BACKGROUND Muscle injuries constitute a large percentage of all injuries in football. PURPOSE To investigate the incidence and nature of muscle injuries in male professional footballers. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Fifty-one football teams, comprising 2299 players, were followed prospectively during the years 2001 to 2009. Team medical staff recorded individual player exposure and time-loss injuries. The first-team squads of 24 clubs selected by the Union of European Football Associations as belonging to the best European teams, 15 teams of the Swedish First League, and another 15 European teams playing their home matches on artificial turf pitches were included. A muscle injury was defined as "a traumatic distraction or overuse injury to the muscle leading to a player being unable to fully participate in training or match play." RESULTS In total, 2908 muscle injuries were registered. On average, a player sustained 0.6 muscle injuries per season. A squad of 25 players can thus expect about 15 muscle injuries per season. Muscle injuries constituted 31% of all injuries and caused 27% of the total injury absence. Ninety-two percent of all muscle injuries affected the 4 major muscle groups of the lower limbs: hamstrings (37%), adductors (23%), quadriceps (19%), and calf muscles (13%). Sixteen percent of the muscle injuries were reinjuries. These reinjuries caused significantly longer absences than did index injuries. The incidence of muscle injury increased with age. When separated into different muscle groups, however, an increased incidence with age was found only for calf muscle injuries and not for hamstring, quadriceps, or hip/groin strains. CONCLUSION Muscle injuries are a substantial problem for players and their clubs. They constitute almost one third of all time-loss injuries in men's professional football, and 92% of all injuries affect the 4 big muscle groups in the lower limbs.
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