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Development of a Standardised System to Classify Injury-Inciting Circumstances in Football: the Football Injury Inciting Circumstances Classification System (FIICCS)

Aiello, Francesco; McCall, Alan; Brown, Susan J.; Serner, Andreas; Fortington, Lauren V.; Huurman, Suzanne Afra Elisabeth; Lewin, Colin; Nagao, Masashi; O’Brien, James; Panossian, Anastasia; Pruna, Ricard; Ramos, Guilherme Passos; Whalan, Matthew; Impellizzeri, Franco M.


Andreas Serner

Lauren V. Fortington

Suzanne Afra Elisabeth Huurman

Colin Lewin

Masashi Nagao

James O’Brien

Anastasia Panossian

Ricard Pruna

Guilherme Passos Ramos

Matthew Whalan

Franco M. Impellizzeri


Background: A comprehensive examination of the sport-specific activities and circumstances being performed at the time of injury is important to hypothesise mechanisms, develop prevention strategies and inform future investigations. Results reported in the literature are inconsistent because inciting activities are reported using different classifications. Hence the aim was to develop a standardised system for the reporting of inciting circumstances. Methods: The system was developed using a modified Nominal Group Technique. The initial panel included 12 sports practitioners and researchers from four continents with respectively ≥ 5 years of experience working in professional football and/or conducting injury research. The process consisted of six phases: idea generation, two surveys, one online meeting and two confirmations. For answers to the closed questions, consensus was deemed achieved if ≥ 70% of respondents agreed. Open-ended answers were qualitatively analysed and then introduced in subsequent phases. Results: Ten panellists completed the study. The risk of attrition bias was low. The developed system includes a comprehensive range of inciting circumstances across five domains: contact type, ball situation, physical activity, session details, contextual information. The system also distinguishes between a core set (essential reporting) and an optional set. The panel deemed all the domains to be important and easy to use both in football and in research environments. Conclusion: A system to classify inciting circumstances in football was developed. Given the extent of reporting inconsistency of inciting circumstances in the available literature, this can be used while further studies evaluate its reliability.

Journal Article Type Article
Acceptance Date Apr 20, 2023
Online Publication Date May 26, 2023
Publication Date 2023-09
Deposit Date May 12, 2023
Publicly Available Date May 26, 2023
Print ISSN 0112-1642
Electronic ISSN 1179-2035
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 53
Issue 9
Pages 1805-1818


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