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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Who is going to get hurt? Predicting injuries in professional soccer</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Alessio Rossi</string-name>
          <email>alessio.rossi2@gmail.com</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Luca Pappalardo</string-name>
          <email>lpappalardo@di.unipi.it</email>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Paolo Cintia</string-name>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Javier Fernandez</string-name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>F. Marcello Iaia</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Daniel Medina</string-name>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Department of Biomedical Science for Health, University of Milan</institution>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Department of Computer Science, University of Pisa</institution>
          ,
          <addr-line>Pisa</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>ISTI-CNR</institution>
          ,
          <addr-line>Pisa</addr-line>
          ,
          <country country="IT">Italy</country>
        </aff>
        <aff id="aff3">
          <label>3</label>
          <institution>Sports Science and Health Department</institution>
          ,
          <addr-line>Football Club Barcelona</addr-line>
          ,
          <country country="ES">Spain</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>Injury prevention has a fundamental role in professional soccer due to the high cost of recovery for players and the strong in uence of injuries on a club's performance. In this paper we provide a predictive model to prevent injuries of soccer players using a multidimensional approach based on GPS measurements and machine learning. In an evolutive scenario, where a soccer club starts collecting the data for the rst time and updates the predictive model as the season goes by, our approach can detect around half of the injuries, allowing the soccer club to save 70% of a season's economic costs related to injuries. The proposed approach can be a valuable support for coaches, helping the soccer club to reduce injury incidence, save money and increase team performance.</p>
      </abstract>
      <kwd-group>
        <kwd>sports analytics</kwd>
        <kwd>data science</kwd>
        <kwd>machine learning</kwd>
        <kwd>sports science</kwd>
        <kwd>predictive analytics</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>
        Injuries are an important issue in professional soccer, as they can negatively
a ect team performance and represent a remarkable expense for soccer clubs.
The cost associated with the process of recovery and rehabilitation for a player
is often considerable, especially in terms of medical care and missed earnings
from merchandising [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. It has been observed that injuries in Spain cause in
average around 16% of season absence by players, corresponding to a total cost
estimation of 188 million euros just in one season [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. Hence, it is not surprising
that injury prediction is attracting a growing interest from soccer managers, who
are interested in intervening with appropriate actions to reduce the likelihood of
injuries of their players. Due to its importance for a club's economy and success,
a big e ort has been put in the sports science literature on investigating injury
prediction in professional soccer [10{12]. A major limitation of existing studies
is that they follow a monodimensional approach, i.e., they use just one variable
at a time to estimate injury risk thus not fully exploiting the complex patterns
underlying measurable aspects of soccer performance. Moreover, in these works
statistical modeling is used mainly to quantify the relation between the chosen
variable and injury likelihood, while an evaluation of the predictive power of a
player's performance is still missing [
        <xref ref-type="bibr" rid="ref6 ref8">8, 6</xref>
        ].
      </p>
      <p>
        In this paper, we propose a data-driven, multidimensional approach to
injury prediction, considered as the problem of forecasting whether or not a player
will get injured in the next training session or o cial game, given his recent
training workload. Our approach is based on automatic data collection through
standard Electronic Performance and Tracking Systems (EPTS) [
        <xref ref-type="bibr" rid="ref4 ref5 ref6 ref7">4, 7, 5, 6</xref>
        ], and
it is intended as a supporting tool to the decision making of soccer managers and
coaches. In the rst stage of our study, we collect data about training workload
of players through GPS devices, covering half of a season of a professional soccer
club. After a preprocessing task, we extract from the data a set of features used
in sports science to describe aspects of training workload, and we enrich them
with information about all the injuries which happen during the half season. We
found that injuries can be successfully predicted with a small set of three
variables: the presence of recent previous injuries, high metabolic load distance and
sudden decelerations. We investigate a real-world scenario where the classi ers
are updated while new training workload and injury data become available as
the season goes by. The machine learning approach can detect more than half of
the injuries during the season, indicating that by using our predictor the soccer
club could have been saved 70% of injury-related costs.
2
      </p>
    </sec>
    <sec id="sec-2">
      <title>Related Work</title>
      <p>
        Several studies performed by Gabbett et al. [13{18, 21] show that muscular
injuries are to some extent preventable. In rugby, they nd that a player has a high
injury risk when his workload is above a certain threshold. The same results are
observed by Hulin et al. [
        <xref ref-type="bibr" rid="ref22">22</xref>
        ] and Ehrmann et al. [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ] for cricket players and
soccer players, respectively. In particular, all these studies assess the ratio between
acute workload (i.e., the average workload in the last 7 days) and chronic
workload (i.e., the average workload in the last 28 days), de ning speci c thresholds
to detect players who could incur in a injury in the future training sessions.
      </p>
      <p>
        The \monotony session load", i.e., the ratio between the mean and the
standard deviation of the session load is widely used in literature. In skating, Foster
et al. [
        <xref ref-type="bibr" rid="ref23">23</xref>
        ] nd that when the session load outweighs a skater's ability to fully
recover before the next session, the skater su ers from the so-called
\overtraining syndrome", a condition that can cause injury [
        <xref ref-type="bibr" rid="ref23">23</xref>
        ]. In basketball, Anderson
et al. [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ] nd a correlation between injury risk and monotony session load.
In soccer, Brink et al. [
        <xref ref-type="bibr" rid="ref24">24</xref>
        ] observe that injured players record higher values of
monotony in the week preceding the injury than non-injured players.
      </p>
      <p>
        Some studies also show that technical-tactical performance during o cial
matches can a ect the players' physical t. Talukder et al. [
        <xref ref-type="bibr" rid="ref25">25</xref>
        ] propose a classi er
able to predict 19% of the injuries occurred in NBA using the players'
technicaltactical performance. They show that the most important features for injury
prediction in basket are the average speed, the number of past competitions
played, the average distance covered, the number of minutes played to date and
the average eld goals attempted.
      </p>
      <p>From the literature, it is clear that all injury prediction studies for soccer
su er from a major limitation: they investigate the correlation between a single
aspect of training workload and injury likelihood but they do not construct any
predictor as a tool to make predictions and prevent injuries. Therefore, to the
best of our knowledge, there is no quanti cation of the potential of predictive
analytics in preventing injuries in professional soccer.
3
3.1</p>
    </sec>
    <sec id="sec-3">
      <title>Dataset preparation</title>
      <sec id="sec-3-1">
        <title>Data collection and feature extraction</title>
        <p>During the season 2013/2014 we monitor the position of twenty-six professional
football players competing in the Italian Serie B during 23 training sessions {
from January 1st to May 31st { using a portable non-di erential 10 Hz global
position system (GPS) integrated with 100 Hz 3-D accelerometer, a 3-D gyroscope,
a 3-D digital compass (STATSports Viper, Northern Ireland). Each player wore
a tight vest where the receiver was placed between their scapulae, and every
player wore his own GPS device for each training session. We recorded a total
of 954 individual training sessions during the 23 weeks and extracted from the
data a set of training workload indicators through the software package Viper
Version 2.1 (STATSports 2014). From every training session we extracted 12
features describing kinematic, metabolic and mechanical aspects of the
individuals' trainings. For each player, we also collected information about age, weight,
height and role on the eld. Moreover, for each player's training session we
collected information about the play time in the o cial game before the training
session and the number of o cial games played before the training session. Table
1 provides a description of the considered features.</p>
        <p>The club's medical sta recorded all the non-contact injuries occurred during
23 weeks. A non-contact injury is de ned as any tissue damage sustained by a
player that causes absence in next football activities for at least the day after
the day of the onset. In this dataset there are 21 non-contact injuries in total.
3.2</p>
      </sec>
      <sec id="sec-3-2">
        <title>Feature engineering and dataset construction</title>
        <p>We construct four training sets transforming the 12 workloads features described
in Table 1 in the following way:
1. Workload Features set (WF) { we consider the training workloads in the
6 most recent training sessions by using an exponential weighted moving
average (EWMA). We also compute the EWMA of feature PI with a span
equal to 6 (PIWF) in order to take into account both the number of a player's
previous injuries and their temporal distance to the current training sessions.</p>
        <p>PIWF = 0 indicates that the player never got injured in the past; PIWF &gt; 0
dTOT
dHSR
dMET
dHML
dEXP
Acc2
Acc3
Dec2
Dec3
DSL
FI
Age
BMI</p>
        <sec id="sec-3-2-1">
          <title>Role PI</title>
          <p>dHML=m</p>
        </sec>
        <sec id="sec-3-2-2">
          <title>Average dHML per minute</title>
        </sec>
        <sec id="sec-3-2-3">
          <title>Distance in meters covered during the training session</title>
        </sec>
        <sec id="sec-3-2-4">
          <title>Distance in meters covered above 5.5m/s</title>
        </sec>
        <sec id="sec-3-2-5">
          <title>Distance in meters covered at metabolic power</title>
        </sec>
        <sec id="sec-3-2-6">
          <title>Distance in meters covered by a player with a Metabolic Power is above 25.5W/Kg</title>
        </sec>
        <sec id="sec-3-2-7">
          <title>Distance in meters covered above 25.5W/Kg and below 19.8Km/h</title>
          <p>Number of accelerations above 2m/s2
Number of accelerations above 3m/s2
Number of decelerations above 2m/s2
Number of decelerations above 3m/s2</p>
        </sec>
        <sec id="sec-3-2-8">
          <title>Total of the weighted impacts of magnitude above 2g. Impacts</title>
          <p>are collisions and step impacts during running</p>
        </sec>
        <sec id="sec-3-2-9">
          <title>Ratio between DSL and speed intensity age of players</title>
        </sec>
        <sec id="sec-3-2-10">
          <title>Role of the player</title>
        </sec>
        <sec id="sec-3-2-11">
          <title>Body Mass Index: ratio between weight (in kg) and the square of height (in meters)</title>
        </sec>
        <sec id="sec-3-2-12">
          <title>Number of injuries of the players before each training session</title>
        </sec>
        <sec id="sec-3-2-13">
          <title>Play time Minutes of play in previous games</title>
        </sec>
        <sec id="sec-3-2-14">
          <title>Games</title>
        </sec>
        <sec id="sec-3-2-15">
          <title>Number of games played before each training session Table 1. Description of the training workload features extracted from GPS data and the players' personal features collected during the study.</title>
          <p>
            indicates that the player got injured at least once in the past; PIWF &gt; 1
indicates that the player got injured more than once in the past.
2. Acute:Chronic Workload Ratio features set (ACWR) { here we consider the
standard de facto used in sports science to estimate injury likelihood [
            <xref ref-type="bibr" rid="ref9">9</xref>
            ] and
compute the ratio between the 6 most recent training sessions by the EWMA
and the EWMA of the previous 28 days.
3. Mean over Standard deviation Workload Ratio (MSWR) { we consider
another way proposed in literature to estimate injury likelihood [
            <xref ref-type="bibr" rid="ref10">10</xref>
            ] and
compute the ratio between the mean and the standard deviation of the training
workloads in the 6 most recent days. The higher the MSWR of a player, the
lower is the variability of his workloads during the training week.
4. we build a dataset based on the union of the three feature sets described
above (WF, ACWR and MSWR) and the personal features in Table 1. This
dataset consists of a vector of 42 features and the injury label indicating
whether or not the player gets injured in next match or training session.
          </p>
          <p>Every training set consists of 954 examples (i.e., individual training sessions)
corresponding to 80 collective training sessions.</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>Experiments</title>
      <p>First of all, we perform a feature selection process based on a Decision Tree
Classi er in order to reduce the dimensionality of the feature space and consequently
the risk of over tting. We use recursive feature elimination with cross-validation
(RFECV) to select the best set of features able to predict injuries in our dataset.</p>
      <p>On the new training dataset derived from the feature selection, we train
a Decision Tree classi er (DT) and a Random Forest Classi er (ETRFC).5 In
particular, we investigate a scenario where the club starts to record data at the
beginning of a season and trains the classi er as the season goes by. Hence,
we proceed from the rst training week (w1) to the most recent one (wi-1). At
training week wi we train the classi ers on weeks w1: : : wi and evaluate their
ability to predict injuries on week wi+1.</p>
      <p>
        Considering injury prediction as a binary classi cation problem where the
injury class (1) is the positive class, we measure the goodness of the classi ers
week by week in terms of precision, recall, F1-score and AUC [
        <xref ref-type="bibr" rid="ref27">27</xref>
        ]. Precision
indicates the fraction of examples that the classi er correctly classi es over the
number of all examples the classi er assigns to that class. Recall indicates the
ratio of examples of a given class correctly classi ed by the classi er, while
F1score is the harmonic mean of precision and recall. AUC (Area Under the Curve)
is the probability that a classi er will rank a randomly chosen positive instance
higher than a randomly chosen negative one (assuming \positive" ranks higher
than \negative"). An AUC close to 1 represents an accurate classi cation, while
an AUC close to 0.5 represents a random classi cation.
      </p>
      <p>
        We compare the goodness of DT and ETRFC with two baselines. Baseline B1
randomly assigns a class to an example by respecting the distribution of classes,
and baseline B2 is a classi er which assigns class 1 (injury) if the exponentially
weighted average of variable PI &gt; 0, and 0 (no injury) otherwise. Finally, we
estimate the economic cost of the injuries for the considered soccer club by
using the methodology suggested by Fernandez et al. [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ], i.e., we multiply the
number of days of \work" absence by the minimal legal salary per day in the
Italian Serie B.
4.1
      </p>
      <sec id="sec-4-1">
        <title>Results</title>
        <p>Just 3 features out of 42 are selected by the feature selection task: PI(WF), d(HMMSLWR)
and DEC(WF). Feature PI(WF) re ects the temporal distance between a player's
2
current training session and the coming back to regular training of a player who
got injured in the past. Features d(HMMSLWR) and DEC(WF) are two training features
2
indicating high metabolic load and sudden decelerations, respectively. We
observe that 42% of the injuries detected by the classi er happened immediately
after the coming back to regular training of players who got injured in the past,
and are characterized by speci c values of d(HMMSLWR) and DEC2(WF), which indicate
5 We use the Python package scikit-learn to train and test all the classi ers.
the metabolic workload variability and the average of sudden decelerations in
the previous 6 days, respectively.</p>
        <p>Due to the low number of injury examples, the classi ers have a poor
predictive performance at the beginning of the season and miss many injuries. However,
the predictive ability improves by time and the classi ers predict most of the
injuries in the second half of the season. The cumulative performance of the
classi ers is highly a ected by the initial period, where injury examples are scarce.
This suggests that trying to prevent injuries since the beginning could not be a
good strategy since classi cation performance can be initially poor due to data
scarcity. An initial period of data collection, whose length depends on the needs
and strategy of the club, is needed in order to collect the adequate amount
of data, and only then reliable classi ers can be trained on the collected data.
Regarding this aspect, in our dataset, we observe that the performance of the
classi ers stabilizes after 16 weeks of data collection. In our case, a reasonable
strategy could be to use the classi ers for injury prevention starting from the
16th week. This suggests that the considered club could e ectively use the
classi ers trained on data from a season to perform injury prediction since the rst
session of the second half of the current season.</p>
        <p>We observe that DT is the best classi er in this scenario detecting more
than half of the injuries (11 injuries out of 21), resulting in a cumulative
F1score = 0:45.6 Table 2 shows the classi cation reports of the two classi ers and
the two baselines at the end of the season. We nd that DT is signi cantly
better than the baselines (Table 2). At the end of the season, DT detects 58% of
the injuries (recall = 0.58) and it correctly predicts 38% of the cases classi ed
as injuries (precision = 0.38). Although the machine learning approach
significantly adds predictive power with respect to existing methods, there is still
room for improvement. Soccer clubs are indeed interested in an algorithm with
high precision to reduce \false alarms", which could negatively a ect a team's
performance due to the forced absence of crucial players.</p>
        <p>We also train DT, ETRFC and the baselines using the entire feature set,
i.e., without performing any feature selection process. These classi ers perform
slightly worse than the classi ers build on the three selected features
(precision, recall, F1-score and AUC are 0.36, 0.52, 0.43, and 0.74, respectively). To
understand if the role of a player a ects injury likelihood, we train distinct
classi ers for every role (defender, mid elder, forwards) and nd that they perform
much worse that the classi ers trained without distinguishing between the roles
(precision, recall, f1-score and AUC are 0.01, 0.04, 0.03 and 0.51, respectively).</p>
        <p>Figure 1 shows the distribution of the number of days of work absence
recorded during the season. The number of work days of absence due to
injuries is 139, i.e., 6% of the working days. Generally, a player returns to regular
physical activity within 5 days (i.e., 15 times out of 21 injuries), while only 6
times a player needed more than 5 days to recover. We estimate a (minimum)
6 DT has the following meta-parameters: max depth = 3, minimum samples for a leaf
= 2, minimum sample split = 11. For all the other meta-parameters we use default
values suggested by sciki-learn (see documentation: http://bit.ly/1T5sf92).
model class prec rec F1 AUC</p>
        <p>DT 0 0.98 0.99 0.99 0.76</p>
        <p>1 0.38 0.58 0.45
ET RF C</p>
        <p>B2
B1
total cost related to injuries of 11,583 euros (139x83 euros = days of absence
x minimal legal salary per day) corresponding to 3.81% of the salary cost of
the soccer club (from January 1st to May 31st the club spent 303,750 euros for
the players' salary). By using DT to predict injuries as the season goes by, the
soccer club could had been able to prevent 11 injuries and save 8,300 euros, 70%
of the economic costs related to injuries during the season (100x83 euros = day
of absence x minimal legal salary per day).</p>
        <p>5
y
c
n
4
e
u
q
e
r3
F
8
7
6
2
1
0
0
5
10</p>
        <p>15 20 25
Days of absence
30
35
40</p>
        <p>Fig. 1. Distribution of the number of days of work absence after an injury.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Conclusion</title>
      <p>
        This study presents a method to predict injuries of soccer players. Athletic
trainers, coaches and physiotherapists can use our method to make decisions about
whether or not to stop a player in next o cial match, thus eventually
preventing his injury, improving team performance and reducing the club's costs. The
proposed study provides an example of how machine learning can be used to
solve a di cult problem in sports analytics such as predicting injuries. An
enlargement of the dataset to include di erent teams, which is planned by the
authors of this paper, might allow to build a more general and robust algorithm
for injury forecasting. With more injury cases we could transform the problem
from a binary classi cation (injury/no-injury) to a multi-class classi cation or
a regression problem, where information about the typology or the severity of
the injuries can be exploited to produce more diverse predictions. Finally, due to
its exibility, our multidimensional approach can be easily extended to predict
injuries in other professional sports, like rugby [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ] and cycling [
        <xref ref-type="bibr" rid="ref28">28</xref>
        ].
Acknowledgements. This work has been partially funded by the EU project
SoBigData grant n. 654024.
      </p>
    </sec>
  </body>
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