Abstract

PurposePsychological factors have shown to be predictors of injury in professional football. However, it seems that this is a two-way relationship, as severe musculoskeletal time-loss injuries have shown to be associated with the onset of symptoms of common mental disorders (CMD). There is no longitudinal study performed exploring this interaction between symptoms of CMD and injuries. The purpose of this study was to explore the interaction between severe musculoskeletal time-loss injuries and symptoms of CMD in professional football players over a 12-month period.MethodsPlayers were recruited by their national players’ unions in five European countries. Symptoms of CMD included in the study were related to distress, anxiety/depression, sleep disturbance and adverse alcohol use.ResultsA total of 384 professional football players were enrolled in the study, of whom 262 (68%) completed the 12-month follow-up period. The mean age of the participants at baseline was 27 ± 5 years, and they had played professional football for 8 ± 5 years on average. Symptoms of CMD at baseline were not associated with the onset of severe musculoskeletal time-loss injuries during the follow-up period with relative risks (and 95% CI) ranging from 0.6 (0.3–1.0) to 1.0 (0.5–2.2). In contrast, severe musculoskeletal time-loss injuries reported at baseline were associated with the onset of symptoms of CMD during the follow-up period with relative risks ranging from 1.8 (0.8–3.7) to 6.9 (4.0–11.9).ConclusionNo relationship was found between symptoms of CMD and the onset of severe musculoskeletal time-loss injuries. However, professional football players who suffered from severe musculoskeletal time-loss injuries are likely to develop subsequent symptoms of CMD. This study emphasizes the need for an interdisciplinary medical approach, which not only focuses on the physical but also on the mental health of professional football players. An early identification of players at risk of symptoms of CMD, such as those suffering from severe musculoskeletal injuries, creates the opportunity for an interdisciplinary clinical medical team to treat the players timely and adequately.Level of evidenceProspective cohort study, Level II.

Highlights

  • The overall risk of injury in professional football is estimated to be 1000 times higher when compared to typical high-risk industrial occupations like in manufacturing, construction or in the service sector [9]

  • A 15-year epidemiological follow-up study among professional football players in Japan found that 2947 injuries occurred in 3984 matches and a mean annual injury rate of 21.8 per 1000 player hours [2]

  • The present study aimed to explore the interaction between severe musculoskeletal time-loss injuries and symptoms of common mental disorders (CMD) in professional football players over a 12-month period

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Summary

Introduction

The overall risk of injury in professional football is estimated to be 1000 times higher when compared to typical high-risk industrial occupations like in manufacturing, construction or in the service sector [9]. This study showed that typically a squad of 25 players could at least expect 50 injuries per season [12]. A 15-year epidemiological follow-up study among professional football players in Japan found that 2947 injuries occurred in 3984 matches and a mean annual injury rate of 21.8 per 1000 player hours [2]. Another 5-year prospective cohort study among professional football players competing at the Australian A-league presented a rate of timeloss injuries ranging from 58.9 to 109.7 time-loss injuries per squad of 25 players [19]. Time-loss injuries that result in a long period without training or competition are considered as major adverse events for the career of a football player, leading even to early retirement in the worst case [15, 31, 34]

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