ISAKOS Congress 2021

2021 ISAKOS Biennial Congress Paper


The Higher Rate of Injury Following the COVID-19 Lockdown Period in Elite Professional Footballers Highlights the Importance of Pre-Season Training

Albert Tang, MBChB, BSc (Hon), MRCS, MSc SEM (Hon), PGDip SEM, Manchester UNITED KINGDOM
John Ranson, MBChB, BSc (Hons), MRCSEd, Manchester UNITED KINGDOM
Neil Jain, BM, MRCS(Ed), FRCS(Tr&Orth), Manchester UNITED KINGDOM

Manchester Institute of Health & Performance, Manchester, UNITED KINGDOM

FDA Status Cleared


We highlight the benefits of a formal preseason in professional football in terms of there being a lower injury rate at the start of the season following a formal preseason.



The ‘preseason’ is an established period of the professional football season for players to gain fitness and has been demonstrated to subsequently improve player performance following the start of the season. Although players are at greater risk of injury in the preseason period, it is questioned whether a preseason subsequently decreases the risk of injury in the start of the formal season itself. Due to the established nature of the preseason no studies have previously reviewed the effect of the preseason on injury rates in the subsequent season.

Our aim was to report the injury rate from post-lockdown professional football games (no preseason programme - NPP) and compare to the start of the season (following a preseason programme - FPP). This would then provide a comparison between the two groups and a determination of the potential beneficial effect of a formal preseason on the injury rates at the start of the formal season.


We compared the injuries sustained across 4 European Professional Football Leagues (Premier League, Serie A, Bundesliga, La Liga) from the first 2 games for each team at the start of the 2019-20 season (FPP group) and from the first 2 games for each team after the re-start of football following lockdown (NPP group). We recorded the frequency, injuries per game, contact and soft tissue injuries. An injury was recorded if the player was deemed unable to continue play.


In total 156 games were reviewed, 78 in the FPP group and 78 in the NPP group. A total of 10 injuries were observed in the FPP group games, 0.13 per game, compared to 30 injuries in the NPP group games, 0.39 per game (p=0.001). The ratio of contact to soft tissue injuries was the same for both groups (1:4). There was no significant difference in the length of downtime between the leagues stopping and restarting (92 -103 days) and no correlation between injury rate and length of downtime.


Injuries in elite professional football were more common in the first 2 games following the restart after lockdown than in the first 2 games of the 2019/20 season. We believe this is due to the beneficial effect of a normal preseason being absent for the restart. We highlight the importance of preseason in reducing injury rates amongst professional footballers.

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