Concussions in German professional football (soccer) - an epidemiological and etiological analysis over nine consecutive seasons.

OBJECTIVES

Data of the German Statutory Accident Insurance (VBG) was used, to analyze the occurrence, time loss, the injury mechanism and situational patterns of concussions in German male professional football.

DESIGN

Prospective observational open cohort study over nine consecutive seasons between 2014/15 and 2022/23.

METHODS

All concussions during the observation period registered by clubs or physicians with the German statutory accidental insurance for professional athletes (VBG) as part of mandatory occupational accident reporting were included for epidemiological analyses. All match concussions leading to ≥7 days of time loss and/or ≥1000€ healthcare costs were included for a standardized video analysis of injury mechanism and situational patterns.

RESULTS

Mean concussion prevalence was 2.9% (95% CI 1.8 to 4.0) resulting in 0.77 concussions (95% CI 0.4 to 1.06) per season for a men's professional football team. The match incidence was 0.84 concussions per 1000 h of match exposure (95% CI 0.72 to 0.96). The odds for a concussion were significantly higher in match-play compared with training (OR 2.82, 95% CI 2.16 to 3.69, p < 0.001). Goalkeepers and defenders were significantly more likely to sustain a concussion compared with midfielders and strikers (p < 0.001). 49.4% of the players returned to play in less than six days without significant differences between BL1 (48.1%, 51/106) and BL2 (50.4%, 63/125). There was no significant difference in mean time loss after concussion between BL1 (7.7 ± 10.6) compared to BL2 (6.9 ± 9.2, p = 0.351). Only 37.5% of the concussions could be identified and validated with public media-based data. Most concussions occurred in head-to-head or hip-to-head collisions and were not judged as foul play by the opponent in 83% of cases.

CONCLUSIONS

The present study delivers a comprehensive high-quality data set over nine consecutive seasons on concussions in professional German soccer which reveals that the implementation of appropriate RTP strategies seems to be lacking.