Case Report: Return to Sport Following the COVID-19 Lockdown and Its Impact on Injury Rates in the German Soccer League.

The Bundesliga made headlines for becoming the first major sports league to return to sport worldwide following COVID-19 lockdown. To-date, there lacks retrospective studies on longitudinal injury rates to elucidate the effect isolation measures had on the health and safety of professional athletes. This study sought to compare injury rates experienced by Bundesliga athletes before and after the COVID-19 lockdown. Data was collected from public injury and player reports regarding the Bundesliga, with injury defined as trauma resulting in loss of game time. Descriptive statistics were used to present differences in injury incidence between all Bundesliga Match days pre- and post-lockdown. Between the league's resumption and completion on May 16 and June 27, 2020, injuries occurred in 21 forwards (FW), 11 central midfielders (CM), 12 wide midfielders (WM), 16 central defenders (CD), 6 fullbacks (FB), and 2 goalkeepers. Players had 1.13 (95% CI 0.78, 1.64) times the odds of being injured following the COVID-19 lockdown, with a 3.12 times higher rate of injury when controlling for games played compared to injury rates pre-lockdown (0.84 injuries per game vs. 0.27 injuries per game). The most frequent injury group was muscular injuries with 23 injuries total, with 17% of athletes experiencing injury during their first competitive match following lockdown. Injury rate increased over 3-fold following COVID-19 lockdown. Athletes did not experience an increased rate of injury with more cumulative competitive matches played. High injury incidence for players yet to complete their first competitive match may imply suboptimal sport readiness following home confinement.