The Football Association Injury and Illness Surveillance Programme: The Incidence, Burden, and Severity of Injuries in English Men's Domestic Football.

Due to the lack of large-scale research investigating the epidemiology of injury in English men's professional football, the present study aimed to examine the incidence rate, severity, and burden of injury in English men's domestic football. Injury surveillance data was prospectively collected and retrospectively analyzed. Time-loss injuries, and match and training exposure, were collected by club medical staff across 12 seasons (2013-2014 to 2024-2025) from English men's domestic clubs playing in the English Premier League and English Football League (EFL-Championship, League One, League Two) (416 team seasons). A bootstrapped negative binomial approach was adopted to calculate incidence rate and burden estimates, temporal analysis and incidence rate (IRR) and burden ratios (IBR), all with accompanying 95% CI. 15 986 time-loss injuries were recorded, resulting in 498 108 days absent over 2 286 030 exposure hours. Injury incidence rate was substantially higher in matches than training (24.9 vs. 3.6 injuries/1000 h; IRR: 7.0 [6.6-7.4]), as was injury burden (835.5 vs. 104.1 days absent/1000 h; IBR: 8.0 [7.5-8.7]). Match injury incidence rate remained stable across the study period, training injury incidence rate decreased by 4% per season (p < 0.001), but match injury burden increased by 5% (p < 0.001). Muscle injury incidence rate increased by 3% per season in matches (p = 0.004), but decreased by 3% in training (p = 0.028). Muscle injury burden increased in both matches (10%, p < 0.001) and training (4%, p = 0.006). Ligament injury incidence rate decreased by 5% per season in training (p < 0.001). Hamstring injuries were the most common diagnosis (1.33 injuries/1000 h) and contributed the greatest overall burden (40.37 days absent/1000 h). Over 12 seasons in English men's professional football, match-play consistently accounts for a greater injury incidence rate and burden than training. While match injury incidence rate has remained stable, burden has increased, specifically for muscle-related injuries.