A four-season prospective study of muscle strain reoccurrences in a professional football club

The aim of this investigation was to characterise muscle strain reinjuries and examine their impact on playing resources in a professional football club. Muscle strains and reoccurrences were prospectively diagnosed over four seasons in first-team players (n = 46). Altogether, 188 muscle strains were diagnosed with 44 (23.4%) of these classed as reinjuries, leading to an incidence of 1.32 strain reoccurrences per 1,000 hours exposure (95% Confidence Interval [CI], 0.93–1.71). The incidence of recurrent strains was higher in match-play compared with training (4.51, 95% CI, 2.30–6.72 vs 0.94, 95% CI, 0.59–1.29). Altogether, 50.0% of players sustained at least 1 reoccurrence of a muscle strain, leading to approximately 3 days lost and 0.4 matches missed per player per season. The incidence of recurrent strains was highest in centre-forwards (2.15, 95% CI, 1.06–3.24), peaked in May (3.78, 95% CI, 0.47–7.09), and mostly affected the hamstrings (38.6% of all reoccurrences). Mean layoff for nonreoccurrences and recurrences was similar: ∼7.5 days. These results provide greater insight into the extent of the problem of recurrent muscle strains in professional football

Concussion in European professional football : a view of team physicians

OBJECTIVES : The objective was to explore the view and thoughts of physicians working in professional football about several aspects (eg, education and use of video footages) likely to enhance concussions’ recognition and on-field management. METHODS : An observational study based on a cross-sectional design by means of an electronic survey was conducted among physicians working for a professional football club in Belgium, England or France. RESULTS : A total of 96 physicians (95% male; mean age: 44 years) completed the survey. Nearly all participants (95%) were in favour of informational sessions about concussion for players or technical staff. Only 5%–10% of the participants mentioned that they had felt pressured by the technical staff or players not to substitute a player with a (potential) concussion. Most participants were in favour of an additional permanent concussion substitution and a temporary concussion substitution. Four out of five participants reported that the availability of instant video footages (side-line) would ease the recognition of concussion. CONCLUSION : A better recognition and on-field management of concussions in professional football can only be achieved with a holistic approach, including adequate laws of the football game and protocols. Especially, regular education of players and technical staff should be made mandatory while the medical teams should be provided side-line with instant video footages.http://bmjopensem.bmj.comam2022Sports Medicin

Determination of the prevalence of knee and hip clinical osteoarthritis in the active professional male footballer and its association with pain, function, injury and surgery

DATA AVAILABILITY STATEMENT : All statistical analysis data are available as supplementary material. Raw data can be requested from the corresponding author, at reasonable request.SUPPLEMENTARY FILE A: Designed questionnaire.SUPPLEMENTARY FILE B: KOOS-PS.SUPPLEMENTARY FILE C: HOOS-PS.SUPPLEMENTARY FILE D: PROMIS-GH.STRENGTHS AND LIMITATIONS 24032023.T22066-Statistical-Analysis-Total Final.OBJECTIVE : To comment on and explore (1) the prevalence of clinical knee and hip os- teoarthritis (OA); (2) the association between pain or function and clinical knee or hip OA; (3) the association between injury or surgery and clinical knee or hip OA. METHODS : Participants were recruited from FIFPRO members. A total of 101 footballers consented to answer (1) a developed questionnaire, (2) patient-reported outcome measures, and (3) be evaluated by their team physician for clinical knee or hip OA. RESULTS : Of the 53% evaluated for clinical knee and hip OA, a prevalence of 9.43% and 7.55% of knee and hip OA, respectively, was found. There was a significant and strong association between knee (p = 0.033; Cramers v Value = 0.523) and hip pain (p = 0.005; Cramers v Value = 0.602) and clinical OA. A significant association existed between Hip dysfunction and Osteoarthritis Outcome short form Scores and clinical OA of the hip (p = 0.036). The odds of clinical knee OA were 1.5 and 4.5 times more after one or more injuries or surgeries, respectively. There was no association between playing position and clinical OA. CONCLUSION : There is a low prevalence of a clinical knee or hip OA in the active professional male footballer. Pain may be a valid symptom to predict or monitor knee or hip OA. Validated assessment tools should be utilised to identify a negative effect on function. The odds of developing clinical OA in the knee with the number of injuries or surgeries. The hip presents with earlier clinical signs of OA compared to the knee.https://www.mdpi.com/journal/sportshj2023Sports Medicin

Avoiding a red card : recommendations for a consistent standard of concussion management in professional football (soccer)

Compared with some collision/contact sports, concussions are relatively uncommon in professional football (soccer).1 2 Nevertheless, professional football has been under repeated scrutiny because of questionable recognition and management (on-field and off-field) of concussions during several high-profile international and national competitions. Given the Concussion in Sport Consensus process has been ongoing for two decades, it is important that professional football adopt consistent policies that represent the highest standard of concussion care.1 We believe the current approach to concussion in some professional football competitions may warrant a red card. Being the world’s highest profile sport, we acknowledge that football’s apparent concussion management oversights may appear to be disproportionately exposed in both the medical and public eye. We also recognise that the Fédération Internationale de Football Association (FIFA) and many professional leagues have made many steps towards promoting high-quality concussion care. Equally, however, variable policies exist that may compromise athlete care, and the sports profile and popularity should be used to promote optimal concussion care and educate millions. As clinicians who have been working in professional football for over 100 cumulated years, we propose a series of measures to improve the recognition and management of concussion across professional football.https://bjsm.bmj.comam2022Sports Medicin

Hamstring muscle injury in football players. Part 2 : preventive strategies.

editorial reviewedPrevention of hamstring injuries represents an important issue for football players and clubs. Preventive strategies can be effective if they include multiple dimensions and are well-structured. Five points appear essential in order to obtain a high-quality preventive strategy: progressive muscle strengthening, optimal workload management, lumbopelvic stability exercises, development of physical condition and optimization of sprint technique. While recognizing the limitations of preventive screening and the difficulty of predicting future injury, screening tests appear relevant for the identification of an individual risk profile for each footballer and in defining each player's work priorities. Finally, secondary prevention starts with the implementation of rigorous and high-level rehabilitation, as well as a special attention to players with a history of hamstring injury.La prévention des lésions musculaires des ischio-jambiers représente une thématique de première importance pour les joueurs et clubs de football. Les stratégies préventives peuvent se révéler efficaces, à condition d’inclure de multiples dimensions à celles-ci et de structurer ces démarches. Cinq points apparaissent incontournables dans l’optique d’obtenir une stratégie préventive de qualité : le renforcement musculaire progressif et raisonné, la gestion équilibrée de la charge de travail, le travail de la stabilité lombo-pelvienne, le développement de la condition physique et l’optimalisation de la gestuelle de course. Tout en reconnaissant les limites du screening préventif et la difficulté de prédire une future blessure, un état des lieux précis peut s’avérer pertinent pour identifier le profil de risque individuel de chaque footballeur et pour définir les priorités de travail de chacun. Enfin, la prévention secondaire démarre par la mise en place d’une rééducation rigoureuse et structurée, ainsi que par une attention particulière aux joueurs avec antécédents de lésions aux ischio-jambiers

La lésion musculaire des ischio-jambiers chez le footballeur - Partim I : épidémiologie, facteurs de risque, mécanismes lésionnels et traitement

peer reviewe

Effect of an injury prevention program on muscle injuries in elite professional soccer

Due to the continual physical, physiological, and psychological demands of elite level soccer increasing the incidence and risk of injuries, preventative training programs have become a common feature of soccer players training schedule. The aim of the current investigation was to examine the effectiveness of a structured injury prevention program on the number of muscle injuries and the total number of injuries within elite professional soccer. The present study was conducted over 2 consecutive seasons, of which the first (2008-2009) being the intervention season and the second the control season (2009-2010). In total, 26 and 23 elite male professional soccer players competing within the Scottish Premier League and European competition participated. The training program was performed twice weekly for the entirety of the season (58 prevention sessions). The results revealed an increase in the total number of injuries within the intervention season (88 vs. 72); however, this was largely due to the greater number of contusion injuries sustained within the intervention season (n = 44) when compared with control season (n = 23). Significantly less muscle injuries were observed during the intervention season (moderate effect), and this occurred concomitant with a bigger squad size (large effect, p \u3c 0.001). The findings from this study identify that a multicomponent injury prevention-training program may be appropriate for reducing the number of muscle injuries during a season but may not be adequate to reduce all other injuries

A three-year prospective study of illness in professional soccer players

The aim of this study was to investigate rates and patterns of illness in professional soccer and their impact on playing resources. Illnesses were prospectively diagnosed over three seasons in first-team professional soccer players (n = 81) by the club's physician. A total of 203 illnesses were diagnosed with a mean of 2.5 ± 0.7 complaints per player per season. The majority of complaints were classed as upper respiratory (74.5%) and gastrointestinal illnesses (13.7%). Of all illness episodes, 19.7% required a lay-off (mean duration: 2.1 days). Per season, 0.3% ± 0.01 of all working days were lost due to illness; each player lost an average of 1.1 ± 0.1 working days and missed 0.1 ± 0.2 matches. Results from this study suggest that common infectious illnesses have little impact on player availability in professional soccer

The Effects of Menstrual Cycle Phase on Elite Athlete Performance: A Critical and Systematic Review

International audienceBackground : In elite athletes, training individualization is widely recommended to optimize competitive performance. Previous studies have evidenced the impact of hormonal fluctuations on different performance parameters among female athletes. While consideration of menstrual cycle (MC) phases as a parameter in training individualization strategies is necessary, systematic evidence identifying such impacts in elite athletes should be evaluated. Objective : Systematically review publications that have investigated the link between MC phases and performance in elite female athletes. The overarching aim is to identify whether a consensus across studies exists enabling evidence-based recommendations for training individualization depending on menstrual cycle phases. Methods : This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three major scientific publication databases were searched from inception until November 3, 2020. Studies included focused on the influence of physiological or psychological parameters throughout at least one phase of the menstrual cycle of elite athletes. Results : A total of 780 search results were yielded and 26 references from a past bibliography were added manually. About 662 papers were reviewed of which 218 studies were assessed for eligibility. Of these, only seven (1%) precisely investigated the influence of a performance or physical parameter during at least one menstrual cycle phase. These seven studies included a total of 314 elite female participants (20.58 ± 1.91 years). Three used interviews, questionnaires or prospective analyses of reports. Four conducted several performance tests or included physical measures although only two performed tests during training or before/during competition. Among the seven studies, five performed hormonal testing through sampling of blood, saliva, or urine. The remaining relied on athletes’ menstruation diaries. The current evidence suggests a variable association between menstrual cycle and a few performance-related outcomes, such as endurance or power resistance, ligament stiffness, decision making skills, psychology, or competitiveness. Conclusion : Different sports performance-related parameters are affected during the menstrual cycle among elite athletes, but the parameters themselves and the magnitude and the direction of the effects are inconclusive. Additional longitudinal and prospective studies to systematically monitor on-field performance parameters are urgently required in order to enable recommendations and training individualization in female elite athletes

Concussion in European professional football: a view of team physicians

Objectives The objective was to explore the view and thoughts of physicians working in professional football about several aspects (eg, education and use of video footages) likely to enhance concussions’ recognition and on-field management.Methods An observational study based on a cross-sectional design by means of an electronic survey was conducted among physicians working for a professional football club in Belgium, England or France.Results A total of 96 physicians (95% male; mean age: 44 years) completed the survey. Nearly all participants (95%) were in favour of informational sessions about concussion for players or technical staff. Only 5%–10% of the participants mentioned that they had felt pressured by the technical staff or players not to substitute a player with a (potential) concussion. Most participants were in favour of an additional permanent concussion substitution and a temporary concussion substitution. Four out of five participants reported that the availability of instant video footages (side-line) would ease the recognition of concussion.Conclusion A better recognition and on-field management of concussions in professional football can only be achieved with a holistic approach, including adequate laws of the football game and protocols. Especially, regular education of players and technical staff should be made mandatory while the medical teams should be provided side-line with instant video footages