Shoulder injuries in professional football: a comparison between goalkeepers and outfield players

Authors: S Mills, C Pritchard, L Funk

References: Presented at ISSMC 2011

Purpose
There are few studies focussing on upper limb injuries in football, with no study focussed on shoulder injuries at a professional level related to player position. This study aims to describe the shoulder injuries sustained in professional football and compare goalkeepers and outfield players.

Material and Methods
A prospective review was undertaken of all shoulder injuries in professional footballers presenting to a single shoulder surgeon over a five-year period. The injury mechanism, clinical, radiological and surgical findings were all collected.

Results
There was a total of 25 patients, of which 10 were goalkeepers and 15 outfield players. Of the goalkeepers, 50% had a rotator cuff injury, compared to 12% of outfield players. Bankart and Hill-Sachs lesions were the most common injuries occurring in outfield players, at 66% and 60% respectively. In both groups there was a high incidence of HAGL lesions (12% of players in total).
Regarding the mechanism of injury, 70% of goalkeepers sustained their injury landing on the ground whilst diving with their arm fully extended and 20% following collision with another player. For outfield players, 66% sustained their injury following collision with another player and 33% after landing on the ground following a tackle.

Conclusion
Shoulder injuries sustained by goalkeepers and outfield players appear to follow common and differing mechanisms and pathological lesions. Rotator cuff injuries are more frequent in goalkeepers, with Bankart tears most common in outfield players. There is an overall higher incidence of HAGL tears compared to our previous series in contact athletes.