Biology of Sport

Examining the severity of knee ligament and thigh muscle match injury types across various climate zones in European football leagues

Slobodan Klačar 1, 2
,
Karim Chamari 3
,
Montassar Tabben 4
,
Slavenko Likić 2
,
Olivier Hue 1

  1. Laboratoire ACTES, UFR-STAPS, Université des Antilles, Pointe-à-Pitre, France

  2. Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina

  3. Naufar Center, Doha, Qatar

  4. Aspetar – Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar

Biol Sport. 2027;44:225-237

DOI: https://doi.org/10.5114/biolsport.2027.165054
Data publikacji online: 2026/10/13
Article file
15_05358_Article.pdf
  1. Ekstrand J, Lundqvist D, Davison M, D’Hooghe M, Pensgaard AM. Communication quality between the medical team and the head coach/manager is associated with injury burden and player availability in elite football clubs. Br J Sports Med. 2019; 53(5):304–308.
  2. McCall A, Dupont G, Ekstrand J. Injury prevention strategies, coach compliance and player adherence of 33 UEFA Elite Club Injury Study teams: a survey of teams’ head medical officers. Br J Sports Med. 2016; 50(12):725–730.
  3. Waldén M, Hägglund M, Ekstrand J. Time-trends and circumstances surrounding ankle injuries in men’s professional football: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med. 2013; 47(12):748–753.
  4. Ekstrand J. Keeping your top players on the pitch: the key to football medicine at a professional level. Br J Sports Med. 2013; 47(12):723–724. doi: 10.1136 /bjsports-2013-092771.
  5. Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. Br J Sports Med. 2001; 35(1):43–47.
  6. Junge A, Dvorak J. Injury surveillance in the world football tournaments 1998–2012. Br J Sports Med. 2013; 47(12):782–788.
  7. Krutsch W, Lehmann J, Jansen P, et al. Prevention of severe knee injuries in men’s elite football by implementing specific training modules. Knee Surg Sports Traumatol Arthrosc. 2020; 28:519–527.
  8. Schwarz E, Duffield R, Lu D, et al. Associations between injury occurrence and environmental temperatures in the Australian and German professional football leagues. Environ Epidemiol. 2025; 9(1):e364.
  9. Soligard T, Schwellnus M, Alonso JM, et al. How much is too much? Part 1: International Olympic Committee consensus statement on load in sport and risk of injury. Br J Sports Med. 2016; 50(17):1030–1041.
  10. Bahr R, Holme I. Risk factors for sports injuries: a methodological approach. Br J Sports Med. 2003; 37(5):384–392.
  11. Nassis GP, Girard O, Chiampas GT, Krustrup P, Racinais S. In-match strategies to mitigate the effect of heat on football players’ health and performance. Br J Sports Med. 2024; 58(11):572–573.
  12. Mabon L. Football and climate change: what do we know, and what is needed for an evidence-informed response? Clim Policy. 2023; 23(3):314–328. doi: 10.1080/14693062.2022 .2147895.
  13. Orchard J. Is there a relationship between ground and climatic conditions and injuries in football? Sports Med. 2002; 32:419–432.
  14. Nybo L, Flouris AD, Racinais S, Mohr M. Football facing a future with global warming: perspectives for players health and performance. Br J Sports Med. 2021; 55(6):297–298.
  15. Jacobson I, Tegner Y. Injuries among female football players—with special emphasis on regional differences. Adv Physiother. 2006; 8(2):66–74.
  16. Ekstrand J. Thigh Muscle Injuries in Professional Football Players: A Seven Year Follow-Up of the UEFA Injury Study. In: Football Traumatology. Springer; 2012:871–875. doi: 10.1007/978-3- 642-15630-4_111.
  17. Ekstrand J, Bengtsson H, Waldén M, Davison M, Khan KM, Hägglund M. Hamstring injury rates have increased during recent seasons and now constitute 24% of all injuries in men’s professional football: the UEFA Elite Club Injury Study from 2001/02 to 2021/22. Br J Sports Med. 2023; 57(5):292–298. doi: 10.1136/bjsports-2021-105407.
  18. Draper G, Wright MD, Ishida A, Chesterton P, Portas M, Atkinson G. Do environmental temperatures and altitudes affect physical outputs of elite football athletes in match conditions? A systematic review of the “real world” studies. Sci Med Footb. 2023; 7(1):81–92.
  19. Waldén M, Hägglund M, Ekstrand J. UEFA Champions League study: a prospective study of injuries in professional football during the 2001–2002 season. Br J Sports Med. 2005; 39(8):542–546.
  20. Orchard J, Seward H, McGivern J. Rainfall, evaporation and the risk of non-contact anterior cruciate ligament injury in the Australian Football League. Med J Aust. 1999; 170(7):304–306.
  21. Ryynänen J, Börjesson M, Karlsson J. Match-related factors influencing injury risk. In: Musahl V, Karlsson J, Neyret PT, Della Villa J, Becker B, eds. Return to Play in Football. Springer; 2018:63–72. doi: 10.1007/978-3-662-55713-6_5.
  22. Orchard JW, Waldén M, Hägglund M, et al. Comparison of injury incidences between football teams playing in different climatic regions. Open Access J Sports Med. 2013; 4:251–260.
  23. Waldén M, Hägglund M, Orchard J, Kristenson K, Ekstrand J. Regional differences in injury incidence in European professional football. Scand J Med Sci Sports. 2013; 23(4):424–430.
  24. Landset S, Bergeron MF, Khoshgoftaar TM. Using weather and playing surface to predict the occurrence of injury in Major League Soccer games: a case study. In: Proceedings of Information Reuse and Integration. IEEE; 2017:366–371. doi: 10.1109/IRI.2017.86.
  25. Azubuike SO, Okojie O. An epidemiological study of football (soccer) injuries in Benin City, Nigeria. Br J Sports Med. 2009; 43(5):382–386. doi: 10.1136/ bjsm.2008.051565.
  26. Orchard JW, Powell JW. Risk of knee and ankle sprains under various weather conditions in American football. Med Sci Sports Exerc. 2003; 35(7):1118–1123.
  27. Kottek M, Grieser J, Beck C, Rudolf B, Rubel F. World map of the Köppen-Geiger climate classification updated. Meteorol Z. 2006; 15(3):259–263. doi: 10.1127/0941-2948/2006/0130.
  28. Beck HE, Zimmermann NE, McVicar TR, Vergopolan N, Berg A, Wood EF. Present and future Köppen-Geiger climate classification maps at 1-km resolution. Sci Data. 2018; 5(1):180214.
  29. GloH2O. Köppen-Geiger climate maps. Accessed May 2026. Available from: https://www.gloh2o.org/koppen/.
  30. Peel MC, Finlayson BL, McMahon TA. Updated world map of the Köppen-Geiger climate classification. Hydrol Earth Syst Sci. 2007; 11(5):1633–1644.
  31. Fuller CW, Ekstrand J, Junge A, et al. Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Scand J Med Sci Sports. 2006; 16(2):83–92.
  32. Hägglund M, Waldén M, Bahr R, Ekstrand J. Methods for epidemiological study of injuries to professional football players: developing the UEFA model. Br J Sports Med. 2005; 39(6):340–346.
  33. NoiseFeed. Football injury database. Accessed May 2026. Available from: https://www.noisefeed.com.
  34. Trequattrini R, Nappo F, Cuozzo B, Manzari A. The emerging of enhanced intellectual capital: the impact of enabling technologies on professional football clubs. In: Esposito De Falco S, Alvino F, Kostyuk A, eds. Intellectual Capital, Smart Technologies and Digitalization: Emerging Issues and Opportunities. Springer; 2021:93–106. doi: 10.1007/978-3-030- 77246-8_7.
  35. Transfermarkt. Football statistics database. Accessed May 2026. Available from: https://www.transfermarkt.com.
  36. Waldén M, Hägglund M, Kristenson K, Ekstrand J. The influence of climate type on injury epidemiology in European professional football. Br J Sports Med. 2011; 45(4):330–331.
  37. Woods C, Hawkins R, Hulse M, Hodson A. The Football Association Medical Research Programme: an audit of injuries in professional football: an analysis of ankle sprains. Br J Sports Med. 2003; 37(3):233–238.
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