The Football Association Injury and Illness Surveillance Study: The Incidence, Burden, and Severity of Injuries in English Women's Domestic Football—A 5‐Year Prospective Cohort Study

The epidemiology of injuries in English women's professional football is yet to be investigated. Therefore, the aim was to examine the incidence, severity, and burden of injury in English women's domestic football. Time-loss injuries, and match and training exposure, were collected by club medical staff across 5 seasons (2018-2023) from English Women's Super League and Championship teams (93 team seasons). The incidence, severity, burden, cause, onset and patterns of injury were examined. A bootstrapped negative binomial approach was employed to calculate incidence and burden estimates, time-trend analysis and injury rate ratios (IRR), all with accompanying 95% CI. 2167 injuries were reported, resulting in 76 687 days absent. Of these, 981 match injuries (eliciting 37 269 days absent) and 1186 training injuries (eliciting 39 418 days absent) were reported. Injury incidence was greater in matches than training (20.5 [16.9-24.1] vs. 2.9 [2.0-4.0] injuries per 1000 h [95% CI]; IRR: 7.3, 95% CI: 5.1-10.1). Match injury burden (775.1 days absent/1000 h [95% CI; 630.0-934.9]) was greater than training (96.9 days absent/1000 h [95% CI: 66.1-138.5]) (IRR: 8.3, 95% CI: 5.4-12.0). Training injury incidence decreased by 28% across the study period (p = 0.041), with no significant seasonal changes for match injury incidence (p = 0.218) or injury burden (p > 0.05). The most common diagnosis was hamstring injury (match: 2.37; training: 0.38; injuries/1000 h), while ACL injuries were the most burdensome (match: 136.31; training: 10.86 days absent/1000 h), with no significant seasonal changes observed (p > 0.05). Overall, the present study showed that injury incidence and burden were greater in matches than training, with incidence decreasing by 28% across the study period in training in English women's domestic football. Hamstring injuries were the most common injury diagnosis, and ACL injuries were the most burdensome; illustrating the need to continue to develop prevention strategies for these injuries. The present study provides injury surveillance information in English women's domestic football and can be a benchmark for the success of future injury prevention strategies.