10-year trend in USA Cup soccer injuries: 1988-1997

Objective: To prospectively document the incidence of competition-related injury rates in an international youth soccer tournament and to analyze the type and location of injuries by age and gender. Design: A prospective injury report form completed for injured players presenting to a medical facility for evaluation by the medical staff. Setting: An international youth soccer tournament occurring annually during mid-July. Participants: 89.500 soccer players. ages 9-19. Measurement/Main Results: A total of 3840 new, play-related injuries were evaluated during 290.344 player-hours of competition from 1988 through 1997. New, play-related injuries per 1000-player-hours decreased from 19.87 in 1988 to 9.89 in 1997. Female injury rates ranged from a maximum of 20.11 in 1989 to a minimum of 10.23 in 1996 and the male injury rate ranged from a maximum of 20.04 in 1988 to a minimum of 7.60 in 1996. The lowest injury rate occurred in the under-19 females (10.64) and highest rates occurred in under-16 (17.68) and under-15 (16.92) females. Heat illness correlated with mean temperature. The aggregate rate of heat illness was 0.6 cases/1000 player-hours under "normal" conditions compared to a rate of 2,8/1000 player-hours during "hot" years. Conclusions: Injury rates for both genders declined over the 10-yr span of the USA Cup study. The aggregate rate of injury was slightly higher for females than males although the difference between male and female rates became less significant as the tournament matured. In conditions of extreme hear and humidity (1988 and 1995) the rate of new, heat illness increased compared with normal years and females were 1.6 times more likely to sustain heat illness than males.