A review advocating caution with Major League Soccer expansion and investment in more rehabilitation professionals

Practitioners' perspective of non-contact injury risk factors and injury prevention programming in professional North American male soccer

OBJECTIVE

To evaluate non-contact injury prevention strategies of professional men's soccer clubs in elite North American league soccer. To understand the application, perceived effectiveness and barriers to implementation.

DESIGN

Online cross-Sectional Study.

SETTING

North American elite soccer teams.

PARTICIPANTS

96 medical and performance support staff of elite North American teams.

MAIN OUTCOME MEASURE

The survey consisted of 20 questions and captured 1) practitioners' demographics; 2) perceptions of risk factors; 3) the use of assessment and monitoring strategies; and 4) perceptions of the implementation of injury prevention programmes'.

RESULTS

Injury prevention programmes were perceived as 'effective' (Median 4, Interquartile range 4-4) and reduced injury rates (n = 94, 98%, 95 CI% 93 to 99). A range of potential risk factors were rated as "very important" (4.58 ± 0.52 Likert scale points; mean ± standard deviation). A multi-disciplinary approach to the design, application and monitoring of programmes was generally adopted. Competing training priorities (n = 75, 78%, 95 CI% 69 to 85) and game schedules (n = 71, 74%, 95 CI% 64 to 82) were the most prevalent barriers to injury prevention implementation.

CONCLUSIONS

Injury prevention programmes were perceived as effective in reducing non-contact injuries. Managing the conflicting priorities between scheduling training, tactical and conditioning goals were considered the key barriers to desired implementation.

The Uptake of Nordic Hamstring Exercise Program for Injury Prevention in Major League Soccer and Its Barriers to Implementation in Practice

CONTEXT

It is well demonstrated that Nordic hamstring (NH) program has poor compliance across European soccer clubs, but little is known about its implementation in Major League Soccer (MLS). The authors aimed to investigate MLS hamstring prevention practices and compliance with the NH program and understand the reasons for its inclusion or exclusion.

DESIGN

A cross-sectional electronic survey was completed by 24 of the 26 (92%) MLS top-division soccer clubs.

METHODS

The survey, based on the Reach, Efficacy, Adoption, Implementation, and Maintenance framework, was sent to team medical staff. Medical staff were also asked for opinions on barriers to implementation.

RESULTS

Eighteen clubs (75%) reported a formal hamstring injury prevention program, with eccentric exercises (94%; 95% CI [confidence interval], 74%-99%), high-speed running (94%; 95% CI, 74%-99%), and NH exercises (89%; 95% CI, 67%-97%) the most common strategies adopted. Fifteen clubs partially implemented the NH program, but only 5 (21%; 95% CI, 9%-40%) completed the full program and were classed as compliant. A total of 20 respondents reported that player perception and muscle soreness (83%; 95% CI, 64%-93%) were barriers to the implementation of the NH program. On a 5-point Likert scale, respondents "partially agreed" (4.13 [0.80]) that the NH exercise could substantially reduce injuries and would be "effective" at their own club (3.88 [0.61]).

CONCLUSIONS

The NH exercise was valued, but negative player perception and muscular soreness were identified as barriers to implementing the full program. Manipulation of volume and frequency should inform future "effectiveness" research to prospectively assess such modifications in the context of MLS.

Effects of intermittent negative pressure and active recovery therapies in the post-match period in elite soccer players: A randomized, parallel arm, comparative study

Study aim: This study compared the effects of intermittent negative pressure therapy (INPT) vs. active recovery therapy (ART) on post-match physiological parameters such as serum CK level and skin temperature of the lower limbs in elite soccer players.

Material and methods: Twenty healthy male professional soccer players from a Brazilian first division soccer club were enrolled in this randomized, parallel arm, open label, comparative study. After participating in 2 soccer matches, they were randomly assigned to two groups (n = 10) to receive a 30-min session of INPT (intermittent exchange of hypobaric pressure range 33 to 51 mmHg) or ART (self-myofascial release, mobility and stability exercises, and cycle ergometer exercise). The intervention was conducted after a match with assessments immediately before and after the intervention and again 24 h after the intervention.

Results: A significant interaction effect (F2,36 = 4.503, p = 0.018, η2 = 0.130) was observed, indicating that the decrease of CK from pre-intervention to 24 h post-intervention was greater in the INPT than in the ART group. Lower limb skin temperature was significantly lower after INPT than after ART (p < 0.003).

Conclusions: Serum CK level and skin temperature of lower limbs showed better recovery up to 24 h after the intervention with INPT in elite soccer players.