Concussion in European professional football: a view of team physicians

Injury surveillance of head and neck injuries with a special focus on sport-related concussions: Eight seasons observational study in professional football in Qatar

OBJECTIVES

To describe the head and neck injuries with a focus on Sport-Related Concussion (SRC) in professional football in Qatar (PFQ) during eight consecutive seasons.

DESIGN

Prospective observational study.

METHODS

Seventeen PFQ teams were included over eight seasons (2013/14-2020/21) study. The injury data were collected by the respective clubs' medical staff using standardized (time-loss injuries) protocols.

RESULTS

Data were obtained from 119 teams' seasons resulting in a total of 87 head and neck injuries (1.8 % of the 4736 time-loss injuries). Head and neck injury rate was of 0.57 injury/squad-season (95%CI: 0.56-0.59), representing 0.12 injury/1000 h (95%CI: 0.09-0.14). Thirty-three concussions were recorded. The concussion rate was 0.25 injury/squad-season (95%CI: 0.23-0.26), representing 0.04 injury/1000 h (95%CI: 0.03-0.06). The concussion proportion of all head injuries was 31.7 % during the four initial seasons and 43.5 % during the following four seasons with a non-significant increase of 11.8 % (X2 = 1267, p = 0.26).

CONCLUSIONS

Injury rates in this cohort remain lower than comparable leagues elsewhere. Even though the incidence rate of SRC did not change significantly over the eight seasons, seasonal variations' trend may indicate that the medical staff are more aware of diagnosing head and neck injuries, including concussion.

Knowledge, attitude and behaviour around concussion at the FIFA Women's World Cup 2023: part 2 - coaches, performance staff and players

The objective of this observational cross-sectional study was to assess the knowledge, attitude and behaviour of coaches and performance staff (i.e. 'coaching staff'), and players from the 32 teams qualified for the FIFA Women's World Cup 2023 regarding assessment and management of concussion in football. Two online surveys were developed: 1) coaching staff, and 2) players. The results were analysed descriptively. Eighty-four coaching staff and 229 players completed the survey. Concussion knowledge: 39% of coaching staff and 33% of players were aware of concussion protocol(s). Knowledge: concussion symptom onset time was correctly reported by 18% of coaching staff and 11% of players. Knowledge about risks related to sustaining a concussion or returning to play too soon varied in both groups. Attitude: 26% of coaching staff and 31% of players reported being very confident or confident in recognizing a suspected concussion. Half of the players (52%) reported to always report symptoms of concussion if feeling any. One (1%) member of the coaching staff and 24 (10%) players reported feeling that a player can return to play with mild symptoms after a concussion. Behaviour: Most coaching staff reported they would have supportive behaviour if faced with a suspected concussion on the pitch. Among players, 64% stated that they would leave the assessment to their team's medical staff, and 4% would encourage their teammates to keep playing. In conclusion, coaching staff and players showed limited knowledge about concussion. Most coaching staff reported attitudes and intended behaviour towards protecting players' health; whilst players' responses varied.

Leadership experiences of elite football team physicians during the COVID-19 pandemic: a pilot study

Objectives

The purpose of this study was to explore the leadership experiences of elite football team physicians during the COVID-19 pandemic.

Methods

A pilot-study based on a cross-sectional design by means of an electronic survey was conducted. The survey relied on 25 questions divided into distinct sections including among others professional and academic experience, leadership experiences and perspectives.

Results

A total of 57 physicians (91% male; mean age: 43 years) gave their electronic informed consent and completed the survey. All participants agreed that the demands of their role had increased during the COVID-19 pandemic. Fifty-two (92%) participants reported that they felt they were expected to take more of a leadership role during the COVID-19 pandemic. Eighteen (35%) reported feeling under pressure to make clinical decisions which were not in keeping with best clinical practice. Additional roles, duties and demands expected of team doctors during the COVID-19 pandemic were subdivided into communication, decision-making, logistical, and public health demands.

Conclusion

The findings from this pilot study suggest that the way in which team physicians at professional football clubs operate has altered since the onset of the COVID-19 pandemic, with greater demands placed on leadership skills including decision-making, communication and ethical stewardship. This has potential implications for sporting organisations, clinical practice and research.

Health conditions among retired professional footballers: a scoping review

Objective

To conduct a scoping review providing an overview of the health conditions occuring in retired male and female professional footballers, with an emphasis on musculoskeletal, mental, neurocognitive, cardiovascular and reproductive health conditions.

Methods

In January 2022, a comprehensive systematic literature search in three databases (MEDLINE via PubMed, SPORTDiscus via EBSCOhost and EMBASE) was conducted for common health conditions among retired male and female professional footballers. Primary research studies (full text available online) which described the incidence or prevalence of a health condition (musculoskeletal, mental, neurocognitive, cardiovascular, reproductive) among retired male and female professional footballers were included for review. Case reports, qualitative research and grey literature were omitted.

Results

In total, 917 eligible articles were identified from the databases, with 41 meeting the eligibility criteria. Osteoarthritis of the hip, knee and ankle were found to be common among retired professional footballers. Mental health symptoms (eg, anxiety, depression) are experienced by retired male and female professional footballers. The incidence of neurocognitive disease appears to be higher among retired male professional footballers than among matched controls. There is very limited evidence examining the presence of health conditions in retired female professional footballers.

Conclusion

Osteoarthritis of the lower limb, musculoskeletal pain and mental health symptoms are common among retired professional footballers. Knowledge about the occurrence and timing of musculoskeletal, mental health and neurocognitive conditions among retired professional footballers can be used by a wide range of stakeholders to proactively intervene during and after a player's career to mitigate risk.

Head injuries in professional football (soccer): Results of video analysis verified by an accident insurance registry

BACKGROUND

Video analysis is one of the most commonly applied methods for analysing football injuries.

PURPOSE

The objective of this study was to assess the accuracy of video analysis for recording head injuries in professional football from official matches in the four highest men's professional football leagues in Germany.

METHODS

In this cohort study, head injuries detected by means of video analysis of all official matches over one season (2017-18) were compared to head injuries registered with the German statutory accident insurance.

RESULTS

Our video analysis yielded 359 head injuries of 287 players. The comparison of head injuries found in our video analysis to those registered with the accident insurance only yielded a match in 23.1% (n = 83), which presents a rather low verification rate. The verification rates varied between the leagues (7.0-30.8%). All injuries documented in the accident insurance registry were found in the video analysis (100%). The types of head injury most often verified by the accident insurance registry (n = 83) were contusion (43.4%), bone fractures (19.3%) and skin lacerations (18.1%). Only 66 of the 359 head injuries (18.4%) resulted in absence from at least one training session and involved a mean time loss of 18.5 days (1-87 days).

CONCLUSION

The mismatch between the number of head injuries found in the video analysis and head injuries registered with the accident insurance is an important methodological issue in scientific research. The low verification rate seems to be due to the unclear correlation between injury severity and clinical consequences of head injuries detected by means of video analysis and the failure of football clubs to register minor head injuries with the accident insurance.