title: The effect of hypermobility on the incidence of injuries in elite-level professional soccer players: a cohort study.
abstract: BACKGROUND
  A recent meta-analysis found that generalized joint hypermobility is a risk factor for knee injuries during contact sports. The effect of hypermobility on the incidence of injuries in elite-level professional soccer players is not known.
  
  
  OBJECTIVE
  To compare the incidence of injury between hypermobile and nonhypermobile elite-level male professional soccer players.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Fifty-four players from an English Premier League soccer club were assessed for hypermobility, using the 9-point Beighton scale (threshold, 4 points or above), at the start of the 2009-2010 season. Time-loss injuries and individual exposure times were recorded during all club training sessions and matches throughout the entire season.
  
  
  RESULTS
  Mean ± standard deviation incidence of injuries was 11.52 ± 11.39 injuries/1000 h, and the prevalence of hypermobility was 33.3% (18 of 54 players). There were 133 injuries during 13 897.5 hours of exposure. During the season, hypermobile participants had a higher incidence of injuries (mean [95% confidence interval] difference, 15.65 [9.18-22.13] injuries/1000 h; P = .001) and were more likely to experience at least 1 injury, a reinjury, and a severe injury compared with nonhypermobile participants. There were 9 severe knee injuries in hypermobile participants, of which 6 were cartilage injuries.
  
  
  CONCLUSIONS
  There was an increased incidence of injury in hypermobile elite-level professional soccer players from an English Premier League club, resulting in more missed days from training and match play. These findings suggest a need for routine screening for hypermobility in professional soccer.
authors.affiliation: Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, United Kingdom.
authors.forename: Matt D
authors.initials: MD
authors.lastname: Konopinski
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Jones
authors.forename: Mark I
authors.initials: MI
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D001265:Athletic Injuries / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications*; D007718:Knee Injuries / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D012916:Soccer / Q000293:injuries*; D015599:Trauma Severity Indices; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult