Muscle and thigh injury incidence rate and burden are higher during pre-season than in-season in a prospective cohort study of senior women’s football players

Lee, J, Fettus, L, Larruskain, J, Lekue, J, Gil, S, Underwood, C, McQuilliam, S ORCID: 0000-0002-4987-5938, Baumert, P and Erskine, R ORCID: 0000-0002-5705-0207 Muscle and thigh injury incidence rate and burden are higher during pre-season than in-season in a prospective cohort study of senior women’s football players. British Journal of Sports Medicine. ISSN 0306-3674 (Accepted)

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Abstract

Objectives: To prospectively compare injury incidence rates (IIR) and injury burden (days lost) between pre-season and in-season in senior women’s football (soccer).

Methods: Injury and exposure data were collected prospectively over two seasons from a cohort of 164 senior women’s footballers (21.5±5.0 years; 61.7±10.7 kg; 1.67±0.10 m) competing in England and Spain 2018-2024. Muscle, ligament, tendon, bone, knee, ankle and thigh IIR and burden were calculated per 1000 h match and training exposure during pre-season and in-season.

Results: In total, 212 injuries were recorded, with 46 (21.7%) occurring during pre-season and 166 (78.3%) during in-season. Muscle injury was the most prevalent injury type in both pre- and in-season, with the quadriceps femoris being the most common injury location during pre-season. Muscle (2.40 [95% CI:1.58-3.65] vs. 1.32 [95% CI:0.98-1.76] injuries/1000h; p=0.021) and thigh (1.82 [95% CI:1.12-2.94] vs. 0.67 [95% CI:0.45-0.99] injuries/1000h; p=0.002) IIR were both higher during pre-season than in-season. Injury burden for both muscle (52 [95% CI:25-152] vs. 22 [95% CI:14-36] days/1000h; p=0.035) and thigh (53 [95% CI:24-154] vs. 13 [95% CI:7-26] days/1000h; p=0.003) was also higher during pre-season.

Conclusion: This is the first study to investigate differences in injury patterns between pre- and in-season in senior women’s football. Muscle and thigh IIR and burden were higher during pre-season, which may be partly explained by a larger proportion of quadriceps femoris injuries. These results suggest that injury prevention strategies in this under-researched population should be prioritised during pre-season, and should focus on the thigh muscles particularly the quadriceps femoris.

Item Type:	Article
Uncontrolled Keywords:	09 Engineering; 11 Medical and Health Sciences; 13 Education; Sport Sciences; 3202 Clinical sciences; 4207 Sports science and exercise; 5201 Applied and developmental psychology
Subjects:	R Medicine > RC Internal medicine > RC1200 Sports Medicine G Geography. Anthropology. Recreation > GV Recreation Leisure > GV561 Sports
Divisions:	Sport and Exercise Sciences
Publisher:	BMJ Publishing Group
Date of acceptance:	29 October 2026
Date Deposited:	30 Oct 2026 13:55
Last Modified:	30 Oct 2026 13:55
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29772

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