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Loud D, Grimshaw P, Kelso R, Robertson WS. Effect of Soccer Boot Outsole Configuration on Translational Traction Across Both Natural and Artificial Playing Surfaces. Orthop J Sports Med 2024; 12:23259671241259823. [PMID: 39131098 PMCID: PMC11311168 DOI: 10.1177/23259671241259823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 01/10/2024] [Indexed: 08/13/2024] Open
Abstract
Background Soccer boots are produced with different stud patterns and configurations to provide players with extra traction on specific surface types to minimize slipping and improve player performance. Excessive traction, however, can lead to foot fixation injuries, particularly anterior cruciate ligament tears. Purpose/Hypothesis The purpose of this study was to explore the translational traction properties of 5 different outsole configurations moving in 4 different directions across both natural grass and artificial grass (AG) playing surfaces. It was hypothesized that longer studs or studs with an asymmetric shape would yield a higher traction coefficient compared with the recommended stud configuration for the given playing surface. Study Design Descriptive laboratory study. Methods A custom-built testing apparatus recorded the translational traction of 5 different soccer boots moving in an anterior, posterior, medial, or lateral direction on both natural grass and AG playing surfaces. A 3-way analysis of variance was performed to determine the effect of outsole configuration on the traction, and a post hoc Tukey analysis was performed to compare different outsole configurations with a control. Results For the natural grass playing surface, the longer and asymmetric studs yielded a significantly higher (P < .05) traction coefficient on 75% of loading scenarios, while on AG, they yielded a significantly higher traction on 50% of loading scenarios. Conclusion Some soccer boots yielded higher traction values compared with the recommended configuration. Clinical Relevance The results highlight the importance of boot selection on different playing surfaces. Higher traction values could increase the injury risk for players due to excessive traction and foot fixation.
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Affiliation(s)
- Danyon Loud
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - Paul Grimshaw
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Richard Kelso
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - William S.P. Robertson
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
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Ramsodit KR, Zwiers R, Dalmau-Pastor M, Gouttebarge V, Kerkhoffs GMMJ. Most elite athletes return to preinjury competitive activity after surgical treatment for medial malleolus stress fractures. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38829266 DOI: 10.1002/ksa.12284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/08/2024] [Accepted: 05/17/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE To provide return-to-performance outcomes after surgical treatment for medial malleolus stress fractures in the elite athlete. Additionally, to describe an individualised surgical approach in the management of medial malleolus stress fractures. METHODS Five athletes (six ankles) underwent surgical treatment for a medial malleolus stress fracture. The surgical technique was based on the extent of the fracture line in steps with first arthroscopic debridement of bony spurs, microfracturing of the fracture line and screw fixation. Return-to-performance data included time to return to sport-specific training, normal training, first competitive activity, performance and the return-to-performance rate. RESULTS Patients returned to sport-specific training at a median of 10 weeks. They started normal training at 16 weeks postoperatively and returned to their first competitive activity after 19 weeks. All patients had bony spurs on the distal tibia which were arthroscopically debrided. One patient received arthroscopic debridement of bony spurs alone. Four patients received additional microfracturing of the fracture line and three patients received screw fixation. All patients achieved clinical and radiographic union on follow-up computed tomography scan at 3 months postsurgery. At latest follow-up, no refractures nor hardware complications, nor any other complications were observed. CONCLUSION Arthroscopic debridement of bony spurs, debridement and microfracturing of the fracture line and screw fixation are all viable surgical tools in the management of medial malleolus stress fractures in elite athletes. The surgical approach containing these options should be tailored to the individual athlete based on the fracture line in the sagittal plane. While most athletes return to full competitive activity in 3-4 months, time to self-reported return to full performance is often much longer. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Kishan R Ramsodit
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
- Amsterdam Movement Sciences (AMS), Aging & Vitality, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
| | - Ruben Zwiers
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
- Amsterdam Movement Sciences (AMS), Aging & Vitality, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
- Department of Orthopedic Surgery, Flevoziekenhuis, Almere, The Netherlands
| | - Miki Dalmau-Pastor
- Human Anatomy and Embryology Unit, Department of Pathology and Experimental Therapeutics, School of Medicine and Health Sciences, The University of Barcelona, Barcelona, Spain
- MIFAS by GRECMIP (Minimally Invasive Foot and Ankle Society), Merignac, France
| | - Vincent Gouttebarge
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
- Amsterdam Movement Sciences (AMS), Aging & Vitality, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Gino M M J Kerkhoffs
- Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Meibergdreef 9, Amsterdam, The Netherlands
- Academic Center for Evidence Based Sports Medicine (ACES), Amsterdam, The Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), IOC Research Center of Excellence, Amsterdam, The Netherlands
- Amsterdam Movement Sciences (AMS), Aging & Vitality, Musculoskeletal Health, Sports, Amsterdam, The Netherlands
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Cole D, Fleming P, Roberts J, James D, Benetti M, Wistel K, Billingham J, Forrester S. Comparison of player perceptions to mechanical measurements of third generation synthetic turf football surfaces. SPORTS ENGINEERING 2023. [DOI: 10.1007/s12283-022-00398-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
AbstractMechanical testing of synthetic turf football surfaces is considered essential to ensure player performance and safety. However, it remains unknown how well the mechanical outputs reflect player perceptions of these surfaces. The first objective of this study was to investigate the agreement between the outputs from the Rotational Traction Tester and the Advanced Artificial Athlete with player perceptions across a range of controlled third generation turf football surfaces. The second objective was to identify the modifications to the Rotational Traction Tester and the Advanced Artificial Athlete configurations and output variables that give the strongest agreement with player perceptions. An indoor test area containing ten third generation turf surfaces with controlled hardness and traction properties was constructed. Each surface was tested using the Advanced Artificial Athlete and Rotational Traction Tester in their current configuration and in several modified configurations aimed at better replicating the player–surface interaction. Using a trained panel paired comparisons technique, 18 University footballers (11 males and 7 females) identified differences in the surfaces based on four sensory attributes Movement Speed, Slip, Leg Shock and Give. Results indicated strong agreement (correlation coefficients between 0.7 and 1.0) across several Rotational Traction Tester and Advanced Artificial Athlete testing configurations and output variables with player perceptions. It is recommended that the current Rotational Traction Tester is improved through added instrumentation to allow surface stiffness to be evaluated (the rate of generation of traction resistance). It is further recommended that the Advanced Artificial Athlete adopts a new algorithm to improve the accuracy of the surface’s Vertical Deformation and Energy Restitution, and the number of drops is reduced from three to one.
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Dawkins J, Teel J, Kitziger R, Khair M. Anterior Cruciate Ligament Injury Prevention and Rehabilitation. HSS J 2023; 19:365-372. [PMID: 37435132 PMCID: PMC10331261 DOI: 10.1177/15563316231154475] [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: 07/20/2022] [Accepted: 09/23/2022] [Indexed: 07/13/2023]
Abstract
At all levels of American football, knee injuries are common, with injuries to the anterior cruciate ligament (ACL) making up a significant proportion. Historically, ACL injuries were career-altering for professional players, but innovative techniques in surgery and rehabilitation have returned many to the field. While there is a consensus on surgical techniques for ACL reconstruction, significant discrepancies remain on injury prevention and rehabilitation programs. This review article describes the burden of ACL injury on players in the National Football League, best practices in injury prevention and rehabilitation, and evidence-based recommendations for preparing injured athletes to return to play.
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Affiliation(s)
| | - Jordan Teel
- Baylor University Medical Center, Dallas, TX, USA
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Desai SS, Dent CS, El-Najjar DB, Swindell HW, Popkin CA. Musculoskeletal Injury in American Football: A Bibliometric Analysis of the Most Cited Articles. Orthop J Sports Med 2023; 11:23259671231168875. [PMID: 37359978 PMCID: PMC10286201 DOI: 10.1177/23259671231168875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background Textbook knowledge and clinical dogma are often insufficient for effective evidence-based decision making when treating musculoskeletal injuries in American football players, given the variability in presentation and outcomes across different sports and different levels of competition. Key evidence can be drawn directly from high-quality published articles to make the appropriate decisions and recommendations for each athlete's unique situation. Purpose To identify and analyze the 50 most cited articles related to football-related musculoskeletal injury to provide an efficient tool in the arsenal of trainees, researchers, and evidence-based practitioners alike. Study Design Cross-sectional study. Methods The ISI Web of Science and SCOPUS databases were queried for articles pertaining to musculoskeletal injury in American football. For each of the top 50 most cited articles, bibliometric elements were evaluated: citation count and density, decade of publication, journal, country, multiple publications by the same first author or senior author, article content (topic, injury area), and level of evidence (LOE). Results The mean ± SD number of citations was 102.76 ± 37.11; the most cited article, with 227 citations, was "Syndesmotic Ankle Sprains" published in 1991 by Boytim et al. Several authors served as a first or senior author on >1 publication, including J.S. Torg (n = 6), J.P. Bradley (n = 4), and J.W. Powell (n = 4). The American Journal of Sports Medicine published the majority of the 50 most cited articles (n = 31). A total of 29 articles discussed lower extremity injuries, while only 4 discussed upper extremity injuries. The majority of the articles (n = 28) had an LOE of 4, with only 1 article having an LOE of 1. The articles with an LOE of 3 had the highest mean citation number (133.67 ± 55.23; F = 4.02; P = .05). Conclusion The results of this study highlight the need for more prospective research surrounding the management of football-related injury. The low overall number of articles on upper extremity injury (n = 4) also highlights an area for further research.
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Affiliation(s)
- Sohil S. Desai
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - Craig S. Dent
- College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Dany B. El-Najjar
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Hasani W. Swindell
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
| | - Charles A. Popkin
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, New York, USA
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Smith PE, Morey M, McManus LJ, Kong A. Magnetic resonance imaging of the ankle: Pathology of the lateral and posterior compartments. J Med Imaging Radiat Oncol 2023. [PMID: 36726341 DOI: 10.1111/1754-9485.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
Magnetic resonance imaging (MRI) is the gold standard for imaging the tendons and the ligaments of the ankle. MRI combines excellent tissue contrast and accurate anatomic delineation of joint structures. In the first article of this series, we discussed a compartmental approach to the interpretation of ankle pathology focusing on the anterior and medial compartments. This article will complete the MR review of the ankle, with a focus on the lateral and posterior compartments of the ankle.
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Affiliation(s)
| | - Matthew Morey
- Epworth Medical Imaging (Geelong), Geelong, Victoria, Australia
| | | | - Andrew Kong
- Regional Imaging (Albury), Albury, New South Wales, Australia
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Castillo-Domínguez A, Torrontegui-Duarte M, Páez-Moguer J, Gómez-del-Pino Á, Cervera-Garvi P, Mainer-Pardos E, Lozano D, García-Romero J. The Influence of Stud Characteristics of Football Boots Regarding Player Injuries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010720. [PMID: 36613041 PMCID: PMC9819624 DOI: 10.3390/ijerph20010720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND the main aim of this study was to analyze the relationship between sole pattern parameters of football boots with the frequency of injuries that occur in semiprofessional and amateur footballers. METHODS The study sample was composed of 77 male football players. All were at least 18 years old, played at least 10 h per week, gave signed informed consent to take part and properly completed the Visual Analogue Scale. This study analysed data from each player's medical history, including age, injuries, years of practice, field type and surface condition information. RESULTS The visual analogic score in semiprofessional players was higher (2.05 ± 2.43) than in amateur players (1.00 ± 1.1). A total of 141 lesions were collected, equivalent to 1.81 injuries for each football player studied (n = 77). The result of the ROC curve indicated that the player's years of practice could predict significantly (p < 0.05) the presence of lower limb injuries, with an area under the curve of 0.714. CONCLUSIONS This study described the predictive capacity of sole pattern characteristics concerning lower limb injuries in amateur and semiprofessional footballers. Football boot variables associated with the number of studs were associated with foot and ankle overload injuries.
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Affiliation(s)
| | | | - Joaquín Páez-Moguer
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | - Álvaro Gómez-del-Pino
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | - Pablo Cervera-Garvi
- Department of Nursing and Podiatry, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Correspondence:
| | - Elena Mainer-Pardos
- Health Sciences Faculty, Universidad San Jorge, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Demetrio Lozano
- Health Sciences Faculty, Universidad San Jorge, Autov. A23 km 299, Villanueva de Gállego, 50830 Zaragoza, Spain
| | - Jerónimo García-Romero
- Department of Human Physiology, Histology, Pathological Anatomy and Sports Physical Education, University of Malaga, 29071 Malaga, Spain
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Ten questions in sports engineering: technology in elite women’s football. SPORTS ENGINEERING 2022. [PMCID: PMC9667860 DOI: 10.1007/s12283-022-00384-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of technology in football is increasing, although, products predominantly focus on men’s football in performance, safety, comfort, and fit considerations. A recent scoping review identified just 32 published scientific articles on technology in women’s football, despite demands of those playing/working in the women’s game increasing. We wish to highlight the progressions made so far and barriers remaining in the elite women’s football technology to shed a light on this topic and prod researchers and manufacturers to help support the evolution of women’s-football-focussed technological considerations. The ten questions presented in this paper address the generic question on whether women’s specific tailoring is needed (Question 1) as well as addressing specific questions on football technology and engineering, such as the progressions made and ongoing issues in the following areas: football kits, religious considerations (hijab designs), sports bras, football boots, balls, football pitches, performance tracking devices, menstrual cycle tracking devices (Question 2–10). It is evidence that certain areas have received more attention than others and with these ten questions we hope to steer readers towards research and engineering gaps for future work.
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Meyers MC, Sterling JC. Lisfranc injury: Prevalence and maintaining a high index of suspicion for optimal evaluation. PHYSICIAN SPORTSMED 2022; 50:507-514. [PMID: 34429021 DOI: 10.1080/00913847.2021.1969218] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To quantify the long-term prevalence of game-related Lisfranc trauma in college football on artificial turf and natural grass. METHODS 32 universities were evaluated over 10 competitive seasons across all Football Bowl Subdivision (FBS) conferences. Outcomes of interest included injury severity, injury category, primary type of injury, player and skill position, injury mechanism and situation, elective imaging and surgical procedures, and field conditions. Injury incidence rates (IIR) were calculated using injuries per 10 games = (number of injuries) number of games) × 10. RESULTS Of the 1577 games documented, 783 games (49.7%) were played on a 3-layer artificial turf (≥9.0 lbs/ft2) infill system versus 794 games (50.3%) played on natural grass. In sum, 78 Lisfranc cases were documented with 34 (43.6%) occurring on artificial turf, and 44 (56.4%) on natural grass. MANOVAs indicated significant main effects by injury category (F3,74 = 6.439; P = .001), and injury mechanism (F5,72 = 3.372; P = .009) observed between surfaces, but not by injury severity (F2,75 = 0.720; P = .490), primary type of injury (F4,73 = 0.772; P = .547), overall player (F2,75 = 0.219; P = .804) and skill positions (F8,69 = 0.850; P = .563), injury situation (F10,67 = 1.030; P = .428), elective imaging and surgical procedures (F3,74 = 0.515; P = .673), or field conditions (F2,75 = 0.375; P = .688). Post hoc analyses indicated significantly greater incidences (P < .05) of Lisfranc trauma on natural grass attributed to shoe:surface interaction during noncontact play, and during no contact, foot rotation or planting. Ligament tears (n = 8; 57.1%), with minimal cases of subluxation/dislocations (n = 4; 28.6%) and fractures (n = 2; 14.3%) comprised grade 3 cases across both surfaces. CONCLUSION In regards to Lisfranc trauma, a 3-layer, heavyweight artificial infill surface is as safe or safer than natural grass. The findings of this study may be generalizable only to this level of football competition.
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Affiliation(s)
- Michael C Meyers
- Human Performance Laboratory, Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID. USA
| | - James C Sterling
- Baylor, Scott & White, Sports and Physical Medicine Center, Dallas, TX, USA
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Gould HP, Lostetter SJ, Samuelson ER, Guyton GP. Lower Extremity Injury Rates on Artificial Turf Versus Natural Grass Playing Surfaces: A Systematic Review. Am J Sports Med 2022; 51:1615-1621. [PMID: 35593739 DOI: 10.1177/03635465211069562] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND No study has provided a comprehensive systematic review of sports injuries on artificial turf versus natural grass. PURPOSE To comprehensively examine the risk of overall injuries and multiple types of lower extremity injuries across all sports, all levels of competition, and on both old-generation and new-generation artificial turf. STUDY DESIGN Systematic review; Level of evidence, 3. METHODS A systematic review of the English-language literature was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All included articles compared overall injury rates or lower extremity (hip, knee, or foot and ankle) injury rates on artificial turf and natural grass. All sports, levels of competition, and turf types were included. Studies were excluded if they did not include overall injury rates or lower extremity injury rates. Because of the heterogeneity of the included studies, no attempt was made to aggregate risk ratios to conduct a quantitative meta-analysis. RESULTS A total of 53 articles published between 1972 and 2020 were identified for study inclusion. Most studies on new-generation turf (13/18 articles) found similar overall injury rates between playing surfaces. When individual anatomic injury locations were analyzed, the greatest proportion of articles reported a higher foot and ankle injury rate on artificial turf compared with natural grass, both with old-generation (3/4 articles) and new-generation (9/19 articles) turf. Similar knee and hip injury rates were reported between playing surfaces for soccer athletes on new-generation turf, but football players, particularly those at high levels of competition, were more likely to sustain a knee injury on artificial turf than on natural grass. CONCLUSION The available body of literature suggests a higher rate of foot and ankle injuries on artificial turf, both old-generation and new-generation turf, compared with natural grass. High-quality studies also suggest that the rates of knee injuries and hip injuries are similar between playing surfaces, although elite-level football athletes may be more predisposed to knee injuries on artificial turf compared with natural grass. Only a few articles in the literature reported a higher overall injury rate on natural grass compared with artificial turf, and all of these studies received financial support from the artificial turf industry.
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Affiliation(s)
- Heath P Gould
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
| | | | - Eric R Samuelson
- Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Gregory P Guyton
- Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland, USA
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Validation of Instrumented Football Shoes to Measure On-Field Ground Reaction Forces. SENSORS 2022; 22:s22103673. [PMID: 35632081 PMCID: PMC9145471 DOI: 10.3390/s22103673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/04/2022] [Accepted: 05/10/2022] [Indexed: 02/04/2023]
Abstract
Ground reaction forces (GRF) have been widely studied in football to prevent injury. However, ambulatory tools are missing, posing methodological limitations. The purpose of this study was to assess the validity of an innovative football shoe measuring normal GRF (nGRF) directly on the field through instrumented studs. A laboratory-based experiment was first conducted to compare nGRF obtained with the instrumented shoe (IS) to vertical GRF (vGRF) obtained with force platform (FP) data, the gold standard to measure vGRF. To this aim, three subjects performed 50 steps and 18 counter-movement jumps (CMJs). Secondly, eleven subjects completed running sprints at different velocities on a football field, as well as CMJs, while wearing the IS. Good to excellent agreement was found between the vGRF parameters measured with the FP and the nGRF measured by the IS (ICC > 0.75 for 9 out of 11 parameters). Moreover, on-field nGRF patterns demonstrated a progressive and significant increase in relation with the running velocity (p < 0.001). This study demonstrated that the IS is a highly valid tool to assess vGRF patterns on a football field. This innovative way to measure vGRF in situ could give new insights to quantify training load and detect neuromuscular fatigue.
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Injury risk among athletes on artificial turf: a review of current literature. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Paliobeis A, Sivasundaram L, Knapik DM, Labelle MW, Olson M, Karns MR, Salata MJ, Voos JE. Injury incidence is higher on artificial turf compared with natural grass in high school athletes: a retrospective cohort study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Sanchez-Sanchez J, Martinez-Rodriguez A, Felipe JL, Hernandez-Martin A, Ubago-Guisado E, Bangsbo J, Gallardo L, Garcia-Unanue J. Effect of Natural Turf, Artificial Turf, and Sand Surfaces on Sprint Performance. A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9478. [PMID: 33348874 PMCID: PMC7767268 DOI: 10.3390/ijerph17249478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 01/13/2023]
Abstract
The aim of this study was to analyze the influence of natural turf, artificial turf, and sand on sprint performance in different sports and to determine how the sport surface affects sprint performance. A systematic search was conducted in Pubmed, Web of Sciences, and SPORTDiscus databases. Out of 5644 studies, 11 studies were included in the meta-analysis. The studies were very heterogeneous, as they examined different structural characteristics or quality parameters. The studies on natural turf and sand showed significant improvements on sprint speed during training. On the other hand, the analysis of fatigue did not reveal significant differences in the deterioration of sprint speed on both natural and artificial turf. Significance was set at p < 0.05. In conclusion, although lower performance in sprint was reported on sand, further studies are needed to explain the differences in sprint on natural and artificial turf.
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Affiliation(s)
| | | | - Jose Luis Felipe
- School of Sport Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain;
| | - Antonio Hernandez-Martin
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45071 Toledo, Spain; (A.H.-M.); (E.U.-G.); (L.G.); (J.G.-U.)
| | - Esther Ubago-Guisado
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45071 Toledo, Spain; (A.H.-M.); (E.U.-G.); (L.G.); (J.G.-U.)
| | - Jens Bangsbo
- Department of Nutrition, Exercise and Sports, University of Copenhaguen, 2177 Copenhagen, Denmark;
| | - Leonor Gallardo
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45071 Toledo, Spain; (A.H.-M.); (E.U.-G.); (L.G.); (J.G.-U.)
| | - Jorge Garcia-Unanue
- IGOID Research Group, Physical Activity and Sport Sciences Department, University of Castilla-La Mancha, 45071 Toledo, Spain; (A.H.-M.); (E.U.-G.); (L.G.); (J.G.-U.)
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15
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Winson DMG, Miller DLH, Winson IG. Foot injuries, playing surface and shoe design: Should we be thinking more about injury prevention. Foot Ankle Surg 2020; 26:597-600. [PMID: 31447244 DOI: 10.1016/j.fas.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/10/2019] [Accepted: 07/31/2019] [Indexed: 02/04/2023]
Abstract
The increasing use of artificial pitches has occurred in a multitude of sports at both professional and amateur levels. Artificial turf has become an extremely attractive option as it is felt to encourage a faster, safer and more entertaining play. However these pitches are not without controversy among sporting professionals and in the media. Foot and ankle injury in sport remains incredibly common and a significant burden on health professionals, but what impact do the new artificial surfaces have on these injuries. This review article aims to establish whether artificial turf has an impact on injury rates in the foot and ankle.
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Affiliation(s)
- Daniel M G Winson
- University Hospital of Wales, Cardiff, Heath Park, Cardiff, CF14 4XW, UK.
| | | | - Ian G Winson
- Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
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16
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Apps C, Rodrigues P, Isherwood J, Lake M. Footwear insoles with higher frictional properties enhance performance by reducing in-shoe sliding during rapid changes of direction. J Sports Sci 2019; 38:206-213. [PMID: 31722621 DOI: 10.1080/02640414.2019.1690618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
A novel 3D motion capture analysis assessed the efficacy of insoles in maintaining the foot position on the midsole platform inside the shoe during rapid change of direction manoeuvres used in team sports. An insole (TI) with increased static (35%) and dynamic (49%) coefficient of friction compared to a regular insole (SI) was tested. Change of direction performance was faster (p < .001) and perceived to be faster (p < .001) in TI compared to SI. Participants utilised greater coefficient of friction in TI compared to SI during a complete turn, but not during a 20 degree side-cut. In-shoe foot sliding reduced across the forefoot and midfoot during the braking phase of the turn and in the rearfoot during the side-cut in TI. Greater in-shoe foot sliding occurred in the turn than the side-cut across all foot regions. Results provide guidance for athletic footwear design to help limit in-shoe foot sliding and improve change of direction performance.
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Affiliation(s)
- Charlotte Apps
- School of Science and Technology, Nottingham Trent University, Nottingham, UK.,School of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Pedro Rodrigues
- Sports Research Laboratory, New Balance Athletics, Inc, Boston, MA, USA
| | - Joshua Isherwood
- School of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Mark Lake
- School of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Chen WH, Hsieh CF, Chan MS, Shih Y, Chen CH, Shiang TY. Optimal shear cushion stiffness at different gait speeds. J Biomech 2019; 93:226-230. [PMID: 31387697 DOI: 10.1016/j.jbiomech.2019.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 01/13/2023]
Abstract
The present study quantified the effects of different shear cushion stiffness on the time to peak posterior shear force (TPPSF), peak posterior shear force (PPSF), average posterior loading rate (APLR), and maximum posterior loading rate (MPLR) at different locomotion speeds using a custom-made sliding platform, as well as to identify the optimal stiffness of shear cushion. Twelve male collegiate students (heel-strikers) performed walking at 1.5 m/s, jogging at 2.5 m/s, and running at 3.5 m/s. A custom-made sliding platform was used to provide the different shear cushion conditions. The shear cushion conditions were fixed (a fixed platform; control group), stiff (K = 2746 N/m), medium stiff (K = 2256 N/m), medium soft (K = 1667 N/m), and soft (K = 1079 N/m). The results showed that all cushion conditions produced sliding displacement and delayed the TPPSF during walking, jogging, and running compared with fixed condition. The APLR and MPLR were lowest under medium soft condition during walking, while the PPSF was similar between medium soft and soft conditions. For jogging and running, the PPSF as well as APLR and MPLR were the lowest under medium stiff condition except the maximum PLR was similar among stiff, medium stiff, and medium soft conditions during running. In conclusion, shear cushion produces appropriate sliding displacement and effectively delays the TPPSF to provide the musculoskeletal system additional time to absorb the impact and reduce loading. The present study demonstrates optimal stiffness of shear cushion at different traveling speeds and suggests that a shear cushion system can be applied in future designs of cushion structures.
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Affiliation(s)
- Wei-Han Chen
- Department of Athletic Performance, National Taiwan Normal University, Taipei, Taiwan
| | - Chen-Fang Hsieh
- Department of Athletic Performance, National Taiwan Normal University, Taipei, Taiwan
| | - Ming-Sheng Chan
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, United States; San Francisco Giants Baseball Club, San Francisco, United States
| | - Yo Shih
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, United States
| | - Chia-Hsiang Chen
- Office of Physical Education, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Tzyy-Yuang Shiang
- Department of Athletic Performance, National Taiwan Normal University, Taipei, Taiwan.
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Sánchez-Sánchez J, Gallardo-Guerrero AM, García-Gallart A, Sánchez-Sáez JA, Felipe JL, Encarnación-Martínez A. Influence of the structural components of artificial turf systems on impact attenuation in amateur football players. Sci Rep 2019; 9:7774. [PMID: 31123289 PMCID: PMC6533268 DOI: 10.1038/s41598-019-44270-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 03/26/2019] [Indexed: 01/13/2023] Open
Abstract
The purpose of this research was to evaluate the influence of the structural components of different 3rd generation artificial turf football field systems on the biomechanical response of impact attenuation in amateur football players. A total of 12 amateur football players (24.3 ± 3.7 years, 73.5 ± 5.5 kg, 178.3 ± 4.1 cm and 13.7 ± 4.3 years of sport experience) were evaluated on three third generation artificial turf systems (ATS) with different structural components. ATS were composed of asphalt sub-base and 45 mm of fibre height with (ATS1) and without (ATS2) elastic layer or compacted granular sub-base, 60 mm of fibre height without elastic layer (ATS3). Two triaxial accelerometers were firmly taped to the forehead and the distal end of the right tibia of each individual. The results reveal a higher force reduction on ATS3 in comparison to ATS1 (+6.24%, CI95%: 1.67 to 10.92, ES: 1.07; p < 0.05) and ATS2 (+21.08%, CI95%: 16.51 to 25.66, ES: 2.98; p < 0.05) elastic layer. Tibia acceleration rate was lower on ATS3 than ATS1 (-0.32, CI95%: -0.60 to -0.03, ES: 4.23; p < 0.05) and ATS2 (-0.35, CI95%: -0.64 to -0.06; ES: 4.69; p < 0.05) at 3.3 m/s. A very large correlation (r = 0.7 to 0.9; p < 0.05) was found between energy restitution and fibre height in both head and tibial peak acceleration and stride time. In conclusion, structural components (fibre height, infill, sub-base and elastic layer) determine the mechanical properties of artificial turf fields. A higher force reduction and lower energy restitution diminished the impact received by the player which could protect against injuries associated with impacts compared to harder artificial turf surfaces.
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Affiliation(s)
- Javier Sánchez-Sánchez
- Universidad Europea de Madrid, School of Sport Sciences, Villaviciosa de Odón-Madrid, 28670, Spain.
| | | | | | | | - José L Felipe
- Universidad Europea de Madrid, School of Sport Sciences, Villaviciosa de Odón-Madrid, 28670, Spain
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19
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Thomson A, Whiteley R, Wilson M, Bleakley C. Six different football shoes, one playing surface and the weather; Assessing variation in shoe-surface traction over one season of elite football. PLoS One 2019; 14:e0216364. [PMID: 31039209 PMCID: PMC6490939 DOI: 10.1371/journal.pone.0216364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 04/18/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION An optimal range of shoe-surface traction (grip) exists to improve performance and minimise injury risk. Little information exists regarding the magnitude of traction forces at shoe-surface interface across a full season of elite football (soccer) using common football shoes. OBJECTIVE To assess variation in shoe-surface traction of six different football shoe models throughout a full playing season in Qatar encompassing climatic and grass species variations. METHODS Football shoes were loaded onto a portable shoe-surface traction testing machine at five individual testing time points to collect traction data (rotational and translational) on a soccer playing surface across one season. Surface mechanical properties (surface hardness, soil moisture) and climate data (temperature and humidity) were collected at each testing time point. RESULTS Peak rotational traction was significantly different across shoe models (F = 218, df = 5, p <0.0001), shoe outsole groups (F = 316.2, df = 2, p < .0001), and grass species (F = 202.8, df = 4, p < 0.0001). No main effect for shoe model was found for translational traction (F = 2.392, p = 0.07). CONCLUSIONS The rotational (but not translational) traction varied substantially across different shoe types, outsole groups, and grass species. Highest rotational traction values were seen with soft ground outsole (screw-in metal studs) shoes tested on warm season grass. This objective data allows more informed footwear choices for football played in warm/hot climates on sand-based elite football playing surfaces. Further research is required to confirm if these findings extend across other football shoe brands.
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Affiliation(s)
- Athol Thomson
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- University of Ulster, Jordanstown, County Antrim, United Kingdom
| | - Rodney Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Mathew Wilson
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Chris Bleakley
- University of Ulster, Jordanstown, County Antrim, United Kingdom
- High Point University, High Point, NC, United States of America
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20
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Bisciotti GN, Chamari K, Cena E, Bisciotti A, Bisciotti A, Corsini A, Volpi P. Anterior cruciate ligament injury risk factors in football. J Sports Med Phys Fitness 2019; 59:1724-1738. [PMID: 31062538 DOI: 10.23736/s0022-4707.19.09563-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) lesion represents one of the most dramatic injuries in a football (soccer) player's career. There are many injury risk factors related to intrinsic (non-modifiable) and/or extrinsic (modifiable) factors of ACL injury. EVIDENCE ACQUISITION Research of the studies was conducted until September 2018 without publication data limitation or language restriction on the following databases: PubMed/MEDLINE, Scopus, ISI, EXCERPTA. EVIDENCE SYNTHESIS To date, evidence from the literature suggests that the risk of ACL injury is multifactorial and involves biomechanical, anatomical, hormonal, and neuromuscular factors. Despite this relative complexity, the mechanisms of injury are well known and rationally classified into two categories: mechanisms of injury based on contact or on non-contact with another player, with the non-contact injury mechanisms clearly prevailing over the mechanisms of contact injury. One of the most frequent biomechanical risk factors, associated with ACL non-contact injury, is represented by the valgus knee in the pivoting and cutting movements and in the landing phase after jumping. Gender-related risk factors show female populations to have a higher predisposition to ACL injury than males However, there are still some theoretical and practical aspects that need further investigation such as; genetic risks together with the role of estrogen and progesterone receptors in female populations, and the in-vivo interaction shoe-playing surface. In particular, the genetic risk factors of ACL lesion seem to be an interesting and promising field of investigation, where considerable progress has still to be made. CONCLUSIONS This narrative review provides an insight into the risk factors of ACL injury that could be used by practitioners for preventing injury in football (soccer).
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Affiliation(s)
- Gian Nicola Bisciotti
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar -
| | - Karim Chamari
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | - Emanuele Cena
- Qatar Orthopedic and Sport Medicine Hospital, FIFA Center of Excellence, Doha, Qatar
| | | | | | | | - Piero Volpi
- FC Internazionale Milano, Milan, Italy.,Unit of Traumatology, Department of Knee Orthopedic and Sports, Humanitas Research Hospital, Rozzano, Milan, Italy
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21
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Meyers MC. Incidence, Mechanisms, and Severity of Game-Related High School Football Injuries Across Artificial Turf Systems of Various Infill Weights. Orthop J Sports Med 2019; 7:2325967119832878. [PMID: 30937317 PMCID: PMC6434442 DOI: 10.1177/2325967119832878] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background: Artificial turf surfaces are developed to duplicate playing characteristics of natural grass. With the newer generations of sand and rubber infill systems, the infill is a common component that varies between fields and is a critical factor that could influence the player-surface interaction. Because the influence of infill weight on sport trauma is unknown, this study quantified football trauma in high schools in the United States across artificial turf systems of various infill weights. Hypothesis: Athletes would not experience differences in game-related injuries across artificial turf systems of various infill weights. Study Design: Cohort study; Level of evidence, 2. Methods: Artificial turf systems were divided into 4 sand/rubber infill weight groups by pounds per square foot: ≥9.0, 6.0-8.9, 3.0-5.9, and 0.0-2.9. A total of 57 high schools in 4 states participated over the course of 5 seasons. Outcomes of interest included injury severity, as a function of infill weight, across head, knee, and shoulder traumas; injury category; primary type of injury; tissue type; specific body location of injury; cleat design; environmental factors; and turf age. Data were subject to multivariate analyses of variance (MANOVAs) and Wilks λ criteria through use of general linear model procedures. Results: Of 1837 games documented, 528 games were played on infill weights of ≥9.0 lb/ft2, 521 on 6.0-8.9 lb/ft2, 525 on 3.0-5.9 lb/ft2, and 263 on 0.0-2.9 lb/ft2, with 4655 total injuries reported. MANOVAs indicated significant infill weight effects across injury severity (F2,4648 = 5.087; P = .0001), with significant main effects also observed by injury category, tissue injured, lower extremity joint and muscle, cleat design, environmental factors, and turf age. Post hoc analyses indicated significantly lower (P < .05 to .0001) total and substantial traumas, concussions, shoe-surface interaction during contact trauma, surface impacts, muscle-tendon overload, cleat design influence, adverse weather trauma, lower extremity injuries, and turf age effect while athletes were competing on the 6.0 to ≥9.0 lb/ft2 infill weight systems compared with the lighter infill weight systems. Conclusion: As infill surface weight decreased, football trauma significantly increased across numerous playing conditions. Based on findings, high school football fields should minimally contain 6.0 pounds of infill per square foot.
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Affiliation(s)
- Michael C Meyers
- Department of Sport Science and Physical Education, Idaho State University, Pocatello, Idaho, USA
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22
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Lozano-Berges G, Clansey AC, Casajús JA, Lake MJ. Lack of impact moderating movement adaptation when soccer players perform game specific tasks on a third-generation artificial surface without a cushioning underlay. Sports Biomech 2019; 20:665-679. [PMID: 30896294 DOI: 10.1080/14763141.2019.1579365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objective of this study was to investigate how the inclusion of a cushioning underlay in a third-generation artificial turf (3G) affects player biomechanics during soccer-specific tasks. Twelve soccer players (9 males/3 females; 22.6 ± 2.3 y) participated in this study. Mechanical impact testing of each 3G surface; without (3G-NCU) and with cushioning underlay (3G-CU) were conducted. Impact force characteristics, joint kinematics and joint kinetics variables were calculated on each surface condition during a sprint 90° cut (90CUT), a sprint 180° cut (180CUT), a drop jump (DROP) and a sprint with quick deceleration (STOP). For all tasks, greater peak resultant force, peak knee extensor moment and peak ankle dorsi-flexion moment were found in 3G-NCU than 3G-CU (p < 0.05). During 90CUT and STOP, loading rates were higher in 3G-NCU than 3G-CU (p < 0.05). During 180CUT, higher hip, knee and ankle ranges of motion were found in 3G-NCU (p < 0.05). These findings showed that the inclusion of cushioning underlay in 3G reduces impact loading forces and lower limb joint loading in soccer players across game-specific tasks. Overall, players were not attempting to reduce higher lower limb impact loading associated with a lack of surface cushioning underlay.
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Affiliation(s)
- Gabriel Lozano-Berges
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain.,AgriFood Institute of Aragon, University of Zaragoza-CITA, Zaragoza, Spain
| | - Adam C Clansey
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - José A Casajús
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain.,AgriFood Institute of Aragon, University of Zaragoza-CITA, Zaragoza, Spain.,Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red Obesity and Nutrition Physiopathology, Madrid, Spain
| | - Mark J Lake
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Silva DCF, Macedo R, Montes AM, Santos R, Vilas-Boas JP, Sousa ASP. Does the cleat model interfere with ankle sprain risk factors in artificial grass? Clin Biomech (Bristol, Avon) 2019; 63:119-126. [PMID: 30889430 DOI: 10.1016/j.clinbiomech.2019.03.004] [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: 10/21/2017] [Revised: 12/27/2018] [Accepted: 03/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The cleats-surface interaction has been described as a possible risk factor for lateral ankle sprain. However, their interaction is still unknown in individuals with chronic ankle instability. The purpose of this study was to determine the influence of different soccer cleats on kinematic, kinetic and neuromuscular ankle variables on artificial grass in soccer players with and without chronic ankle instability. METHODS Eighty-two amateur athletes divided in two groups: 40 with chronic ankle instability and 42 without chronic ankle instability. All subjects performed 2 series of 6 consecutive crossover jumps with dominant foot, each one with one of the four models of cleats (Turf, Artificial grass, Hard and Firm ground). Cleat and group main effect and interactions of kinematic, kinetic and neuromuscular variables were analyzed according to factorial repeated measures ANOVA. FINDINGS No statistically significant cleat and group main effect and interactions were identified in kinematic, kinetic and electromyographic magnitude of the peroneal muscles. A main effect of the group was observed for peroneus longus activation time for TF model (p = 0.010). INTERPRETATION In soccer players, the contributor variables for ankle sprain were not influenced by the kind of soccer cleat used in a functional jump test on artificial grass. However, players with chronic ankle instability present delayed postural adjustments in peroneus longus with the TF model compared to players without chronic ankle instability.
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Affiliation(s)
- Diogo C F Silva
- Functional Sciences Department, School of Health, Polytechnic Institute of Porto, Center for Rehabilitation Research (CIR) - Center of Studies of Human Movement and Activity, R. Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
| | - Rui Macedo
- Physiotherapy Department, School of Health, Polytechnic Institute of Porto, Center for Rehabilitation Research (CIR) - Center of Studies of Human Movement and Activity, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
| | - António Mesquita Montes
- Physiotherapy Department, School of Health, Polytechnic Institute of Porto, Center for Rehabilitation Research (CIR) - Center of Studies of Human Movement and Activity, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Rubim Santos
- Physics Department, School of Health, Polytechnic Institute of Porto, Center for Rehabilitation Research (CIR) - Center of Studies of Human Movement and Activity, R. Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
| | - João Paulo Vilas-Boas
- Faculty of Sport, CIFI2D, Porto Biomechanics Laboratory (LABIOMEP), University of Porto, R. Dr. Plácido Costa, 91, 4200-450 Porto, Portugal.
| | - Andreia S P Sousa
- Physiotherapy Department, School of Health, Polytechnic Institute of Porto, Center for Rehabilitation Research (CIR) - Center of Studies of Human Movement and Activity, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal.
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Straw CM, Samson CO, Henry GM, Brown CN. Does variability within natural turfgrass sports fields influence ground-derived injuries? Eur J Sport Sci 2018; 18:893-902. [PMID: 29614918 DOI: 10.1080/17461391.2018.1457083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Natural turfgrass sports fields exhibit within-field variations due to climatic conditions, field construction, field management, and foot traffic patterns from field usage. Variations within a field could influence the playing surface predictability and require athletes to make abrupt or frequent adjustments that lead to increased ground-derived injury occurrence. This study introduces a new methodology aimed at evaluating the potential relationship between within-field variations of turfgrass sports field properties and ground-derived athlete injuries. Collegiate Club Sport athletes self-reported ground-derived injuries over two years. Soil moisture, turfgrass quality, surface hardness, and turfgrass shear strength were quantified from their two home fields. Hot spot analysis identified significantly high (hot spots) and low (cold spots) values within the fields. Injury locations were compared to hot spot maps each month. Binomial proportion tests determined if there were differences between observed injury proportions and expected proportions. Twenty-three ground-derived injuries were reported overall. The observed injury proportions occurring in turfgrass quality cold spots [0.52 (95% CI 0.29-0.76)] and soil moisture hot spots [0.43 (95% CI 0.22-0.66)] was significantly higher than expected [0.20 (p < .001) and 0.21 (p < .05), respectively]. Most injuries in significant areas of turfgrass quality, soil moisture, and surface hardness were along edges of hot and cold spots. These results suggest a potential relationship between within-field variations and ground-derived injuries, particularly in transition areas between non-significant and significant high and low values. Future larger-scale studies can incorporate the reported methodology to validate this relationship and implement strategies that reduce ground-derived injuries.
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Affiliation(s)
- Chase M Straw
- a Department of Crop and Soil Sciences , University of Georgia , Athens , GA , USA.,b Department of Horticultural Science , University of Minnesota , Saint Paul , MN , USA
| | | | - Gerald M Henry
- a Department of Crop and Soil Sciences , University of Georgia , Athens , GA , USA
| | - Cathleen N Brown
- c Department of Kinesiology , University of Georgia , Athens , GA , USA.,d College of Public Health and Human Sciences , Oregon State University , Corvallis , OR , USA
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Taylor JB, Nguyen AD, Griffin JR, Ford KR. Effects of turf and cleat footwear on plantar load distributions in adolescent American football players during resisted pushing. Sports Biomech 2017. [PMID: 28632050 DOI: 10.1080/14763141.2016.1271448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Metatarsal and midfoot injuries are common in American football. Footwear design may influence injury rates by altering plantar foot loading patterns in these regions. The purpose of this study was to determine the effect of cleat design on in-shoe plantar foot loading during a football-specific, resisted pushing task. Twenty competitive football players (age 14.7 ± 1.8 years, height 1.72 ± 0.10 m, and mass 71.8 ± 26.9 kg) completed three trials of pushing a weighted sled at maximal effort in a standard shoe (CLEAT) and artificial turf-specific shoe (TURF), with flexible in-shoe force measuring insoles. Repeated measures ANOVAs identified mean differences in maximum force and relative load under all regions of the foot. Results showed higher forces in the CLEAT under the medial (p < 0.001) and lateral (p = 0.004) midfoot, central (p = 0.007) and lateral (p < 0.001) forefoot, and lesser toes (p = 0.01), but lower forces in the hallux (p = 0.02) compared to the TURF shoe. Additionally, relative loading was higher in the CLEAT under the medial (p < 0.001) and lateral (p = 0.002) midfoot and lateral (p < 0.001) forefoot, but lower in the medial forefoot (p = 0.006) and hallux (p < 0.001) compared to the TURF shoe. The two shoes elicited distinct plantar loading profiles and may influence shoe selection decisions during injury prevention or rehabilitation practices.
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Affiliation(s)
- Jeffrey B Taylor
- a Department of Physical Therapy, Congdon School of Health Sciences , High Point , NC , USA
| | - Anh-Dung Nguyen
- b Department of Athletic Training, Congdon School of Health Sciences , High Point , NC , USA
| | | | - Kevin R Ford
- a Department of Physical Therapy, Congdon School of Health Sciences , High Point , NC , USA
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Silva DCF, Santos R, Vilas-Boas JP, Macedo R, Montes AM, Sousa ASP. Influence of Cleats-Surface Interaction on the Performance and Risk of Injury in Soccer: A Systematic Review. Appl Bionics Biomech 2017; 2017:1305479. [PMID: 28684897 PMCID: PMC5480019 DOI: 10.1155/2017/1305479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 03/22/2017] [Accepted: 04/11/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To review the influence of cleats-surface interaction on the performance and risk of injury in soccer athletes. DESIGN Systematic review. DATA SOURCES Scopus, Web of science, PubMed, and B-on. ELIGIBILITY CRITERIA Full experimental and original papers, written in English that studied the influence of soccer cleats on sports performance and injury risk in artificial or natural grass. RESULTS Twenty-three articles were included in this review: nine related to performance and fourteen to injury risk. On artificial grass, the soft ground model on dry and wet conditions and the turf model in wet conditions are related to worse performance. Compared to rounded studs, bladed ones improve performance during changes of directions in both natural and synthetic grass. Cleat models presenting better traction on the stance leg improve ball velocity while those presenting a homogeneous pressure across the foot promote better kicking accuracy. Bladed studs can be considered less secure by increasing plantar pressure on lateral border. The turf model decrease peak plantar pressure compared to other studded models. CONCLUSION The soft ground model provides lower performance especially on artificial grass, while the turf model provides a high protective effect in both fields.
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Affiliation(s)
- Diogo C. F. Silva
- Área Científica de Ciências Funcionais, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - Rubim Santos
- Área Científica de Física, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - João Paulo Vilas-Boas
- Faculdade de Desporto, CIFI2D, Universidade de Desporto e Laboratório de Biomecânica do Porto, Universidade do Porto, Porto, Portugal
| | - Rui Macedo
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - António Mesquita Montes
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Área Científica de Fisioterapia, Escola Superior de Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal
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Meyers MC. Incidence, Mechanisms, and Severity of Match-Related Collegiate Men's Soccer Injuries on FieldTurf and Natural Grass Surfaces: A 6-Year Prospective Study. Am J Sports Med 2017; 45:708-718. [PMID: 27872124 DOI: 10.1177/0363546516671715] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous injuries have been attributed to playing on artificial turf. More recently, newer generations of artificial turf have been developed to duplicate the playing characteristics of natural grass. Although artificial turf has been deemed safer than natural grass in some studies, few long-term studies have been conducted comparing match-related collegiate soccer injuries between the 2 playing surfaces. HYPOTHESIS Collegiate male soccer athletes do not experience any difference in the incidence, mechanisms, or severity of match-related injuries between FieldTurf and natural grass. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Male soccer athletes from 11 universities were evaluated over 6 seasons. Demographic features and predictors included player position, cleat design, player weight, turf age, and environmental factors. Outcomes of interest included injury incidence, injury category, time loss, injury mechanism and situation, type of injury, injury grade and anatomic location, injury severity, head and lower extremity trauma, and elective medical procedures. All match-related injuries were evaluated by the attending head athletic trainer and team physicians on site and subsequently in the physician's office when further follow-up and treatment were deemed necessary. In sum, 765 collegiate games were evaluated for match-related soccer injuries sustained on FieldTurf or natural grass during 6 seasons. RESULTS Overall, 380 team games (49.7%) were played on FieldTurf versus 385 team games (50.3%) played on natural grass. A total of 722 injuries were documented, with 268 (37.1%) occurring on FieldTurf and 454 (62.9%) on natural grass. Multivariate analysis per 10 team games indicated a significant playing surface effect: F2,720 = 7.260, P = .001. A significantly lower total injury incidence rate (IIR) of 7.1 (95% CI, 6.6-7.5) versus 11.8 (95% CI, 11.3-12.2; P < .0001) and lower rate of substantial injuries, 0.7 (95% CI, 0.5-1.0) versus 1.9 (95% CI, 1.5-2.3; P < .03), were documented on FieldTurf versus natural grass, respectively. Analyses also indicated significantly less trauma on FieldTurf when comparing injury category, time loss, player position, injury mechanism and situation, injuries under various environmental conditions, cleat design, turf age, anatomic location, and elective medical procedures. No significant difference (F11,710 = 0.822, P = .618) between surfaces by knee injury was observed, with the majority of knee injuries involving patellar tendinopathies/syndromes followed by medial collateral ligament injuries on both surfaces. CONCLUSION Although similarities existed between FieldTurf and natural grass during competitive match play, FieldTurf is, in many cases, safer than natural grass when comparing injuries in collegiate men's soccer. The findings of this study, however, may not be generalizable to other levels of competition or to other artificial surfaces.
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Affiliation(s)
- Michael C Meyers
- Human Performance Laboratory, Department of Sport Science and Physical Education, Idaho State University, Pocatello, Idaho, USA
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Silva DC, Santos R, Vilas-Boas JP, Macedo R, Montes A, Sousa AS. The influence of different soccer cleat type on kinetic, kinematic and neuromuscular ankle variables in artificial turf. FOOTWEAR SCIENCE 2016. [DOI: 10.1080/19424280.2016.1240246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Diogo C.F. Silva
- Área Científica de Ciências Funcionais, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - Rubim Santos
- Área Científica de Física, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - J. Paulo Vilas-Boas
- CIFI2D, Universidade de Desporto e Laboratório de Biomecênica do Porto, Universidade do Porto, Porto, Portugal
| | - Rui Macedo
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - António Montes
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - Andreia S.P. Sousa
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
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Weaver BT, Fitzsimons K, Braman J, Haut R. The role of shoe design on the prediction of free torque at the shoe-surface interface using pressure insole technology. Sports Biomech 2016; 15:370-84. [PMID: 27240101 DOI: 10.1080/14763141.2016.1174287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The goal of the current study was to expand on previous work to validate the use of pressure insole technology in conjunction with linear regression models to predict the free torque at the shoe-surface interface that is generated while wearing different athletic shoes. Three distinctly different shoe designs were utilised. The stiffness of each shoe was determined with a material's testing machine. Six participants wore each shoe that was fitted with an insole pressure measurement device and performed rotation trials on an embedded force plate. A pressure sensor mask was constructed from those sensors having a high linear correlation with free torque values. Linear regression models were developed to predict free torques from these pressure sensor data. The models were able to accurately predict their own free torque well (RMS error 3.72 ± 0.74 Nm), but not that of the other shoes (RMS error 10.43 ± 3.79 Nm). Models performing self-prediction were also able to measure differences in shoe stiffness. The results of the current study showed the need for participant-shoe specific linear regression models to insure high prediction accuracy of free torques from pressure sensor data during isolated internal and external rotations of the body with respect to a planted foot.
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Affiliation(s)
- Brian Thomas Weaver
- a Explico Engineering Co. , Novi , MI , USA.,b Orthopaedic Bioemchanics Laboratories , Michigan State University , East Lansing , MI , USA
| | - Kathleen Fitzsimons
- b Orthopaedic Bioemchanics Laboratories , Michigan State University , East Lansing , MI , USA
| | - Jerrod Braman
- b Orthopaedic Bioemchanics Laboratories , Michigan State University , East Lansing , MI , USA
| | - Roger Haut
- b Orthopaedic Bioemchanics Laboratories , Michigan State University , East Lansing , MI , USA
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Weaver BT, Braman JE, Haut RC. A Direct Method for Mapping the Center of Pressure Measured by an Insole Pressure Sensor System to the Shoe's Local Coordinate System. J Biomech Eng 2016; 138:061007. [PMID: 27109294 DOI: 10.1115/1.4033476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Indexed: 01/12/2023]
Abstract
A direct method to express the center of pressure (CoP) measured by an insole pressure sensor system (IPSS) into a known coordinate system measured by motion tracking equipment is presented. A custom probe was constructed with reflective markers to allow its tip to be precisely tracked with motion tracking equipment. This probe was utilized to activate individual sensors on an IPSS that was placed in a shoe fitted with reflective markers used to establish a local shoe coordinate system. When pressed onto the IPSS the location of the probe's tip was coincident with the CoP measured by the IPSS (IPSS-CoP). Two separate pushes (i.e., data points) were used to develop vectors in each respective coordinate system. Simple vector mathematics determined the rotational and translational components of the transformation matrix needed to express the IPSS-CoP into the local shoe coordinate system. Validation was performed by comparing IPSS-CoP with an embedded force plate measured CoP (FP-CoP) from data gathered during kinematic trials. Six male subjects stood on an embedded FP and performed anterior/posterior (AP) sway, internal rotation, and external rotation of the body relative to a firmly planted foot. The IPSS-CoP was highly correlated with the FP-CoP for all motions, root mean square errors (RMSRRs) were comparable to other research, and there were no statistical differences between the displacement of the IPSS-CoP and FP-CoP for both the AP and medial/lateral (ML) axes, respectively. The results demonstrated that this methodology could be utilized to determine the transformation variables need to express IPSS-CoP into a known coordinate system measured by motion tracking equipment and that these variables can be determined outside the laboratory anywhere motion tracking equipment is available.
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Kent R, Forman JL, Lessley D, Crandall J. The mechanics of American football cleats on natural grass and infill-type artificial playing surfaces with loads relevant to elite athletes. Sports Biomech 2015; 14:246-57. [DOI: 10.1080/14763141.2015.1052749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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32
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Thomson A, Whiteley R, Bleakley C. Higher shoe-surface interaction is associated with doubling of lower extremity injury risk in football codes: a systematic review and meta-analysis. Br J Sports Med 2015; 49:1245-52. [DOI: 10.1136/bjsports-2014-094478] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2015] [Indexed: 01/13/2023]
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33
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Kent R, Forman JL, Crandall J, Lessley D. The mechanical interactions between an American football cleat and playing surfacesin-situat loads and rates generated by elite athletes: a comparison of playing surfaces. Sports Biomech 2015; 14:1-17. [DOI: 10.1080/14763141.2015.1024277] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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34
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Lievers WB, Adamic PF. Incidence and Severity of Foot and Ankle Injuries in Men's Collegiate American Football. Orthop J Sports Med 2015; 3:2325967115581593. [PMID: 26674882 PMCID: PMC4622345 DOI: 10.1177/2325967115581593] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: American football is an extremely physical game with a much higher risk of injury than other sports. While many studies have reported the rate of injury for particular body regions or for individual injuries, very little information exists that compares the incidence or severity of particular injuries within a body region. Such information is critical for prioritizing preventative interventions. Purpose: To retrospectively analyze epidemiological data to identify the most common and most severe foot and ankle injuries in collegiate men’s football. Study Design: Descriptive epidemiology study. Methods: Injury data were obtained from the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) for all foot and ankle injuries during the 2004-2005 to 2008-2009 seasons. Injuries were analyzed in terms of incidence and using multiple measures of severity (time loss, surgeries, medical disqualifications). This frequency and severity information is summarized in tabular form as well as in a 4 × 4 quantitative injury risk assessment matrix (QIRAM). Results: The rate of foot and ankle injuries was 15 per 10,000 athletic exposures (AEs). Five injuries were found to be responsible for more than 80% of all foot and ankle injuries: lateral ankle ligament sprains, syndesmotic (high ankle) sprains, medial ankle ligament sprains, midfoot injuries, and first metatarsophalangeal joint injuries. Ankle dislocations were found to be the most severe in terms of median time loss (100 days), percentage of surgeries (83%), and percentage of medical disqualifications (94%), followed by metatarsal fractures (38 days, 36%, and 49%, respectively) and malleolus fractures (33 days, 41%, and 59%, respectively). Statistical analysis suggests that the 3 measures of severity are highly correlated (r > 0.94), thereby justifying the use of time loss as a suitable proxy for injury severity in the construction of the QIRAM. Conclusion: Based on the QIRAM analysis, the 5 highest risk injuries were identified based on both incidence and severity (ankle dislocations, syndesmotic sprains, lateral ankle ligament sprains, metatarsal fractures, and malleolus fractures). A better understanding of the relative incidence and severity of these injuries will allow coaches, trainers, and researchers to more effectively focus their preventative interventions.
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Affiliation(s)
- W Brent Lievers
- Bharti School of Engineering, Laurentian University, Sudbury, Ontario, Canada. ; Centre for Research in Occupational Safety and Health (CROSH), Laurentian University, Sudbury, Ontario, Canada
| | - Peter F Adamic
- Department of Mathematics and Computer Science, Laurentian University, Sudbury, Ontario, Canada
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Button KD, Braman JE, Davison MA, Wei F, Schaeffer MC, Haut RC. Rotational stiffness of American football shoes affects ankle biomechanics and injury severity. J Biomech Eng 2015; 137:061004. [PMID: 25751589 DOI: 10.1115/1.4029979] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Indexed: 12/26/2022]
Abstract
While previous studies have investigated the effect of shoe-surface interaction on injury risk, few studies have examined the effect of rotational stiffness of the shoe. The hypothesis of the current study was that ankles externally rotated to failure in shoes with low rotational stiffness would allow more talus eversion than those in shoes with a higher rotational stiffness, resulting in less severe injury. Twelve (six pairs) cadaver lower extremities were externally rotated to gross failure while positioned in 20 deg of pre-eversion and 20 deg of predorsiflexion by fixing the distal end of the foot, axially loading the proximal tibia, and internally rotating the tibia. One ankle in each pair was constrained by an American football shoe with a stiff upper, while the other was constrained by an American football shoe with a flexible upper. Experimental bone motions were input into specimen-specific computational models to examine levels of ligament elongation to help understand mechanisms of ankle joint failure. Ankles in flexible shoes allowed 6.7±2.4 deg of talus eversion during rotation, significantly greater than the 1.7±1.0 deg for ankles in stiff shoes (p = 0.01). The significantly greater eversion in flexible shoes was potentially due to a more natural response of the ankle during rotation, possibly affecting the injuries that were produced. All ankles failed by either medial ankle injury or syndesmotic injury, or a combination of both. Complex (more than one ligament or bone) injuries were noted in 4 of 6 ankles in stiff shoes and 1 of 6 ankles in flexible shoes. Ligament elongations from the computational model validated the experimental injury data. The current study suggested flexibility (or rotational stiffness) of the shoe may play an important role in both the severity of ankle injuries for athletes.
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Sánchez-Sánchez J, García-Unanue J, Jiménez-Reyes P, Gallardo A, Burillo P, Felipe JL, Gallardo L. Influence of the mechanical properties of third-generation artificial turf systems on soccer players' physiological and physical performance and their perceptions. PLoS One 2014; 9:e111368. [PMID: 25354188 PMCID: PMC4213020 DOI: 10.1371/journal.pone.0111368] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/01/2014] [Indexed: 01/13/2023] Open
Abstract
The aim of this research was to evaluate the influence of the mechanical properties of artificial turf systems on soccer players' performance. A battery of perceptive physiological and physical tests were developed on four different structural systems of artificial turf (System 1: Compacted gravel sub-base without elastic layer; System 2: Compacted gravel sub-base with elastic layer; System 3: Asphalt sub-base without elastic layer; System 4: Asphalt sub-base with elastic layer). The sample was composed of 18 soccer players (22.44±1.72 years) who typically train and compete on artificial turf. The artificial turf system with less rotational traction (S3) showed higher total time in the Repeated Sprint Ability test in comparison to the systems with intermediate values (49.46±1.75 s vs 47.55±1.82 s (S1) and 47.85±1.59 s (S2); p<0.001). The performance in jumping tests (countermovement jump and squat jump) and ball kicking to goal decreased after the RSA test in all surfaces assessed (p<0.05), since the artificial turf system did not affect performance deterioration (p>0.05). The physiological load was similar in all four artificial turf systems. However, players felt more comfortable on the harder and more rigid system (S4; visual analogue scale = 70.83±14.28) than on the softer artificial turf system (S2; visual analogue scale = 54.24±19.63). The lineal regression analysis revealed a significant influence of the mechanical properties of the surface of 16.5%, 15.8% and 7.1% on the mean time of the sprint, the best sprint time and the maximum mean speed in the RSA test respectively. Results suggest a mechanical heterogeneity between the systems of artificial turf which generate differences in the physical performance and in the soccer players' perceptions.
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Affiliation(s)
- Javier Sánchez-Sánchez
- School of Sport Sciences, UCAM, Universidad Católica San Antonio, Murcia, Spain
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
- * E-mail:
| | | | - Pedro Jiménez-Reyes
- School of Sport Sciences, UCAM, Universidad Católica San Antonio, Murcia, Spain
| | - Ana Gallardo
- School of Sport Sciences, UCAM, Universidad Católica San Antonio, Murcia, Spain
| | - Pablo Burillo
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
- Sport Sciences Institute, Camilo José Cela University, Villafranca del Castillo, Madrid, Spain
| | - José Luis Felipe
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
- School of Sport Sciences, European University, Villaviciosa de Odón, Madrid, Spain
| | - Leonor Gallardo
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
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Brock E, Zhang S, Milner C, Liu X, Brosnan JT, Sorochan JC. Effects of two football stud configurations on biomechanical characteristics of single-leg landing and cutting movements on infilled synthetic turf. Sports Biomech 2014; 13:362-79. [PMID: 25301011 DOI: 10.1080/14763141.2014.965727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Multiple playing surfaces and footwear used in American football warrant a better understanding of relationship between different combinations of turf and footwear. The purpose of this study was to examine effects of shoe and stud types on ground reaction force (GRF) and ankle and knee kinematics of a 180° cut and a single-leg 90° land-cut on synthetic turf. Fourteen recreational football players performed five trials of the 180° cut and 90° land-cut in three shoe conditions: non-studded running shoe, and football shoe with natural and synthetic turf studs. Variables were analyzed with a 3 × 2 (shoe × movement) repeated measures analysis of variance (p < 0.05). Peak vertical GRF (p < 0.001) and loading rate (p < 0.001) were greater during 90° land-cut than 180° cut. For 180° cut, natural turf studs produced smaller peak medial GRFs compared to synthetic turf studs and non-studded shoe (p = 0.012). For land-cut, peak eversion velocity was reduced in running shoes compared to natural (p = 0.016) and synthetic (p = 0.002) turf studs. The 90° land-cut movement resulted in greater peak vertical GRF and loading rate compared to the 180° cut. Overall, increased GRFs in the 90° land-cut movement may increase the chance of injury.
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Affiliation(s)
- Elizabeth Brock
- a Department of Kinesiology, Recreation, and Sport Studies , The University of Tennessee , Knoxville , TN , USA
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38
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Ballal MS, Usuelli FG, Montrasio UA, Molloy A, La Barbera L, Villa T, Banfi G. Rotational and peak torque stiffness of rugby shoes. Foot (Edinb) 2014; 24:107-10. [PMID: 25095720 DOI: 10.1016/j.foot.2014.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Revised: 06/25/2014] [Accepted: 06/27/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Sports people always strive to avoid injury. Sports shoe designs in many sports have been shown to affect traction and injury rates. The aim of this study is to demonstrate the differing stiffness and torque in rugby boots that are designed for the same effect. METHODS Five different types of rugby shoes commonly worn by scrum forwards were laboratory tested for rotational stiffness and peak torque on a natural playing surface generating force patterns that would be consistent with a rugby scrum. RESULTS The overall internal rotation peak torque was 57.75±6.26 Nm while that of external rotation was 56.55±4.36 Nm. The Peak internal and external rotational stiffness were 0.696±0.1 and 0.708±0.06 Nm/deg respectively. Our results, when compared to rotational stiffness and peak torques of football shoes published in the literature, show that shoes worn by rugby players exert higher rotational and peak torque stiffness compared to football shoes when tested on the same natural surfaces. There was significant difference between the tested rugby shoes brands. CONCLUSION In our opinion, to maximize potential performance and lower the potential of non-contact injury, care should be taken in choosing boots with stiffness appropriate to the players main playing role.
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Affiliation(s)
- Moez S Ballal
- University Hospital Aintree, Longmoor Lane, Liverpool L7 9AL, UK.
| | | | | | - Andy Molloy
- University Hospital Aintree, Longmoor Lane, Liverpool L7 9AL, UK
| | - Luigi La Barbera
- Laboratory of Biological Structure, Mechanics Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano and IRCCS Galeazzi, Italy
| | - Tomaso Villa
- Laboratory of Biological Structure, Mechanics Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano and IRCCS Galeazzi, Italy
| | - Giuseppe Banfi
- CTS Piede e Caviglia, RCCS Galeazzi, 4 Zip 20100 Milan, Italy
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Poulos CCN, Gallucci J, Gage WH, Baker J, Buitrago S, Macpherson AK. The perceptions of professional soccer players on the risk of injury from competition and training on natural grass and 3rd generation artificial turf. BMC Sports Sci Med Rehabil 2014; 6:11. [PMID: 24581229 PMCID: PMC4108054 DOI: 10.1186/2052-1847-6-11] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 02/14/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND The purpose of this study was to describe professional soccer players' perceptions towards injuries, physical recovery and the effect of surface related factors on injury resulting from soccer participation on 3rd generation artificial turf (FT) compared to natural grass (NG). METHODS Information was collected through a questionnaire that was completed by 99 professional soccer players from 6 teams competing in Major League Soccer (MLS) during the 2011 season. RESULTS The majority (93% and 95%) of the players reported that playing surface type and quality influenced the risk of sustaining an injury. Players believed that playing and training on FT increased the risk of sustaining a non-contact injury as opposed to a contact injury. The players identified three surface related risk factors on FT, which they related to injuries and greater recovery times: 1) Greater surface stiffness 2) Greater surface friction 3) Larger metabolic cost to playing on artificial grounds. Overall, 94% of the players chose FT as the surface most likely to increase the risk of sustaining an injury. CONCLUSIONS Players believe that the risk of injury differs according to surface type, and that FT is associated with an increased risk of non-contact injury. Future studies should be designed prospectively to systematically track the perceptions of groups of professional players training and competing on FT and NG.
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Affiliation(s)
- Constantine CN Poulos
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - John Gallucci
- JAG Physical Therapy, New Jersey, USA
- Major League Soccer, New York City, USA
| | - William H Gage
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Joseph Baker
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Sebastian Buitrago
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
| | - Alison K Macpherson
- School of Kinesiology and Health Science, York University, 4700 Keele St, M3J 1P3 Toronto, Canada
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Schrier NM, Wannop JW, Lewinson RT, Worobets J, Stefanyshyn D. Shoe traction and surface compliance affect performance of soccer-related movements. FOOTWEAR SCIENCE 2014. [DOI: 10.1080/19424280.2014.886302] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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WANNOP JOHNW, LUO GENG, STEFANYSHYN DARRENJ. Footwear Traction and Lower Extremity Noncontact Injury. Med Sci Sports Exerc 2013; 45:2137-43. [DOI: 10.1249/mss.0b013e318299ac56] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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42
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Meyers MC. Incidence, mechanisms, and severity of match-related collegiate women's soccer injuries on FieldTurf and natural grass surfaces: a 5-year prospective study. Am J Sports Med 2013; 41:2409-20. [PMID: 23942283 DOI: 10.1177/0363546513498994] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous injuries have been attributed to playing on artificial turf. Over the past 2 decades, however, newer generations of synthetic turf have been developed to duplicate the playing characteristics of natural grass. Although synthetic turf has been determined to be safer than natural grass in some studies, few long-term studies have been conducted comparing match-related collegiate soccer injuries between the 2 playing surfaces. HYPOTHESIS Collegiate female soccer athletes do not experience any difference in the incidence, mechanisms, and severity of match-related injuries on FieldTurf and on natural grass. STUDY DESIGN Cohort study: Level of evidence, 2. METHODS Female soccer athletes from 13 universities were evaluated over 5 competitive seasons for injury incidence, injury category, time of injury, injury time loss, player position, injury mechanism and situation, primary type of injury, injury grade and anatomic location, field location at the time of injury, injury severity, head and lower extremity trauma, cleat design, turf age, and environmental factors. In sum, 797 collegiate games were evaluated for match-related soccer injuries sustained on FieldTurf or natural grass during 5 seasons. RESULTS Overall, 355 team games (44.5%) were played on FieldTurf versus 442 team games (55.5%) on natural grass. A total of 693 injuries were documented, with 272 (39.2%) occurring during play on FieldTurf and 421 (60.8%) on natural grass. Multivariate analysis per 10 team games indicated a significant playing surface effect: F₂,₆₉₀ = 6.435, P = .002, n-β = .904. A significantly lower total injury incidence rate (IIR) of 7.7 (95% confidence interval [CI], 7.2-8.1) versus 9.5 (95% CI, 9.3-9.7) (P = .0001) and lower rate of substantial injuries, 0.7 (95% CI, 0.5-1.0) versus 1.5 (95% CI, 1.2-1.9) (P = .001), were documented on FieldTurf versus natural grass, respectively. Analyses also indicated significantly less trauma on FieldTurf when comparing injury time loss, player position, injury grade, injuries under various field conditions and temperatures, cleat design, and turf age. CONCLUSION Although similarities existed between FieldTurf and natural grass during competitive match play, FieldTurf is a practical alternative when comparing injuries in collegiate women's soccer. It must be reiterated that the findings of this study may be generalizable to only collegiate competition and this specific artificial surface.
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Affiliation(s)
- Michael C Meyers
- Michael C. Meyers, FACSM, Department of Sport Science and Physical Education, Idaho State University, 921 South 8th Avenue, Stop 8105, Pocatello, ID 83209-8105.
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Galbusera F, Tornese DZ, Anasetti F, Bersini S, Volpi P, Barbera LL, Villa T. Does soccer cleat design influence the rotational interaction with the playing surface? Sports Biomech 2013; 12:293-301. [DOI: 10.1080/14763141.2013.769277] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Epidemiology of syndesmosis injuries in intercollegiate football: incidence and risk factors from National Collegiate Athletic Association injury surveillance system data from 2004-2005 to 2008-2009. Clin J Sport Med 2013; 23:278-82. [PMID: 23339895 DOI: 10.1097/jsm.0b013e31827ee829] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe the incidence and risk factors for high ankle sprains (ie, syndesmosis injuries) among National Collegiate Athletic Association (NCAA) football players. DESIGN Descriptive epidemiologic study. SETTING Data were examined from the NCAA's Injury Surveillance System (ISS) for 5 football seasons (from 2004-2005 to 2008-2009). PARTICIPANTS All NCAA men's football programs participating in the ISS. ASSESSMENT OF RISK FACTORS No additional risk factors were introduced as a result of this analysis. MAIN OUTCOME MEASURES For partial and complete syndesmosis injuries, outcome measures included incidence, time lost from participation, and requirement for surgical repair. RESULTS The overall incidence of high ankle sprains in NCAA football players was 0.24 per 1000 athlete exposures, accounting for 24.6% of all ankle sprains. Athletes were nearly 14 times more likely to sustain the injury during games compared with practice; complete syndesmosis injuries resulted in significantly greater time lost compared with partial injuries (31.3 vs 15.8 days). Less than 3% of syndesmosis injuries required surgical intervention. There was a significantly higher injury incidence on artificial surfaces compared with natural grass. The majority of injuries (75.2%) occurred during contact with another player. CONCLUSIONS Our data suggest a significantly higher incidence of syndesmosis injuries during games, during running plays, and to running backs and interior defensive linemen. The wide range in time lost from participation for complete syndesmosis injuries underscores the need for improved understanding of injury mechanism and classification of injury severity such that prevention, safe return to play protocols, and outcomes can be further improved.
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A Meta-Analysis of Soccer Injuries on Artificial Turf and Natural Grass. ACTA ACUST UNITED AC 2013; 2013:380523. [PMID: 26464877 PMCID: PMC4590909 DOI: 10.1155/2013/380523] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 06/04/2013] [Indexed: 01/13/2023]
Abstract
The goal of this investigation was to determine if playing or training on third-generation artificial turf (AT) surfaces increases the incidence rate of injuries compared to natural grass (NG) surfaces. This was accomplished by a meta-analysis performed on previously published research. Eight studies met the criteria of competitive soccer players, participation on both surfaces, and presentation of both exposure time and injury occurrence. Exposure time and injury incidence values were used to generate injury rate ratios (IRRs, AT/NG) for all injuries as well as specific injuries. Subgroup analyses were also performed by condition (match or training), gender, and age (youth or adult). The overall IRR was 0.86 (P < 0.05) suggesting a lower injury risk on AT than NG. However, there was considerable heterogeneity between studies. Analyses of individual injuries and subgroups found that in many cases IRR values were significantly less than 1.0. In no case was the IRR significantly greater than 1.0. Based on this, it appears that the risk of sustaining an injury on AT under some conditions might be lowered compared to NG. However, until more is known about how issues such as altered playing styles affect injury incidence, it is difficult to make firm conclusions regarding the influence of AT on player safety.
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Iacovelli JN, Yang J, Thomas G, Wu H, Schiltz T, Foster DT. The effect of field condition and shoe type on lower extremity injuries in American Football. Br J Sports Med 2013; 47:789-93. [DOI: 10.1136/bjsports-2012-092113] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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O'Connor AM, James IT. Association of lower limb injury with boot cleat design and playing surface in elite soccer. Foot Ankle Clin 2013; 18:369-80. [PMID: 23707183 DOI: 10.1016/j.fcl.2013.02.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Reducing external injury risk factors associated with the boot-surface interaction is important in reducing the incidence and severity of foot and ankle injury. A review of prospective football (soccer) injury epidemiology studies determined that the incidence of noncontact ankle sprain injury is relatively high. Research on the impact of cleat shape and configuration and boot design on the boot-surface interaction is providing new understanding of the impact on player biomechanics and injury risk but is not keeping pace with commercial advances in boot design and innovation in natural and synthetic turf surface technology.
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Dragoo JL, Braun HJ, Harris AHS. The effect of playing surface on the incidence of ACL injuries in National Collegiate Athletic Association American Football. Knee 2013; 20:191-5. [PMID: 22920310 DOI: 10.1016/j.knee.2012.07.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Revised: 06/14/2012] [Accepted: 07/08/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Artificial playing surfaces are widely used for American football practice and competition and anterior cruciate ligament (ACL) injuries are common. This study analyzed the National Collegiate Athletic Association (NCAA) Injury Surveillance System (ISS) men's football ACL injury database from 2004-2005 through 2008-2009 to determine the effect of playing surface on ACL injury in NCAA football athletes. METHODS This database was reviewed from the 2004-2005 through 2008-2009 seasons using the specific injury code, "Anterior cruciate ligament (ACL) complete tear." The injury rate was computed for competition and practice exposures. Ninety-five percent confidence intervals were calculated using assumptions of a Poisson distribution. Pair-wise, two-sample tests of equality of proportions with a continuity correction were used to estimate the associations of risk factors. RESULTS There was an incidence rate of 1.73 ACL injuries per 10,000 athlete-exposures (A-Es) (95% CI 1.47-2.0) on artificial playing surfaces compared with a rate of 1.24 per 10,000 A-Es (1.05-1.45, p<0.001) on natural grass. The rate of ACL injury on artificial surfaces is 1.39 times higher than the injury rate on grass surfaces. Non-contact injuries occurred more frequently on artificial turf surfaces (44.29%) than on natural grass (36.12%). CONCLUSIONS NCAA football players experience a greater number of ACL injuries when playing on artificial surfaces.
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Affiliation(s)
- Jason L Dragoo
- Department of Orthopaedic Surgery, Stanford University, Palo Alto, CA 94063-6342, USA.
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Zanetti EM, Bignardi C, Franceschini G, Audenino AL. Amateur football pitches: Mechanical properties of the natural ground and of different artificial turf infills and their biomechanical implications. J Sports Sci 2013; 31:767-78. [DOI: 10.1080/02640414.2012.750005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Hughes MG, Birdsey L, Meyers R, Newcombe D, Oliver JL, Smith PM, Stembridge M, Stone K, Kerwin DG. Effects of playing surface on physiological responses and performance variables in a controlled football simulation. J Sports Sci 2013; 31:878-86. [DOI: 10.1080/02640414.2012.757340] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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