Injury incidence among soccer referees A systematic review

Main Article Content

Antonio Brusini
https://orcid.org/0000-0002-4883-881X
Simone Tersigni
Benedetta Papotti
https://orcid.org/0009-0009-2157-8286

Abstract

Background: The scientific interest in the match performances of soccer referees has grown substantially over the past two decades. Referees need to maintain good physical performance to reduce injuries. So, this study aims to identify the injury rates in soccer referees. Methods: A search was conducted on the main international databases (PubMed, Scopus, Web of Science). Amateur and professional levels are both considered. Reviews, no English language studies, and studies that did not investigate only referees are not considered. Results: The search produced 380 results, 167 after removing duplicate results. In the end, 11 studies are selected. The match injury incidence ranges from 0.7 to 19.6 per 1000 hours; the training injury incidence ranges from 0.3 to 4.6 per 1000 hours. Conclusions: Monitoring injury incidence in referees is crucial, particularly in short-time competitions, which exhibit a notably high incidence.

Article Details

How to Cite
Brusini, A., Tersigni, S., & Papotti, B. (2025). Injury incidence among soccer referees: A systematic review. Scientific Journal of Sport and Performance, 5(2), 205–214. https://doi.org/10.55860/SZGJ5246
Section
Review Paper
Author Biography

Simone Tersigni, Cremona Local Health Authority

Emergency Department.

References

Al Attar, W. S. A., Bizzini, M., Alkabkabi, F., Alshamrani, N., Alarifi, S., Alzahrani, H., et al. (2021). Effectiveness of the FIFA 11+ Referees Injury Prevention Program in reducing injury rates in male amateur soccer referees. Scandinavian journal of medicine & science in sports, 31(9), 1774-1781. https://doi.org/10.1111/sms.13983 DOI: https://doi.org/10.1111/sms.13983

Bizzini, M., Junge, A., Bahr, R., & Dvorak, J. (2009). Injuries and musculoskeletal complaints in referees--a complete survey in the top divisions of the swiss football league. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 19(2), 95-100. https://doi.org/10.1097/JSM.0b013e3181948ad4 DOI: https://doi.org/10.1097/JSM.0b013e3181948ad4

Bizzini, M., Junge, A., Bahr, R., Helsen, W., & Dvorak, J. (2009). Injuries and musculoskeletal complaints in referees and assistant referees selected for the 2006 FIFA World Cup: retrospective and prospective survey. British journal of sports medicine, 43(7), 490-497. https://doi.org/10.1136/bjsm.2008.048314 DOI: https://doi.org/10.1136/bjsm.2008.048314

Bizzini, M., Junge, A., Bahr, R., & Dvorak, J. (2009). Female soccer referees selected for the FIFA Women's World Cup 2007: survey of injuries and musculoskeletal problems. British journal of sports medicine, 43(12), 936-942. https://doi.org/10.1136/bjsm.2008.051318 DOI: https://doi.org/10.1136/bjsm.2008.051318

Bizzini, M., Junge, A., Bahr, R., & Dvorak, J. (2011). Injuries of football referees: a representative survey of Swiss referees officiating at all levels of play. Scandinavian journal of medicine & science in sports, 21(1), 42-47. https://doi.org/10.1111/j.1600-0838.2009.01003.x DOI: https://doi.org/10.1111/j.1600-0838.2009.01003.x

Castillo-Rodríguez, A., Alejo-Moya, E. J., Figueiredo, A., Onetti-Onetti, W., & González-Fernández, F. T. (2023). Influence of physical fitness on decision-making of soccer referees throughout the match. Heliyon, 9(9), e19702. https://doi.org/10.1016/j.heliyon.2023.e19702 DOI: https://doi.org/10.1016/j.heliyon.2023.e19702

De Oliveira, M., Reis, L., & Inácio, A. (2016). Injury incidence in Brazilian football referees. Archivos de Medicina Del Deporte, 33(2), 108-112.

Di Salvo, V., Carmont, M. R., & Maffulli, N. (2012). Football officials activities during matches: a comparison of activity of referees and linesmen in European, Premiership and Championship matches. Muscles, ligaments and tendons journal, 1(3), 106-111.

Dvorak, J., Junge, A., Grimm, K., & Kirkendall, D. (2007). Medical report from the 2006 FIFA World Cup Germany. British journal of sports medicine, 41(9), 578-581. https://doi.org/10.1136/bjsm.2006.034579 DOI: https://doi.org/10.1136/bjsm.2006.034579

Fernández-Ruiz, V., López-Samanes, Á., Del Coso, J., Pino-Ortega, J., Sánchez-Sánchez, J., Terrón-Manrique, P., et al. (2021). Influence of Football Match-Play on Isometric Knee Flexion Strength and Passive Hip Flexion Range of Motion in Football Referees and Assistant Referees. International journal of environmental research and public health, 18(22), 11941. https://doi.org/10.3390/ijerph182211941 DOI: https://doi.org/10.3390/ijerph182211941

Gabrilo, G., Ostojic, M., Idrizovic, K., Novosel, B., & Sekulic, D. (2013). A retrospective survey on injuries in Croatian football/soccer referees. BMC musculoskeletal disorders, 14, 88. https://doi.org/10.1186/1471-2474-14-88 DOI: https://doi.org/10.1186/1471-2474-14-88

Hägglund, M., Waldén, M., Magnusson, H., Kristenson, K., Bengtsson, H., & Ekstrand, J. (2013). Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British journal of sports medicine, 47(12), 738-742. https://doi.org/10.1136/bjsports-2013-092215 DOI: https://doi.org/10.1136/bjsports-2013-092215

Kordi, R., Chitsaz, A., Rostami, M., Mostafavi, R., & Ghadimi, M. (2013). Incidence, nature, and pattern of injuries to referees in a premier football (soccer) league: a prospective study. Sports health, 5(5), 438-441. https://doi.org/10.1177/1941738113481428 DOI: https://doi.org/10.1177/1941738113481428

Krustrup, P., & Bangsbo, J. (2001). Physiological demands of top-class soccer refereeing in relation to physical capacity: effect of intense intermittent exercise training. Journal of sports sciences, 19(11), 881-891. https://doi.org/10.1080/026404101753113831 DOI: https://doi.org/10.1080/026404101753113831

López-Valenciano, A., Ruiz-Pérez, I., Garcia-Gómez, A., Vera-Garcia, F. J., De Ste Croix, M., Myer, G. D., & Ayala, F. (2020). Epidemiology of injuries in professional football: a systematic review and meta-analysis. British journal of sports medicine, 54(12), 711-718. https://doi.org/10.1136/bjsports-2018-099577 DOI: https://doi.org/10.1136/bjsports-2018-099577

Matute-Llorente, Á., Sánchez-Sánchez, J., Castagna, C., & Casajús, J.A. (2020). Injuries of a Spanish top-level sample of football referees. A retrospective study. Apunt. Sports Med. 55, 146-152. https://doi.org/10.1016/j.apunsm.2020.07.001 DOI: https://doi.org/10.1016/j.apunsm.2020.07.001

Moen, C., Andersen, T. E., Clarsen, B., Madsen-Kaarød, G., & Dalen-Lorentsen, T. (2023). Prevalence and burden of health problems in top-level football referees. Science & medicine in football, 7(2), 131-138. https://doi.org/10.1080/24733938.2022.2055782 DOI: https://doi.org/10.1080/24733938.2022.2055782

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71.

Preissler, A. A., Schons, P., Costa, R. R., Reichert, T., Oliveira, H. B., DE Vargas, G. D., et al. (2022). A comparison of the internal and external load demands imposed on professional soccer referees in FIFA's current model of physical test in relation to games. The Journal of sports medicine and physical fitness, 62(3), 308-316. https://doi.org/10.23736/S0022-4707.21.12104-8 DOI: https://doi.org/10.23736/S0022-4707.21.12104-8

Samarein, M. R., Samanipour, M. H., Asjodi, F., Shokati, P., Fallahi, Z., Brownlee, T. E., et al. (2023). Comparisons and associations among anthropometric indices of first and second division and assistant soccer referees. Frontiers in psychology, 14, 1149779. https://doi.org/10.3389/fpsyg.2023.1149779 DOI: https://doi.org/10.3389/fpsyg.2023.1149779

Szymski, D., Opitz, S., Pfeifer, C., Rupp, M., Angele, P., Alt, V., et al. (2022). High injury rates and weak injury prevention strategies in football referees at all levels of play. Scandinavian journal of medicine & science in sports, 32(2), 391-401. https://doi.org/10.1111/sms.14083 DOI: https://doi.org/10.1111/sms.14083

Talović, M., Denis, Č., Alić, H., Jelešković, E., Enes, Đ., Ormanović, et al. (2018). Strength asymmetry differences between premier league and first league football referees. Acta Kinesiologica, 1, 86-92.

Vieira, P., Alonso, A., Ingham, S., Oliveira, A., Schmidt, B., & Faloppa, F. (2019). Incidence of musculoskeletal injuries in soccer referees: a three-year study. Revista Brasileira de Medicina do Esporte, 25, 258-262. https://doi.org/10.1590/1517-869220192503182833 DOI: https://doi.org/10.1590/1517-869220192503182833

Weston, M. (2015). Match performances of soccer referees: the role of sports science. Movement & Sport Sciences-Science & Motricité, (87), 113-117. https://doi.org/10.3917/sm.087.0113 DOI: https://doi.org/10.1051/sm/2014011

Weston, M., Castagna, C., Impellizzeri, F. M., Bizzini, M., Williams, A. M., & Gregson, W. (2012). Science and medicine applied to soccer refereeing: an update. Sports medicine (Auckland, N.Z.), 42(7), 615-631. https://doi.org/10.2165/11632360-000000000-00000 DOI: https://doi.org/10.2165/11632360-000000000-00000

Wilson, F., Byrne, A., & Gissane, C. (2011). A prospective study of injury and activity profile in elite soccer referees and assistant referees. Irish medical journal, 104(10), 295-297.

Witvrouw, E., Danneels, L., Asselman, P., D'Have, T., & Cambier, D. (2003). Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. The American journal of sports medicine, 31(1), 41-46. https://doi.org/10.1177/03635465030310011801 DOI: https://doi.org/10.1177/03635465030310011801