Professional Asian football players have a higher rate of anterior cruciate ligament (ACL) ruptures and hamstring injuries than European football athletes, according to a new study.
ACL, Hamstring Injuries More Common in Asian Football
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In “Injury and illness epidemiology in professional Asian football: lower general incidence and burden but higher ACL and hamstring injury burden compared with Europe,” published online on January 5, 2021 in The British Journal of Sports Medicine, the researchers analyzed injury and illness epidemiology in professional Asian football.
They followed prospectively teams from the Asian Football Confederation league for three consecutive seasons, 2017 through 2019. Overall, there were 13 teams per season, 322 team months. The researchers collected data on time-loss injuries and illnesses as well as individual match and training exposures.
During the three consecutive seasons, the athletes had 232,665 hours of exposure (88.6% training and 11.4% matches) and sustained 1,159 injuries. About 496 of the injuries occurred during matches and 610 during training. Thirty-two injuries were reported “not applicable” and for 21 injuries data was missing.
Injury incidence was greater during match play (19.2±8.6 injuries per 1000 hours) than training (2.8±1.4; p < 0.0001). Overall incidence was 5.1±2.2.
The injury burden was also greater for match injuries than it was for training injuries (456±336 days per 1,000 hours vs. 54±34 days; p < 0.0001).
Complete ACL ruptures with 0.14 injuries (95% CI 0.9 to 0.19) and 29.8 days lost, and hamstring strains with 0.86 injuries (0.74 to 0.99) and 17.5 days lost were responsible for the greatest burden.
The researchers also reported that 9.9% of all injuries were reinjuries.
Index injuries caused 22.6±40.8 days of absence compared with 25.1±39 for reinjuries (p = 0.62). There were also 175 illnesses recorded which led to 1.4±2.9 days of time loss per team per month.
“Professional Asian football is characterized by an overall injury incidence similar to that reported from Europe, but with a high rate of ACL ruptures and hamstring injury, warranting further investigations,” the researchers wrote.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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