Summary
Problem
Some 590.000 Austrians (7,3 % of the population), both male and female, play soccer in their spare time. On the one hand there is the organised sport in the form of clubs, on the other the freely organised recreational soccer. Around 390.000 football players are currently organised in the 2.253 clubs belonging to the Austrian Football Association (ÖFB), the remaining 200.000 players participate in their sport without being a member of a soccer club.
Some 42,000 football players suffer an injury every year. Compared to other sports, the risk of injury is exceptionally high: out of 100 players, 7 become injured.
With a rate of 7,1 % soccer has the highest rate of injury out of all popular sports in Austria. By way of comparison, 1,5 % of alpine skiers suffer injuries, 1,4 % of those playing tennis, 1,2 % of the nation's joggers, 1,1 % cycling or 0,8 % walking/hiking. And these are by no means minor injuries. A noteworthy 21 % have to undergo indoor hospital treatment. Only alpine skiing beats this figure somewhat with 24 %. With other popular sports the figure is significantly lower. What remains unclear, however, are the factors which determine the risk of injury in soccer and which criteria can and should be taken into account for targeted prevention.
Objectives
The aim of the study was to identify the factors which, according to the opinion of insiders (those involved, experts), have a considerable influence on the risk of injury in soccer and represent potential starting points for prevention. Using these findings and by working together with top officials the idea was to find practical ways of accident prevention in soccer and ideally develop a programme for injury prevention which can be put into practice quickly.
Method
An initial review of the literature available on the subject revealed quite clearly that there was no basis for a quantitative empirical study. On the one hand there was no reasonable or plausible model of the interplay of the circumstances in question (such as player motivation, levels of physical fitness, playing ability, group dynamics, training methods, referee performance, rules and regulations, equipment, state of the pitch/playing area etc.); on the other hand there were also no practicable or proven instruments to quantify these circumstances. The following approach was taken in order to possibly later develop such a practical, comprehensible model. First of all the existing literature on soccer accidents was studied and the findings summarised using a schedule of categories. Following this and using appropriate avenues of discussion, in-depth interviews were held with experts and the findings summarised professionally.
The objective of the qualitative research approach was not to specify frequencies of particular be-havioural patterns - as in quantitative methodology - but to find answers to the question why?. Instead of the more common statistical sampling the study employed theoretical samp-ling. The random sampling may seem to be restricted, the depth of its data however is considerable.
35 people were interviewed, all of whom having personal 'access' to soccer and personal experiences. The interview partners were football players from various club levels and positions, football players who play for a hobby, sports physicians, coaches, sport teachers, referees, instructors, sports commentators, spectators and various club officials. Assuming the method of questioning was appropriate, an in-depth insight into the subject matter was to be expected from these people.
Results
In evaluating the interviews numerous possible and likely risk factors were determined in the areas of physical and psychological requirements, playing behaviour, equipment, soccer ground, coaches, referees and spectators.
Weaknesses in physical fitness and technique due to previous injuries or poor quality, and imbalance in training also play a part along with poor preparation prior to the match and injuries which have not had time to heal properly. Players who allow themselves to be provoked by the opponent and the spectators have a greater risk of injury, likewise the go-it-alone players who are keen to take risks. With regard to equipment, footwear and the low acceptance of protective equipment are the factors that increase the risk of injury. A badly kept pitch is an additional source of danger. Inadequate training of the coaches and referees, shortcomings in coaching and a coach encouraging his team to play particularly aggressively all contribute towards an increase in the risk of injury. Spectators are also in a position to provoke an aggressive atmosphere.
As a result of these expert opinions the authors recommend preventive measures for soccer. Balanced training, giving injuries ample time to heal and proper pre- and post-match preparation can make soccer safer. Fair play, the ignoring of provocations and skilled use of technique and tactics are just as much a part of prevention as are the use of shin pads and foot-wear chosen according to pitch conditions. Attaching more importance to the training of
coaches and referees and the upkeep of pitches (grass) and the quality of artificial pitches represent further starting points. For football players who play as a hobby it would make sense to reduce playing time and make the pitch smaller, due to evident shortcomings in physical fitness.
The findings of the study show clear starting points for the prevention of injuries and signs of hope for the future without having to change the face of soccer. Many people responsible do not currently seem to be aware to the desired extent that the majority of soccer injuries represent a problem, that this problem is not unavoidable and that prevention does not go against the grain of soccer as we know it.
Conclusion
Further to these findings and the starting points resulting therefrom with regard to prevention, the people responsible in organised soccer were invited to take part in the joint development of a programme for injury prevention. The following long-term goals have been set out:
By means of appropriate information and persuasive power, the people responsible at club level should be aware that injury prevention increases the value of soccer as accidents are harmful not only to the players but also to the capabilities of the club. Numerous injuries mean frequent rest periods for the active participants and a weakening of the team's performance. Many players are forced to give up the sport prematurely due to injury. The problem, the possible injury prevention measures and the benefits of prevention should therefore be focussed on as a central theme and be a standard feature of all communication channels in organised soccer particularly where work with young players is concerned.
In order to be successful in the process the flow of information has to be a concern and a parallel responsibility of those responsible in the sport and the active participants themselves. External institutions can initiate excellent injury prevention, but they cannot provide it. Success depends on an alliance between club and association officials together with science, health policy, sports policy, insurance companies and advisory bodies for accident prevention. Effective steps towards accident prevention in soccer can only be found and taken when people work together. The implementation has to be the responsibility of the top officials themselves, within the framework of their work with the sport and the practising of the sport.
A planned programme should be compiled and realized to be launched together with an effective (but not harmful to the image) PR campaign. The appropriate information material such as folders, small scale activities, training aids, competitions etc. must be prepared carefully. The idea is to position and consolidate the topic over a period of several years.
Model clubs should be created. A type of standard should specify what clubs have to realize in the field of injury prevention. Here the practical existing opportunities and restrictions are to be taken into consideration in order to win over realistic prime clubs. By means of pragmatically developed criteria the clubs should be able to be awarded a “safe soccer club seal of quality. A certification (and also rejection) mechanism should be installed for this purpose. It can be assumed that such an award, which can perhaps also be combined with other bonuses, will form an attractive incentive in competitive sport.