Purpose Few studies include data from different consecutive seasons to assess specific trends in injury risk over time. The current study aimed to investigate the presence and risk factors of injuries in professional football (soccer) players during four consecutive seasons. Methods 166 professional football players in a Greek team were observed during four consecutive seasons, 2015/16 to 2018/19. Injuries were assessed and multiple regression analysis was used to evaluate the potential risk factors. Results The prevalence of injured players was high (72.3%), with a mean number of 2.3 injuries per injured player, and the injury incidence was 86 injuries/1000 match-playing-exposure hours. The mean rehabilitation days were 29.0/injured player (95% CI 22.2-35.9) and 12.7/injury (95% CI 9.1-16.3). The majority of injuries were moderate-to-major/severe and most were traumatic rather than overuse (p < 0.05). The number of injuries was positively correlated with seasonal rotation from 2015/16 to 2018/19 (stand. beta = 0.123, p = 0.016), matches played (stand. beta = 0.203, p < 0.001), recurrence of injury (stand. beta = 0.527, p < 0.001) and days of rehabilitation (stand. beta = 0.372, p < 0.001). Conclusion High prevalence of injuries was found while the increase of match-playing exposure hours, the frequency of official matches per week, the recurrence of injury, and the rehabilitation days were the main predicted risk factors. To reduce the risk of injuries, continuous efforts are required such as player rotation during the season.
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