

¹UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
Pekka Kannus

²The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland
Jari Parkkari

¹UKK Institute, Tampere Research Centre of Sports Medicine, UKK Instituutti, Tampere, Finland
Heidi Haapasalo

³Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
Hannele Forsman

⁴Eerikkilä Sports Institute Training Center, Eerikkilä, Tammela, Finland
Jani Raitanen

²The UKK Institute for Health Promotion Research, UKK Instituutti, Tampere, Finland

⁵Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland
Kati Pasanen

⁶Sport Injury Prevention Research Centre Faculty of Kinesiology Alberta Children’s Hospital Research Institute, McCaig Institute for Bone and Joint Health, Calgary, Canada

Abstract

This prospective study evaluated the incidence and pattern of acute injuries in youth (9- to 14-year- old) football players. Ten football clubs [n=730 players (567 males, 163 females)] participated in the 20-week follow-up study (January–June 2015). Data was collected by sending a standardized weekly SMS to players’ parents/guardians with follow-up interviews for injured players. During the study period, 278 players (38%) sustained 410 acute injuries. The overall injury incidence for males and females was 6.47 (95% CI, 5.84–7.09) injuries per 1000 h of football exposure. Most injuries (40%) caused minimal absence from sports. Eighty-four percent of the injuries affected the lower extremities, with the ankle (30%), knee (17%), and thigh (16%) being the most commonly injured body sites. Females had significantly higher ankle injury rate (IRR) 1.85 (95% CI, 1.18–2.91, p=0.007) and non-contact ankle injury rate IRR 2.78 (95% CI, 1.91–4.02, p<0.001) than males. In conclusion, our results showed that the acute injury incidence among youth football is moderately high, and females are at higher risk for ankle injuries. Injury prevention programs aimed at preventing ankle injuries should be considered in the future.

Key words

football - epidemiology - acute injury - sports injury - youth

Full Text

References

References
1 Football Association of Finland, 2018. Vuosikertomus. https://www.palloliitto.fi/sites/default/files/Palloliitto/vuosikertomus_2018.pdf; Accessed 28 February 2020
2 Faude O, Rößler R, Junge A. Football injuries in children and adolescent players: Are there clues for prevention?. Sports Med 2013; 43: 819-837
3 Krustrup P, Aagaard P, Nybo L. et al. Recreational football as health promoting activity: A topical review. Scand J Med Sci Sports 2010; 20: 1-13
4 Hoff J, Helgerud J. Endurance and strength training for soccer players: Physiological considerations. Sports Med 2004; 34: 165-180
5 Steffen K, Myklebust G. Olsen et al. Preventing injuries in female youth football – a cluster-randomized controlled trial. Scand J Med Sci Sports 2008; 18: 605-614
6 Froholdt A, Olsen OE, Bahr R. Low risk of injuries among children playing organized soccer: A prospective cohort study. Am J Sports Med 2009; 37: 1155-1160
7 Radelet MA, Lephart SM, Rubinstein EN. et al. Survey of the injury rate for children in community sports. Pediatrics 2002; 110: e28
8 Rössler R, Junge A, Chomiak J. et al. Soccer injuries in players aged 7–12 years: A descriptive epidemiological study over 2 seasons. Am J Sports Med 2016; 44: 309-317
9 Aoki H, Kohno T, Fujiya H. et al. Incidence of injury among adolescent soccer players: A comparative study of artificial and natural grass turfs. Clin J Sport Med 2010; 20: 1-7
10 Brink MS, Nederhof E, Vissvher C. et al. Monitoring load, recovery and performance in young elite soccer players. J Strength Cond Res 2010; 24: 597-603
11 Brito J, Malina RM, Seabra A. et al. Injuries in Portuguese youth soccer players during training and match play. J Athl Train 2012; 47: 191-197
12 Ergun M, Denerel HN, Binnet MS. et al. Injuries in elite youth football players: A prospective three-year study. Acta Orthop Traumatol Turc 2013; 47: 339-346
13 Giannotti M, Al-Sahab B, McFaull S. et al. Epidemiology of acute soccer injuries in Canadian children and youth. Pediatr Emerg Care 2011; 27: 81-85
14 Hägglund M, Walden M. 2016. Risk factors for acute knee injury in female youth football. Knee Surg Sports Traumatol Arthrosc 2016; 24: 737-746
15 Kakavelakis KN, Vlazakis S, Vlahakis I. et al. Soccer injuries in childhood. Scand J Med Sci Sports 2003; 13: 175-178
16 Peterson L, Junge A, Graf-Baumann T. et al. Incidence of football injuries and complaints in different age groups and skill-level groups. Am J Sports Med 2000; 28: 51-57
17 Steffen K, Andersen TE, Bahr R. Risk of injury on artificial turf and natural grass in young female football players. Br J Sports Med 2007; 41: 33-37
18 Nilstad A, Bahr R, Andersen TE. Text messaging as a new method for injury registration in sports: A methodological study in elite female football. Scand J Med Sci Sports 2012; 24: 243-249
19 Moller M, Attermann J. Mykleburst et al. Injury risk in Danish youth and senior elite handball using a new SMS text messages approach. Br J Sports Med 2012; 46: 531-537
20 Ekegren C, Gabbe B, Finch C. et al. Injury reporting via SMS text messaging in community sport. Inj Prev 2014; 20: 266-271
21 Van Mechelen W, Hlobil H, Kemper HCG. Incidence, severity, aetiology and prevention of sports injuries. Sports Med 1992; 14: 82-99
22 Harriss DJ, Macsween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 update. Int J Sports Med 2019; 40: 813-817
23 Fuller CW, Ekstrand J, Junge A. et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Clin J Sport Med 2006; 16: 97-106
24 Olsen O-E, Myklebust G, Engebretsen L. et al. Injury mechanisms for anterior cruciate ligament injuries in team handball. A systematic video analysis. Am J Sports Med 2004; 32: 1002-1012
25 Leppänen M, Pasanen K, Clarsen B. et al. Overuse injuries are prevalent in children’s competitive football: A prospective study using the OSTRC Overuse Injury Questionnaire. Sports Med 2018; 0: 1-8
26 StataCorp LP.. Stata Base Reference Manual, Release 13. College Station, TX: Stata Press; 2013. https://www.stata.com/manuals13/r.pdf; accessed 5 May 2020
27 Owoeye BA, Akimbo RA, Tella A. et al. Efficacy of the FIFA 11+ Warm-up programme in male youth football: a cluster randomised controlled trial. J Sports Sci Med 2014; 13: 321-328
28 Pasanen K, Parkkari J, Pasanen M. et al. Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study. BMJ 2008; 337: a295
29 Soligard T, Myklebust G, Steffen K. et al. A comprehensive warm-up programme to prevent injuries in young female footballers: Cluster randomised controlled trial. Br J Sports Med 2008; 44: 787-793
30 Steffen K, Emery CA, Romiti M. et al. High adherence to a neuromuscular injury prevention program (Fifa 11 +) improves functional balance and reduces injury risk in Canadian youth female football players: A cluster randomised controlled trial. Br J Sports Med 2013; 47: 794-802
31 Rössler R, Junge A, Bizzini M. et al. A multinational cluster randomised controlled trial to assess the efficacy of ‘11+ kids’: A warm-up programme to prevent injuries in children’s football. Sports Med 2017; 22: 1-12
32 Walden M, Atroshi I, Magnusson H. et al. Prevention of acute knee injuries in adolescent female football players: A cluster randomised controlled trial. BMJ 2012; 344: e3042
33 Dvorak J, Lichtenstein E, Beaudoin F. et al. A multinational cluster randomised controlled trial to assess the efficacy of ‘11+ kids’: A warm-up programme to prevent injuries in children’s football. Sports Med 2017; 22: 1-12
34 Le Gall F, Carling C, Reilly T. Injuries in young elite female soccer players: An 8-season prospective study. Am J Sports Med 2008; 36: 276-284
35 Larruskain J, Lekue JA, Diaz N. et al. A comparison of injuries in elite male and female football players: A five-season prospective study. Scand J Med Sci Sports 2018; 22: 237-245
36 Söderman K, Adolphson J, Lorentzon R. et al. Injuries in adolescent female players in European football: A prospective study over one outdoor soccer season. Scand J Med Sci Sports 2001; 11: 299-304
37 Rössler R, Junge A, Chomiak J. et al. Risk factors for football injuries in young players aged 7–12 years. Scand J Med Sci Sports 2018; 28: 1176-1182
38 Van Beijsterveldt AMC, Horst N, Port IGL. et al. How effective are exercise-based injury prevention programmes for soccer players?. Sports Med 2013; 43: 257-265
39 Powell JW, Barber-Foss KD. Sex-related injury patterns among selected high school sports. Am J Sports Med 2000; 28: 385-391
40 Giannotti M, Al-Sahab B, McFaull S. et al. Epidemiology of acute head injuries in Canadian children and youth soccer players. Injury 2010; 41: 907-912

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