The effect of hypermobility on the incidence of injury in professional football: A multi-site cohort study

Abstract

BackgroundA recent study demonstrated joint hypermobility increased the incidence of injury in an elite football team utilising a univariate statistical model. ObjectivesTo compare injury incidence between hypermobile and non-hypermobile elite football players incorporating a multi-site design and multivariate inferential statistics. Methods80 players comprising 3 English Championship football teams were followed prospectively during the 2012–2013 season. Joint hypermobility was assessed according to the 9-point Beighton Criteria at the start of the study period. A cut-off score of ≥4 categorised a participant as hypermobile. Player exposure and time-loss injuries were recorded throughout. ResultsMean ± standard deviation incidence of injuries was 9.2 ± 10.8 injuries/1000 h. The prevalence of hypermobility was 8.8%. Hypermobiles had a tendency for higher injury incidence (mean [95% confidence interval] difference, 5.2 [0.9–2.7] injuries/1000 h; p = 0.06). Cox regression analyses found training exposure to be highly significant in terms of injury risk (p < 0.001) for all participants. Non-hypermobiles had a lower injury risk (p = 0.11), according to the Cox model, which is suggestive but not conclusive that hypermobility predisposes injury risk. ConclusionsHypermobility showed a trend towards increased risk of injury. Training exposure is a significant injury risk factor in elite football.