Potential head injuries in men's football, futsal and beach soccer: Distinct exposure-adjusted frequency and patterns from a comparative video analysis.

PURPOSE: Football, futsal and beach soccer differ in playing conditions, but data on differences in head injury characteristics are limited. The aim of this study was to systematically analyse and compare potential head injuries in these disciplines.

METHODS

Footage from 148 matches across three men's international tournaments (2022 FIFA World Cup, 2024 FIFA Futsal World Cup and 2024 FIFA Beach Soccer World Cup) were reviewed to identify potential head injuries (any event where a player remained down >5 s and/or requested medical-attention with the body part involving head/neck), player actions, visible signs of possible concussion, medical-assessments and outcomes. Incidence rates (IRs; number of potential head injuries per 1000 match-hours) were reported separately for each discipline based on official and total exposure times (the duration from initial to final whistle).

RESULTS

A total of 395 potential head injuries were identified: 186 (IR:85.8/1000 match-hours) in football, 86 (IR:247.8) in futsal and 123 (IR:627.5) in beach soccer. After exposure adjustment, IRs were 76.4, 122.3 and 383.2, respectively. Direct opponent contact was the main mechanism for all disciplines (football 81.5%, futsal 76.2%, beach soccer 78.9%). Unintentional ball-to-head impacts accounted for 6% of cases (football), 16.7% (futsal), and 13.8% (beach soccer). In beach soccer, 17.9% of injuries were associated with overhead kicks. Visible signs of a possible concussion were observed in 16.3% of cases (football), 9.5% (futsal) and 20.3% (beach soccer).

CONCLUSION

Incidence and patterns of potential head injuries differ across football, futsal and beach soccer, underscoring the need for individual recognition in all three disciplines. Ball-related impacts contributed significantly to the differences in IRs and overhead kicks posing a unique risk in beach soccer. Targeted preventive strategies, such as specific drills on safe blocking in futsal, and training to improve the safe execution of overhead kicks in beach soccer, may help reduce these risks.

LEVEL OF EVIDENCE: N/A.