Intrinsic risk factors - Gender

There is not sound evidence on the impact of gender on muscle injury risk in soccer, mainly because women's soccer has become very popular in the last years and most scientific studies have been carried out using as reference point the data of male players (Figure 1).

In a review [12] seven studies showed that female athletes had a higher incidence of injury, two reported that male athletes showed a higher incidence of injury, five studies found no association between sex and injury, and one found that the rate of ankle and knee specific injuries differed with gender. There is no evidence of difference in the incidence of muscle injuries between males and females. It is also well documented that female athletes have more knee injuries than male athletes, specifically ACL sprains. Within intercollegiate sports, female soccer players were 9 times more likely to sustain an ACL tear than male soccer players [1].

In conclusion, although it is clear that female athletes are at increased risk of suffering ACL injuries, the relation between gender and other types of lower extremity injury is unclear.

Figure 1. Female soccer is today very popular.

• Age

Age is a widely studied risk factor for muscle injuries, particularly in recent years, with the increase in the average age of players, especially at the amateur level (Figure 2). In available literature, there are conflicting data about age as a predisposing factor to muscle injuries. Some studies have identified increasing age as an independent risk factor for muscle injuries in Australian footballers [14-16] and soccer players [2,45]. These authors found increased risk in Australian footballers and soccer players older than 23 years [14,45]. Furthermore each year of age has been reported to increase the risk of muscle injuries by as much as 1.3 times in Australian footballers [15] and by 1.8 times in soccer players [17]. In a study on 123 female soccer players (age range 14-39 years), the authors found a significantly increased risk of overall injury in athletes older than 25 years compared with younger athletes [18]. In a study on professional soccer players the incidence of global muscle injuries increases with age, but an increased incidence with age has been found for calf muscle injuries only, and not for hamstring, quadriceps or hip/groin injuries [19]. During training sessions, players in the oldest age group (over 30 years) had a significantly higher incidence than young (below 22 years) players, while there were no differences compared to the intermediate (22-30 years) age group. During matches, young players had a lower incidence than the intermediate and older age groups [19]. All studies that report age as significant risk factor conclude that age increases hamstring injury risk independently of other variables such as previous injury.

The explanation for increased muscle injury risk, with age is quite controversial. Some authors maintain that it is due to an increase of weight and a reduction of the flexibility of the hip flexors in athletes 25 years or older [20]; others indicate the cause in the reduction of lean body mass and strength [21].

Other hypotheses are age-related changes in muscle structure [13] and entrapment of L5/S1 nerve root due to hypertrophy of the lumbo-sacral ligament [22].

However, there are also some studies that found no correlation between aging and increase of muscle injuries [12,22,23].

Figure 2. Soccer: a passion all over the world, for babies and old players.

In consideration of data available in literature further studies of longer duration are required to determine the effective importance of aging on muscle injuries.

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  • Category: Musculoskeletal system