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Diz JBM, Dutra MTP, Feijó IC, Sogno ALM, Silva FR, Carnevale GDEF, Moreira BDES, Silva CFM. LOW BACK PAIN ESTIMATES IN PROFESSIONAL SOCCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. ACTA ORTOPEDICA BRASILEIRA 2023; 31:e266012. [PMID: 38115872 PMCID: PMC10726716 DOI: 10.1590/1413-785220233105e266012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/22/2022] [Indexed: 12/21/2023]
Abstract
Objective To evaluate the epidemiological and clinical characteristics of low back pain (LBP) in adult professional soccer players. Methods Systematic review and meta-analysis. Results The review included 44 studies. The pooled prevalence of LBP during ≤ 1 season was 1% (95%CI = 0-4%) in men. The pooled point prevalence of LBP was 25% (95%CI = 16-36%) in men and 28% (95%CI = 20-37%) in women. The pooled past-year prevalence of LBP was 34% (95%CI = 24-44%) in men. The pooled lifetime prevalence of LBP was 32% (95%CI = 25-39%) in men and 50% (95%CI = 32-69%) in women. The pooled frequency of LBP/total number of injuries was 2% (95%CI = 1-3%) in men and 4% (95%CI = 2-5%) in women. The pooled incidence rate of LBP/1,000 player-hours of exposure was 0.30 (95%CI = 0.17- 0.53) in men and 0.32 (95%CI = 0.06 -1.87) in women. The recurrence of LBP ranged from 3% to 63% in men. The intensity of LBP ranged from 1.68 (2.39) to 4.87 (2.14) points on a 0-10 scale (minimum = 0 and maximum = 8 points). The severity of LBP (days absent from professional activities due to pain) ranged from 2 (0) to 10 (19) days (minimum = 1 and maximum = 28 days). Conclusion Adult elite soccer players have a substantial prevalence of LBP. The frequency and incidence of LBP (compared with other conditions and sports) seems to be low. Estimates of the recurrence, intensity, and severity of LBP are uncertain. Level of Evidence II, Systematic Review of Level II Studies.
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Dupré T, Potthast W. Are sprint accelerations related to groin injuries? A biomechanical analysis of adolescent soccer players. Sports Biomech 2022:1-13. [PMID: 36260511 DOI: 10.1080/14763141.2022.2133740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/04/2022] [Indexed: 10/24/2022]
Abstract
Groin injuries have one of the highest incidences in soccer and can be career threatening, especially for adolescents, due to their high recurrence rate. Quick accelerations have been connected to groin injuries along with kicking and change of directions. Purpose of this study was to examine the hip joint kinematics, kinetics and the muscle forces of adductor longus and gracilis during first ground contact of a linear sprint acceleration performed by adolescent soccer players. Twenty-two male participants were investigated with 3D motion capture and two force plates. Inverse dynamics were used to calculate the kinematics, kinetics and muscle forces. The kinematics show a constant extension during the stance phase and a quick transition from an abduction to an adduction movement at 90% stance, which coincides with the highest forces in adductor longus and gracilis. This indicates a high load on the adductor muscles due to eccentric contractions combined with high muscle forces in the adductors. Compared to previously investigated inside passing and change of direction movements, adductor muscle forces and angular velocities are higher in this study. Therefore, it is suggested that sprint accelerations are likely to be connected to the development of groin injuries in adolescent soccer players.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
- Department of Exercise Science, Olympic Training Centre Rhineland-Palatinate/Saarland, Mainz, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
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Dupré T, Tryba J, Potthast W. Muscle activity of cutting manoeuvres and soccer inside passing suggests an increased groin injury risk during these movements. Sci Rep 2021; 11:7223. [PMID: 33790373 PMCID: PMC8012386 DOI: 10.1038/s41598-021-86666-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Cutting manoeuvres and inside passing are thought to increase the risk of sustaining groin injuries. But both movements have received little research attention in this regard. The purpose of this study was to investigate the muscle activity of adductor longus and gracilis as well as hip and knee joint kinematics during \documentclass[12pt]{minimal}
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\begin{document}$$90^{\circ }$$\end{document}90∘-cutting and inside passing. Thirteen male soccer players were investigated with 3D-motion capturing and surface electromyography of adductor longus and gracilis while performing the two movements. Hip and knee joint kinematics were calculated with AnyBody Modelling System. Muscle activity of both muscles was significantly higher during the cutting manoeuvre compared to inside passing. Kinematics showed that the highest activity occurred during phases of fast muscle lengthening and eccentric contraction of the adductors which is known to increase the groin injury risk. Of both movements, cutting showed the higher activity and is therefore more likely to cause groin injuries. However, passing might also increase the risk for groin injuries as it is one of the most performed actions in soccer, and therefore most likely causes groin injuries through overuse. Practitioners need to be aware of these risks and should prepare players accordingly through strength and flexibility training.
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Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany.
| | - Julian Tryba
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, 50933, Cologne, Germany
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Benca E, Ziai P, Hirtler L, Schuh R, Zandieh S, Windhager R. Biomechanical evaluation of different ankle orthoses in a simulated lateral ankle sprain in two different modes. Scand J Med Sci Sports 2019; 29:1174-1180. [PMID: 31059147 PMCID: PMC6852038 DOI: 10.1111/sms.13455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/25/2019] [Accepted: 04/25/2019] [Indexed: 12/26/2022]
Abstract
Ankle orthoses are commonly used for prevention of recurrent ankle sprains. While there are some data on their functional performance or restriction of range of motion, there is little knowledge on the quantifiable passive mechanical effectiveness of various devices. This study aimed to determine the prophylactic stabilization effect for commonly prescribed ankle orthoses in a simulated recurrent ankle sprain. Eleven anatomic lower leg specimens were tested in plantar flexion and hindfoot inversion in a simulated ankle sprain in a quasi-static and dynamic test mode at 0.5°/s and 50°/s internal rotation, respectively. Tests included intact specimens, same specimens with the ruptured anterior talofibular ligament (ATFL), followed by stabilization with five different semi-rigid orthoses: AirGo Ankle Brace, Air Stirrup Ankle Brace, Dyna Ankle 50S1, MalleoLoc, and Aequi. Compared to the injured and unprotected state, two orthoses (AirGo and Air Stirrup) significantly reinforced the ankle. The Aequi ankle brace restored stability comparable to an intact joint. Dyna Ankle 50S1 and MalleoLoc provided insufficient resistance to applied internal rotation compared to the ankle with ruptured ATFL. Ankle orthoses varied significantly in their ability to stabilize the unstable ankle during an ankle sprain in both testing modes. Presented objective data on passive stabilization reveal a lack of supporting evidence for clinical application of ankle orthoses.
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Affiliation(s)
- Emir Benca
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Pejman Ziai
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Lena Hirtler
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | - Reinhard Schuh
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Shahin Zandieh
- Department of Radiology, Hanusch Hospital, Vienna, Austria
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
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Liporaci RF, Saad MC, Bevilaqua-Grossi D, Riberto M. Preseason intrinsic risk factors-associated odds estimate the exposure to proximal lower limb injury throughout the season among professional football players. BMJ Open Sport Exerc Med 2018; 4:e000334. [PMID: 29955374 PMCID: PMC6018857 DOI: 10.1136/bmjsem-2017-000334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/27/2018] [Accepted: 03/30/2018] [Indexed: 11/25/2022] Open
Abstract
Background/aim Football players frequently face the occurrence of non-contact musculoskeletal injuries. The purpose of the study was to verify whether the evaluation of combined risk factors could produce a score system to determine the probability of injury in football players during the Brazilian football season. Methods Sixty-two male professional soccer players recruited from the first and second division soccer teams, with ages between 18 and 36 years. Functional performance evaluations were carried out at the beginning of the preseason which included strength and jumping tests, history of injuries and characteristics of athletes. Results and conclusions The results were grouped and a score/monogram was constructed.
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Affiliation(s)
- Rogério Ferreira Liporaci
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Camargo Saad
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Riberto
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
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Dupré T, Funken J, Müller R, Mortensen KRL, Lysdal FG, Braun M, Krahl H, Potthast W. Does inside passing contribute to the high incidence of groin injuries in soccer? A biomechanical analysis. J Sports Sci 2018; 36:1827-1835. [PMID: 29333946 DOI: 10.1080/02640414.2017.1423193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thomas Dupré
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Johannes Funken
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Ralf Müller
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | | | | | - Markus Braun
- Ballspielverein Borussia 09 e.V. Dortmund, Dortmund, Germany
| | - Hartmut Krahl
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
| | - Wolfgang Potthast
- Institute of Biomechanics and Orthopedics, German Sport University Cologne, Cologne, Germany
- ARCUS Clinics Pforzheim, Pforzheim, Germany
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Jones RI, Ryan B, Todd AI. Muscle fatigue induced by a soccer match-play simulation in amateur Black South African players. J Sports Sci 2015; 33:1305-11. [DOI: 10.1080/02640414.2015.1022572] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Aoki H, O'Hata N, Kohno T, Morikawa T, Seki J. A 15-year prospective epidemiological account of acute traumatic injuries during official professional soccer league matches in Japan. Am J Sports Med 2012; 40:1006-14. [PMID: 22408048 DOI: 10.1177/0363546512438695] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Few prospective epidemiological studies on soccer match injuries have collected continuous data using subjects from the same group. PURPOSE To investigate long-term injury-induced changes during official matches in the professional Japanese soccer league. STUDY DESIGN Descriptive epidemiological study. METHODS Acute injuries during official matches among top-division Japanese professional soccer leaguers were prospectively collected from 1993 to 2007. Injuries preventing player participation for 7 days or more were defined as a reportable injury. Interseasonal variations of injury rate (IR: injuries/1000/player hours) and injury pattern (type, location, circumstances, severity, injury time, positional role, and relationship to weather) were analyzed. RESULTS Throughout the study period, 2947 injuries from 3984 matches occurred. Mean annual IR was 21.77/1000 player hours, and annual variance showed gradual decrement throughout the study period. The proportion of injury type and location were not significantly changed. Sprain and contusion as injury type and thigh and ankle joint as location were the most common in every season. Contact-related injuries comprised 73.3% on average and were observed to occur more frequently during the last 15 minutes and extra time of match play. The proportion of foul play-related injuries showed a clear declining trend. The proportion of severe injury showed a sporadic increase from 2001 to 2004. The second, fifth, and sixth 15-minute match segments showed a higher IR. Goalkeepers had a lower IR versus other field players. Matches on rainy days resulted in a lower IR than did those held under other weather conditions. CONCLUSION Long-term surveillance and statistical feedback of injury characteristics to organization members were considered effective in improving safer play awareness among players and for referees to reduce injury incidence, particularly foul play-related injuries.
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Affiliation(s)
- Haruhito Aoki
- Department of Orthopaedic Surgery, St Marianna University School of Medicine, Kawasaki, Japan.
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9
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Factors associated with increased propensity for hamstring injury in English Premier League soccer players. J Sci Med Sport 2010; 13:397-402. [DOI: 10.1016/j.jsams.2009.08.003] [Citation(s) in RCA: 134] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 07/25/2009] [Accepted: 08/02/2009] [Indexed: 11/23/2022]
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Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports 2007; 18:40-8. [PMID: 17355322 DOI: 10.1111/j.1600-0838.2006.00634.x] [Citation(s) in RCA: 293] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose was to test the effect of eccentric strength training and flexibility training on the incidence of hamstring strains in soccer. Hamstring strains and player exposure were registered prospectively during four consecutive soccer seasons (1999-2002) for 17-30 elite soccer teams from Iceland and Norway. The first two seasons were used as baseline, while intervention programs consisting of warm-up stretching, flexibility and/or eccentric strength training were introduced during the 2001 and 2002 seasons. During the intervention seasons, 48% of the teams selected to use the intervention programs. There was no difference in the incidence of hamstring strains between teams that used the flexibility training program and those who did not [relative risk (RR)=1.53, P=0.22], nor was there a difference compared with the baseline data (RR=0.89, P=0.75). The incidence of hamstring strains was lower in teams who used the eccentric training program compared with teams that did not use the program (RR=0.43, P=0.01), as well as compared with baseline data for the same intervention teams (RR=0.42, P=0.009). Eccentric strength training with Nordic hamstring lowers combined with warm-up stretching appears to reduce the risk of hamstring strains, while no effect was detected from flexibility training alone. These results should be verified in randomized clinical trials.
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Affiliation(s)
- A Arnason
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
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11
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Is injury the major cause of elite soccer players being unavailable to train and play during the competitive season? Phys Ther Sport 2006. [DOI: 10.1016/j.ptsp.2006.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Waldén M, Hägglund M, Ekstrand J. Injuries in Swedish elite football--a prospective study on injury definitions, risk for injury and injury pattern during 2001. Scand J Med Sci Sports 2005; 15:118-25. [PMID: 15773867 DOI: 10.1111/j.1600-0838.2004.00393.x] [Citation(s) in RCA: 134] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to study the risk for injury and injury pattern in Swedish male elite football and to compare two different injury definitions. A prospective cohort study was conducted during 2001 on all 14 teams (310 players) in the Swedish top division. Injuries and individual exposure were recorded. Injury was defined as time-lost injury (715 injuries) and for comparison as tissue injury (765 injuries). No significant difference in the risk for injury between tissue injuries and time-lost injuries was found during matches (27.2 vs. 25.9 injuries per 1000 match hours, P=0.66) or training sessions (5.7 vs. 5.2 injuries per 1000 training hours, P=0.65). The risk for injury during training was significantly higher during the pre-season compared with the competitive season (P=0.01). Thigh strain was the single most common injury (14%). Knee sprain was the most common major injury (absence >4 weeks). Overuse injuries and re-injuries were frequent and constituted 37% and 22% of all injuries. Re-injuries caused significantly longer absence than their corresponding initial injuries (P=0.02). The risk for re-injury (P=0.02) and overuse injury (P<0.01) was significantly higher during the pre-season compared with the competitive season.
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Affiliation(s)
- Markus Waldén
- Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, Linköping, Sweden.
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Hägglund M, Waldén M, Ekstrand J. Injury incidence and distribution in elite football--a prospective study of the Danish and the Swedish top divisions. Scand J Med Sci Sports 2005; 15:21-8. [PMID: 15679568 DOI: 10.1111/j.1600-0838.2004.00395.x] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Danish and Swedish male top football divisions were studied prospectively from January to June 2001. Exposure to football and injury incidence, severity and distribution were compared between the countries. Swedish players had greater exposure to training (171 vs. 123 h per season, P<0.001), whereas exposure to matches did not differ between the countries. There was a higher risk for injury during training in Denmark than in Sweden (11.8 vs. 6.0 per 1000 h, P<0.01), whereas for match play there was no difference (28.2 vs. 26.2 per 1000 h). The risk for incurring a major injury (absence from football more than 4 weeks) was greater in Denmark (1.8 vs. 0.7 per 1000 h, P = 0.002). The distribution of injuries according to type and location was similar in both countries. Of all injuries in Denmark and Sweden, overuse injury accounted for 39% and 38% (NS), and re-injury for 30% and 24% (P = 0.032), respectively. The greater training exposure and the long pre-season period in Sweden may explain some of the reported differences.
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Affiliation(s)
- Martin Hägglund
- Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, Linköping, Sweden.
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Abstract
BACKGROUND The injury rate in soccer is high, and effective injury prevention methods are needed. PURPOSE To test the effect of a video-based awareness program on the incidence of acute injuries in soccer. STUDY DESIGN Randomized control trial; Level of evidence, 1. METHODS Participants were elite male soccer players from the top 2 divisions in Iceland. Fifteen of 20 teams completed the study: 7 intervention teams (127 players) and 8 control teams (144 players) chosen by random. Just before the start of the 2000 soccer season, the intervention teams were visited with an intervention program. The program included a 15-minute presentation with information on the injury risk of playing elite soccer, typical injuries, and their mechanisms. Then the players worked together in pairs and analyzed video sequences to develop preventive strategies. The 12 video sequences were selected from the previous Icelandic soccer season, representing 3 typical injury mechanisms that accounted for more than half of all incidents recorded. During the season, team physical therapists prospectively recorded all acute injuries, and coaches recorded training exposure on a special form. Injury incidence was compared between groups and between the 1999 and 2000 seasons for teams that participated in both seasons. RESULTS No difference was observed in injury incidence between the intervention (6.6 +/- 0.7 injuries per 1000 player hours) and control groups (6.6 +/- 0.7 injuries per 1000 player hours). Furthermore, there was no difference in injury location or type. CONCLUSION The video-based injury awareness program showed no effect on injury rate.
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Affiliation(s)
- Arni Arnason
- Oslo Sports Trauma Research Center, Norwegian University of Sport & Physical Education, Oslo, Norway.
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Arnason A, Tenga A, Engebretsen L, Bahr R. A prospective video-based analysis of injury situations in elite male football: football incident analysis. Am J Sports Med 2004; 32:1459-65. [PMID: 15310571 DOI: 10.1177/0363546504262973] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The mechanisms for football injuries are largely unknown. AIM To describe the characteristics of injury situations in elite male football using a video-based method called football incident analysis. STUDY DESIGN Prospective cohort study. METHODS During the 1999 season, videotapes from 52 matches in the Icelandic elite football league were reviewed. Incidents (N = 95) were recorded when the match was interrupted by the referee because of a suspected injury. Team physical therapists recorded injuries prospectively (N = 28 time-loss injuries). RESULTS Duels caused 84 of the incidents, mostly tackling duels (n = 54). The exposed player's attention appeared to be focused away from the opponent in 93% of the cases. The 3 main mechanisms observed were (1) breakdown attacks, tackling from the side or the front, attention focused on the ball (24%); (2) defensive tackling duels, attention focused on the ball or low ball control (20%); and (3) heading duels, attention focused on the ball in the air (13%). CONCLUSION Most incidents and injuries occurred during breakdown attacks and when a player was involved in tackling duels. Player attention appeared to be focused mainly on the ball, not on the opponent challenging him to gain ball possession.
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Affiliation(s)
- Arni Arnason
- Department of Physical Therapy, University of Iceland, Reykjavik, Iceland.
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Abstract
The Swedish male senior national football team was followed prospectively between 1991 and 1997. During these 6 years, the team played 73 official matches and had three training camps. The senior author (J. E.) attended 57 of these matches and the three training camps and these matches and training camps, are included in the present study. Exposure to football was recorded individually for each player. The team physician examined all injuries. Total exposure was 7245 h (6235 training and 1010 match hours) and there were 71 injuries (40 training and 31 match injuries). Five (16%) of the match injuries were major, with more than 4 weeks of absence from football. The injury incidence during training was 6.5/1000 h and the injury risk during matchplay was 30.3/1000 h. A significantly higher injury incidence was found for matches lost compared to matches won or drawn (52.5 vs. 22.7/1000 h, P=0.026). No statistically significant difference for injury was found between competitive matches and friendly matches. No difference was found between home and away matches or matches on neutral ground. The risk for injury when playing in a national team compares with previously reported figures for professional football at a high level.
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Affiliation(s)
- Jan Ekstrand
- Department of Social Medicine and Public Health Science, Linköping University, and the Sports Clinic, Linköping, Sweden.
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Hägglund M, Waldén M, Ekstrand J. Exposure and injury risk in Swedish elite football: a comparison between seasons 1982 and 2001. Scand J Med Sci Sports 2004; 13:364-70. [PMID: 14617057 DOI: 10.1046/j.1600-0838.2003.00327.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The long-term development of injury risk in Swedish male elite football was studied. Two prospective cohort studies from seasons 1982 and 2001 were compared with respect to exposure to football, injury incidence and injury severity. The mean number of training sessions during the season had increased by 68% between 1982 and 2001 (142 vs. 238, P<0.001), whereas teams played more matches in 1982 (49 vs. 41, P=0.02). The total exposure to football had increased by 27%. Three out of four players incurred an injury in both seasons. In 2001, players suffered more training injuries due to an increased training exposure. Accounting for risk exposure, there was no difference in injury incidence or severity between the two seasons. The incidence was 8.3 injuries/1000 h of total exposure (4.6 in training and 20.6 in matches) in 1982, compared to 7.8/1000 h-1 (5.2 in training and 25.9 in matches) in 2001. Major injuries accounted for 9% of all injuries, corresponding to an incidence of 0.8/1000 h of football, in both seasons. A trend from semi-professionalism to full professionalism in Swedish elite football was seen during the last two decades. The injury risk did not change over the same period.
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Affiliation(s)
- Martin Hägglund
- Department of Social Medicine and Public Health Science, Linköping University, Linköping, Sweden.
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18
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Andersen TE, Engebretsen L, Bahr R. Rule violations as a cause of injuries in male norwegian professional football: are the referees doing their job? Am J Sports Med 2004; 32:62S-8S. [PMID: 14754861 DOI: 10.1177/0363546503261412] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Foul play is an important cause of injury in football. Reduction of foul play and adherence to the laws of the game may be possible interventions to reduce the rate of injuries. PURPOSE To evaluate how violations of the laws of the game contribute to injury and to investigate whether the decisions made by the referees are correct in high-risk situations. STUDY DESIGN Prospective cohort study. METHODS Videotapes and injury information were collected for 174 of 182 matches from the male Norwegian professional league during the 2000 season. Three Norwegian FIFA referees performed retrospective blinded evaluation of the 406 incidents. RESULTS Less than one-third of the injuries identified on video and about 40% of the incidents with a high risk of injury resulted in a free kick being awarded. About 1 in 10 of these situations led to either a yellow or red card. The agreement between decisions made by the match referee and the expert referee panel was good, that is, their decisions agreed in 85% of the situations in which injury occurred. CONCLUSIONS There may be a need for an improvement of the laws of the game of football to protect players from dangerous play.
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Affiliation(s)
- Thor Einar Andersen
- Oslo Sports Trauma Research Center, Norwegian University of Sport and Physical Education, Olso, Norway
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Abstract
BACKGROUND The injury risk in football is high, but little is known about causes of injury. PURPOSE To identify risk factors for football injuries using a multivariate model. STUDY DESIGN Prospective cohort study. METHODS Participants were 306 male football players from the two highest divisions in Iceland. Before the 1999 football season started, the following factors were examined: height, weight, body composition, flexibility, leg extension power, jump height, peak O(2) uptake, joint stability, and history of previous injury. Injuries and player exposure were recorded throughout the competitive season. RESULTS Older players were at higher risk of injury in general (odds ratio [OR] = 1.1 per year, P = 0.05). For hamstring strains, the significant risk factors were age (OR = 1.4 [1 year], P < 0.001) and previous hamstring strains (OR = 11.6, P <0.001). For groin strains, the predictor risk factors were previous groin strains (OR = 7.3, P = 0.001) and decreased range of motion in hip abduction (OR = 0.9 [1 degrees ], P = 0.05). Previous injury was also identified as a risk factor for knee (OR = 4.6) and ankle sprains (OR = 5.3). CONCLUSIONS Age and previous injury were identified as the main risk factors for injury among elite football players from Iceland.
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Affiliation(s)
- Arni Arnason
- Oslo Sports Trauma Research Center, University of Sport & Physical Education, Oslo, Norway
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20
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Andersen TE, Floerenes TW, Arnason A, Bahr R. Video analysis of the mechanisms for ankle injuries in football. Am J Sports Med 2004; 32:69S-79S. [PMID: 14754862 DOI: 10.1177/0363546503262023] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although ankle sprains are frequent in football, little is known about their mechanisms. PURPOSE To describe the injury mechanisms for ankle injuries in male elite football. STUDY DESIGN Prospective cohort study. METHODS Videotapes and injury information were collected for 313 of 409 matches from Norwegian and Icelandic elite football during the 1999 to 2000 seasons. Video recordings of incidents that resulted in ankle injuries were analyzed and cross-referenced with injury reports from the team medical staff. RESULTS A total 46 acute ankle injuries were reported to have occurred, that is, 4.5 injuries per 1000 match hours. Of these, 26 (57%) were identified on the videotapes. Two mechanisms thought to be specific to football were found: 1) player-to-player contact with impact by an opponent on the medial aspect of the leg just before or at foot strike, resulting in a laterally directed force causing the player to land with the ankle in a vulnerable, inverted position; and 2) forced plantar flexion where the injured player hit the opponent's foot when attempting to shoot or clear the ball. CONCLUSIONS Systematic video analysis provides detailed information on the mechanisms for ankle injuries in football-for lateral ligament sprains and for the condition dubbed "footballer's ankle."
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Affiliation(s)
- Thor Einar Andersen
- Oslo Sports Trauma Research Center, University of Sports and Physical Education, Oslo, Norway.
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21
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Abstract
Most soccer, rugby union, rugby league, American football, Australian football and Gaelic football competitions over the world are played on natural grass over seasons that commence in the early autumn (fall) and extend through winter. Injury surveillance in these competitions has usually reported high rates of injury to the lower limb and an increased incidence of injuries early in the season. This 'early-season' bias has not usually been reported in summer football competitions, or in sports played indoors, such as basketball. Although easily compared rates have not often been published there has also been a reported trend towards a greater injury incidence in football played in warmer and/or drier conditions. Injury incidence in American football played on artificial turf has often been reported to be higher than in games played on natural grass. This review concludes that the most plausible explanation for all of these reported findings involves variations in playing surface characteristics. Shoe-surface traction for the average player is the specific relevant variable that is most likely to correlate with injury incidence in a given game of football. Shoe-surface traction will usually have a positive correlation with ground hardness, dryness, grass cover and root density, length of cleats on player boots and relative speed of the game. It is possible that measures to reduce shoe-surface traction, such as, ground watering and softening, play during the winter months, use of natural grasses such as perennial ryegrass (Lolium perenne L.) and player use of boots with shorter cleats, would all reduce the risk of football injuries. The most pronounced protective effect is likely to be on injuries to the lower limb of a noncontact nature, including anterior cruciate ligament injuries. Intervention studies should be performed, both using randomised and historical controls.
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Affiliation(s)
- John Orchard
- Centre for Sports Medicine Research and Education, University of Melbourne, Melbourne, Victoria, Australia
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22
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Gissane C, White J, Kerr K, Jennings D. An operational model to investigate contact sports injuries. Med Sci Sports Exerc 2001; 33:1999-2003. [PMID: 11740290 DOI: 10.1097/00005768-200112000-00004] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE A cyclical operational model is proposed to examine the interrelationship of a number of factors that are involved in sports injury epidemiology. In sports injury research, investigations often attempt to identify a unique risk factor that distinguishes an injured player. However, a wide variety of factors can contribute to a sports injury occurring, and an understanding of the cause of injury is important to advance knowledge. METHODS The proposed model identifies a healthy/fit player initially, although the player may exhibit a number of intrinsic risk factors for sports injury. Before exposure to extrinsic risk factors, there is the opportunity for implementation of prevention strategies by coaching personnel and the sports medicine team. These strategies might include, among others, appropriate warm-up, adequate hydration, wearing protective equipment, and prophylactic taping. Additionally, preventative screening could take place to assess the various intrinsic and extrinsic risk factors that could lead to sports injury. DISCUSSION Two examples of how the operational model relates to contact sports injury cases are presented. Participating in sport inevitably exposes the player to external risk factors that predispose toward injury. The treatment of the injured player aims to restore the player to preinjury playing status and to prevent the injury from becoming chronic. CONCLUSIONS It is suggested that the application of this proposed cyclical model may lead to greater success in understanding the multifaceted nature of sports injuries and furthermore help minimize injury risk and support the rehabilitation of injured contact sports participants.
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Affiliation(s)
- C Gissane
- Department of Health Studies, Brunel University, Osterley Campus, Isleworth, Middlesex, TW5 7DU, England, UK.
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23
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Abstract
Studies on the incidence of football injuries vary in the definition of injury, study design, methods of data collection, and observation periods. The aim of this study was to review the different methodologies applied in the evaluation of football injuries as well as to analyze the influence of data collection methods on the incidence of football injuries. In this study, injury data obtained weekly by a physician during 1 year of follow-up in 264 football players were compared with the results of retrospective questionnaires completed by the players at the end of the observation period. In the retrospective questionnaire, the incidence of injuries as well as of complaints was significantly lower than that found in the weekly follow-up examinations. Approximately every third moderate injury and less than 10% of the mild injuries were remembered retrospectively. The shorter the period of symptoms and the longer ago the injury occurred, the more frequently it was forgotten. However, even severe injuries, such as fractures, were not reported in the retrospective investigation. Based on the review of the literature and the data presented, recommendations in relation to study design, the definition of injury, and the calculation of incidence are proposed.
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Affiliation(s)
- A Junge
- Schulthess Clinic, Zurich, Switzerland
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24
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Hawkins RD, Fuller CW. A prospective epidemiological study of injuries in four English professional football clubs. Br J Sports Med 1999; 33:196-203. [PMID: 10378073 PMCID: PMC1756169 DOI: 10.1136/bjsm.33.3.196] [Citation(s) in RCA: 382] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To define the causes of injuries to players in English professional football during competition and training. METHOD Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. RESULTS In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p < 0.01) higher than that during training (3.5). The IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p < 0.01) injuries in competition in the 15 minute periods at the end of each half. Strains (41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p < 0.01) more injuries to the dominant body side. Reinjury counted for 22% of all injuries. Only 12% of all injuries were caused by a breach of the rules of football, although player to player contact was involved in 41% of all injuries. CONCLUSIONS The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition.
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Affiliation(s)
- R D Hawkins
- Centre for Hazard and Risk Management, Loughborough University, Leics, United Kingdom
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25
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Abstract
We investigated the frequency, cause and location of injuries in Icelandic elite soccer in 1991. The incidence of injuries for the individual player was 34.8 +/- 5.7 per 1000 game-hours and 5.9 +/- 1.1 per 1000 practice-hours. The most common types of injuries were muscle strains (29%), ligament sprains (22%), contusions (20%), and other injuries (29%). The frequency of reinjury was markedly high, where 44% of the strains and 58% of the sprains were registered as reinjuries. Strains occurred mainly during sprinting, sprains by tackling, and contusion during other contact. Significantly more injuries occurred on artificial turf than on grass or gravel in correlation to number of hours in games and practices. Teams who had the longest pre-season preparation period obtained significantly fewer injuries during the season.
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Affiliation(s)
- A Arnason
- Icelandic College of Sport and Physical Education, Laugarvatn, Iceland
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26
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Surve I, Schwellnus MP, Noakes T, Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med 1994; 22:601-6. [PMID: 7810782 DOI: 10.1177/036354659402200506] [Citation(s) in RCA: 227] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A study was undertaken to evaluate the effect of a semi-rigid ankle orthosis (Sport-Stirrup) on the incidence of ankle sprains in soccer players during 1 playing season. Senior soccer players were divided into 2 groups: players with previous ankle sprains (N = 258) and players without such history (N = 246). The players in these groups were each randomly allocated to either a semi-rigid orthosis or a control group at the start of the playing season. All subsequent injuries during the season and the total number of playing hours were documented. There was a significant reduction in the incidence of ankle sprains (injuries/1000 playing hours) by ankles in the orthosis group with previous sprains (0.14) compared with the nonbraced group with previous sprains (0.86). The incidence of ankle sprains was significantly higher in the nonbraced group with previous sprains (0.86) compared with the nonbraced group without previous sprains (0.46). Thus, in this study, a semirigid orthosis significantly reduced the incidence of recurrent ankle sprains in soccer players with previous history of ankle sprains.
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Affiliation(s)
- I Surve
- Medical Research Council, University of Cape Town, South Africa
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27
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28
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Affiliation(s)
- M Hunt
- Accident and Emergency Department, King's College Hospital, London, UK
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