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Epidemiology of injuries among Italian footballers: the role of the playing field
  1. Francesco Paolo Bianchi1,
  2. Valter Veneziani2,
  3. Michele Alberto Cantalice1,
  4. Angela Notarnicola3,
  5. Silvio Tafuri1
  1. 1 Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, Italy
  2. 2 Degree course in Sport and Movement Science, School of Medicine, Aldo Moro University of Bari, Bari, Italy
  3. 3 Orthopaedics Unit, Department of Basic Medical Science, Neuroscience and Sensory Organs, Faculty of Medicine and Surgery, University of Bari, General Hospital, Bari, Italy
  1. Correspondence to Professor Silvio Tafuri, Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari 70124, Italy; silvio.tafuri{at}


Background Football has a higher injury rate compared with other team sports such as rugby, in terms of two main categories: intrinsic (individual) and extrinsic (environmental) factors. The playing field is an extrinsic risk factor which has been poorly investigated in the literature.

Purpose The aim of our study was to define the incidence and risk factors of injuries in a cohort of footballers comparing the role of three different types of playing field (hard court, natural grass or synthetic grass).

Study design This was a cross sectional prevalence study.

Methods The population comprised footballers recruited by a convenience sample; the instrument used for the survey was an anonymous self-administered questionnaire.

Results 267 football players were enrolled (average age 23.4±4.8 years), of whom 33.7% (n=90/267) played on hard court, 33.0% (n=88/267) on natural grass and 33.3% (n=89/267) on synthetic grass. The overall incidence of injury was 40.1 (95% CI 34.1 to 46.8) ×1000 person-years of training, with higher values for ankle and knee injuries. Ankle injuries (aOR 0.4; P=0.021) were associated with playing on natural grass as a protective factor, while playing on natural grass seemed to be a risk factor for muscular injuries (aOR 2.3; P=0.026).

Conclusion Our study showed a high lifetime prevalence of injury among footballers (57%), in particular among athletes who play and train on a hard court. We have studied a topic poorly investigated previously and provide the opportunity to understand interventions to increase the capacity of stakeholders in preventing injuries.

  • epidemiology
  • playground
  • health education
  • multiple injury
  • burden of disease
  • sports / leisure facility

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  • Contributors Bianchi FP and Veneziani V designed the study, collected results, analysed data and draft the manuscript. Cantalice MA contributed to the collection and analysis of data. Tafuri S e Notarnicola A tested the questionnaire and revised the protocol of the study and the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The study was approved by Osservatorio Epidemiologico Regionale.

  • Provenance and peer review Not commissioned; externally peer reviewed.