Relationship between Posture and Non-Contact Lower Limb Injury in Young Male Amateur Football Players: A Prospective Cohort Study

Abstract

Posture, a potentially modifiable injury risk factor, is considered important in injury screening/prevention in athletes, yet few studies investigate relationships between posture and injury. This prospective cohort study investigated whether static posture is associated with lower limb injury risk in male football players (n = 263). Nine aspects of static standing posture (left and right rearfoot, knee interspace, lateral knee, lumbar lordosis, thoracic kyphosis, scoliosis S and C, forward head) were assessed from photographs during the pre-season using the modified Watson and Mac Donncha scale, which was dichotomised for analysis (deviated or normal). Player characteristics (age, height, mass, body mass index, competition level), match/training exposure, and previous and in-season non-contact lower limb injuries were recorded. Binary logistic regression investigated relationships between posture and injury (previous and in-season). Eighty previous and 24 in-season lower limb injuries were recorded. Previous injury was not associated with any postural variable. In-season injury was associated with previous injury (OR = 3.04, 95% CI 1.20–7.68, p = 0.02) and having a normal thoracic curve compared to kyphosis (OR = 0.38, 95% CI 0.15–1.00, p = 0.05) but no other postural variables. Static postural deviations observed in male football players in the pre-season are not typically associated with non-contact lower limb injury risk; thus, they are unlikely to add value to pre-season screening programs.