INTRODUCTION: Systematic evidence suggests that team sport athletes with lower baseline cognitive performance are at higher risk of sustaining non-contact injuries (Avedesian et al. 2022). While previous studies have focused primarily on rather lower cognitive functions (e.g, reaction time and visual perception) (Avedesian et al., 2022), the aim of this study was to investigate the potential influence of executive performance measures (e.g., cognitive flexibility, working memory) on the risk of sustaining a non-contact injury in elite football players. METHODS: Seventy-nine professional male football players (4 teams of first Slovenian league, age: 24.4±4.5 years; BMI: 21.3 Kg/m2) participated in our prospective case-control study. Computerized (PsyToolkit) and pen-and-paper tests (Trail-Making-Test) were used to compare baseline cognitive performance (visual screening, simple and choice reaction time, working memory, cognitive flexibility,) between players who experienced at least one non-contact injury (n=29) and those who remained uninjured (n=35, con-trols) during the one-year follow-up period. Variance analyses were applied to investigate potential differences between groups. RESULTS: The majority of non-contact injuries affected the lower extremity (79.3%), with thigh (56.7%) and knee (28.2%) being the most common injury sites. Both groups differed significantly in terms of age (25.7 vs. 23.3; p = 0.04) but not for BMI (p = 0.458). Analysis of covariance (age as covariate) showed a signifi-cantly faster visual screening performance for the non-contact injury group compared to the controls (14.6 vs 17.8 sec, p=0.019). No significant between-group differences were found for the other cogni-tive measures assessed (p > 0.05). CONCLUSION: Our findings seem to contradict previous evidence. Better visual screening skills may predispose higher in-game performance increasing the odds of being a regular player. The longer playing exposure times might have made them more vulnerable to injuries than players with less playing time. However, this interpretation is speculative based on our data. To further elucidate how the occurrence of non-contact injuries relates to executive cognitive performance in professional football, the assessment of playing status (e.g., regular or substitute player), position and exposure time is crucial.
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