Match Situations Leading to Head Injuries in Professional Male Football (Soccer)—A Video-based Analysis Over 12 Years

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To identify risk situations promoting head injuries in professional male football (soccer) and to investigate the impact of a rule change in 2006 punishing elbow-head contacts.


Analysis of video sequences of head events leading to head injury.


Professional football players of the first male German Bundesliga.

Main Outcome Measures:

Observational criteria of head impacts on video recordings (players' actions preceding head injuries, foul play—referee's decision and assessment of rater, ball possession, on-pitch medical treatment, and consequences of head impact).


Three hundred thirty-four head injuries were reported in kicker Sportmagazin corresponding to an incidence rate of 2.25 (95% confidence interval 2.01-2.51) per 1000 player match hours. The injured player predominantly jumped (60%), headed the ball (36%), or ran forwards (20%); the noninjured players mainly jumped (64%), headed the ball (27%), or raised the elbow to the head (23%). Free ball situations (2 players challenge for the ball) caused most of the head injuries (81%). The players' action “raising the elbow” during a head injury seemed to be lower after the rule change.


Jumping for the ball with the intention of heading is the predominant action associated with head injury risk. Head injuries occur most often when players challenge for the ball in a header duel. As head injuries bear the potential risk of long-term health sequelae, the identification of situational circumstances is essential to develop preventative means in the future.

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