Analysis of injuries in male soccer players: study on San Marino league

Purpose: Football is the most widely practiced and followed sport worldwide, yet it also presents one of the highest injury rates, especially at the amateur level where preventive and rehabilitative resources are often limited. While numerous studies have addressed injuries in professional football, there remains a gap in understanding the specific risk factors and injury patterns in non-elite contexts, such as in the Republic of San Marino. The aim of present work is to retrospectively analyze the injury incidence in that country. Methods: This retrospective study investigated injury incidence and patterns among amateur football players in San Marino. Data were collected through an online questionnaire targeting male players involved in the local football league. The collected responses (50 players, mean age 29,5 ± 11,9 years, height 183 ± 17 cm, weight 79 Kg ± 24 Kg) were analyzed and compared with existing literature on professional and amateur football injuries. Risk factors were assessed based on intrinsic (e.g., age, fitness level, previous injuries) and extrinsic (e.g., training volume, pitch surface, season timing) categories. Results: The findings evidence a high prevalence of injuries among amateur players, with muscular strains (32,6%), knee and ankle ligament sprains (28,2%), and overuse injuries (26,2%) being the most common. Lower extremities are the main involved area of the body (83%) and moderate severity represents the most frequent type of injury (55,3%). Notably, the study confirmed a higher rate of injury recurrence due to insufficient rehabilitation protocols and suboptimal training loads (29,7%). Fatigue, poor physical conditioning, and the quality of playing surfaces were also found to be significant contributors to injury risk. A lower training-to-competition time ratio (TTE/CTE) correlated with increased injury incidence. Conclusions: Injury prevention in amateur football requires more structured and context-specific interventions, especially in small-scale realities like San Marino. Emphasizing structured pre-season conditioning, consistent application of neuromuscular and proprioceptive exercises, and improving training quality and surface conditions can substantially reduce the incidence and recurrence of injuries. These findings underscore the need for tailored injury prevention programs even in amateur sports settings.