Epidemiology of Achilles Tendon Rupture in Italian First Division Football (Soccer) Players and Their Performance After Return to Play

Objective: To evaluate the epidemiology, incidence rate, incidence proportion, and prevalence of Achilles tendon ruptures (ATRs) in professional footballers and their performance after the injury. Data Sources: Professional male footballers participating in Serie A in 11 consecutive seasons (2008/2009-2018/2019) were screened to identify ATRs through the online football archive transfermarkt.com . Exposure in matches and training was calculated. The number of matches played in the 5 seasons before and after ATRs was obtained, when possible, together with transfers to a different team or participation in lower Divisions. Main Results: Eleven ATRs were found in 11 footballers with a mean age of 29.8 +/- 4.4 years; 72% of ATR involved the nondominant leg; 58% occurred during matches and 42% during training, with no peculiar distribution along the playing season. The overall incidence proportion was 0.17% (0.11% during matches and 0.06% during training). The overall incidence rate was 0.007 injuries per 1000 hours of play (0.051 during matches and 0.003during training; P < 0.0001). All players returned to play soccer after a mean of 170 +/- 35 days after ATRs and participated in an official match after a mean of 274 +/- 98 days. However, 2 seasons after ATRs, 3 footballers were playing in a lower Division; 1 played less than 10 matches (compared with >25 matches in the 5 seasons before an ATR) and 1 had retired. Conclusions: An overall ATR rate of 0.007 per 1000 hours of soccer play and an incidence proportion of 0.17% were reported. All footballers return to play; however, up to 40% players decreased the level of play by reducing the number of games or participating in a lower Division 2 seasons after an ATR.

Automated summary

This study evaluated the epidemiology and incidence of Achilles tendon ruptures (ATRs) in professional footballers. The study found an overall incidence rate of 0.007 and an incidence proportion of 0.17% for ATRs. All players were able to return to play, but 40% of them showed a decrease in performance level after the injury.