Perceptions of football players regarding injury risk factors and prevention strategies

Development and validation of an interview guide for examining the effects of sports careers on the quality of life of retired Portuguese football players

Introduction

Considering the importance of assessing the impacts resulting from a sport career, this study aimed at developing and validating a semi-structure interview guide suitable for quantifying the sociodemographic and epidemiological profile of former professional football players.

Methods

Based on the theoretical frameworks and several methodological procedures, an interview guide was developed, consisting of 3 areas of conceptual organization (A1. Biographical data; A2. Professional Career; and A3. Post-Career Transition) and 8 data collection categories (C1. Personal data; C2. Professional data; C3. Sociodemographic background; C4. Epidemiological pathway; C5. Moment of career retirement (career transition); C6. Post-career sociodemographic pathway; C7. Post-career epidemiological pathway; and C8. Perceptions of post-career planning). Thus, in procedural terms, four stages were considered for the construction and validation of the interview guide, namely the Ad hoc construction of the interview guide (i), the review of the in-terview guide by a panel of experts (ii), definition of procedures and protocol for the application of the interview (iii), and the application of the pilot study for the face validation of the interview guide (iv). The sample consisted of two former Portuguese professional players.

Results and discussion

To analyze and discuss the data, a content analysis was carried out on all the answers given to each question in the script by the interviewees. From them, matrices were created with the response references to each subcategory. In this way, it was possible to analyse the type of answers given by the interviewees and relate them to the theoretical perspectives of the topic being investigated. The results showed that the interview guide for the study of the impacts of the sports careers on the quality of life of Portuguese former football players shows reliability for the collection of qualitative and quantitative information from the respective content analysis. The use of the interview guide characterizes the path of former player, providing information and knowledge on the sociodemographic and epidemiological impact factors resulting from their post-career.

Healthcare providers have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes

BACKGROUND

Being up-to-date with evidence-based knowledge of lower limb sports injuries is essential for Healthcare professionals (HCPs).

PURPOSE

To assess whether HCPs possess up-to-date knowledge of lower limb sports injuries by comparing their knowledge to that of athletes.

METHODS

With an expert panel, we developed an online quiz of 10 multiple-choice questions on various topics related to lower-limb sports injuries. Maximal score was 100. We used social media to invite HCPs (5 groups: Physiotherapists, Chiropractors, Medical Doctors, Trainers, and Other therapists) and athletes of all levels (amateur, semi-pro, and pro) to participate. We drafted the questions according to conclusions from the latest systematic reviews and meta-analyses.

RESULTS

1526 participants completed the study. Final quiz scores ranged from zero (n = 28, 1.8%) to 100 (n = 2, 0.1%) and were distributed normally with a mean score of 45.4 ± 20.6. None of the 6 groups' means surpassed the set threshold of 60 points. Multiple linear regressions of covariates indicated that age, gender, engagement in physical activity, learning hours per week, reading scientific journals, reading popular magazines and blogs, trainers, and other therapists' groups explained 19% of the variances (-5.914<β < 15.082, 0.000<p < 0.038).

CONCLUSIONS

HCPs have insufficient up-to-date knowledge of lower limb sports injuries, and their knowledge is similar to that of athletes of all levels. HCPs probably do not possess the proper tools to assess scientific literature Academic and sports medicine societies should look into ways to improve the scientific knowledge integration of HCPs.

The perception of injury risk and prevention among football players: A systematic review

Football is associated with a certain risk of injury, leading to short- and long-term health consequences. However, the perception of football players about injury risk and prevention strategies is poorly documented. The present article reviewed the literature about perceptions, beliefs, attitudes and knowledge toward injury risk and prevention strategies in football players. An electronic search was performed in PubMed, Scopus, Web of Science, and APA PsychINFO until July 2022. Studies were eligible if they included the perceptions, beliefs, attitudes, and knowledge about injury risk and prevention in football players from any competitive level. The risk of bias was assessed in included studies using the Joanna Briggs Institute critical appraisal checklist. A total of 14 studies were included. Most football players agreed that their risk of injury is high and prevention strategies are important, however they do not intend to use some of these strategies. The most frequent perceived injury risk factors were low muscle strength, lack of physical fitness, fatigue, excessive training and type and condition of surfaces. The most frequent perceived injury prevention factors were warm-up, workload monitoring and strength and conditioning training. It is essential to acknowledge perceived injury risk factors, as well as a better understanding of how coaching and medical departments' perceptions match with players' perceptions, and a modification in the perceptions of the several stakeholders at different levels of action.

Facilitators and barriers for implementation of a load management intervention in football

Background

In a recent randomised controlled trial, we found that a commonly used training load management approach was not effective in preventing injuries and illnesses in Norwegian elite youth footballers.

Aim

To investigate players’ and coaches’ barriers and facilitators to a load management approach to prevent injuries and illnesses and their attitudes and beliefs of load management and injuries and illnesses in general.

Methods

We asked players and coaches about their views on injury risk in football, the benefits and limitations of load management in general and implementation of load management in football. The questionnaires used were based on similar studies using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.

Results

We recorded answers from 250 players and 17 coaches. Most players (88%) reported that scientific evidence showing improved performance from the intervention measures is a key facilitator to completing the intervention. Similarly, coaches reported that the most important facilitator was scientific evidence that the preventive measures were effective (100%). Players reported that the coach’s attitude to preventive measures was important (86%), and similarly, 88% of coaches reported that the player’s attitude was important.

Conclusions

By having a mutual positive attitude towards the intervention, players and coaches can positively contribute to each other’s motivation and compliance. Both players and coaches reported scientific evidence for load management having injury-preventive and performance-enhancing effect and being time efficient as important facilitators.

Trial registration number

Trial registration number

Injury risk profile of amateur Irish women soccer players and players' opinions on risk factors and prevention strategies

OBJECTIVE

To explore injury profile, opinions on risk factors and injury prevention, among Irish amateur women soccer players.

DESIGN

A cross-sectional online survey.

SETTING

Irish amateur winter league.

PARTICIPANTS

Active players ≤18 years of age.

MAIN OUTCOMES

Differences were found between injured and uninjured groups, and risk factors that significantly predict soccer injury were identified.

RESULTS

168 injuries were reported by 83 respondents during the winter season. An increased prevalence of competition anxiety was observed in (53.8%:n = 85 of respondents) compared to other risk factors. There was a negative association between injuries and players' general health state (OR = 0.820, 95% CI 0.7-0.9, p = 0.007). Players' knowledge about some risk factors including playing position, joint hypermobility, and playing during menses contradicts current evidence. 50%; n = 67 of the respondents had not received any education on injury risk or prevention.

CONCLUSION

This study identified that Irish amateur women soccer players that responded have different characteristics, prevalence of risk factors and injury profiles to women players from different levels and countries. The findings suggest that some players may not be aware of the existing evidence base pertaining to common risk factors for injury. Further research is required to confirm the findings and explore the implementation of injury prevention strategies.

Comparison of multidirectional jump performance and lower limb passive range of motion profile between soccer and basketball young players

This study was performed aimed at comparing multidirectional bilateral and unilateral jump performance and passive range of motion (ROM) of lower limbs between soccer and basketball young players and evaluating associations between inter-limb ROM asymmetry and bilateral jump performance. A total of 67 young male athletes participated in this study, who were classified as soccer (n = 40; 15.55 ± 1.5 y; 1.76 ± 0.12 m; 58.15 ± 10.82 kg; 19.84 ± 2.98 kg·m2) and basketball (n = 27; 15.7 ± 1.66 y; 1.76 ± 0.12 m; 62.33 ± 16.57 kg; 19.84 ± 2.98 kg·m2) players. Participants were asked to perform bilateral and unilateral multidirectional jumps, and passive ROM of hip (flexion, extension and abduction), knee (flexion) and ankle (dorsiflexion) joints was also assessed. Significant between-group differences were observed for hip extension with flexed knee ROM in dominant (soccer: 142.43 ± 7.74°; basketball: 148.63 ± 8.10°) and non-dominant (soccer: 144.38 ± 8.36°; basketball: 148.63 ± 6.45°) legs; hip flexion with flexed knee ROM in dominant (soccer: 13.26 ± 4.71°; basketball: 9.96 ± 3.42°) and non-dominant (soccer: 12.86 ± 4.55°; basketball: 9.70 ± 3.62°) legs; and for the ratio of hip abduction (soccer: 1.02 ± 0.08; basketball: 0.97 ± 0.11). However, no significant between-group differences were observed for bilateral and unilateral jump capacity, or for inter-limb asymmetries (dominant vs. non-dominant leg). Finally, no associations were observed between ROM ratio (dominant vs. non-dominant leg) and bilateral jump performance. These findings lead to the suggestion that differences on passive ROM values in young male athletes may be sport-specific. Additionally, there seems to be need for the implementation of training strategies specifically aimed at improving bilateral or unilateral jump ability, or at diminishing inter limb passive ROM differences in order to improve multidirectional jump performance for neither soccer nor basketball youth male players.

Étude sur la perception des blessures par les athlètes et leurs influences sur la réalisation de mesures de prévention des blessures en athlétisme

Introduction

Mieux comprendre les conséquences psychologiques d’une blessure et l’influence de celle-ci sur les modifications de comportement et la réalisation d’un programme de prévention semble pertinent pour la prise en charge thérapeutique et dans une optique de prévention. Ainsi, l’objectif de cette présente étude a donc été (1) d’analyser la perception des blessures par les athlètes, et (2) d’analyser l’influence de celles-ci sur la réalisation de mesures de prévention.

Méthodes

Nous avons conduit une étude observationnelle quantitative rétrospective nationale de recueil du ressenti des athlètes de compétition licenciés à la Fédération française d’athlétisme vis-à-vis de leurs antécédents de blessures, leur perception de la blessure et les programmes de prévention des blessures, par un questionnaire informatique envoyé aux athlètes au printemps 2020.

Résultats

Au total, 7712 réponses d’athlètes ont été incluses dans cette analyse, incluant 37 % de femmes et 63 % d’hommes, âgés de 37,9 ± 14,8 ans (de 18 à 87 ans), allant de niveau international à départemental, couvrant toutes les disciplines de l’athlétisme. Soixante-dix pour cent des athlètes n’avaient jamais réalisé de programme de prévention des blessures durant leur carrière, alors que 30 % estimaient en avoir suivi un de manière partielle ou totale. Quatre-vingt dix pour cent des athlètes avaient eu au moins une blessure depuis le début de leur pratique. Les sportifs rapportaient qu’une blessure engendrait une tristesse, une frustration, un dégoût et une préoccupation de se refaire mal au même endroit. Ils étaient conscients qu’une mauvaise prise en charge pouvait entraîner une récidive ou une nouvelle blessure. Les athlètes avec antécédent de blessure réalisaient significativement plus un programme de prévention des lésions que ceux ne s’étant jamais blessés. Ceux s’étant déjà blessés croyaient en l’efficacité des programmes de prévention, davantage que ceux sans antécédent de blessure. En revanche, il n’y avait pas de différence de perception de l’intérêt de mesures préventives telles que l’hygiène de vie, l’écoute de son corps, de ses douleurs et de sa fatigue entre les athlètes avec et sans antécédent de blessures.

Conclusion

Une blessure peut entraîner des conséquences psychologiques non négligeables pour l’athlète. Ses répercussions sont importantes à prendre en compte dans la prise en charge globale des lésions.

Comparison of 10 vs. 20 min neuromuscular training for the prevention of lower extremity injuries in male youth football: A cluster randomised controlled trial

The aim of this study was to compare the effects of 20 min neuromuscular training with a programme of 10 min in youth football players. 342 (15.4 ± 1.7 years) male football players from 18 teams were included, and cluster-randomized by team into two intervention groups. Both groups performed an injury prevention programme twice a week over five months using the same exercises but a different duration. The first intervention group (INT10, n = 175) performed the programme for 10 min, the second intervention group (INT20, n = 167) for 20 min. Primary outcomes were lower extremity (LE) injuries. Secondary outcomes were injury type, severity, mechanism and compliance to the intervention. 13 teams with 185 players were included for final analysis. No significant group difference was found between INT10 (6.37 per 1000 h) and INT20 (7.20 per 1000 h) for the incidence rate ratio of the lower extremities (IRR = 1.03, 95% confidence interval 0.59, 1.79), nor for the distribution of injury location, type, severity or mechanism. The results show that performing preventive exercises for 10 min is no less effective than 20 min in youth football players. Shorter training sessions can, therefore, be effectively used for injury prevention.

TRIAL REGISTRATION

DRKS00015282.

Perceptions of the technical staff of professional teams regarding injury prevention in Spanish national futsal leagues: a cross-sectional study

Futsal is a sport with increasing popularity and level of performance, both in male and female categories. Also, there are several injuries along a season, so it is needed to know how to reduce this burden. The purpose of this study was to describe the perceptions of technical staff on injury risk factors, risk testing and preventive measures, and the strategies used by them within professional male and female futsal teams. A cross-sectional study was designed during the 2017–2018 season. A total of 32 futsal teams involved in male and female Spanish national futsal leagues completed, through an online survey platform, a questionnaire about injury risk factors, risk testing and preventive measures. Findings showed that: (a) most teams reported enough human resources, but insufficient material and time resources, (b) the main risk factors detected were previous injuries, strength deficits and dehydration, (c) functional movement patterns, flexibility tests and self-report questionnaires were the most applied tests for detecting injury risks in their players and (d) most of the main preventive measures used by technical staff matched with the best valued by them. Technical staff defined properly the main risk factors in futsal performance, as well as they applied preventive strategies with scientific support. The information provided in this research could be of interest for sport scientists and technical staff when designing more accurate and efficient injury prevention programs in futsal.

Can we improve coaches' injury prevention views and implementation practices in the community female Gaelic sport of camogie?

Objectives

To evaluate the effect of a nationwide coach education workshop on the attitudes towards, willingness and perceived ability of camogie coaches to implement a Camogie Injury Prevention Programme (CIPP) and their implementation of this programme 4 weeks after the workshop.

Methods

Coaches (n=98) from all four provinces in Ireland were recruited and completed a questionnaire prior to and immediately following a developed workshop on the CIPP. Four weeks later 40 of the 98 coaches completed a follow-up questionnaire. Descriptive statistics were completed and a mixed between-within analysis of variance was conducted to examine the differences in willingness and perceived ability to conduct the CIPP over time and between genders. Non-parametric tests examined the differences in attitude scores. The implementation rate of the programme 4 weeks following the workshop was also assessed.

Results

Just 13.4% of coaches had previously heard of the CIPP. Significant improvements in attitudes towards, willingness and perceived ability to conduct the CIPP was noted (p<0.001) post-workshop. Ninety-one per cent of coaches reported that implementing the CIPP in a phased approach with their teams would be beneficial. The camogie coaches primarily viewed the CIPP content favourably, finding the exercises important, relevant and mostly enjoyable. However, some coaches reported that the Nordic hamstring curl is too challenging for players to complete (immediately following workshop: 28.7%; 4 weeks later: 53.3%). Four weeks after the workshop, 72.5% of coaches who responded were implementing the CIPP with their teams in the community.

Conclusions

Due to the success of the education workshop, the Camogie Association should incorporate this injury prevention workshop into all mandatory camogie coaching education courses.

Injury Prevention in Amateur Soccer: A Nation-Wide Study on Implementation and Associations with Injury Incidence

Prevention programmes can reduce injury risk in amateur soccer. Hence, we examined the implementation of injury prevention in the real-world context of Swiss amateur soccer. In 2004 (n = 1029), 2008 (n = 705) and 2015 (n = 1008), a representative sample of Swiss amateur soccer coaches was interviewed by telephone about the frequency of injuries in their teams, the implementation of preventive measures and the use of injury prevention programmes. In the 2015 survey, 86.1% of amateur coaches stated that injury prevention is important and 85.3% of amateur coaches reported that they would implement some kind of preventive measures. The proportion of teams which performed a prevention programme according to minimal standards remained unchanged between 2008 (21.7%) and 2015 (21.9%), although a second prevention programme was made available in 2011. Only 8.6% of the 30+/40+ league teams, which are composed as a function of age, implemented a programme. Overall, the level of implementation of prevention programmes in this real-world context is still unsatisfactory. Offering an additional programme did not lead to a higher willingness to implement such programmes among the coaches. Concerted efforts are needed to remove barriers that hinder the use of such programmes, particularly among coaches of 30+/40+ league teams.

Winning at all costs: a review of risk-taking behaviour and sporting injury from an occupational safety and health perspective

Professional athletes involved in high-performance sport are at a high injury risk, which may lead to long-term health consequences. Professional athletes often expose themselves to risky behaviours, resulting in a higher acceptance level of occupational risk compared to other occupations. To date, many studies have focused on elite athletes' specific injury prevention techniques. The objective of this narrative review is to (1) summarise elite athletes' attitudes towards important occupational safety and health (OSH) practices, including injury reporting, medicine usage and personal protective equipment (PPE) usage, and (2) explore factors that may influence elite athletes' injury awareness. If injury awareness were given a similar weighting in elite sports as in any other highly physical occupation, the potential benefits to elite athletes and their long-term health could be highly significant. This review identifies that most elite athletes are not aware that sporting injuries are occupational injuries requiring behaviours determined by OSH rules. All the 39 studies identified met the moderate methodological quality criteria according to the Mixed Methods Appraisal Tool (MMAT). The factors impeding athletes' injury awareness from achieving occupational health standards are discussed from three safety management perspectives: organisational, societal and individual. This review contributes to a better understanding of how to build a positive safety culture, one that could reduce elite athletes' injury rate and improve their long-term wellbeing. Further research is required to develop a quantitative measurement instrument to evaluate occupational health awareness in the sport context. Based on the papers reviewed, the study population was categorised as elite, professional, high-performance amateur and student-athletes.

Winning at all costs: a review of risk-taking behaviour and sporting injury from an occupational safety and health perspective

Professional athletes involved in high-performance sport are at a high injury risk, which may lead to long-term health consequences. Professional athletes often expose themselves to risky behaviours, resulting in a higher acceptance level of occupational risk compared to other occupations. To date, many studies have focused on elite athletes' specific injury prevention techniques. The objective of this narrative review is to (1) summarise elite athletes' attitudes towards important occupational safety and health (OSH) practices, including injury reporting, medicine usage and personal protective equipment (PPE) usage, and (2) explore factors that may influence elite athletes' injury awareness. If injury awareness were given a similar weighting in elite sports as in any other highly physical occupation, the potential benefits to elite athletes and their long-term health could be highly significant. This review identifies that most elite athletes are not aware that sporting injuries are occupational injuries requiring behaviours determined by OSH rules. All the 39 studies identified met the moderate methodological quality criteria according to the Mixed Methods Appraisal Tool (MMAT). The factors impeding athletes' injury awareness from achieving occupational health standards are discussed from three safety management perspectives: organisational, societal and individual. This review contributes to a better understanding of how to build a positive safety culture, one that could reduce elite athletes' injury rate and improve their long-term wellbeing. Further research is required to develop a quantitative measurement instrument to evaluate occupational health awareness in the sport context. Based on the papers reviewed, the study population was categorised as elite, professional, high-performance amateur and student-athletes.

Physiological, kinematic, and electromyographic responses to kinesiology-type patella tape in elite cyclists

Kinesiology-type tape (KTT) has become popular in sports for injury prevention, rehabilitation, and performance enhancement. Many cyclists use patella KTT; however, its benefits remain unclear, especially in uninjured elite cyclists. We used an integrated approach to investigate acute physiological, kinematic, and electromyographic responses to patella KTT in twelve national-level male cyclists. Cyclists completed four, 4-minute submaximal efforts on an ergometer at 100 and 200 W with and without patella KTT. Economy, energy cost, oxygen cost, heart rate, efficiency, 3D kinematics, and lower-body electromyography signals were collected over the last minute of each effort. Comfort levels and perceived change in knee stability and performance with KTT were recorded. The effects of KTT were either unclear, non-significant, or clearly trivial on all collected physiological and kinematic measures. KTT significantly, clearly, and meaningfully enhanced vastus medialis peak, mean, and integrated electromyographic signals, and vastus medialis-to-lateralis activation. Electromyographic measures from biceps femoris and biceps-to-rectus femoris activation ratio decreased in either a significant or clinically meaningful manner. Despite most cyclists perceiving KTT as comfortable, increasing stability, and improving performance, the intervention exerted no considerable effects on all physiological and kinematic measures. KTT did alter neuromuscular recruitment, which has potential implications for injury prevention.

Dose-Response Relationship of Neuromuscular Training for Injury Prevention in Youth Athletes: A Meta-Analysis

Background: Youth athletes with intensive sports participation are at an increased risk of sustaining injuries. Neuromuscular training programs reduce sports-related injury risk in this population, however, the dose-response relationship is largely unknown. Thus, the aim of this meta-analysis was to identify the optimal frequency, volume, duration, and period of neuromuscular training to prevent injuries in youth athletes.

Methods: Computerized database searches (PubMed, Scopus, SPORTDiscus, The Cochrane Library, PEDro) were conducted in January 2017, with search terms related to youth sports, neuromuscular training, and injury prevention. Eligible trials (i) evaluated a neuromuscular training program; (ii) included youth athletes of 21 years or younger; (iii) had an analytical design (RCTs, quasi-experimental, cohort studies); (iv) contained original data; (v) and provided injury data. Two reviewers independently extracted data and assessed quality of eligible studies. Injury rate ratios (IRRs) for lower extremity injuries were pooled meta-analytically, and moderator analyses examined the effect of training frequency, duration, volume, and period.

Results: Data from 16 trials yielded an overall risk reduction of 42% with neuromuscular training (IRR = 0.58, 95%CI 0.47–0.72). Training frequencies of two (IRR = 0.50; 95%CI 0.29–0.86) or three times (IRR = 0.40; 95%CI 0.31–0.53) per week revealed the largest risk reduction, and a weekly training volume of more than 30 min tended to be more effective compared to lower volumes. Programs with 10–15 min (IRR = 0.55; 95%CI 0.42–0.72) session duration produced effects comparable to those with longer session duration (IRR = 0.60; 95%CI 0.46–0.76). Interventions lasting more than 6 months were not superior to shorter programs.

Conclusion: This meta-analysis revealed that NMT performed in short bouts of 10–15 min, two to three times per week, with a weekly training volume of 30–60 min had the largest preventive effect for lower extremity injuries in youth athletes. These effects can be achieved within 20–60 sessions and training periods of <6 months. The present results are derived from a relatively small number of studies with heterogeneous methodological quality and should be treated with caution.

The study was a priori registered at PROSPERO (CRD42016053473).