Injuries and musculoskeletal complaints in referees and assistant referees selected for the 2006 FIFA World Cup: retrospective and prospective survey

Background: There is a considerable amount of scientific literature on football, but few studies have focused on referees, despite their key role in this sport. Existing studies focus on the physiological demands and training of referees. Purpose: To analyse injuries and musculoskeletal complaints in referees and assistant referees selected for the 2006 FIFA World Cup. Study design: Retrospective survey and prospective study. Methods: During the preparation camps for the 2006 FIFA World Cup in Germany, all 123 referees pre-selected for the tournament completed a questionnaire on injuries and musculoskeletal complaints. During the tournament, the characteristics and consequences of all injuries and complaints incurred by the 63 officiating referees were documented. Results: More than 40% of the referees reported having incurred an injury and more than 60% having had musculoskeletal complaints during their career. About 20% of the group reported having suffered from musculoskeletal complaints in the last match. During the World Cup, 14 referees (22%) incurred an injury and more than 30% had musculoskeletal complaints. This prospectively collected data showed an incidence of 20.8 injuries per 1000 match hours (95% CI: 4.17 to 37.4). The most common acute injuries were hamstring strains, calf strains, and ankle sprains, while the most frequent locations of complaints were the low back, hamstring and knee. Conclusion: Considering the injury profile, the prevalence of associated musculoskeletal complaints, and the high physiological demands of refereeing, it appears that injury prevention programmes should be developed and integrated into the fitness training routine of the referee.