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Schneider KN, Zafeiris T, Gosheger G, Klingebiel S, Rickert C, Schachtrup T, Theil C. Shoulder dislocations in professional male football (soccer): A retrospective epidemiological analysis of the German Bundesliga from season 2012/2013 until 2022/2023. Knee Surg Sports Traumatol Arthrosc 2024; 32:1591-1598. [PMID: 38643395 DOI: 10.1002/ksa.12199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/24/2024] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
PURPOSE Injuries exert a detrimental impact on the team performance in professional football. Shoulder dislocations are known for their severity and often cause substantial lay-off times. However, there is a notable gap in the general understanding regarding the frequency and convalescence of these events in professional football. Thus, the aims of this study were (1) to determine the incidence, (2) to evaluate return to competition (RTC) and redislocation events (RDEs) and (3) to identify relevant player-, match- and injury-related parameters. METHODS All shoulder dislocations within the highest three German football leagues (1.-3. Bundesliga) during the seasons 2012/2013 until 2022/2023 were identified. Player-, injury- and match-related data were obtained by performing a media analysis. Data were analysed using descriptive statistics. p Value was set at 0.05. RESULTS A total of 90 first-time shoulder dislocations in 89 players with a median age of 25 years (interquartile range [IQR]: 23-28) were available for analysis. The incidence was 9.1 per 1000 Bundesliga matches played and increased over time. Forty-four (49%) shoulder dislocations were treated conservatively and 46 (51%) operatively. Median RTC was 24 days (IQR: 12-43) following conservative and 103 days (IQR: 85-135) following surgical treatment (p < 0.001). Twenty-two (24%) players suffered a redislocation, of whom 13 (59%) underwent initial conservative and nine (41%) initial surgical treatment (not significant [n.s.]). RDE following conservative treatment was after a median of 4 months (IQR: 2-22) and 7 months (IQR: 3-23) following surgical treatment (n.s.). CONCLUSION The incidence of shoulder dislocation within professional football is increasing and currently amounts to 9.1 per 1000 matches played. A conservative treatment leads to a quicker RTC, while frequency and time to RDE were similar regardless of treatment. The increasing incidence of shoulder dislocations in professional football necessitates an analysis of relevant injury mechanisms and the implementation of specific preventive measures. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
| | - Theodoros Zafeiris
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
| | - Georg Gosheger
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
| | - Sebastian Klingebiel
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
| | - Carolin Rickert
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
| | - Tim Schachtrup
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
| | - Christoph Theil
- Department of Orthopaedics and Tumor Orthopaedics, University Hospital of Münster, Münster, Germany
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Lima EBDS, Belangero PS, Lara PHS, Ribeiro LM, de Figueiredo EA, Andreoli CV, Pochini ADC, Ejnisman B, Pagura JR, Cohen M, Arliani GG. Shoulder injuries in Brazilian professional football players: epidemiological analysis of 3828 games. J ISAKOS 2024; 9:290-295. [PMID: 38296185 DOI: 10.1016/j.jisako.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES Football is a globally played sport that poses potential risks for musculoskeletal injuries. Upper-limb injuries have a lower incidence rate than lower-limb injuries but can still cause absenteeism and performance impairment in football players. This descriptive epidemiological study aimed to evaluate and compare the epidemiological data on shoulder injuries among professional football players in two major Brazilian football championships. METHODS Data were collected throughout the championships, and club physicians medically evaluated each player during official games using two online forms. The collected information included the player's age and position, injury diagnosis, laterality, location on the field where the injury occurred, playing time, imaging examinations performed, need for surgical treatment, time to return to play (TRP), and recurrence of the injury. The incidence of injuries was evaluated using the Federation Internationale de Football Association (FIFA) incidence formula. RESULTS A total of 107 shoulder injuries were recorded (4.3% of all injuries), with a FIFA incidence of 0.847. Glenohumeral dislocations (GHDs) and acromioclavicular dislocations (ACDs) accounted for 37.38% and 35.51% of all shoulder injuries, respectively. Goalkeepers and defenders presented, respectively, a 2.15 and 1.57 times increased risk of suffering shoulder injuries, while attackers presented a 0.63 times decreased risk. Injury recurrence was observed in 14.95% of cases, with GHDs and ACDs showing recurrence rates of 35.00% and 5.26%, respectively. Surgery was performed in 9.35% of cases, with GHDs representing 50% of all surgeries. The average TRP was 22.37 days, with severe and major injuries accounting for 11.21% and 10.28% of all injuries, respectively. Goalkeepers had the highest average TRP of 36.15 days. Recurring injuries had a higher average TRP of 33.44 days compared to nonrecurring injuries, which had an average TRP of 20.43 days. Surgically treated injuries had the highest average TRP of 112.5 days. CONCLUSION Shoulder injuries in the professional football scenario are of great concern due to the high recurrence rate and need for surgical treatment, which will lead to a long TRP. These findings emphasize the need to implement prevention protocols and effective treatments to reduce the consequences of such injuries, which are usually underestimated in this sport. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Ewerton Borges de Souza Lima
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Paulo Santoro Belangero
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Paulo Henrique Schmidt Lara
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Leandro Masini Ribeiro
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Eduardo Antônio de Figueiredo
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Carlos Vicente Andreoli
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Alberto de Castro Pochini
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Benno Ejnisman
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil.
| | - Jorge Roberto Pagura
- Brazilian Football Confederation, Avenida Luis Carlos Prestes, 130 - Barra da Tijuca, Rio de Janeiro, RJ 22775-055, Brazil
| | - Moisés Cohen
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
| | - Gustavo Gonçalves Arliani
- Sports Traumatology Center, Discipline of Sports Medicine and Physical Activity, Department of Orthopedics and Traumatology, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP 04022-002, Brazil
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3
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Bastias E, Otte FW, Vaughan J, Swainston S, O' Sullivan M. An ecological approach for skill development and performance in soccer goalkeeper training: Empirical evidence and coaching applications. J Sports Sci 2024:1-12. [PMID: 38293847 DOI: 10.1080/02640414.2024.2306449] [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: 01/28/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024]
Abstract
Ecological approaches in sport consider that athletes adapt to properties of the task and the surrounding environment. Thus, task and environment are key constraints of performance. Yet, the influence of task and environmental constraints on athletes' performance needs empirical examination, especially in sport-specific contexts such as soccer goalkeeping. This study aimed to examine if and how task and environmental constraints influenced goalkeepers (GKs') performances. We monitored performance coefficients of two professional female GKs across 13 training tasks that varied based on 9 constraints, referring to both interactions among athletes and properties of the surrounding landscape. Results showed that constraints explain ~ 47% of the observed variability in GKs' performances. Numerical complexity (i.e., the potential interactions between athletes) showed a major influence on performance, which indicates that number of interactions among athletes may constrain GKs' perceived opportunities for action. Field dimensions and landscape representativity (including elements such as penalty area(s), target goal(s) and constraints for shooting) showed positive relationships with performance, supporting that training designs retaining closer proximity to the game may benefit GKs' performances. Overall, results supported that athlete-environment couplings could be understood as a multifactorial model and hence, a combination of task constraints are necessary for designing effective learning environments.
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Affiliation(s)
- Elliot Bastias
- Research and Development Department, AIK Fotboll, Stockholm, Sweden
| | | | - James Vaughan
- Research and Development Department, AIK Fotboll, Stockholm, Sweden
| | - Scott Swainston
- Department of Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Mark O' Sullivan
- Department of Sport and Social Sciences, Norwegian School of Sport Sciences, Oslo, Norway
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Silvers-Granelli H, Bizzini M, Mandelbaum B, Arundale A, Pohlig R, Snyder-Mackler L. High Compliance with the 11+ Injury Prevention Program Results in Better Win-Loss Records. Int J Sports Phys Ther 2023; 18:1065-1075. [PMID: 37795333 PMCID: PMC10547084 DOI: 10.26603/001c.87502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/09/2023] [Indexed: 10/06/2023] Open
Abstract
Background The 11+ injury prevention program (IPP) has been shown to decrease injury rates. However, few studies have investigated compliance and its overall relationship to team performance. Hypothesis/Purpose To examine if level of compliance while implementing the 11+ would impact team performance outcomes (wins, losses and ties). The authors hypothesized that higher team compliance to the IPP would be consistent with improved overall team performance (more wins and fewer losses). Study Design Prospective, cluster randomized controlled trial. Methods This study was conducted in NCAA men's soccer teams for one season and examined the efficacy of the 11+ IPP. The outcome variables examined were levels of compliance and team performance record: wins, losses, and ties. Twenty-seven teams (n=675 players) served as the intervention group (IG) and used the 11+ program while 34 teams (n=850 players) served as the control group (CG). Compliance and team performance were recorded. There were three compliance categories that were defined prospectively, low (LC, < 1 dose/week), moderate (MC, >1 and <2 doses/week), and high (HC, >2 doses/week). Descriptive and inferential tests were used to compare the CG, the IG, and compliance to team performance. Three independent t-tests were used to analyze outcome to group (IG vs. CG). A one way-MANOVA test was used to analyze compliance to win/loss/tie record, followed up by one-way ANOVA tests to analyze how compliance impacted wins, losses and ties, independently. Partial η2 measures were calculated to determine the effect size of level of compliance on outcome. A Tukey post-hoc analysis was used to analyze specific differences between levels of compliance and specific outcome measures. Results There were significantly more wins (IG: 10.67±2.63 versus CG: 8.15±3.83, CI, 7.95 - 9.69, p = 0.005) and fewer losses (IG: 5.56±1.97 versus CG: 8.12±3.59, CI, 5.66 to 7.43, p = 0.002) recorded for the teams using the 11+ program. There was a statistically significant difference between levels of compliance (high, moderate or low) on the dependent variables (wins, losses, and ties), F(3, 22) = 3.780, p =0.004; Wilks' Λ = .435; partial η2 = .340. Conclusion The 11+ has the capacity to improve overall team performance in male collegiate soccer teams. The higher the compliance, the more favorable the team performance. This research may be a vital addition when attempting to persuade coaching staffs to adopt an IPP into their training regimen. Level of Evidence Level I.
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Affiliation(s)
| | | | - Bert Mandelbaum
- Orthopaedic Surgery Cedars-Sinai Kerlan-Jobe Institute - Santa Monica
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Paraskevopoulos E, Pamboris GM, Papandreou M. The Changing Landscape in Upper Limb Sports Rehabilitation and Injury Prevention. Sports (Basel) 2023; 11:sports11040080. [PMID: 37104154 PMCID: PMC10145846 DOI: 10.3390/sports11040080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
This editorial aims to feature authors who intend to submit their research to this Special Issue of Sports entitled "Clinical Advances in Upper Limb Sports Rehabilitation and Injury Prevention" in areas that need special consideration [...].
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Affiliation(s)
- Eleftherios Paraskevopoulos
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
| | - George M Pamboris
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
| | - Maria Papandreou
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
- Laboratory of Advanced Physiotherapy, University of West Attica, 12243 Athens, Greece
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Liaghat B, Pedersen JR, Husted RS, Pedersen LL, Thorborg K, Juhl CB. Diagnosis, prevention and treatment of common shoulder injuries in sport: grading the evidence - a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med 2023; 57:408-416. [PMID: 36261251 PMCID: PMC10086287 DOI: 10.1136/bjsports-2022-105674] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/09/2022]
Abstract
This statement paper summarises and appraises the evidence on diagnosis, prevention, and treatment of common shoulder injuries in sports. We systematically searched Medline and Embase. The Grading of Recommendations Assessment, Development and Evaluation tool was applied to evaluate the overall quality of evidence.For diagnosis, we included 19 clinical tests from mixed populations. Tests for anterior instability, biceps-labrum complex injuries and full subscapularis rupture had high diagnostic accuracy (low to moderate quality of evidence).For prevention, the Oslo Sports Trauma Research Center, the Shoulder Control, the FIFA 11+ shoulder injury prevention programmes, and a baseball-specific programme (range of motion, stretching, dynamic stability and strengthening exercises) showed moderate to large effect size in reducing the risk of shoulder injury compared with no intervention (very low to moderate quality of evidence).For treatment, a rehabilitation programme including stretching, ice packs, electrotherapy and compression, and strengthening exercises showed a large effect size in reducing pain and disability compared with no intervention in athletes with subacromial impingement syndrome (very low to moderate quality of evidence). For the treatment of supraspinatus tendinopathy, hyperthermia treatment (heating the skin to 38°C-40°C) resulted in large effect size in reducing pain and disability compared with ultrasound or pendular swinging and stretching exercises (moderate quality of evidence). Strengthening exercise alone or in combination with stretching exercises promoted a large effect in reducing shoulder pain (cohort studies, no comparators) (very low quality of evidence). The quality of evidence for most estimates was low to moderate, indicating that future high-quality research may alter our recommendations for clinical practice.
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Affiliation(s)
- Behnam Liaghat
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Evidence-Based Orthopaedics (CEBO), Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Julie Rønne Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rasmus Skov Husted
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark
- Center for General Practice, Aalborg University, Aalborg, Denmark
- Clinical Orthopedic Research Hvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Lisbeth Lund Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Danish Society of Sports Physical Therapy, Odense, Denmark
| | - Kristian Thorborg
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
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de Souza Lima EB, de Godoy GP, Osés GL, Lara PHS, Ribeiro LM, Andreoli CV, de Castro Pochini A, Belangero PS, Arliani GG, Ejnisman B, Cohen M. Epidemiology of Upper Limb Injuries in two major Brazilian Soccer Championships from 2016 to 2019. J Exp Orthop 2022; 9:120. [PMID: 36515745 DOI: 10.1186/s40634-022-00560-1] [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: 06/19/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate epidemiological data of upper limb injuries in professional athletes who participated in two major Brazilian soccer championships between 2016 and 2019. METHODS A prospective cohort study was conducted to evaluate the teams of two divisions over four seasons within the Brazilian Soccer Championship and the Paulista Soccer Championship. Clubs and their doctors were contacted to participate in the study and guided on the correct way to enter data via online platforms: Transfermarkt (Transfermarkt GmbH & Co. KG) and Survey Monkey (Momentive.AI). Demographic data, injury characteristics, and FIFA Incidence Formula were analyzed. RESULTS Overall, the study analyzed 3,828 matches and 126,357 hours of play. Upper limb injuries were registered 169 times, representing 6.8% of total injuries, with a FIFA incidence of 1.34. Most lesions occurred in forward players (21.3%), the shoulder exhibited the highest number of injuries (63.3%). The player's position was related to the location on the field where the injury occurred (p < 0.001); however, there was no relationship between the type of injury and the location on the body (p > 0.001). The average time to return to play was 19.1 days (range 0-200 days) and it was longer for goalkeepers. The necessity of surgical treatment was statistically associated with additional time to return to play (p < 0.001). CONCLUSIONS Shoulder injuries were the most frequent upper limb injury sustained during the two major Brazilian soccer championships. Forward players suffered the most upper limb injuries and goalkeepers experienced the longest time to return to play.
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Affiliation(s)
- Ewerton Borges de Souza Lima
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil.
| | - Gabriel Paris de Godoy
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Guilherme Ladeira Osés
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Paulo Henrique Schmidt Lara
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Leandro Masini Ribeiro
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Carlos Vicente Andreoli
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Alberto de Castro Pochini
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Paulo Santoro Belangero
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Gustavo Gonçalves Arliani
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Benno Ejnisman
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
| | - Moisés Cohen
- Department of Orthopaedics and Traumatology, Sports Traumatology Group, Discipline of Sports Medicine, Escola Paulista de Medicina, Federal University of São Paulo, R. Estado de Israel, 713 - Vila Clementino, São Paulo, SP, Brazil
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8
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Diaz CC, Forlenza EM, Lavoie-Gagne OZ, Knapik DM, Korrapati A, Chahla J, Forsythe B. Acromioclavicular Joint Separation in UEFA Soccer Players: A Matched-Cohort Analysis of Return to Play and Player Performance From 1999 to 2018. Orthop J Sports Med 2021; 9:23259671211026262. [PMID: 34708134 PMCID: PMC8543588 DOI: 10.1177/23259671211026262] [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: 02/25/2021] [Accepted: 03/04/2021] [Indexed: 11/15/2022] Open
Abstract
Background Acromioclavicular joint (ACJ) separation injuries are uncommon in professional soccer players, threatening future performance and team contributions. Data regarding return to play (RTP) in professional soccer players after ACJ separation are limited. Purpose To determine the rate, time to RTP, and player performance after ACJ separation in soccer players from the top 5 professional European leagues when compared with a retrospective, matched cohort of uninjured players. Study Design Cohort study; Level of evidence, 3. Methods Professional soccer players suffering ACJ separation injuries between 1999 and 2018 were identified and were matched to uninjured players (2 controls to 1 injured player) by position, height, age, season year, and length of time played. Information on date of injury, timing to RTP, and player performance metrics (minutes played, games played, goals scored, assists made, and points per game) were collected from transfermarkt.co.uk, uefa.com, fifa.com, official team websites, public injury reports, and press releases. Change in performance metrics for the 4 seasons after the season of injury were based on metrics 1 season before injury. Univariate comparisons were performed using independent 2-group t tests and Wilcoxon rank-sum tests when normality of distributions was violated. Results A total 59 soccer players with ACJ separation injuries were identified. Mean age at injury was 24.6 ± 5.3 years. Of these, 81% of the players returned to play, with 69% returning within postinjury season 1. Mean time to RTP was 49.8 ± 24.3 days (5.9 ± 4.1 games). Two players suffered recurrent ACJ separation injuries in their professional soccer careers. There were no significant differences between athletes who sustained ACJ injuries versus control athletes in the number of games played, minutes per game per season, goals scored, assists, or points in the 4 seasons after injury. Defenders played fewer minutes and recorded fewer assists during postinjury season 1 when compared with control athletes. Conclusion Of the 59 elite soccer players who sustained ACJ separation injuries during the study period, 81% returned to elite competition. Performance metrics were similar to preinjury levels and matched, uninjured control players.
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Affiliation(s)
- Connor C Diaz
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Enrico M Forlenza
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Ophelie Z Lavoie-Gagne
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Derrick M Knapik
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Avinaash Korrapati
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Jorge Chahla
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian Forsythe
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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9
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Al Attar WSA, Faude O, Bizzini M, Alarifi S, Alzahrani H, Almalki RS, Banjar RG, Sanders RH. The FIFA 11+ Shoulder Injury Prevention Program Was Effective in Reducing Upper Extremity Injuries Among Soccer Goalkeepers: A Randomized Controlled Trial. Am J Sports Med 2021; 49:2293-2300. [PMID: 34138672 DOI: 10.1177/03635465211021828] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Soccer is one of the most popular sports worldwide. Goalkeepers are more likely to injure their upper limbs, particularly their shoulders, than outfield players. To reduce upper extremity injuries, the FIFA 11+ Shoulder Injury Prevention Program (FIFA 11+S) was developed. PURPOSE The purpose of this study was to assess the effectiveness of the FIFA 11+S program in reducing the incidence of upper extremity injuries among amateur soccer goalkeepers. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS A total of 726 goalkeepers, who were blinded to study intent, were randomly assigned to the experimental group (n = 360) or control group (n = 366). The experimental group was instructed to perform the FIFA 11+S program before all training sessions for 1 season (6 months). The control group was instructed to continue performing their usual routine warm-up program before training sessions for 1 season. Primary outcomes included the incidence of upper extremity injury and incidence of mechanism, type, and severity of injury measured using injury risk ratios (IRR); compliance with the experimental and control interventions was also recorded. RESULTS A total of 50 injuries (0.62 injuries per 1000 exposure-hours) were reported in the experimental group, and 122 injuries (1.94 injuries/1000 hours) were reported in the control group. The FIFA 11+S program reduced the total number of upper extremity injuries by 68% (IRR = 0.32 [95% CI, 0.27-0.34]) compared with the usual warm-up. The FIFA 11+S program reduced the incidence of contact injury (IRR = 0.30 [95% CI, 0.25-0.31]), noncontact injury (IRR = 0.40 [95% CI, 0.35-0.43]), initial injury (IRR = 0.34 [95% CI, 0.29-0.36]), recurrent injury (IRR = 0.20 [95% CI, 0.17-0.21]), and overuse injury (IRR = 0.40 [95% CI, 0.35-0.43]). Participants in the experimental group demonstrated a significant decrease in injuries of minor (IRR = 0.32 [95% CI, 0.27-0.34]) and moderate severity (IRR = 0.33 [95% CI, 0.29-0.35]) compared with the control group. We noted no difference in compliance between the experimental and control groups (80% vs 73%, respectively; P = .92). CONCLUSION The FIFA 11+S program resulted in 50% fewer upper extremity injuries among soccer goalkeepers, compared with a regular warm-up. REGISTRATION ACTRN12618001080213 (Australian New Zealand Clinical Trials Registry).
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Affiliation(s)
- Wesam Saleh A Al Attar
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia.,Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Mario Bizzini
- Human Performance Lab, Schulthess Clinic, Zürich, Switzerland
| | - Saud Alarifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Hosam Alzahrani
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Raed S Almalki
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Riyadh G Banjar
- Department of Physical Therapy, College of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Ross H Sanders
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, Australia
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Zarei M, Eshghi S, Hosseinzadeh M. The effect of a shoulder injury prevention programme on proprioception and dynamic stability of young volleyball players; a randomized controlled trial. BMC Sports Sci Med Rehabil 2021; 13:71. [PMID: 34193267 PMCID: PMC8246688 DOI: 10.1186/s13102-021-00300-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The "FIFA 11 + Shoulder" programme has been reported to reduce the incidence of upper extremity injuries among soccer goalkeepers. It has also been recommended for overhead sports. The purpose of this study was therefore to investigate the effect of an 8-week "FIFA 11 + shoulder" (11 + S) programme on shoulder joint position sense (JPS), threshold to detect passive motion (TTDPM) and upper quarter Y Balance Test in young male volleyball players. METHODS Thirty-two healthy young elite male volleyball players (17.49 ± 1.47 years) participated in this quasi-experimental study. Participants, recruited from two clubs participating in Iranian premier league, were randomly assigned into two groups; (1) the intervention group who performed the "FIFA 11 + shoulder" programme as their warm up protocol, three times per week, and (2) the control group who kept their routine warm up protocol meanwhile. Proprioception tests including JPS and TTDPM of internal and external rotator muscles of the dominant shoulder were recorded via the isokinetic system pro 4. The upper quarter Y Balance Test determined the shoulder dynamic stability. RESULTS No statistically significant differences were observed for JPS and TTDPM of shoulder internal and external rotator muscles; shoulder stability however significantly increased only in the intervention group (p = 0.03, ηp2=0.02). CONCLUSION Upper quarter dynamic stability improvement due to the 11+S programme leads to volleyball players' performance and may therefore contribute to a reduction in risk of sustaining injury if applied long-term. TRIAL REGISTRATION The trial was retrospectively registered atIranian Registry of Clinical Trials with the number of IRCT20201030049193N1 at 04/12/2020.
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Affiliation(s)
- Mostafa Zarei
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Velenjak Square, Evin, 1983963113 Tehran, Iran
| | - Saeed Eshghi
- Sport Rehabilitation and Health Department, Faculty of Sports Sciences and Health, Shahid Beheshti University, Velenjak Square, Evin, 1983963113 Tehran, Iran
| | - Mahdi Hosseinzadeh
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
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Andersson JK, Bengtsson H, Waldén M, Karlsson J, Ekstrand J. Hand, Wrist, and Forearm Injuries in Male Professional Soccer Players: A Prospective Cohort Study of 558 Team-Seasons From 2001-2002 to 2018-2019. Orthop J Sports Med 2021; 9:2325967120977091. [PMID: 33553455 PMCID: PMC7841683 DOI: 10.1177/2325967120977091] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The literature on upper extremity injuries in professional soccer players is scarce, and further insight into the onset and cause of these injuries as well as potential differences between goalkeepers and outfield players is important. PURPOSE To investigate the epidemiology of hand, wrist, and forearm injuries in male professional soccer players between 2001 and 2019. STUDY DESIGN Descriptive epidemiology study. METHODS Between the 2001-2002 and 2018-2019 seasons, 120 European male soccer teams were followed prospectively for a varying number of seasons (558 team-seasons in total). Time-loss injuries and player-exposures to training sessions and matches were recorded on an individual basis in 6754 unique players. Injury incidence was reported as the number of injuries per 1000 player-hours, and between-group differences were analyzed using Z statistics and rate ratios (RRs) with 95% CIs. Between-group differences in layoff time were analyzed. RESULTS In total, 25,462 injuries were recorded, with 238 (0.9%) of these affecting the hand (71.4%; n = 170), wrist (16.8%; n = 40), and forearm (11.8%; n = 28), producing an incidence of 0.065 injuries per 1000 hours. A majority of the injuries were traumatic with an acute onset (98.7%; n = 235). Fractures were the most common injuries recorded (58.8%; n = 140), often involving the metacarpal bones (25.2%; n = 60) and phalanges (10.1%; n = 24). The injury incidence was significantly higher for goalkeepers (115 injuries; 0.265 per 1000 hours) compared with outfield players (123 injuries; 0.038 per 1000 hours) (RR, 7.0 [95% CI, 5.4-9.0]). Goalkeepers also had a significantly longer mean layoff time than outfield players (23 ± 27 vs 15 ± 27 days; P = .016). CONCLUSION Injuries to the hand, wrist, and forearm constituted less than 1% of all time-loss injuries in male professional soccer players. Fractures were most common and constituted more than half of all injuries. Goalkeepers had a 7-fold higher incidence and an over 1-week longer mean layoff time compared with outfield players.
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Affiliation(s)
- Jonny K. Andersson
- Department of Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Håkan Bengtsson
- Football Research Group, Linköping University, Linköping, Sweden
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Markus Waldén
- Football Research Group, Linköping University, Linköping, Sweden
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Orthopaedics, Hässleholm-Kristianstad Hospitals, Hässleholm, Sweden
| | - Jón Karlsson
- Department of Surgery, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Football Research Group, Linköping University, Linköping, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jan Ekstrand
- Football Research Group, Linköping University, Linköping, Sweden
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Eshghi S, Zarei M, Abbasi H, Alizadeh S. The Effect of Shoulder Injury Prevention Program on Shoulder Isokinetic Strength in Young Male Volleyball Players. Res Sports Med 2020; 30:203-214. [PMID: 33327786 DOI: 10.1080/15438627.2020.1860050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The purpose of this study was to examine the effects of an eight-week 11 + S programme on isokinetic shoulder strength in young male volleyball players. Twenty-eight top-level young male volleyball players were recruited for this study. The players were randomly assigned into intervention (14 players) and control (14 players) groups. The intervention group performed the 11 + S as a warm-up before training at least three times a week for eight weeks. Dominant shoulder strength was measured using an isokinetic dynamometer at 60°/s and 180°/s. The functional deceleration ratio (FDR) was calculated as a functional strength profile. 20% FDR improvement after eight weeks of 11 + S at 180°/s (p = 0.003) were observed. No other statistically significant effects for shoulder strength improvement was observed (p > 0.05). Eight weeks of 11 + S warm-up programme improved the glenohumeral muscle imbalance by increasing the functional deceleration ratio (FDR) of shoulder muscles in young male volleyball players.
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Affiliation(s)
- Saeed Eshghi
- Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Mostafa Zarei
- Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Hamed Abbasi
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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Baritello O, Khajooei M, Engel T, Kopinski S, Quarmby A, Mueller S, Mayer F. Neuromuscular shoulder activity during exercises with different combinations of stable and unstable weight mass. BMC Sports Sci Med Rehabil 2020; 12:21. [PMID: 32226628 PMCID: PMC7098120 DOI: 10.1186/s13102-020-00168-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recent shoulder injury prevention programs have utilized resistance exercises combined with different forms of instability, with the goal of eliciting functional adaptations and thereby reducing the risk of injury. However, it is still unknown how an unstable weight mass (UWM) affects the muscular activity of the shoulder stabilizers. Aim of the study was to assess neuromuscular activity of dynamic shoulder stabilizers under four conditions of stable and UWM during three shoulder exercises. It was hypothesized that a combined condition of weight with UWM would elicit greater activation due to the increased stabilization demand. METHODS Sixteen participants (7 m/9 f) were included in this cross-sectional study and prepared with an EMG-setup for the: Mm. upper/lower trapezius (U.TA/L.TA), lateral deltoid (DE), latissimus dorsi (LD), serratus anterior (SA) and pectoralis major (PE). A maximal voluntary isometric contraction test (MVIC; 5 s.) was performed on an isokinetic dynamometer. Next, internal/external rotation (In/Ex), abduction/adduction (Ab/Ad) and diagonal flexion/extension (F/E) exercises (5 reps.) were performed with four custom-made-pipes representing different exercise conditions. First, the empty-pipe (P; 0.5 kg) and then, randomly ordered, water-filled-pipe (PW; 1 kg), weight-pipe (PG; 4.5 kg) and weight + water-filled-pipe (PWG; 4.5 kg), while EMG was recorded. Raw root-mean-square values (RMS) were normalized to MVIC (%MVIC). Differences between conditions for RMS%MVIC, scapular stabilizer (SR: U.TA/L.TA; U.TA/SA) and contraction (CR: concentric/eccentric) ratios were analyzed (paired t-test; p ≤ 0.05; Bonferroni adjusted α = 0.008). RESULTS PWG showed significantly greater muscle activity for all exercises and all muscles except for PE compared to P and PW. Condition PG elicited muscular activity comparable to PWG (p > 0.008) with significantly lower activation of L.TA and SA in the In/Ex rotation. The SR ratio was significantly higher in PWG compared to P and PW. No significant differences were found for the CR ratio in all exercises and for all muscles. CONCLUSION Higher weight generated greater muscle activation whereas an UWM raised the neuromuscular activity, increasing the stabilization demands. Especially in the In/Ex rotation, an UWM increased the RMS%MVIC and SR ratio. This might improve training effects in shoulder prevention and rehabilitation programs.
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Affiliation(s)
- Omar Baritello
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
| | - Mina Khajooei
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
| | - Tilman Engel
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
| | - Stephan Kopinski
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
| | - Andrew Quarmby
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
| | - Steffen Mueller
- Computer Science and Therapy Science, Trier University of Applied Science, Schneidershof, 54293 Trier, Germany
| | - Frank Mayer
- Clinical Exercise Science, Department Sports and Health Science Medicine, University Outpatient Clinic Potsdam, University of Potsdam, Am Neuen Palais 10, House 12, 14469 Potsdam, Germany
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Baker SP, Fulcher ML, Exeter DJ, Mcmorland AJ, Sahni M. Can a short neuromuscular warmup before tackling improve shoulder joint position sense in rugby players? J Sports Med Phys Fitness 2019; 60:562-567. [PMID: 31062539 DOI: 10.23736/s0022-4707.19.09568-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In rugby the tackle is a complex task requiring joint position sense (JPS). Injuries commonly occur during the tackle and these account for significant time lost from training and play. Simulated tackling tasks have previously shown a reduction in shoulder joint position sense and it is possible that this may contribute to injury. There is growing evidence in support of injury prevention programs, but none so far are dedicated specifically to tackling. We postulate that a brief neuromuscular warmup could alter the negative effects of fatigue on shoulder JPS. METHODS In this field based, repeated measures design study, 25 semi-professional Rugby players participated. JPS was measured at criterion angles of 45° and 80° of right arm shoulder external rotation. Reproduction accuracy prior to and following a neuromuscular warmup and simulated tackling task was then assessed. RESULTS In pre-warmup JPS measures, the spread of angle errors were larger at the 80° positions. Adding the warmup, the spread of the angle errors at the 80° positions decreased compared to pre-intervention measures. Two one-sided tests (TOST) analysis comparing pre- and post-testing angle errors, with the addition of the warmup, indicated no difference in JPS. CONCLUSIONS The neuromuscular warmup resulted in a decrease in JPS error variance meaning fewer individuals made extreme errors. The TOST analysis results also suggest the neuromuscular warmup used in this study could mitigate the negative effects of tackling on JPS that has been seen in prior research. This neuromuscular warmup could play a role in preventing shoulder injuries. It can easily be added to existing successful injury prevention programs.
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Affiliation(s)
- Simon P Baker
- Axis Sports Medicine Specialists, Auckland, New Zealand -
| | | | | | - Angus J Mcmorland
- Department of Exercise Sciences, Center for Brain Research, Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
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Goodman AD, Etzel C, Raducha JE, Owens BD. Shoulder and elbow injuries in soccer goalkeepers versus field players in the National Collegiate Athletic Association, 2009-2010 through 2013-2014. PHYSICIAN SPORTSMED 2018; 46:304-311. [PMID: 29618228 DOI: 10.1080/00913847.2018.1462083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Examination of the incidence of shoulder and elbow injuries in the collegiate soccer player population is limited, as is comparison between goalkeepers and field players. We hypothesized that goalkeepers would have a higher incidence of shoulder and elbow injuries than field players. Furthermore, we sought to determine the incidence of shoulder and elbow injuries among National Collegiate Athletic Association (NCAA) soccer players, and to determine injury risk factors. METHODS The NCAA Injury Surveillance Program database was analyzed for injuries to NCAA men's and women's soccer players during the 2009-2010 through 2013-2014 academic years. The incidence of injury was calculated per 10,000 athletic exposures (AE) for goalkeepers versus field players, activity, and injury characteristics, and compared using univariate analysis and risk-ratios to determine injury risk factors. RESULTS While the overall incidence of shoulder and elbow injuries in soccer players was 2.7/10,000AE [95% CI 2.62-2.78], the incidence among goalkeepers was 4.6-fold higher (8.3 vs. 1.8/10,000AE, p < 0.0001). Goalkeepers had significantly higher incidences of injury in practice (21.3-fold) and in the preseason (16.1-fold) than field players. Women goalkeepers were disproportionately affected, with injury incidences 7.7-fold higher than women field players, and 1.9-fold higher than male goalkeepers. Acromioclavicular joint injuries, rotator cuff tears/sprains, and elbow and shoulder instability constituted the majority of the goalkeeper injuries. CONCLUSIONS Shoulder and elbow injuries in NCAA soccer players are significantly more common in goalkeepers than field players. Incidence varies widely by position and injury, with a number of associated risk factors. Soccer players sustaining these injuries, along with their coaches and medical providers, may benefit from this injury data to best manage expectations and outcomes. Soccer governing bodies may use this to track injury incidence and response to preventative measures.
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Affiliation(s)
- Avi D Goodman
- a Department of Orthopaedics , Rhode Island Hospital/Brown University , Providence , RI , USA
| | | | - Jeremy E Raducha
- a Department of Orthopaedics , Rhode Island Hospital/Brown University , Providence , RI , USA
| | - Brett D Owens
- a Department of Orthopaedics , Rhode Island Hospital/Brown University , Providence , RI , USA
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