Within-club comparison of injury patterns, burden and incidence in senior and under-21 South African professional football players.

BACKGROUND

South African football injury epidemiology remains limited and internally heterogeneous. No South African study was identified by the authors that directly compared senior and under-21 male squads within the same professional club across one competitive season while examining both contact and non-contact injuries.

METHODS

This retrospective cohort study analyzed anonymized clinical injury profiles and exposure records from 69 male players registered to a senior squad (N.=33) and an under-21 squad (N.=36) during one competitive season. Only time-loss injuries were included. Injuries were diagnosed by the physiotherapist working across both squads. Individual players' accrued training and match hours were summed to generate squad exposure denominators. Injury incidence was expressed per 1000 exposure-hours. Between-squad comparisons were reported as incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Because original injury-type categories contained sparse cells, inferential comparison of injury type was based on grouped categories.

RESULTS

The senior squad sustained 95 injuries across 9 864 exposure-hours (9.63/1000 h), while the under-21 squad sustained 46 injuries across 6030 exposure-hours (7.63/1000 h). Overall injury incidence did not differ significantly between squads (IRR 1.26; 95% CI 0.89 to 1.80; P=0.19). Match injury incidence exceeded training incidence in both groups. Muscle/strain injuries accounted for approximately half of all injuries in both squads. Posterior thigh injuries were the most common anatomical location, and ligament/tendon-related injuries represented a larger proportional burden in the under-21 squad.

CONCLUSIONS

The findings suggest a comparable overall seasonal injury burden between squads, but indicate clinically relevant differences in injury composition, time-loss burden and exposure context. Transition into senior football may be shaped less by large differences in overall incidence than by differences in tissue profile, burden and the contexts in which injury occurs.