INTRODUCTION: Female professional footballers present a high incidence of thigh muscle injuries with a meaningful burden (1). Injuries in elite women`s football are scarcely investigated and no study has been conducted in the highest competitive level in Scotland (1,2). The aim of this study was to examine the extent and pattern of non-contact muscle injuries (Nc-Mi), and their respective incidence and burden in a professional female football team playing in Scottish Women`s Premier League (SWPL 1). METHODS: During the 2022-23 season, all injuries that required medical attention (0 day) or led to time-loss were recorded prospectively (as per IOC consensus definitions) by the medical team of the club in 30 unique professional female footballers (mean age: 23 ± 5 years). Nc-MI incidence was calculated as the number of injuries per 1000 playing hours and injury burden as the number of days lost per 1000 hours. RESULTS: A total of 393 injuries were recorded, 255 (65%) were non-contact lower limb injuries, of which 77% (n=196) were Nc-Mi. This reflects an incidence of 48.3 (95% CI 41.8 to 55.6) injuries per 1000h and a nearly tenfold higher incidence of no time-loss compared with time-loss injuries (43.6; 95% CI 37.4 to 50.5 vs 4.7; 95% CI 2.8 to 7.3). Burden of acute onset injuries was significantly greater than gradual onset (33.3 days vs 16.3 days per 1000h, pp<0.0001). Injury incidence (11.9; 5.7-21.8 vs 2.8; 1.3-5.3) and burden (160.3; 134.4-189.7 vs 20.5; 15.9-26.1) were higher for match compared to training (p<0.0001). Hamstring injuries had the highest match injury burden (90.2 days lost per 1000h), the most burdensome muscle injury in training was the quadriceps (14.3 days lost per 1000h). CONCLUSION: Consideration of time loss injuries only might limit the understanding of potential training load errors on player`s musculoskeletal system. The high prevalence and incidence of no-time-loss muscle injuries, particularly of gradual onset indicates the necessity to reflect on them to enhance the understanding of load stimuli response. A greater quadriceps injury burden occurring in training differs from the greater burden of hamstring injuries occurring in matches. Muscle injury risk reduction strategies may therefore be tailored by muscle group on an individual basis, considering the context and type of onset in order to develop an optimal player robustness to lower limb non-contact muscle injuries.
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