@Article{Materne2026,
journal="Biology of Sport",
issn="0860-021X",
year="2026",
title="A stratified ecological model of injury etiology in professional football: a context‑driven “game model” of injury risk constraints management and foresight reasoning under uncertainty",
abstract=" Understanding sports injury etiology, causation, and risk mitigation remains a central focus in  sports medicine research. However, current models remain generic, neglecting the sport-specific characteristics  and environmental specificities that shape both injury-risk and -resilience. This gap is especially critical in  football, where injury risk is inherently intricate and multifactorial. To address this, we propose a novel conceptual  approach built around a context-driven “Game Model”, specifically tailored to the football’s complexity. The  core of our model is centred on the principle that a player’s injury-risk is directly dependent on the dynamics  and context of the team/club rather than being solely determined by a simple causality of prematurely and  haphazardly musculoskeletal “intrinsic factors”. Our model is structured around five superposed “Ecological  Strata”, which incorporate the concept of “contextual drivers” mapping the non-linear dynamics of the different  constraints within the football environment that influence team and player injury-risk. Through this structure,  we bring to light overlooked elements, including player interconnection, non-exposure, response versus adaptation,  delayed recursive loop, non-time-loss injuries and foresight-driven clinical reasoning paired with hindsight  clinical review, each capturing a dimension of risk that linear models fail to account for. Taken together, our  context-driven approach reframes injury-risk recognition as dynamic, contextual, and intuitive, allowing clinicians  to navigate, rather than merely react to uncertainty. In doing so, our model offers operational perspectives and  windows of opportunities for injury-risk constraints management, enabling more proactive clinical reasoning  and transdisciplinary collaborative decision-making, alongside targeted interventions to maintain and develop  player health, robustness and performance within the football environment. ",
author="Materne, Olivier
and Philippaerts, Renaat
and Depluvrez, Yves
and Kalema, Rudy
and Bradley, Paul
and Kaux, Jean‑Francois
and Greig, Matt
and McNaughton, Lars
and Chamari, Karim",
pages="149--170",
doi="10.5114/biolsport.2027.165058",
url="http://dx.doi.org/10.5114/biolsport.2027.165058"
}