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Amirneni A, Elahi J, Iftikhar N, Ganti L. Mitigating the Risks of Lower Extremity Injuries in Soccer: A Comprehensive Analysis of Lower Extremity Injury Rates in Soccer Between 2014 and 2023. Orthop Rev (Pavia) 2024; 16:122315. [PMID: 39156913 PMCID: PMC11329367 DOI: 10.52965/001c.122315] [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: 07/25/2024] [Accepted: 08/03/2024] [Indexed: 08/20/2024] Open
Abstract
Objective With events such as the Copa America 2024, the 2026 World Cup, and the arrival of European stars in Major League Soccer (MLS), the already observed and forecasted rise of soccer in the United States (US) seems to be an inevitable outcome. Although regular participation in soccer features several benefits, including increasing cardiovascular health, decreasing stress, and promoting interpersonal relationships, the risk of injury, as is the case in any sport, is ever present. Although many sports that are popular in America feature high rates of concussion, rotator cuff injuries, and general upper extremity injuries, soccer, being more strenuous on the lower-half of the body, features a disproportionate rate of lower extremity injuries. An analysis of the frequencies of these injuries, relative to factors such as year of injury, age, gender, location of injury, and diagnosis of injury, may help organizational bodies and soccer leagues implement new regulations regarding the usage of protective equipment and rules regarding gameplay. This study aims to illuminate these takeaways in an effort to better patient care outcomes in soccer-related injuries. Method This paper utilized the National Electronic Injury Surveillance System Database (NEISS) to compile data on lower extremity soccer-related injuries within the defined study period, 2014-2023. Inclusion criteria for the study involved all patients presenting to the emergency department (ED) within the study period and within the defined age range of 0 to 69 years old, with injuries sustained from or related to soccer. Using NEISS, trends were elucidated discriminating based on year of injury, sex, age group, location of injury, and diagnosis group of injury. Results Within the defined study period of 10 years, from 2014-2023, there were approximately 843,063 total soccer-related lower extremity injuries which presented to various EDs across the US. Regarding majorities, the most injuries were sustained in 2014 (12.84% of total injuries), most patients sustaining injuries were male (66.6% of all patients), and within the age range of 10-19 years old (63.24% of all patients), with the most instances occurring at age 15. Lower extremity injuries were most reported to be affecting the ankle with 306,797 incidences (36.39% of total injuries seen) and the most frequent diagnosis group was reported to be strains/sprains with 396,420 (47.02% of total injuries seen) total occurrences. Conclusion This study analyzes the incidents of lower extremity injuries while participating in soccer for the last 10 years, 2014-2023. The study provides new data regarding the frequency of injuries and their relative rate with respect to year of injury, age group, sex, location of injury, and diagnosis. The results of this study show injury majorities and trends which can be used to dictate changes in regulation regarding gameplay and the utilization of protective equipment in order to mitigate injuries related to the lower extremities in soccer.
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Affiliation(s)
| | | | | | - Latha Ganti
- Seminole High
- Rutgers University
- University of Florida
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Fallon Verbruggen F, Kaľata M, Marenčáková J, Malý T, Zahálka F. The effect of biological maturation on foot morphology, and their relation to postural stability performance in male footballers. J Sports Med Phys Fitness 2023; 63:1155-1164. [PMID: 37535341 DOI: 10.23736/s0022-4707.23.15037-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND Biological maturity (BM) and foot morphology (FM) can independently alter neuromuscular loading on the ankle-foot complex, potentially causing stability deficits and injury predisposition. However, the influence of BM on FM, and how much both explain neuromuscular performance in postural stability (PS) tests, has been understudied. This study aimed to investigate the effect of BM on FM, and then discover to what extent both factors explain the variance in PS performance in adolescent footballers. METHODS Over one season, 399 three-dimensional foot scans were gathered from 72 footballers (U12-U15). PS was measured by center of pressure (COP) displacement in bilateral and unilateral stance. The Khamis and Roche equation determined maturity status (MS), while formulae from Mirwald and Khamis and Roche estimated timing of biological maturation (TBM). Principal component analysis determined nine principal components that explained the most variance in FM. An ANCOVA determined the effect of TBM on FM principal components, with covariates of age, height, weight, playing position, and foot preference. Step-wise linear regression determined the explanation of COP displacement by the above-mentioned predictors. RESULTS There was significantly increased foot pronation during and after peak height velocity/puberty. MS and four foot principal components (foot arch and width, great toe width and length) were significant predictors in all PS tests (R2: 0.105-0.180). CONCLUSIONS TBM had a significant effect on FM presentation, and should be a part of adolescent foot assessment. While they only explained a small amount of variance, determining MS and FM may identify those requiring additional PS attention.
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Affiliation(s)
- Ferdia Fallon Verbruggen
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic -
| | - Maroš Kaľata
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Jitka Marenčáková
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Tomáš Malý
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - František Zahálka
- Sport Research Center, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
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Filter A, Olivares-Jabalera J, Dos'Santos T, Madruga M, Lozano J, Molina A, Santalla A, Requena B, Loturco I. High-intensity Actions in Elite Soccer: Current Status and Future Perspectives. Int J Sports Med 2023. [PMID: 37130547 DOI: 10.1055/a-2013-1661] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Over the years, soccer has become more physically demanding; the number and frequency of high-intensity actions have increased, and these activities are decisive in determining the match outcome. Importantly, the reductionist approach commonly used to analyze high-intensity actions does not contemplate a more contextualized perspective on soccer performance. Traditionally, most investigations have only provided quantitative data regarding sprints (i. e. time, distances, frequency) without examining "how" (e. g. type of trajectory or starting position) and "why" (e. g. tactical role) soccer players sprint. In fact, other high-intensity actions, apart from running, are not even mentioned (i. e. curve sprints, change of direction, and specific-jump tasks). This has led to the use of tests and interventions that do not accurately reflect real game actions. Given the true technical-tactical-physical demands of each playing position, this narrative review collected a wide-spectrum of current soccer-related articles and provided a discussion regarding high-intensity actions, with a positional-based approach. In this narrative review, practitioners are encouraged to contemplate and consider the different elements that characterize high-intensity actions in soccer, in order to assess and train soccer players under a more sport-specific and integrative perspective.
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Affiliation(s)
- Alberto Filter
- FSI Lab, Football Science Institute, Granada, Spain
- Research Group Physical Activity, Health and Sport CTS-948, Pablo de Olavide University, Sevilla, Spain
| | - Jesús Olivares-Jabalera
- FSI Lab, Football Science Institute, Granada, Spain
- Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Universidad de Granada, Granada, Spain
| | - Thomas Dos'Santos
- Department of Sport and Exercise, Manchester Metropolitan University, Manchester, United Kingdom of Great Britain and Northern Ireland
- Manchester Institute of Sport, Manchester, United Kingdom of Great Britain and Northern Ireland
| | - Marc Madruga
- Physical Therapy Department, International University of Catalonia, Barcelona, Spain
- Sport Performance Area, Barcelona Football Club, Barcelona, Spain
- Return to Play and Sports Training Center, reQ, Barcelona, Spain
| | | | - Alejandro Molina
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- Campus Universitario, University of San Jorge Faculty of Health Sciences, Villanueva de Gallego, Spain
| | - Alfredo Santalla
- FSI Lab, Football Science Institute, Granada, Spain
- Research Group Physical Activity, Health and Sport CTS-948, Pablo de Olavide University, Sevilla, Spain
| | | | - Irineu Loturco
- Sport Science, NAR - Nucleus of High Performance in Sport, São Paulo, Brazil
- Department of Human Movement Sciences, Federal University of Sao Paulo, Sao Paulo, Brazil
- Sport and Exercise Science, University of South Wales, Pontypridd, United Kingdom of Great Britain and Northern Ireland
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Diaz CC, Lavoie-Gagne OZ, Korrapati A, John NS, Diaz MI, Forlenza EM, Trasolini NA, Forsythe B. Return to Play and Player Performance After Foot Fracture in UEFA Soccer Players. Orthop J Sports Med 2022; 10:23259671221078308. [PMID: 35299713 PMCID: PMC8921753 DOI: 10.1177/23259671221078308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/28/2021] [Indexed: 12/03/2022] Open
Abstract
Background: There is a paucity of information on rate and time to return to play (RTP) in elite-level soccer players who have sustained foot fractures. Purpose: To (1) determine the rate and timing of RTP after foot fracture (eg, tarsal, metatarsal, or phalangeal), (2) investigate foot fracture reinjury incidence after RTP, and (3) evaluate performance after foot fracture as compared with matched, uninjured controls. Study Design: Descriptive epidemiology study. Methods: Athletes sustaining foot fractures were identified across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Injured athletes were matched to controls (1:1) using demographic characteristics and performance metrics from 1 season before injury. The authors recorded RTP rate, reinjury incidence, player characteristics associated with RTP within 2 seasons of injury, player availability, field time, and performance metrics during the 4 seasons after injury. Results: A total of 192 elite soccer players sustaining a foot fracture were identified; 40 players (20.8%) underwent operative treatment. Athletes missed an average of 69.41 ± 59.43 days and 5.15 ± 23.28 games. In the 4 seasons after injury, 80% of players returned to play, with 72% returning to play within 1 season of injury. Nine players (5%) sustained a subsequent foot fracture. Athletes with a foot fracture demonstrated significantly longer league retention compared with uninjured controls (P < .001). Elite soccer players older than 30 years of age were less likely to RTP (odds ratio, 0.67; P = .002), whereas career experience, field position, and baseline performance showed no significant association with RTP rates. Injured athletes demonstrated similar performance to controls during the 4 years after injury, and there were no position-dependent differences on subgroup analysis. The players who underwent operative treatment had more assists per 90 minutes and more team points per game during the first season after injury compared with athletes treated nonoperatively. Conclusion: Foot fractures in elite soccer players resulted in moderate loss of play time (69.41 days). RTP rates were high at 80%, although players older than 30 years of age were less likely to RTP. On RTP, athletes who sustained a foot fracture maintained performance similar to preinjury levels and to uninjured controls.
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Affiliation(s)
- Connor C. Diaz
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Ophelie Z. Lavoie-Gagne
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Avinaash Korrapati
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Nalin S. John
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Mariah I. Diaz
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Enrico M. Forlenza
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas A. Trasolini
- Department of Orthopaedic Surgery, Wake Forest Baptist, Winston-Salem, North Carolina, USA
| | - Brian Forsythe
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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Blanchard S, Bellaïche L, Kuliberda Z, Behr M. Influence of Footwear on Posture and Comfort in Elite Rugby Players. Int J Sports Med 2021; 43:269-277. [PMID: 34560788 DOI: 10.1055/a-1255-2803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Influence of footwear on posture in athletes is poorly documented despite its potential impact on biomechanics and injury risk. The aim of this study was to investigate effects of different footwear geometries on comfort and posture on a cohort of 48 elite rugby players. Spine posture was characterized by photogrammetry, while center of pressure was measured by means of a force platform. Three different footwear outsoles architectures (one rugby shoe with flat outsole, one rugby shoe with a 10 mm heel rise and foot arch support, and a running shoe with a 10mm heel rise and foot arch support) were compared to non-shod in randomized order. Then comfort felt at the level of foot and spine was also estimated by subjective questionnaires. Compared to the flat rugby model, both other models induced significantly (p<0.05) greater comfort at the level of foot and spine, a slight shift toward of center of pressure and a spinal posture closer to that observed when non-shod. The footwear geometry influences comfort and posture at the level of the foot as well as spine and should be considered in a dual purpose of injury prevention and performance.
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Affiliation(s)
- Sylvain Blanchard
- Racing 92 Rugby Club, Scientific & Medical Department, Le Plessis-Robinson.,Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
| | | | - Zbigniew Kuliberda
- EtioSYSTEMS, Evaluation Sportive, Strasbourg Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
| | - Michel Behr
- Aix-Marseille I University, IFSTTAR, LBA UMR T24, Marseille
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The Fifth Metatarsal Bone Fracture in Athletes - Modalities of Treatment Related to Agility in Soccer Players. J Hum Kinet 2021; 79:101-110. [PMID: 34400990 PMCID: PMC8336555 DOI: 10.2478/hukin-2020-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 5th metatarsal fracture is a common foot fracture which could exclude a player from competition for several months and significantly affect his or her career. This manuscript presents the treatment and rehabilitation of professional soccer players who had acute fractures of the 5th metatarsal bone and a cannulated screw fixation. The main purpose of the analysis was to determine the minimum time necessary for a permanent return to the sport after a 5th metatarsal fracture among professional soccer players. We followed the surgical and rehabilitation path of 21 professional soccer players from the Polish League (Ist and IInd divisions) who suffered from the 5th metatarsal bone fracture. All players underwent standard percutaneous internal fixation with the use of cannulated screws. The total inability to play lasted for 9.2 (± 1.86) weeks among players treated only surgically (n = 10), 17.5 (± 2.5) weeks in the conservative and later surgery group, excluding players with nonunion (n = 6), and 24.5 (± 10.5) weeks for nonunion and switch treatment (n = 4) players. Prompt fracture stabilization surgery is recommended for athletes, enabling the implementation of an aggressive rehabilitation protocol as soon as possible. Early limb loading after surgery (from week 2) does not delay fracture healing or hinder the bone union, thus rehabilitation plays a crucial role in shortening the time of RTP (return to play) and is obligatory for each athlete who undergoes surgical treatment.
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Liporaci RF, Yoshimura S, Baroni BM. Perceptions of Professional Football Players on Injury Risk Factors and Prevention Strategies. SCI MED FOOTBALL 2021; 6:148-152. [DOI: 10.1080/24733938.2021.1937689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wagemans J, Kuppens K, Peeters G, Baert I. There is a difference in functional ankle stability between different types of footwear in male athletes: A cross-sectional study. Foot (Edinb) 2021; 46:101764. [PMID: 33279791 DOI: 10.1016/j.foot.2020.101764] [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: 08/24/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 02/04/2023]
Abstract
CONTEXT Lateral ankle sprains (LAS) are among the most common injuries in sports, with a poor long - term prognosis due to high chronicity and recurrence rates. Chronic ankle instability (CAI) results up to 40% of people that endured a first - time LAS. OBJECTIVE The aim of this study was to compare ankle stability between groups characterised by the use of different types of footwear during their sport activities. DESIGN Cross-sectional study. SETTING Firm training surface, local sport clubs. PARTICIPANTS Fifty - one male subjects were recruited, distributed in four groups based on the type of footwear they use during their sport activities. MAIN OUTCOME MEASURES All subjects performed four clinical ankle stability tests, and completed the Dutch version of the Cumberland Ankle Instability Tool (CAIT) and Profile of Mood States (POMS). All clinical ankle stability tests were performed barefoot. RESULTS Subjects performing their sport activities barefoot scored better than subjects performing their sport with shoes at the multiple hop test (p=.002 to .047) and executed the figure-of-8 hop test significantly faster than subjects with submalleolar ankle support (AS) (p=.019). Subjects with submalleolar AS and studs showed significantly better results than subjects with supramalleolar AS on the CAIT- score (p=.024, p=.030) and the side- hop test (p=.050, p=.045). They also scored significantly better than subjects with submalleolar AS for the side - hop test (p=.032), foot - lift test (p=.019) and figure-of 8 hop test (p=.011). CONCLUSION Barefoot sports performing subjects appear to have better ankle stability compared to subjects performing their sports with shoe support. Subjects performing sports with high AS appear to have worst ankle stability. LEVEL OF EVIDENCE Level III, Cross-sectional study.
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Affiliation(s)
- Jente Wagemans
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Kevin Kuppens
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Departments of Human Physiology and Physiotherapy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
| | - Greta Peeters
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
| | - Isabel Baert
- Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; MOVANT research group, University of Antwerp, Antwerp, Belgium(1)
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Plantar loading in the youth soccer player during common soccer movements and risk for foot injury. Injury 2020; 51:1905-1909. [PMID: 32564963 DOI: 10.1016/j.injury.2020.06.009] [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: 02/27/2020] [Revised: 05/08/2020] [Accepted: 06/11/2020] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Soccer players are at high risk of stress injuries in the foot. While most research addresses this issue in professional athletes, there is little information concerning young athletes. As soccer is practiced around the world since early infancy, we set out to determine whether young soccer athletes are susceptible to increased foot loading that increase risk factors for foot injuries in a similar manner as reported by the literature to the adult athlete. METHODS twenty-six male adolescents (mean age 16 years old) were organized into two groups: soccer players (n = 13) and controls (n = 13). Groups were compared regarding foot sensitivity, ankle range of motion, Q-angle, and plantar pressure determined during running and cutting movements performed at maximal speed and using different shoes. RESULTS Foot sensitivity, ankle range of motion and Q-angle did not differ between the groups. During performance of soccer actions, young players showed higher peak pressure in the lateral region of the foot including the fifth metatarsal region. These higher peaks were minimized by manipulation of the footwear. CONCLUSION In summary, young soccer athletes show dynamic plantar pressure patterns that are related to foot injury in the adult athlete, and this condition can be minimized by the manipulation of the footwear. Additional attention should be paid to the young athlete in soccer aiming to minimize long-term risk for stress injuries in the foot.
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