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Effect of 2 Soccer Matches in a Week on Physical Performance and Injury Rate

Article  in  The American Journal of Sports Medicine · September 2010

DOI: 10.1177/0363546510361236 · Source: PubMed

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Effect of 2 Soccer Matches in a Week
on Physical Performance and Injury Rate
Gregory Dupont,*yz PhD, Mathieu Nedelec,yz MSc, Alan McCall,z MSc, Derek McCormack,z MD,
Serge Berthoin,y PhD, and Ulrik Wisløff,§ PhD
From the yLaboratory of Human Movement Studies, EA 3608, Artois and Lille 2 Universities,
France, zCeltic Lab, Sport Science Department, Celtic FC, Glasgow, Scotland, and the
§
Department of Circulation and Medical Imaging, Norwegian University of Science and
Technology, Trondheim, Norway

Background: Recovery duration may be too short during the congested fixtures of professional soccer players with regard to
maintaining physical performance and a low injury rate.
Purpose: To analyze the effects of 2 matches per week on physical performance and injury rate in male elite soccer players.
Study Design: Cohort study; Level of evidence, 3.
Methods: Match results, match-related physical performance, and injuries were monitored during 2 seasons (2007–2008 and 2008–
2009) for 32 professional soccer players in a top-level team participating in the UEFA (Union of European Football Associations)
Champions League. Total distance, high-intensity distance, sprint distance, and number of sprints were collected for 52 home
matches. Injuries and player participation in matches and training were recorded throughout the full season.
Results: Physical performance, as characterized by total distance covered, high-intensity distance, sprint distance, and number of
sprints, was not significantly affected by the number of matches per week (1 versus 2), whereas the injury rate was significantly higher
when players played 2 matches per week versus 1 match per week (25.6 versus 4.1 injuries per 1000 hours of exposure; P \ .001).
Conclusion: The recovery time between 2 matches, 72 to 96 hours, appears sufficient to maintain the level of physical performance
tested but is not long enough to maintain a low injury rate. The present data highlight the need for player rotation and for improved
recovery strategies to maintain a low injury rate among athletes during periods with congested match fixtures.
Keywords: recovery; fatigue; match analysis; player

Several studies have focused on fatigue during a soccer
match.14,17 Mohr et al14 analyzed fatigue and reduced
performance at 3 stages during a match: after short-term
intense periods, in the initial phase of the second half, and
at the end of the match. However, fatigue can also arise
from repetition of matches within a short period. Elite soccer
players participate in national championship matches,
league cup matches, national cup matches, UEFA (Union
of European Football Associations) Champions League
and/or UEFA Cup matches, and international matches.
For these players, it is common to play 2 matches per week
(Saturday or Sunday 1 Tuesday or Wednesday) over several
*Address correspondence to Gregory Dupont, PhD, Laboratory of
Human Movement Studies, EA 3608, Artois, Lille 2 University, France,
9 rue de l’universite, 59790 Ronchin, France
The authors declared that they had no conflicts of interests in their
authorship and publication of this contribution.
The American Journal of Sports Medicine, Vol. 38, No. 9
DOI: 10.1177/0363546510361236
Ó 2010 The Author(s)
weeks. Ispirlidis et al11 demonstrated that it took 96 to 120
hours of rest to achieve prematch values for 20-m sprint
performance as well as normalize blood markers of muscle
damage (creatine kinase) and inflammation (uric acid).
Consequently, for players involved in 2 matches within 96
hours, one could expect reduced match-related physical
performance, as characterized by total distance covered,
high-intensity distance, sprint distance, and number of
sprints during the second match.
Injury risk is another concern for soccer players and clubs
in terms of health, performance, and cost. Hawkins et al10
reported an average of 1.3 injuries per player per season in
English professional soccer. They found that the greatest
injury rate occurred in the two 15-minute periods toward
the end of both halves, with significantly more injuries
(P \ .01) in the second half of matches. According to
Ekstrand et al,7 a period with a congested match calendar
can lead to fatigue, increasing the risk of injury and poor per-
formance during the following period. They found that 60%
of the players who had played more than 1 match a week
before the World Cup incurred injuries or underperformed

1752
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Vol. 38, No. 9, 2010
during the tournament. However, to our knowledge, no
study has compared injury rates and match-related physical
performance according to the number of matches per week
(1 versus 2). The aim of this study was to determine
match-related physical performance and injury rate in
male elite soccer players playing either 1 or 2 games per
week. We hypothesized that match-related physical per-
formance decreases and injury rate increases when 2
matches per week are played within 96 hours, in comparison
with 1 match per week.
MATERIALS AND METHODS
Participants
Match results, match-related physical performance, and
injuries were monitored during 2 seasons (2007–2008 and
2008–2009) for 32 professional soccer players playing for
the same top-level team (as of July 1, 2007: age, 25.6 6 3.8
years; height, 182.4 6 6.9 cm; body mass: 81.3 6 8.5 kg).
This study was made with the agreement of the Ethical
Committee in Biomedical Research of the organization
CCPPRB (Lille, France) and the recommendation of the
Helsinki Declaration.
During the 2 seasons, the team played 123 matches: 76
Scottish Premier League, 16 Champions League, 7 Scottish
Cup, 6 Scottish League Cup, and 18 friendly. The team
played 67 matches separated by 3 or 4 days and 56 matches
separated by at least 5 days. Among the 32 players selected
for this study, 19 played from 1 to 14 international matches
during the 2 seasons studied. These matches were taken
into account in the injury rates but not for the match-
related physical performance. To analyze the effects of 2
matches per week on related physical performance and
injury rate, 2 paired groups were formed according to the
number of days between 2 matches. The first group (G1)
comprised players who had not played a match for 6 days
or more. The second group (G2) comprised players who
played 2 matches within 4 days. Individual written consent
was obtained from all participating players. The inclusion
in the group depended on the recovery time between 2
matches and the playtime per player. The selection of the
group was not made according to the team matches but
according to the matches played by each player. Because
there were only 11 players selected per match, some play-
ers could play a midweek match in UEFA Champions
League without playing the previous game 3 days earlier.
In this condition, these players were included in G1. Con-
versely, when a player played a midweek full match in
UEFA Champions League and another weekend full match
3 days later in the national league, the second game was
recorded in the G2. The playtime was an additional factor
in the selection of the group. The criterion to be included
in the G2 was to have played at least 75 minutes within
the 4 days preceding the game. For example, if a player
played 90 minutes in the first game and 90 minutes 3
days later in the second game, the data from the second
game were recorded in the G2.
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Effect of 2 Soccer Matches in a Week 1753
Match Analyses and Physical Performance
We analyzed physical performance for only the home
matches because the data collection device was set in the
home stadium and was not portable. We analyzed 52 home
matches (38 Scottish Premier League, 8 Champions League,
4 Scottish Cup, 2 Scottish League Cup) using computerized
image recognition system based on semiautomatic video
match analysis (Amisco Pro 1.0.2, Sport Universal Process,
Nice, France). Detailed information and procedure of this
system have been described.4 We analyzed movements of
the 20 outfield players (goalkeepers excluded) during the
whole match by means of 8 stable synchronized cameras
positioned at the top of the stadium with a sampling
frequency of 25 Hz. Signals and angles obtained by the
encoders were sequentially converted into digital data and
recorded on 6 computers for postmatch analyses. From the
stored data, the image recognition software (in ‘‘athletic
mode’’) obtained the total distance covered, the distance
covered between 19 and 24 km per hour (high-intensity
distance), the distance covered above 24 km per hour (sprint
distance), and the number of sprints for the 2 teams. Home
team outfield players were assigned to 1 of 5 positional
groups: central defender, fullback, central midfield, exter-
nal midfield, and forward. From these data, whole match
activity, match activity per half, match activity according
to position, and match activity according to the score (win-
ning versus losing team) were analyzed. The coefficients of
variation (CVs) for total distance, high-intensity distance,
sprint distance, and number of sprints were calculated for
all the players according to their positions (CV, inter-
individual) and then for the players who played the greatest
number of matches for each of the 5 positional groups (CV,
intraindividual). For the match-related physical perfor-
mance, only the players who played the full games were
retained. When a player played a first match for at least 75
minutes and then a second full match (90 minutes) within
4 days, the second match was classified as G2. When the sec-
ond match was played at least 6 days later, it was classified
as G1.
We analyzed the effects of 2 matches per week on
match-related physical performance for 23 players, given
that 9 players were not involved in one of the groups
(G1 or G2). For match-related physical performance, G1
comprised 23 players playing a total of 130 games (1 to
14 matches per player), whereas G2 comprised 23 players
playing a total of 116 games (1 to 18 matches per player).
To compare the match-related physical performance
between G1 and G2, we calculated the averages for total
distance covered, high-intensity distance, sprint distance,
and number of sprints for each player in both groups. We
analyzed the 4 parameters characterizing the match-related
physical performance (total distance, high-intensity dis-
tance, sprint distance, and number of sprints) on 246
matches, which corresponded to 984 (246 3 4) data points.
For the link between physical activity (as characterized by
total distance, high-intensity distance, sprint distance, and
number of sprints covered) and the score of the match
(winning versus losing team), we analyzed 42 matches
(10 matches had resulted in a draw). This analysis
1754 Dupont et al
included the 2 teams with the 22 players and corresponded
to 3696 data points (22 players 3 42 matches 5 924 data
points 3 4 parameters studied 5 3696 data points).
Injury Definition, Classification, Severity, and Injury Rate
Injury data corresponded to time loss injuries, which
resulted when a player was unable to take full part in
future soccer training or matches owing to physical
complaints.8 Illnesses, diseases, and mental complaints
were not considered physical complaints but were taken
into account to calculate match and training exposure.
We recorded information about circumstances (training
or match), mechanism of injury (traumatic or overuse),
location, type, recurrent injury, time lost because of injury,
and the number of matches missed according to the
number of matches per week (1 versus 2). The same club
doctor diagnosed all injuries, and an injured player was
considered injured until the club doctor cleared him for
participation in full training or matches. We monitored
location and type of injury according to the classifications
proposed by Fuller et al.8 Location was classified according
to the main groupings (head and neck, upper limbs, trunk,
lower limbs) and categories (head and face; neck and
cervical spine; shoulder and clavicula; upper arm; elbow;
forearm; wrist; hand, finger, and thumb; sternum, ribs,
and upper back; abdomen; lower back, pelvis, and sacrum;
hip and groin; thigh; knee; lower leg and Achilles tendon;
ankle; foot and toe). Type of injury was classified according
to the main groupings (fracture and bone stress, joint and
ligament, muscle and tendon, contusions, laceration and
skin lesion, central or peripheral nervous system, other)
and categories (fracture; other bone injuries; dislocation
and subluxation; sprain and ligament injury; lesion of
meniscus or cartilage; muscle rupture, tear, strain, and
cramps; tendon injury, rupture, tendinosis, and bursitis;
hematoma, contusion, and bruise; abrasion; laceration;
concussion; nerve injury; dental injuries; other injuries).
Injury severity was defined as the number of days that
had elapsed from the date of injury to the date of the
player’s return to full participation in team training and
availability for match selection. Injuries were classified
into 4 categories of severity, according to the length of
absence from full training sessions and matches, including
the day of injury9: slight (1-3 days), minor (4-7 days),
moderate (8-28 days), and major (more than 28 days). A
recurrent injury was defined as an injury of the same
type and at the same site as a previous injury; it occurred
after a player’s return to full participation from the pre-
vious injury; and it was defined as early, late, and delayed
when it occurred within 2 months, 2 to 12 months, and
more than 12 months, respectively. We monitored the
duration of training sessions (in the gym and on the field
of play) and matches (hours) for each player. Match
exposure was defined as play between teams from different
clubs. Training exposure corresponded to team-based and
individual physical activities under the control or guidance
of the team’s coaching or fitness staff that aimed at main-
taining or improving players’ soccer skills or physical con-
dition. Injury rate was calculated as all injuries per 1000
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The American Journal of Sports Medicine
hours of soccer (training 1 matches), injuries per 1000
hours of training, and injuries per 1000 hours of matches.
The effects of 2 matches per week on injury rate were ana-
lyzed for the 32 players during the 2 seasons. The analyses
included the 123 matches played by the team and the inter-
national matches played by each player. When a player
played a first match for at least 75 minutes and then a sec-
ond match at least 75 minutes within 4 days, the second
match played was classified as G2. When the second match
was played at least 6 days later, it was classified as G1.
When a player belonging to G2 was injured within 4 days
after a match during a training session, he still belonged
to G2. If the injury occurred after the fourth day, the player
was classified in G1. Players belonging to G1 who were
injured during a training session stayed in G1.
Sessions Between the Games and Diet
According to the number of games per week, the typical week
consisted of 5 to 6 training sessions. When 1 game per week
was played, an injury prevention program was implemented
during the 2 strength sessions, which included proprio-
ceptive exercises, jumping exercises, Nordic hamstring
lowers, and core (plank and side plank). After each hard
training session and match, players were advised to
immerse themselves in a cold bath at 15°C for 14 minutes
and to use compression garments for 12 hours. For diet
(food and hydration), players were advised by the team
nutritionist. No supplements were recommended. Players
ate their prematch meal 3 hours before the match, which
was composed of low-glycemic-index carbohydrate foods.
At the end of the game, the players consumed high-glycemic-
index carbohydrate foods and proteins (sport drinks, milk-
shakes, yogurt, soup, sandwiches).
Statistical Analysis
Results are expressed as means 6 standard deviations.
Inter- and intraindividual CVs were calculated for the total
distance, high-intensity distance, sprint distance, and num-
ber of sprints. The normality distribution of the data was
checked with the Kolmogorov-Smirnov test completed by
the Lilliefors method. As data were normally distributed,
we used parametric tests. Paired t test was used to compare
match-related physical performance between G1 and G2,
between first and second halves, and between winning
and losing teams. Fisher exact test was used to compare
injury rates (number of injuries per 1000 hours of exposure)
between training and match and between G1 and G2. For
injury rate, we also calculated the 95% confidence intervals
(CIs). A one-way analysis of variance was used to test for
possible differences in positions. When a significant effect
was detected, post hoc analyses were carried out using
a Tukey test. Significance was accepted at P \ .05.
RESULTS
Match Activities
Whole Match Activity. Mean total distance, high-intensity
distance, sprint distance, and number of sprints covered
Vol. 38, No. 9, 2010 Effect of 2 Soccer Matches in a Week 1755

TABLE 1
Match Distances Covered at Different Intensities by Players According to Positiona

Total Distance, m High-Intensity Distance, m Sprint Distance, m No. Sprints

Central defender 9924 6 389 285 6 95 123 6 63 562

CV, % (Range) 3.9 (8952 to 10 924) 33.2 (103 to 564) 51.4 (19 to 364) 41.9 (1 to 10)
Fullback 10 762 6 573 559 6 151 311 6 130 13 6 5
CV, % (Range) 5.3 (9455 to 11 882)b 27.1 (235 to 869)b 41.8 (101 to 633)b 39.6 (5 to 29)b
Central midfielder 11 935 6 721 631 6 240 293 6 115 13 6 5
CV, % (Range) 6.0 (10 107 to 13 669)b,c,d 40.0 (104 to 1389)b 39.2 (60 to 534)b,d 37.2 (3 to 24)b
External midfielder 11 742 6 696 650 6 162 298 6 168 13 6 6
CV, % (Range) 5.9 (9841 to 13 227)b,c 24.9 (231 to 1157)b,c 56.5 (67 to 788)b,d 48.2 (3 to 29)b
Forward 11 317 6 635 651 6 200 240 6 122 12 6 5
CV, % (Range) 5.6 (9417 to 12 653)b,c 30.7 (133 to 998)b,c 50.7 (47 to 577)b 44.6 (2 to 24)b

a
CV, coefficient of variation.
b
Significantly longer than central defender.
c
Significantly longer than fullback.
d
Significantly longer than forward.

TABLE 2 groups were as follows: 3.3%, 47.8%, 34.4%, 29.3% for the
Match Distances Covered at Different Intensities by the fullback (31 games); 2.6%, 52.1%, 55.4%, 45.0% for the cen-
Winning Team and the Losing Team tral defender (45 games); 3.2%, 48.7%, 26.9%, 28.1% for the
central midfield player (38 games); 3.0%, 36.0%, 35.6%,
Winning Team Losing Team 29.0% for the external midfield player (35 games); and
Total distance, m 117 631 6 2713 117 916 6 4732 5.6%, 37.5%, 35.1%, 33.5% for the forward (24 games).
First half 59 064 6 1739 59 865 6 2472 Match Activity According to the Score (Winning Versus
Second half 58 567 6 1913 58 051 6 3155 Losing Teams). Total distance, sprint distance, and number
High-intensity 5849 6 558 6161 6 688a of sprints covered by the winning team were not sig-
distance, m nificantly different from those performed by the losing
First half 2918 6 409 2977 6 450 team (Table 2). However, high-intensity distance was signif-
Second half 2930 6 354 3185 6 465a icantly shorter (P 5 .02) for the winning team than for the
Sprint distance, m 2535 6 450 2409 6 431
losing team. This difference was linked to the high-intensity
First half 1228 6 280 1186 6 298
distance covered during the second half, which was sig-
Second half 1307 6 268 1222 6 261
Sprints, n 1245 6 175 1217 6 163 nificantly shorter (P 5 .003) for the winning team than for
First half 606 6 112 611 6 116 the losing team, whereas no significant difference was found
Second half 640 6 111 606 6 112 for the first half and the match overall (Table 2).
Effects of 2 Matches per Week on Match Activity. No
a
Significantly longer than the winning team. significant difference was found in terms of total distance
covered, high-intensity distance, sprint distance, and
during the matches were as follows: 11 049 6 982 m (CV, number of sprints between G1 and G2.
8.8%; range, 8952 to 13 669 m), 539 6 230 m (CV, 42.7%;
range, 103 to 1389 m), 256 6 151 m (CV, 58.7%; range,
19 to 788 m), and 11.0 6 5.7 (CV, 51.6%; range, 1 to 29), Injuries
respectively. Total distance covered during first half
(5570 6 514 m) was significantly longer (P \ .001) than Exposure to Training and Match. During the 2 seasons,
that covered during second half (5479 6 523 m). No signif- players trained 511 6 176 hours (range, 125 to 781 hours)
icant difference was found between first half and second and played 67 6 57 hours in matches (range, 8 to 178 hours).
half in terms of high-intensity distance (273 6 141 versus In total, the 32 players were exposed to 16 339 hours of train-
266 6 134 m, respectively), sprint distance (127 6 87 ver- ing and 2156 hours of matches during the 2 seasons.
sus 129 6 85 m, respectively), and the number of sprints Total Injury and Injury Rate. A total of 165 injuries and
(5.4 6 3.2 versus 5.6 6 3.3, respectively). a mean 5.2 6 3.7 injuries per player (range, 0 to 16 per
Match Activity According to Player Position. Table 1 player) in matches and training over the 2 seasons were
presents total distance, high-intensity distance, sprint dis- reported retrospectively. In total, players who suffered
tance, and number of sprints covered during the matches injuries were not available for 2443 days (79 6 63; range,
by the players according to their positions, as well as the 3 to 244) and 418 matches (13.5 6 13.1; range, 0 to 53).
interindividual CVs. The intraindividual CVs for total dis- Injury rate during match time (48.7 injuries per 1000
tance, high-intensity distance, sprint distance, and num- hours of exposure; 95% CI, 39.4-58.0) was significantly
ber of sprints according to position and the players higher (P \ .001) than that during training (3.7 injuries
playing the greatest number of matches at 1 of 5 positional per 1000 hours of exposure; 95% CI, 2.7-4.6).

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1756 Dupont et al The American Journal of Sports Medicine

TABLE 3
Injury Rate, Injury Severity, Reinjury, and Mechanism of Injury Classified According to Group: G1 Versus G2

G1 G2 Total

Injury rate per 1000 hr exposurea

Overall 4.1 (3.0-5.1) 25.6 (20.8-30.5)b 8.9 (7.6-10.3)
Match 19.3 (11.9-26.7) 97.7 (76.1-119.2)b 48.7 (39.4-58.0)
Training 2.5 (1.6-3.4) 8.3 (5.2-11.4)b 3.7 (2.7-4.6)
Injury severity, n
Slight 22 26 48
Minor 16 33 49
Moderate 17 33 50
Major 3 15 18
Reinjury, n
Early 5 17 22
Late 0 13 13
Delayed 0 2 2
Mechanism of injury, n
Traumatic 16 23 39
Overuse 42 84 126

a
Confidence interval (95%) in parentheses.
b
Significantly higher than the G1.

TABLE 4 TABLE 5
Main Groupings and Categories for the Location of Injuries Main Groupings and Categories for the Type of Injuries
According to Group: G1 Versus G2 According to Group: G1 Versus G2

G1 G2 Total G1 G2 Total

Head and neck Fracture and bone stress

Head, face 1 2 3 Fracture 0 0 0
Neck, cervical spine 2 0 2 Other bone injuries 0 0 0
Upper limbs Joint (nonbone) and ligament
Shoulder, clavicula 0 0 0 Dislocation, subluxation 0 0 0
Upper arm 0 0 0 Sprain, ligament injury 10 24 34
Elbow 0 0 0 Lesion of meniscus or cartilage 1 12 13
Forearm 0 0 0 Muscle and tendon
Wrist 0 0 0 Muscle rupture, tear, strain, cramps 36 57 93
Hand, finger 0 0 0 Tendon injury, rupture, tendinosis, bursitis 3 5 8
Trunk Contusions
Sternum, ribs, upper back 1 4 5 Hematoma, contusion, bruise 6 6 12
Abdomen 0 4 4 Laceration and skin lesion
Lower back, pelvis, sacrum 2 2 4 Abrasion 0 0 0
Lower limbs Laceration 2 3 5
Hip, groin 10 13 23 Central, peripheral nervous system
Thigh 15 32 47 Concussion 0 0 0
Knee 6 22 28 Nerve injury 0 0 0
Lower leg, Achilles tendon 10 8 18 Other
Ankle 6 15 21 Dental injuries 0 0 0
Foot, toe 5 5 10 Other injuries 0 0 0

DISCUSSION

Effects of 2 Matches per Week on Injury Rate. Twenty-
one players experienced at least 1 injury in G1, whereas
31 players suffered at least 1 injury in G2. Table 3 presents
injury rates, injury severity, reinjury, and mechanism of
injury according to group (G1 versus G2). Tables 4 and 5
present main groupings and categories for the location
and type of injuries according to group (G1 versus G2).
The overall injury rate was 8.9 injuries per 1000 hours of
exposure (95% CI, 7.6-10.3).
The purpose of this study was to analyze the effects of 2
matches per week on match-related physical performance
and injury rate in male elite soccer players. We hypothesized
(1) that match-related physical performance, as character-
ized by total distance, high-intensity distance, sprint dis-
tance, and number of sprints, decreases when players play
2 matches per week and (2) that the injury rate is higher for
the players playing 2 matches per week. The first hypothesis
was rejected because match-related physical performance

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Vol. 38, No. 9, 2010
did not significantly decrease when players played 2 matches
per week; the second hypothesis was confirmed because the
injury rate for G2 (25.6 injuries per 1000 hours of exposure)
was significantly higher (P \ .001) than that found for G1
(4.1 injuries per 1000 hours of exposure).
The use of evidence-based postmatch recovery proce-
dures may explain the reason no significant difference
was found between G2 and G1 for the match-related physical
performance. For the present study, players were advised to
do the following immediately after the match: to have a cold
bath at 15°C for 14 minutes, to use compression garments for
12 hours, and to consume meals with large amounts of carbo-
hydrates until the next match. These recommendations are
based on previous studies showing the procedures to be effi-
cient in optimizing the recovery. Vaile et al19 showed that
cold-water immersion is effective in reducing the physiolog-
ical and functional deficits associated with delayed onset of
muscle soreness, including improved recovery of isometric
force and dynamic power and a reduction in localized edema.
In comparison with passive recovery, compression garments
led to a significant increase in subsequent performance with
trained elderly cyclists5 and significantly enhanced creatine
kinase clearance with elite male rugby players.11 Ivy et al12
showed that when no carbohydrate was ingested after exer-
cise, the rate of muscle glycogen synthesis was very low (1 to
2 mmol/kg/h), whereas the ingestion of carbohydrate in the
first hours after exercise resulted in enhanced muscle gly-
cogen restoration (4.5 to 11.0 mmol/kg/h). In addition, a pre-
match meal including a large amount of carbohydrate
sources was organized 3 hours before the match because
such ingestion of a carbohydrate-rich meal (140 g to 330 g,
carbohydrates) 3 to 5 hours before exercise increases muscle
glycogen levels and improves exercise performance.15 These
procedures may have helped the players to recover quicker
and thus explain why there was no significant decline in
match-related physical performance in game 2 when com-
pared with game 1.
In the present study, when 2 matches per week were
played, the time between them was 72 to 96 hours. Several
authors have shown that this recovery time is not long
enough to return to prematch levels for maximal strength,
sprinting ability over 20 m,11 and countermovement jump
performance.1 These parameters may have decreased 72 to
96 hours after the match and may have affected the risk of
injury, without significantly affecting total distance, high-
intensity distance, sprint distance, and number of sprints.
The match-related physical performance of professional
top-level soccer players has been studied with an equivalent
system (ProZone5,16) and with the same system (Amisco4):
The subsequent results in terms of total distance, high-
intensity distance, sprint distance, and number of sprints
are in agreement with our results, whether for the team or
according to the position. Central defender was found to
cover significantly less distance, high-intensity distance,
and sprint distance and fewer number of sprints.
An interesting finding was that high-intensity distance is
significantly shorter for the winning team than for the losing
team in the second half, whereas there is no significant dif-
ference for the first half. This result may be explained by the
fact that when a team takes the lead in a game, the target is
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Effect of 2 Soccer Matches in a Week 1757
to maintain that advantage to win the match. To reach this
target, the winning team has to try to keep the ball, whereas
the losing team has to press the opponent and must there-
fore increase the high-intensity runs. As such, high-inten-
sity distance depends not only on the fitness level but also
on the match situations and the tactical and technical levels.
Teams with more technically and tactically skilled players
can probably cover less distance at higher intensity than
that of other teams. Di Salvo et al5 found that league posi-
tion affects high-intensity activity, with less successful
English Premier League teams covering significantly longer
high-intensity distances and sprint distances than their
more successful counterparts. In addition, some players
have the potential to run longer high-intensity distances
during a match but do not do so, because it is not required
according to the match situation. So, the high-intensity dis-
tance appears questionable because match-to-match varia-
tions were high for all the players whatever their positions
(interindividual CV, 42.7%), according to the position (inter-
individual CVs, 24.9% to 40.0%), and for the player who
played most of the games at each of the 5 positions (intrain-
dividual CVs, 36.0% to 52.1%). These results confirmed
those found by Rampini et al,16 where the CV was higher
for high-intensity distance and sprint distance than for total
distance. Owing to the high variability and poor reliability of
the amount of high-intensity running speed, the practical
applications of these results need to be interpreted with
this in mind.
The overall injury rate (8.9 injuries per 1000 hours) and
the injury rates during training (3.7 injuries per 1000 hours)
and matches (48.7 injuries per 1000 hours) were in the range
of the results found by some authors.1,2 For the injury anal-
ysis performed according to group (G1 versus G2), it is diffi-
cult to compare these data because of the specific nature of
the procedure—that is, to analyze the influence of the num-
ber of days between 2 matches. Thus, there are no data avail-
able to explain the high rate of injuries found in G2. However,
for the 2006 World Cup, Dvorak et al6 reported an injury rate
of 81 injuries per 1000 hours of exposure, which is slightly
lower than our results, 97.7 injuries per 1000 hours. In this
tournament, the high rate of injury may have been linked
to the number of days between 2 matches, given that most
matches were played every 3 and 5 days. Although some of
the players studied probably had more than 4 days between
matches, this result highlights the risk of injuries when the
recovery between 2 matches is short. Ekstrand et al7
reported that a congested soccer calendar increases the
risk of injury or underperformance. Results from the present
study confirm the high risk of injury during a congested cal-
endar, but parameters used to study physical performance
were not affected. Performance in the study led by Ekstrand
et al7 was subjectively assessed by 3 international experts;
so, it will be interesting to analyze which part of the perfor-
mance was altered and what link may result with risk of
injury. The authors suggested that repetition of matches
can lead to lack of motivation and mental burnout, which
would affect concentration and coordination.
According to Junge and Dvorak13 in a review of the litera-
ture, soccer injuries predominately affect the ankle, the knee
joints, and the muscles of the thigh and calf. Their analysis is
1758 Dupont et al
in agreement with our results (Table 4). In the present study,
we found that most injuries were caused by overuse (76%),
which is slightly higher than the 62% found by Hawkins
et al10 (with English professional soccer) and much higher
than those reported by Junge and Dvorak13 (26% to 59%).
Injury caused by overuse was 2 times higher in G2 (n, 84)
than in G1 (n, 42). These results suggest that inadequate
recovery between matches leads to fatigue and increases the
risk of injury associated with overuse. Results concerning
the recurrrent injuries seem to confirm this hypothesis given
that reinjuries appear higher for G2 (n, 32) than G1 (n, 5).
Injury in soccer represents a serious problem in terms of
health and performance for players and clubs. In the pres-
ent study, major injuries represented about 11% of the
total injuries, and most of the major injuries occurred
with G2 (about 83%). Injury prevention programs signifi-
cantly reduce injury rate2,3,18; however, when time
between matches is limited (such as 72 to 96 hours), it is
difficult to implement such a program because the priority
is to optimize recovery. In the present study, the team
played 67 matches separated by 3 or 4 days, and 19 players
played from 3 to 14 international matches. During this
period, no injury prevention program was performed. In
the future, it would be interesting to implement an injury
prevention program that does not affect match-related
physical performance but reduces the injury rate.
In summary, although match-related physical perfor-
mance, as characterized by total distance covered, high-
intensity distance, sprint distance, and number of sprints,
was not significantly affected by the number of matches
per week, the injury rate was significantly higher for G2
than for G1. So, the recovery time between 2 matches, 72
to 96 hours, appears sufficient to maintain the level of
match-related physical performance tested in the present
study but not to maintain a low injury rate. These results
indicate that the parameters tested during the matches
(total distance covered, high-intensity distance, sprint dis-
tance, and number of sprints) are not sensitive enough to
indicate anything about the expected injury rate. One of
the limits in this study concerns the sample studied; it
would be interesting to extend this study with more teams
from different countries and to analyze the intensity level
of the matches on the risk of injury. The introduction of
a prevention program with G1 but not G2 is another of
the study’s limits, given that injury prevention signifi-
cantly reduces injury rate.2,3,18 However, when time
between matches is limited, as was the case for G2
(between 72 to 96 hours), it is difficult to implement such
a program because the priority is to optimize recovery.
Future research could focus on the introduction of an
injury prevention program that does not affect match-
related physical performance but reduces the injury rate.
Future studies are needed to identify the indicators associ-
ated with a high rate of injury. To reduce the injury rate,
coaches, sports scientists, and medical teams should con-
sider player rotation, especially when match fixtures are
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The American Journal of Sports Medicine
congested, as well as try to optimize the recovery protocol.
The present data highlight the need for improved recovery
strategies to maintain a low injury rate during periods
with congested match fixtures.
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