Effective injury prevention in soccer

[Importance and application of injury prevention in Austrian football - a survey among 687 coaches]

BACKGROUND

Soccer is one of the most popular sports in the world but associated with a high risk of injury. For this reason, the study of the etiology of injuries is of great interest and numerous prevention programs have been developed in recent years. Since these prevention programs must be embedded into training routine, trainers are primarily responsible for their implementation. The present study aimed to survey Austrian soccer coaches engaged in professional, amateur or youth teams with respect to their opinions on injuries as well as the application of respective prevention programs.

METHODS

An online questionnaire was developed and sent to all coaches registered in the Austrian Football Association.In addition to personal data, the trainers' attitudes to the subject of injury prevention were also asked. It was also asked which preventive measures the trainers consider important and which they also use in their training and to what extent.

RESULTS

A total of 687 trainers took part in the survey. 2,3%, 37,5% and 43,6% of trainers were engaged in professional, amateur and youth clubs, respectively. The rest gave no information. The majority of respondents (56%) considered injuries a major concern in soccer. Inadequate fitness (75,7%) as well as insufficient preparation (60,7%) and poor regeneration (59,2%) were seen as the greatest risk factors for injuries. Appropriate warm-up (66,8%), regeneration (59,4%) and core stabilization training (58,2%) were considered the most effective preventative measures. More than 50% of the participants were not familiar with any of the most widely applied injury prevention programs, and only 15.4% actually implemented those programs in their training.The substantial interest in injury prevention notwithstanding, the respective standard of knowledge amongst Austrian coaches is poor. In light of the high prevalence of injuries, it is most important to inform trainers about injury prevention programs and possibilities to implement them in training practice.

Menstrual Cycle and Sport Injuries: A Systematic Review

The presence of female athletes has only increased in recent years, as has the incidence of injuries in female sports activities. These injuries are conditioned by multiple factors, including hormonal agents. It is estimated that the menstrual cycle may be related to the predisposition to suffer an injury. However, a causal relationship has not yet been established. The aim of this study was to analyse the relationship between the menstrual cycle and injuries in female sports practice. A systematic search of the scientific literature available in PubMed, Medline, Scopus, Web of Science, and Sport Discus was carried out in January 2022. With 138 articles, only eight studies were found that met the selection criteria for this study. Peak estradiol is associated with increased laxity, strength, and poor use of neuromuscular control. Thus, the ovulatory phase is associated with an increased risk of injury. In conclusion, it seems that hormonal fluctuations throughout the menstrual cycle alter values such as laxity, strength, body temperature, and neuromuscular control, among others. This fact causes women to constantly adapt to hormonal variations, which exposes them to a higher risk of injury.

Sports Injuries of a Portuguese Professional Football Team during Three Consecutive Seasons

Professional football players are exposed to high injury risk due to the physical demands of this sport. The purpose of this study was to characterize the injuries of a professional football team in the First Portuguese League over three consecutive sports seasons. Seventy-one male professional football players in the First Portuguese Football League were followed throughout the sports seasons of 2019/2020, 2020/2021, and 2021/2022. In total, 84 injuries were recorded. Each player missed an average of 16.6 days per injury. Lower limbs were massively affected by injuries across all three seasons, mainly with muscular injuries in the quadriceps and hamstrings and sprains in the tibiotarsal structure. Overall, the injury incidence was considerably higher in matches than in training. The two times of the season that proved most conducive to injuries were the months of July and January. Our results emphasize the importance of monitoring sports performance, including injury occurrence, and assisting in identifying risk factors in professional football. Designing individualized training programs and optimizing prevention and recovery protocols are crucial for maximizing this global process.

Predictive Modeling of Injury Risk Based on Body Composition and Selected Physical Fitness Tests for Elite Football Players

Injuries are one of the most significant issues for elite football players. Consequently, elite football clubs have been consistently interested in having practical, interpretable, and usable models as decision-making support for technical staff. This study aimed to analyze predictive modeling of injury risk based on body composition variables and selected physical fitness tests for elite football players through a sports season. The sample comprised 36 male elite football players who competed in the First Portuguese Soccer League in the 2020/2021 season. The models were calculated based on 22 independent variables that included players' information, body composition, physical fitness, and one dependent variable, the number of injuries per season. In the net elastic analysis, the variables that best predicted injury risk were sectorial positions (defensive and forward), body height, sit-and-reach performance, 1 min number of push-ups, handgrip strength, and 35 m linear speed. This study considered multiple-input single-output regression-type models. The analysis showed that the most accurate model presented in this work generates an error of RMSE = 0.591. Our approach opens a novel perspective for injury prevention and training monitorization. Nevertheless, more studies are needed to identify risk factors associated with injury prediction in elite soccer players, as this is a rising topic that requires several analyses performed in different contexts.

Practical Use of the Navigate Pain Application for the Assessment of the Area, Location, and Frequency of the Pain Location in Young Soccer Goalkeepers

Next to winning, minimizing injuries during training and matches is one of the primary goals of professional team sports games. Soreness and pain can be early indicators and risk factors for acute or long‐term injuries. Monitoring pain intensity and duration, as well as potential sources, are useful for planning practices and can be effective means for preventing injury. The aim of this study was to assess the areas and locations of pain in young soccer goalkeepers during a training camp, and to differentiate the area and frequency between pain arising from the muscles (MP), joints (JP), or as a result of an impact (IP). Recordings of the MP, JP, and IP location along with the area were performed using digital body mapping software (Navigate Pain Android app, Aalborg University, Denmark) installed on a tablet personal computer at the end of each training day across a 5‐day training camp. There was a significant difference in the area between the three types of pain (p < 0.001). The post hoc analysis revealed statistically significant differences between the pixel areas of IP versus JP (p < 0.001), IP versus MP (p < 0.001), and JP versus MP (p < 0.001). There was no significant time‐effect for the IP area between 1‐5 days of training (p = 0.610), neither for MP (p = 0.118) or JP (p = 0.797) and no significant difference for all three pain areas between the front and the back side of the body. The body regions most often reported for MP were thighs, while for JP they were groin and hips, and for IP the hips, shoulders, and forearms were most frequently indicated. This is the first study to map and report the pain distribution associated with training across a 5‐day training camp in soccer goalkeepers, and these findings emphasize the value of using digital pain drawings clinically as well as for monitoring the health status of soccer players.

Effective injury forecasting in soccer with GPS training data and machine learning

Injuries have a great impact on professional soccer, due to their large influence on team performance and the considerable costs of rehabilitation for players. Existing studies in the literature provide just a preliminary understanding of which factors mostly affect injury risk, while an evaluation of the potential of statistical models in forecasting injuries is still missing. In this paper, we propose a multi-dimensional approach to injury forecasting in professional soccer that is based on GPS measurements and machine learning. By using GPS tracking technology, we collect data describing the training workload of players in a professional soccer club during a season. We then construct an injury forecaster and show that it is both accurate and interpretable by providing a set of case studies of interest to soccer practitioners. Our approach opens a novel perspective on injury prevention, providing a set of simple and practical rules for evaluating and interpreting the complex relations between injury risk and training performance in professional soccer.

Shoulder injuries in soccer goalkeepers: review and development of a FIFA 11+ shoulder injury prevention program

In the last years, shoulder injuries have represented an increasing health problem in soccer players. The goalkeepers are more exposed to shoulder disorders than other field players. Injury prevention exercises for upper limbs were cited in few studies involving throwing athletes, but we know that goalkeepers need a specific program. The purpose of this study is to describe the development of an adapted Fédération Internationale de Football Association (FIFA) 11+ program, namely the FIFA 11+ shoulder, which targets the prevention of shoulder injuries in soccer goalkeepers. The FIFA 11+ shoulder program is structured into three parts: general warming-up exercises, exercises to improve strength and balance of the shoulder, elbow, wrist, and finger muscles, and advanced exercises for core stability and muscle control. The exercises were selected based on recommendations from studies demonstrating high electromyographic activity.

The efficacy of exercise in preventing injury in adult male football: a systematic review of randomised controlled trials

BACKGROUND

Injury prevention measures might reduce the impact of injury on footballers and football clubs. Increasing research has evaluated the use of exercise for injury prevention. However, research has focused on adolescent females. No high-quality systematic reviews have evaluated the efficacy of all forms of exercise on preventing injury in adult male football.

OBJECTIVE

Our objective was to conduct a systematic review to evaluate the efficacy of exercise in preventing injury in adult male football.

DATA SOURCES

Comprehensive searches of electronic databases CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, Embase, AMED (The Allied and Complementary Medicine Database), the Cochrane Central Register of Controlled Trials, PEDro (The Physiotherapy Evidence Database), SPORTDiscus™, the National Research Register, Current Controlled Trials website (York), and http://www.ClinicalTrials.gov were conducted using predefined search terms to identify relevant studies published up to 1 March 2013. Screening of references, searches of grey literature, and hand searches of relevant journals were also employed.

STUDY SELECTION

Included studies were randomized controlled trials using injury incidence as an outcome measure to evaluate the efficacy of an exercise intervention on uninjured male footballers aged 16 years and over. Articles not written in English were excluded.

DATA EXTRACTION

Two researchers independently searched data sources, screened studies for eligibility, evaluated risk of bias, and extracted data using predefined criteria.

STUDY APPRAISAL AND SYNTHESIS METHODS

Risk of bias of included trials was assessed using the Cochrane Collaboration's tool for assessing risk of bias. There was insufficient trial comparability (outcome measures, interventions, injury type) for meta-analysis, and a qualitative analysis was performed.

RESULTS

Eight trials (n = 3,355) from five countries met the inclusion criteria. All trials were assessed as having a high risk of bias. Two trials reported statistically significant reductions in hamstring injuries with eccentric exercise, and two reported statistically significant reductions in recurrent ankle sprains with proprioceptive exercise. Four trials showed no statistically significant difference in injury incidence with exercise interventions targeting a range of injuries.

LIMITATIONS

Notable limitations of included trials included poor reporting and limited blinding. A high risk of bias and insufficient comparability across trials prevented quantitative data synthesis.

CONCLUSIONS

Limitations in the context of study quality and heterogeneity resulted in an inability to reach a clear conclusion regarding efficacy of exercise for injury prevention in adult male football. Future low risk of bias, properly powered, and comprehensively reported trials are warranted to evaluate the efficacy of exercise on injury prevention. The use of eccentric hamstring exercise for hamstring injury prevention and proprioceptive training for recurrent ankle sprain prevention might be a good focus for future trials, as existing trials with a high risk of bias suggest an effect.