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The Effect of Playing Position on Injury Risk in Male Soccer Players: Systematic Review of the Literature and Risk Considerations for Each Playing Position

October 11, 2018 | Surgery
Francesco Della Villa, MD ; Bert R. Mandelbaum, MD ; Lawrence J. Lemak, MD
Author and Disclosure Information

Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.

Dr. Della Villa is a Resident Sport Medicine Physician, Post Graduate School of Sport and Exercise Medicine, Alma Mater Studiorum Bologna University, Bologna, Italy; and Education and Research Department, Isokinetic Medical Group, FIFA Medical Center of Excellence, Bologna, Italy. Dr. Mandelbaum is an Orthopedic Surgeon, Cedar Sinai Kerlan Jobe Institute, Los Angeles, California. Dr. Lemak is an Orthopedic Surgeon, Lemak Health, Birmingham, Alabama.

Address correspondence to: Francesco Della Villa, MD, Education and Research Department, Isokinetic Medical Group, FIFA Medical Center of Excellence, Via di casteldebole 8/4 40132 Bologna, Italy. (tel, 00390512986800; email, f.dellavilla@isokinetic.com).

Francesco Della Villa, MD Bert R. Mandelbaum, MD Lawrence J. Lemak, MD . The Effect of Playing Position on Injury Risk in Male Soccer Players: Systematic Review of the Literature and Risk Considerations for Each Playing Position. Am J Orthop.

October 11, 2018

TAKE-HOME POINTS

  • Playing positions haven’t been extensively evaluated as an injury risk factor in elite, non-elite, and youth soccer (football).
  • Different playing positions may have different injury rates and patterns due to different load, different movement patterns, and peculiar combination of anticipated and non-anticipated (reactive movements).
  • The existing literature suggests that goalkeepers seem to be at lower general injury risk if compared to outfield players in male soccer (football).
  • There is also a tendency towards strikers (forwards) to be at higher risk of match (but not training) injuries. This result is however not consistent between all the studies considered and should be interpreted cautiously.
  • When studying injury risk in male soccer match and training injuries should be considered separately and playing position should be evaluated as a potential predictor of injury incidence.

RESULTS

STUDY SELECTION

Of the 1609 potential items we found in the existing literature, 102 full-text articles were screened for eligibility. Only 11 papers met the inclusion criteria and were included in the systematic review, including 2 studies on youth soccer and 9 studies on adult soccer (Figure 1). Five of the selected studies tracked only match injuries, while the remaining 6 studies presented data on both match and training injuries. As a matter of fact, the effect of player position was not so commonly evaluated or at least reported in the existing literature. Studies’ characteristics and main findings regarding player’s position are reported in Table.

GENERAL INJURY RISK AND PLAYING POSITION

Of the 11 studies included for qualitative synthesis, 5 studies reported no significant effect of player’s position on general risk of injury,7-11 3 studies reported a greater risk in forwards,12-14 1 study reported a greater risk in MFs,15 1 study reported a greater risk in forwards and central defenders,8 and finally 1 study reported a significant lower risk in GKs.16 Additionally, 2 more studies reported GKs to be at the lowest injury risk,12,13 another study reported GKs to have lost the lower number of matches,8 1 study didn’t consider the GK position in the analysis due to the low number of injuries,17 limiting the analysis on the outfield positions.

Out of the 5 studies reporting no significant effect of playing position on injury risk, 1 study found a tendency to more injuries in forward players,10 a second study found a tendency for higher injury risk in midfielders,18 and a third study found a tendency for higher risk in defenders.17 Considering only the 5 studies reporting data on match injuries, 3 reported a higher risk in forwards,12-14 while a fourth one reported a tendency for increased risk in forwards10 even if not statistically significant. On the other hand, evaluating the 6 studies reporting data on match and training injuries, most of the studies, 4 out of 6, reported no effect of playing position.17-20 The main findings of the studies are also expressed graphically in Figures 2A, 2B.

DISCUSSION

The main finding of this study is that there is substantially no agreement regarding the effect of player position on general injury risk in male soccer.

First, we must underline that not many studies have evaluated prospectively the influence of player’s position on injury risk. Of the 11 selected studies, 5 (5/11) reported no significant effect of playing position,7,10,17,18,20 while the remaining studies (6/11)8,12-16 reported a significant effect of player position on the risk of injury, with various results depending on the single study. It should be noted that the 2 studies with the longest observational period (15 consecutive seasons)16,19 did not report any difference in injury risk considering only the outfield playing positions.  

Continue to: We will now review the findings...

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