INTRODUCTION: Injury surveillance is an integral part of elite football given medico-legal responsibilities and the need to mitigate injury occurrence in the interests of player welfare. Long-term, large-scale studies characterising specific injury diagnosis in international football are scarce, with previous studies only examining international tournaments [1,2]. The aggregation of injuries into broad categories, a lack of injury severity analysis and the inability to assess specific match and training injury patterns limit the practical use of current literature. This study aimed to compare injury patterns and specific diagnoses in matches and training, and their associated incidence and severity, in English men`s senior international football over 8 seasons. METHODS: Time-loss injuries and match and training exposure were collected across 8 seasons (2012-20) in English men`s international teams (U20/U21/Senior). Incidence (injuries/1000h), and severity (% of total days absent) of injury patterns and specific injury diagnoses were determined. Chi-square test was used to assess differences in the distribution of injuries between matches and training. Significance was set at P<0.05. RESULTS: 215 injuries were recorded (match: 126, training: 89) over 8 seasons. The most common match injury diagnoses were lower limb haematomas (22%,7.0/1000h), hamstrings muscle/tendon (13%,4.0/1000h) and lateral ankle ligament injuries (10%,3.3/1000h). In training, lower limb haematomas (12%,0.4/1000h), hamstrings muscle/tendon (11%,0.4/1000h) and quadriceps and hip/groin muscle/tendon injuries (both 9%,0.3/1000h) were most common. There were no differences in commonality between matches and training (P>0.05). The most severe match injury diagnoses were ACL (19%), lateral ankle ligament (13%) and quadriceps muscle/tendon injuries (11%). In training, MCL (19%), quadriceps muscle/tendon (16%) and hamstrings muscle/tendon injuries (12%) were most severe. ACL and lateral ankle ligament injuries were more severe in matches than training (both P<0.001). Quadriceps muscle/tendon (P<0.001), MCL (P<0.001) and hamstrings muscle/tendon injuries (P=0.048) were more severe in training than matches. CONCLUSION: No differences were shown in the patterns and specific diagnoses of injuries in matches compared to training, suggesting that the differing contextual factors between matches and training did not influence injury commonality. Lateral ankle ligament injuries were more severe in matches compared to training, potentially attributed to increased player contact through tackling and fouls in matches. The greater severity for hamstrings and quadriceps muscle/tendon injuries in training compared to matches warrants further investigation.
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