Impact of Lower Extremity Injuries on Performance Metrics by Position in Male Major League Soccer Players: A Position-Specific Analysis of Return to Play and Performance from 2018-2023

Introduction Lower extremity injuries are common in male professional soccer players, yet no known studies examine how these injuries impact return to play in these athletes. Objective To analyze whether lower extremity injuries affected the rate of return to play and performance in male Major League Soccer players. Materials/Methods Injury data from the 2018-2023 men’s professional soccer seasons for both Major League Soccer and International Leagues were collected from FBref, Transfermrkt, and the MLS Player Availability Report. Players were included if they experienced a lower extremity injury during the 2018-2023 soccer seasons. Injuries were included if they resulted in absence from a minimum of 14 days, including games or practices. Performance metrics were analyzed across three periods: short-term, defined as within the same year of injury; medium-term, up to one-year post-injury; and long-term, up to two years post-injury. Statistical analysis comparing performance metrics before and after the injury were conducted using Microsoft excel and Julius. Paired t-tests were used to asses statistical significance. Results Of the 1,522 total injuries from 2018-2023, 838 (55.1%) were considered lower extremity injuries. Among all positions, the knee was the most commonly injured structure (151.18%). The Center Back was the most commonly injured position (166 injuries, 19.8%). Conclusions Through the data, it was found that the knee was the most injured body part. Center Backs experienced both declines and improvements in performance metrics. Forwards demonstrated a decrease in goals per game and other offensive metrics following injury. These findings can help sports medicine professionals enhance patient recovery, prolong players’ career, and develop targeted injury prevention strategies by understanding the position specific impacts of lower extremity injuries on soccer performance.