Factors affecting peak impact force during soccer headers and implications for the mitigation of head injuries

UEFA Women's Elite Club Injury Study: a prospective study on 1527 injuries over four consecutive seasons 2018/2019 to 2021/2022 reveals thigh muscle injuries to be most common and ACL injuries most burdensome

OBJECTIVE

Injuries in women's football (soccer) have scarcely been investigated, and no study has been conducted in the highest competitive level involving club teams from different countries. Our aim was to investigate the time-loss injury epidemiology and characteristics among women's elite football players over four seasons.

METHODS

596 players from 15 elite women's teams in Europe were studied prospectively during the 2018/2019 to 2021/2022 seasons (44 team seasons). Medical staff recorded individual player exposure and time-loss injuries. Injury incidence was calculated as the number of injuries per 1000 playing hours and injury burden as the number of days lost per 1000 hours.

RESULTS

1527 injuries were recorded in 463 players with an injury incidence of 6.7 (95% CI 6.4 to 7.0) injuries per 1000 hours and a nearly fourfold higher incidence during match play compared with training (18.4, 95% CI 16.9 to 19.9 vs 4.8, 95% CI 4.5 to 5.1; rate ratio 3.8, 95% CI 3.5 to 4.2). Thigh muscle injuries (hamstrings 12%, 188/1527, and quadriceps 11%, 171/1527) were the most frequent injury, while anterior cruciate ligament (ACL) injury had the highest burden (38.0 days lost per 1000 hours, IQR 29.2-52.1) with median days lost of 292 (IQR 246-334) days. Concussions constituted 3% (47/1527) of all injuries, with more than half of them (55%, 26/47) due to ball-related impact.

CONCLUSION

An elite women's football team can expect approximately 35 time-loss injuries per season. Thigh muscle injury was the most common injury and ACL injury had the highest injury burden.

Head Impact Exposure in Female Collegiate Soccer by Activity Type

Soccer, one of the most popular sports in the world, has one of the highest rates of sports-related concussions. Additionally, soccer players are frequently exposed to nonconcussive impacts from intentionally heading the ball, a fundamental component of the sport. There have been many studies on head impact exposure in soccer, but few focus on soccer practices or practice activities. This study aimed to characterize the frequency and magnitude of head impacts in National Collegiate Athletic Association Division I female soccer practice activities using a custom-fit instrumented mouthpiece. Sixteen players were instrumented over the course of 54 practice sessions. Video analysis was performed to verify all mouthpiece-recorded events and classify practice activities. Category groupings of practice activities include technical training, team interaction, set pieces, position-specific, and other. Differences in head impact rates and peak resultant kinematics were observed across activity types and category groupings. Technical training had the highest impact rate compared to other category groupings. Impacts occurring during set piece activities had the highest mean kinematic values. Understanding drill exposure can help inform coaches on training plans aimed to reduce head impact exposure for their athletes.

Repeatability of a piezoelectric force platform to measure impact metrics for a single model of football

The visco-elastic properties of a football influence how it bounces and therefore its performance in a game. Previously, high-speed camera footage has been used to quantify deformation, coefficient of restitution and contact time for an impact between a football and a rigid surface but these systems do not provide any information on the forces acting on the football during the impact. The aim of this study was to determine the repeatability of measuring the peak impact force, impulse, rise time and loading rate for four samples of the same model of football using a commercial force platform (Kistler 9281EA). A football impacted the floor-mounted piezoelectric-type force platform at 6.04 and 19.4 m s−1. High absolute (coefficient of variation (CV) ≤ 10%) and relative (intraclass correlation coefficient (ICC) ≥ 0.94) repeatability was observed for repeated impacts at both velocities. The minimal detectable differences were calculated to evaluate the ability for the force platform to be used to make meaningful comparisons between footballs. For all metrics, the minimum detectable difference accounted for less than 5% of the mean value. Therefore, it can be concluded that provided the difference in impact metrics between football models exceeds the minimal detectable difference, the commercial force platform can be used to measure and detect differences in physical impact metrics between models of footballs.

An EMG-Based Constitutive Law for Force Generation in Skeletal Muscle - Part II: Model Validation On the Ankle Joint Complex

This study evaluates the predictive ability of the skeletal muscle force model derived previously within the ankle joint complex. The model is founded in dimensional analysis, using electromyography and the muscle force-length, force-velocity, and force-frequency curves as inputs. Seventeen subjects (8 males, 9 females) performed five different exercises that activated the primary muscles crossing the ankle joint. Motion capture, force plate, and electromyography data were collected during these exercises. A constant, Km, was calculated for each muscle of each subject using four of the five exercises. The fifth exercise was used to validate the results by treating the moments due to muscle forces as known and all other components in Euler's second law as unknown. While muscle forces cannot be directly validated in vivo, methods can be developed to test these values with reasonable confidence. This study compared moments about the ankle joint due to the calculated muscle forces to the sum of the moments due to all other sources and the kinematic terms in the second Newton-Euler equation of rigid body motion. Average percent errors for each subject ranged from 4.2% to 15.5% with an average percent error across all subjects of 8.2% while maximum percent errors for each subject ranged from 33.3% to 78.0% with an overall average maximum of 52.4%. Future work will examine sensitivity analyses to identify potential simplifications to the model and solution process and will validate the model on a more complex joint.

The effect of ball characteristics on head acceleration during purposeful heading in male and female youth football players

Objective: The objective of this cross-sectional study was to explore the effects of different ball types and characteristics on head acceleration during purposeful heading in youth football players. Methods: Experienced male and female players (n = 61) aged between 12-17 years completed heading trials with 4 different balls (Ball 1 mass 192 grams (g), pressure 5.0 pounds per square inch (psi); Ball 2 432 g, 5.0 psi; Ball 3 255 g, 5.0 psi; Ball 4 430 g, 10.5 psi) whilst wearing a head-mounted accelerometer and gyroscope. Balls 1, 2 and 4 were size 5 balls; Ball 3 was a size 4 ball.Results: Multivariate analysis of variance and post-hoc univariate analyses revealed a statistically significant difference between ball type and head acceleration during heading for both linear acceleration (adjusted R² = 0.68; F = 140.90; p = <0.001) and angular velocity (adjusted R² = 0.28; F = 26.52; p = <0.001). Ball 1 (lightest size 5 ball) and Ball 3 (size 4 ball) demonstrated linear head accelerations up to 59% lower (p = <0.01) when compared with Ball 4 (size 5 regulated match ball).Discussion: Head acceleration during purposeful heading is influenced by changes to ball pressure, ball size and/or ball mass. Changing ball characteristics, particularly in youth football training when heading is being taught, should be an easy strategy to implement.