High Performance Soccer: A scoping review of injuries in professional soccer athletes
Creators: name: Colaço, Denis Junior
name: De Sá, Clodoaldo Antônio
Publisher: name: OSF
Year: 2024
Subjects: elite athlete
sports injuries
sports medicine

description: Soccer is one of the most popular sports on the planet (Batista, 2021) with around 400 million players (Silva et al., 2019), at least 30 million of whom are Brazilian. According to the International Football Federation (FIFA), around 200 million athletes around the world are professionals. 
Professional athletes are those who have a written contract with a club and are paid more than they actually spend on their soccer activity (FIFA Regulations on the Status and Transfer of Players 2023). Any other player who doesn't fit this description is considered an amateur. Furthermore, injuries in professional soccer are defined by Maestro et al. (2022) as any physical complaint suffered by a player as a result of a soccer match or training session, regardless of medical care or time lost from soccer activities. Injuries are one of the main factors that jeopardize athletes' careers and generate considerable annual costs for clubs and the health system.
From this perspective, the evolution of professional soccer practice shows new competition scenarios, where players are exposed to an excessive number of games, which can exceed 80 matches in a single season (Possolini and Berto, 2022) for clubs and/or national teams. This causes the athlete a high level of wear and tear, increasing sports injuries, which cause great damage in several areas for the athlete, their club (Barbalho et al., 2017; Lopes, 2017; Nascimento and Chiapeta, 2017 apud Possolini and Berto, 2022). In this scenario, injuries in sport, but especially in soccer, are multifactorial (Mandorino et al., 2023), and the associated factors can be intrinsic (e.g. flexibility, strength, age, gender, previous injury) or extrinsic (e.g. training load, rules, playing surface, etc.).
Depending on the tactical characteristics of the team, the planning of a match and the positions they occupy on the pitch, soccer players have very different biomechanical and even metabolic demands. The dynamics of a soccer match require actions with high physical and metabolic demands such as jumping, abrupt stops, accelerations, decelerations, sprints, among others, which requires a high physical training load so that the athlete can meet the demands of each game in the best possible way.
In this context, controlling training and competition overloads is a determining factor in reducing the number of injuries. Thus, Guex et al. (2012) show that footballers most at risk of injury are those who play in a speed position, since they are the athletes most susceptible to covering long distances with greater accelerations and abrupt decelerations. In this context, the course of injuries can often affect the continuation of a footballer's career, due to the degree of damage caused. Kaprio et al. (2001) report that one in five elite male athletes have ended their careers due to injury, corroborating Heinonen et al. (2011) who state that injuries account for around 47% of soccer dropouts.
In addition, injuries to players, especially those with higher salaries, represent a significant loss for clubs, significantly impacting the soccer market, which accounts for around 0.78% of Brazil's gross domestic product (Caboclo, 2019), not to mention the damage to the player's professional career due to long periods away from games and training (Asif, et al., 2017). It should also be noted that injuries are also associated with the early end of sporting careers (Heinonen, et al., 2011), with players finding it difficult to adapt to their post-career lives, largely as a result of injuries sustained while playing soccer (Carapinheira et al., 2018).
Considering the context presented above, this review seeks to synthesize the knowledge available in the scientific literature about the factors associated with injuries in professional soccer players and to understand the multidimensionality of the factors associated with the etiologies of injuries. It is therefore important to map, identify and characterize injuries, and what strategies and mechanisms are known to reduce the incidence of injuries in soccer. In order to constitute a fundamental element in the planning of clubs considering the maximum performance of athletes with the least possible number of injuries.