The effect of hypermobility on the incidence of injuries in elite-level professional soccer players: a cohort study

Am J Sports Med. 2012 Apr;40(4):763-9. doi: 10.1177/0363546511430198. Epub 2011 Dec 16.


Background: A recent meta-analysis found that generalized joint hypermobility is a risk factor for knee injuries during contact sports. The effect of hypermobility on the incidence of injuries in elite-level professional soccer players is not known.

Purpose: To compare the incidence of injury between hypermobile and nonhypermobile elite-level male professional soccer players.

Study design: Cohort study; Level of evidence, 2.

Methods: Fifty-four players from an English Premier League soccer club were assessed for hypermobility, using the 9-point Beighton scale (threshold, 4 points or above), at the start of the 2009-2010 season. Time-loss injuries and individual exposure times were recorded during all club training sessions and matches throughout the entire season.

Results: Mean ± standard deviation incidence of injuries was 11.52 ± 11.39 injuries/1000 h, and the prevalence of hypermobility was 33.3% (18 of 54 players). There were 133 injuries during 13 897.5 hours of exposure. During the season, hypermobile participants had a higher incidence of injuries (mean [95% confidence interval] difference, 15.65 [9.18-22.13] injuries/1000 h; P = .001) and were more likely to experience at least 1 injury, a reinjury, and a severe injury compared with nonhypermobile participants. There were 9 severe knee injuries in hypermobile participants, of which 6 were cartilage injuries.

Conclusion: There was an increased incidence of injury in hypermobile elite-level professional soccer players from an English Premier League club, resulting in more missed days from training and match play. These findings suggest a need for routine screening for hypermobility in professional soccer.

MeSH terms

  • Adolescent
  • Adult
  • Athletes*
  • Athletic Injuries / epidemiology
  • Athletic Injuries / etiology*
  • Athletic Injuries / physiopathology
  • Cohort Studies
  • Humans
  • Joint Instability / complications*
  • Knee Injuries / epidemiology
  • Knee Injuries / etiology
  • Knee Injuries / physiopathology
  • Male
  • Soccer / injuries*
  • Trauma Severity Indices
  • United Kingdom / epidemiology
  • Young Adult