Injury Profile in German Amateur Women’s Football Is Knee-Centred and Match-Dominated: A Prospective One-Season Cohort Study

Background: Injury epidemiology in women’s football has primarily focused on elite athletes, whereas the amateur level, representing the vast majority of female players worldwide, remains largely under-explored. We aimed to provide a first prospective one-season characterisation of injuries in German amateur women’s football. Methods: In this prospective observational cohort study, 26 clubs comprising 450 female amateur players in Bavaria were monitored over the 2023/24 season using standardised time-loss injury questionnaires as used in current professional registry studies. Injuries were characterised by anatomical location, type, mechanism, and activity context (match vs. training); proportions are reported with 95% binomial exact confidence intervals (CI). Results: A total of 68 injuries were recorded. Regarding injuries with documented information, 66.7% (95% CI 54.0–77.8) were acute traumatic and 78.2% (95% CI 65.0–88.2) occurred during matches. Lower-extremity injuries dominated (80.3%; 95% CI 71.2–90.5), led by the knee as the single most frequent region (28.2%; 95% CI 18.1–40.1). Ligament injuries were the most common injury type (27.9%). Seven ACL ruptures were documented (10.3%; 95% CI 4.2–20.1), all of which occurred during match play. Indirect-contact mechanisms were significantly over-represented among all knee injuries (OR 6.92, 95% CI 1.52–31.6; p = 0.012). Conclusions: Amateur injury profile in this study reproduced the knee-centred, match-dominated pattern of elite female football while carrying a relative ACL burden at the upper end of professional reference data; given the small number of ACL events (n = 7), this signal is hypothesis-generating. These findings support the extension of structured neuromuscular prevention programmes into German amateur women’s football.