Injuries and risk factors in elite female football

Anterior cruciate ligament (ACL) injuries represent a major problem in pivoting sports, and female football players seem to have a 2-3 times higher risk compared to male players. These injuries have serious short- and long-term consequences, including long rehabilitation time and increased risk of early osteoarthritis. In addition, we know that 60-



Place: Norges idrettshøgskole AUD D

Formal title

Risk factors for anterior cruciate ligament injuries in elite female football players


The aim of the study is to investigate injuries and risk factors among Norwegian elite female football players and to assess screening tools that may be used to identify knee injury risk.


The study is designed as a prospective cohort study where all female football players in the Norwegian elite league (Toppserien) have been invited to participation and screening of potential risk factors for ACL injuries. The screening involves one complete day of testing at the Norwegian School of Sport Sciences to assess potential biomechanical, anatomical, neuromuscular and genetic risk factors. The test day will have a total duration of about 7 hours per player. After the screening tests all ACL injuries occurring during football activity will be recorded. In addition, the players tested in 2009 were invited to participate in an individual registration of exposure and injuries using text messaging (SMS). These players weekly recorded their hours of training, minutes of match play and all time-loss injuries throughout the season. Players reporting an injury were contacted to collect information regarding the injury circumstances.


Prospective individual injury registration using text messaging resulted in more complete recording of injury patterns among elite female football players than standard team medical staff registration, which underestimated the incidence of time-loss injuries substantially (Paper 1).

Greater BMI was the only factor significantly associated with new lower extremity injuries in elite female soccer players. Greater BMI was associated with thigh injuries and players with lower peak knee valgus angles in a drop jump landing were more likely to sustain a new ankle injury. The history of a previous knee injury was associated with new injuries to the lower leg/foot, whereas neither of the intrinsic factors assessed were associated with knee injuries (Paper 2).

 Physiotherapists can reliably identify female athletes with high knee valgus angles during a vertical drop jump landing using real-time observational screening, but the screening test scores did not correlate to knee abduction moments. We found high inter-rater agreement between three physiotherapists using the screening test (Paper 3).

 Greater body height and static knee valgus, as well as lower hip abductor strength were associated with greater peak knee valgus angles in a drop jump landing. The multiple regression model with anatomical and neuromuscular characteristics combined explained 13% of the variance in the observed peak knee valgus (Paper 4).

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