Time‐loss burden and diagnostic‐label capture of hip and groin injuries in elite men's football: An 18‐season cohort of five major European leagues

Purpose To quantify the frequency and time‐loss burden of publicly reported hip and groin injuries in elite men's football across five major European leagues, to describe how time loss is concentrated across reported labels and across players, and to assess how often a public database captures specific hip‐preservation labels. Methods We retrospectively analysed Transfermarkt‐derived injury histories, performance records, and player profiles from the Premier League, LaLiga, Serie A, Bundesliga and Ligue 1 (2007/08–2024/25). Cases were identified by a prespecified algorithm and classified using a Doha‐informed descriptive framework; every primary‐cohort event underwent manual review, with duplicate blinded validation of the high‐priority 21.6%. Outcomes included event frequency, reported incidence and days lost per 100 player‐seasons, days and matches lost, severity, subsequent reported hip/groin events, player‐level burden concentration and a descriptive burden‐share ratio (BSR; each group's percentage of days lost divided by its percentage of events). Empirical uncertainty around BSR was summarised with 10,000‐resample nonparametric bootstrap percentile intervals. Results Among 50,723 player‐seasons, 2678 publicly reported injuries in 1836 players accounted for 88,724 days and 14,503 matches missed. Adductor‐related injuries were most frequent (45.3%; BSR: 0.79, 95% bootstrap interval: 0.75–0.84). Pubic‐related/pubalgia injuries were less frequent (6.4%) but had the longest median absence (41.5 days) and the highest descriptive BSR (1.73, 1.49–2.01). Burden was 63.0 days lost per 100 player‐seasons for adductor‐related labels, 60.9 for groin/inguinal‐related labels and 19.5 for pubic‐related/pubalgia labels (cohort, 174.9). Severe injuries (>28 days) comprised 34.5% of events and 72.9% of days lost. Time loss was concentrated at player level: the 100 players with the greatest burden (5.4% of affected players) accounted for 26.7% of all days lost and the 10 highest‐burden players (0.5%) for 5.4%, corresponding to 4.9‐fold and 9.9‐fold concentrations. No captured record contained specific labels for femoroacetabular impingement syndrome, labral pathology, hip arthroscopy, chondral injury or dysplasia. A prespecified hip‐preservation public‐label proxy signal accounted for 22.6% of events and 31.7% of days lost; this proxy does not establish the prevalence of any underlying diagnosis. Conclusions Publicly reported label frequency and time‐loss burden differed, consistent with established burden‐based injury prioritisation. Time loss was concentrated in a small minority of labels and of players, a distribution that does not follow definitionally from the thresholds used to describe it. This large multi‐league public‐data analysis complements but cannot replace exposure‐based, diagnosis‐confirmed surveillance. Pubic‐related and prolonged hip‐related labels identify high‐burden groups for prospective phenotyping, while the prespecified proxy signal should be interpreted as hypothesis‐generating rather than diagnostic. Level of Evidence Level III, retrospective cohort study.