The Effects of Fixture Congestion on Injury in Professional Male Soccer: A Systematic Review

Abstract
Background Professional soccer teams are often required to compete with ≤ 4 days recovery between matches. Since congested schedules reduce recovery time between matches, players are possibly at an increased injury risk. To date, there are no published systematic reviews on the impact of match congestion on injuries during professional male soccer. Objective The aim of this systematic review was to assess the effects of fixture congestion on injuries during professional soccer. Methods Following pre-registration on the Open Science Framework (https://osf.io/86m25/) and conforming with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic searches of four electronic databases (PubMed, Scopus, SPORTDiscus, and Web of Science) were conducted by independent researchers from inception until February 2022. Articles were included if they were original articles written in English and contained relevant time-loss injury data (injury that results in unavailability for training and/or match-play) for male professional soccer players regarding periods of fixture congestion (a minimum of two matches with ≤ 4 days recovery). Results A total of eight articles were included in the review. Five studies identified that congested fixture schedules expose players to increased match injury incidence, although layoff duration was typically lower during congested periods. Two studies identified that training and overall injury incidence were higher during congested periods, with another study identifying a lower training injury incidence during congested periods. Conclusion Injury risk is, overall, increased during fixture-congested periods; however, the layoff duration is typically shorter. The current findings have implications for practitioners regarding the management, periodisation, monitoring, and design of training and competition schedules.