title: The epidemiology of groin injury in senior football: a systematic review of prospective studies.
abstract: BACKGROUND
  Groin injuries are troublesome in men's and women's football.
  
  
  OBJECTIVE
  To review the literature on the epidemiology of groin injury in senior football and compare injury occurrence between sexes.
  
  
  METHODS
  Studies were identified through a search of PubMed, EMBASE, CINAHL and Web of Science, in the reference lists of the selected articles and the authors' bibliographies. The number of injuries, percentage of groin injury from all injuries and rate of groin injury per 1000 h were extracted. Exposure and injury data were aggregated across included studies and the absolute differences in groin injury proportion and rate of groin injury were compared between sexes. Risk of bias was assessed using a 5-item checklist.
  
  
  RESULTS
  34 articles met the study criteria and were included. The proportion of groin injury in club-seasonal football was 4-19% in men and 2-14% in women. Aggregated data analysis (29 studies) showed a higher relative proportion of groin injury in men than in women (12.8% vs 6.9%, absolute difference 5.9%, 95% CI 4.6% to 7.1%). The rate of groin injury varied from 0.2 to 2.1/1000 h in men and 0.1 to 0.6/1000 h in women's club football, and aggregated analysis (23 studies) showed a more than two-fold higher rate in men (0.83/1000 h vs 0.35/1000 h, rate ratio 2.4, 95% CI 2.0 to 2.9). High risk of bias was identified for participant selection (18 studies), exposure (17 studies) and precision estimate (16 studies).
  
  
  CONCLUSIONS
  Groin injuries are frequent in senior football and are more common in men than women. Future research needs to be of higher quality.
authors.affiliation: Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Football Research Group, Linköping, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Waldén
authors.affiliation: Football Research Group, Linköping, Sweden Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Martin
authors.identifier: http://orcid.org/0000-0002-6883-1471
authors.initials: M
authors.lastname: Hägglund
authors.affiliation: Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Football Research Group, Linköping, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Ekstrand
mesh_terms: D001265:Athletic Injuries / Q000453:epidemiology; D005260:Female; D006119:Groin / Q000293:injuries*; D006801:Humans; D007391:International Cooperation; D008297:Male; D011446:Prospective Studies; D017678:Sex Distribution; D012916:Soccer / Q000293:injuries*