Injuries During Return to Sport After the COVID-19 Lockdown: An Epidemiologic Study of Italian Professional Soccer Players

Abstract

Background: The injury rate in professional soccer players may be influenced by match frequency. Purpose: To assess how changes in match frequency that occurred because of coronavirus disease 2019 (COVID-19) influenced training and match injuries in the Italian Serie A league. Study Design: Descriptive epidemiology study. Methods: Three phases in the Serie A league, each 41 days long, were evaluated: phase A was the beginning of the 2019-2020 season; phase B was a period after the COVID-19 lockdown was lifted, when the remaining matches of the season were played with greater frequency; and phase C was the beginning of the 2020-2021 season. All male professional soccer players who were injured during the 3 phases were included. Player age, height, position, injury history, and return to play (RTP) were retrieved from a publicly available website. Training- and match-related injuries during each of the 3 phases were collected and compared. Moreover, match injuries that occurred after the lockdown phase (phase B), in which there were 12 days designated for playing matches (“match-days”), were compared with injuries in the first 12 match-days of phases A and C. Results: When comparing 41-day periods, we observed the injury burden (per 1000 exposure-hours) was significantly lower in phase B (278.99 days absent) than in phase A (425.4 days absent; P < .05) and phase C (484.76 days absent; P < .05). A longer mean RTP period was recorded in phase A than in phase B (44.6 vs 23.1 days; P < .05). Regarding 12–match day periods (81 days in phase A, 41 days in phase B, and 89 days in phase C), there was a significantly higher match injury rate (0.56 vs 0.39 injuries/1000 exposure-hours; P < .05) and incidence (11.8% vs 9.3%; P < .05) in phase B than in phase A and a longer mean RTP period in phase A than in phase B (41.8 vs 23.1 days; P < .05). Finally, the rate and incidence of training-related injuries were significantly higher in phase B (4.6 injuries/1000 exposure-hours and 6.5, respectively) than in phase A (1.41 injuries/1000 exposure-hours and 2.04, respectively) ( P < .05). Conclusion: Both training- and match-related injuries were greater during the abbreviated period after the COVID-19 lockdown. These may be linked to the greater match frequency of that period.

Changes in sport-related concussion and traumatic brain injury in New Zealand during the first two years of the COVID-19 pandemic

“…For instance, there is evidence suggesting that professional football and rugby athletes experienced increased injury incidence rates during post-lockdown periods. 18 , 19 , 20 Two main potential explanations have been offered. Firstly, extended lockdown and restrictions can lead to deterioration in training quality and volume, and subsequent deconditioning can lead to increased risk of injury.…”

“…Firstly, extended lockdown and restrictions can lead to deterioration in training quality and volume, and subsequent deconditioning can lead to increased risk of injury. 18 Secondly, to make up for lost time, there may be considerable match congestion when resuming competition post-lockdown. That is, playing the same number of matches in fewer days can significantly increase the risk of injury, 18 although this may be mitigated by having an adequate period of training prior to resuming the competition.…”

“… 18 Secondly, to make up for lost time, there may be considerable match congestion when resuming competition post-lockdown. That is, playing the same number of matches in fewer days can significantly increase the risk of injury, 18 although this may be mitigated by having an adequate period of training prior to resuming the competition. 19 , 20 …”

Impact and control of the COVID pandemic in an elite sports club: Real Madrid

“…Speaking more specifically about soccer teams, the publications on COVID and soccer often focus on particular aspects such as the impact of quarantine or COVID on team sports performance [18,19,[46][47][48] or the psychological impact of the pandemic on players and their families [33,49]. There are reports on the change in sporting outcomes caused by pandemic conditions, such as a lower win ratio when playing in stadiums without a crowd [17, [50][51][52][53][54] and FIFA regulations during the pandemic [55][56][57].…”

Are Football Players More Prone to Muscle Injury after COVID-19 Infection? The “Italian Injury Study” during the Serie a Championship

“…Indeed, muscle injuries still represent the first cause of injuries in football, accounting for a huge amount of missed matches for the players [ 20 , 21 ]. However, to the best of our knowledge, only a few studies have focused on the association between SARS-CoV-2 infection and muscle strain injuries in elite football players [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], often with questionable and conflicting results [ 30 ]. Furthermore, none of these studies investigated the influence of the COVID-19 level on the risk of injury.…”