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Gasparin GB, Ribas LO, Flores HN, Bueno GBDB, Vrkoslaw L, Bittencourt NFN, Baroni BM. Uncovering injuries in Brazilian elite women's football: A prospective cohort study. J Sci Med Sport 2024; 27:228-233. [PMID: 38336547 DOI: 10.1016/j.jsams.2024.01.008] [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: 09/09/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To elucidate the injury profile in Brazilian elite women's football. DESIGN Prospective cohort study. METHODS Time-loss injuries, along with match and training exposure, were monitored throughout a full season in four Brazilian elite clubs. RESULTS Sixty-three out of 133 players (47 %) sustained 112 time-loss injuries along the season, leading to 0.8 injuries per player on average. The overall injury incidence rate was 5.0 injuries per 1000 h of exposure. Sudden onset injuries occurred at a rate of 4.2/1000 h of overall exposure, with rates of 15.9/1000 h during matches and 2.9/1000 h during training sessions. Forty-eight percent of the time-loss injuries were attributed to non-contact events. Gradual onset injuries accounted for 16 % of the injuries, resulting in a rate of 0.8/1000 h of overall exposure. The most affected locations were knee and thigh (29 % of all injuries for each), followed by ankle (17 %) and hip/groin (13 %). Muscle/tendon was the most affected tissue (47 % of all injuries), followed by ligament/joint capsule (33 %), bone (10 %), and cartilage/synovium/bursa (7 %). Ankle sprains, hamstring strains, and anterior cruciate ligament injuries accounted for over one-third of the injuries. Mild, moderate, and severe injuries account for 40 %, 43 %, and 17 % of cases, respectively. Overall, 18 % of cases were categorized as re-injuries, and 40 % of those occurred within 2 months of the index injury. CONCLUSIONS This study provides the initial understanding into the injury profile of Brazilian elite women's football. This information should serve as a guiding resource for injury prevention programs.
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Affiliation(s)
- Gabriela Bissani Gasparin
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
| | | | | | | | - Luana Vrkoslaw
- Associação Ferroviária de Esportes, Araraquara, SP, Brazil
| | | | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
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Diz JBM, Dutra MTP, Feijó IC, Sogno ALM, Silva FR, Carnevale GDEF, Moreira BDES, Silva CFM. LOW BACK PAIN ESTIMATES IN PROFESSIONAL SOCCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. ACTA ORTOPEDICA BRASILEIRA 2023; 31:e266012. [PMID: 38115872 PMCID: PMC10726716 DOI: 10.1590/1413-785220233105e266012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/22/2022] [Indexed: 12/21/2023]
Abstract
Objective To evaluate the epidemiological and clinical characteristics of low back pain (LBP) in adult professional soccer players. Methods Systematic review and meta-analysis. Results The review included 44 studies. The pooled prevalence of LBP during ≤ 1 season was 1% (95%CI = 0-4%) in men. The pooled point prevalence of LBP was 25% (95%CI = 16-36%) in men and 28% (95%CI = 20-37%) in women. The pooled past-year prevalence of LBP was 34% (95%CI = 24-44%) in men. The pooled lifetime prevalence of LBP was 32% (95%CI = 25-39%) in men and 50% (95%CI = 32-69%) in women. The pooled frequency of LBP/total number of injuries was 2% (95%CI = 1-3%) in men and 4% (95%CI = 2-5%) in women. The pooled incidence rate of LBP/1,000 player-hours of exposure was 0.30 (95%CI = 0.17- 0.53) in men and 0.32 (95%CI = 0.06 -1.87) in women. The recurrence of LBP ranged from 3% to 63% in men. The intensity of LBP ranged from 1.68 (2.39) to 4.87 (2.14) points on a 0-10 scale (minimum = 0 and maximum = 8 points). The severity of LBP (days absent from professional activities due to pain) ranged from 2 (0) to 10 (19) days (minimum = 1 and maximum = 28 days). Conclusion Adult elite soccer players have a substantial prevalence of LBP. The frequency and incidence of LBP (compared with other conditions and sports) seems to be low. Estimates of the recurrence, intensity, and severity of LBP are uncertain. Level of Evidence II, Systematic Review of Level II Studies.
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Abdoo O, Martinez C, Forshey T, Myers H, Hendren S, Pietrosimone LS. Do Climate and Environmental Characteristics Influence Concussion Incidence in Outdoor Contact Sports? A Systematic Review. J Athl Train 2023; 58:987-997. [PMID: 37115014 PMCID: PMC10784884 DOI: 10.4085/1062-6050-0655.22] [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] [Indexed: 04/29/2023]
Abstract
OBJECTIVE To obtain a comprehensive understanding of the implications of environmental and climate factors on sport-related concussion incidence in outdoor contact sports. DATA SOURCES MEDLINE (via Ovid), Embase (via Elsevier), CINAHL Complete (via EBSCOhost), SPORTDiscus (via EBSCOhost), and Scopus (via Elsevier). STUDY SELECTION Studies that report incidence of sport-related concussion, assess data from athletes participating in outdoor contact sports, report on 1 or more climate or environmental factors, and report a diagnosis of concussion performed by a licensed medical professional were included. Reasons for exclusion included no report on extrinsic or environmental factors, no data on sport-related concussion incidence, and self-report of concussion diagnosis. DATA EXTRACTION This systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using 2 reviewers at each phase and a third reviewer for conflict resolution. DATA SYNTHESIS A total of 7558 articles were reviewed, and 20 met the inclusion criteria. There was moderate to strong strength of evidence concluding no difference between surface type (grass versus artificial) on sport-related concussion risk. Moderate to strong strength of evidence was found supporting no difference in sport-related concussion incidence based on game location (home versus away). There was no consensus on the effects of altitude or temperature on sport-related concussion incidence. One high-quality study found a decreased risk of sport-related concussion when playing in wet versus dry conditions. Heterogenous populations and data collection methods prevented extraction and meta-analysis. CONCLUSIONS Although a consensus on specific environmental and climate factors that influence sport-related concussion incidence was limited, the majority of studies were of high quality and gave insight into opportunities for future investigation. Administrators of large injury surveillance databases should consider including specific environmental and climate factors to provide investigators with robust data sets to better understand potential associations with sport-related concussion.
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Gurau TV, Gurau G, Musat CL, Voinescu DC, Anghel L, Onose G, Munteanu C, Onu I, Iordan DA. Epidemiology of Injuries in Professional and Amateur Football Men (Part II). J Clin Med 2023; 12:6293. [PMID: 37834937 PMCID: PMC10573283 DOI: 10.3390/jcm12196293] [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: 08/02/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Background (1): Men's football is a physically demanding contact sport that involves intermittent bouts of sprinting, jogging, walking, jumping and changes of direction. The physical demands of the game vary by level of play (amateur club, sub-elite and open club or international), but injury rates at all levels of the men's football game remain the highest of all sports. Objective: The aim of this study is to conduct a systematic review of data from the epidemiological literature regarding the profile, severity and mechanisms of injuries and the frequency of recurrent injuries in professional and amateur football players. Methods (2): A systematic review, according to PRISMA guidelines, was performed up to June 2023 in the databases of PubMed, Web of Science, Google academic, Google scholar and the Diva portal. Twenty-seven studies that reported data on the type, severity, recurrence and mechanisms of injury in professional and amateur men's football were selected and analyzed. Two reviewers independently audited data and assessed the study quality using the additional and adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): In professional male football players, the mean prevalence of muscle/tendon injuries was 39.78%, followed by joint and ligament injuries-21.13%, contusions-17.86%, and fractures-3.27%, and for amateur football players, the prevalence's were 44.56% (muscle/tendon injuries), 27.62% (joint and ligament injuries), 15.0% (contusions) and 3.05% (fracture), respectively. The frequency of traumatic injuries was higher in amateur football players (76.88%) compared to professional football players (64.16%), the situation being reversed in the case of overuse injuries: 27.62% in professional football players and 21.13% in amateur football players. Most contact injuries were found in professional footballers (50.70%), with non-contact injuries predominating in amateur footballers (54.04%). The analysis of the severity of injuries showed that moderate injuries dominated in the two categories of footballers; the severe injuries in amateur footballers exceeded the severe injuries recorded in professional footballers by 9.60%. Recurrence proportions showed an inverse relationship with the level of play, being higher in amateur footballers (16.66%) compared to professional footballers (15.25%). Conclusions (4): Football-related injuries have a significant impact on professional and amateur football players and their short- and long-term health status. Knowing the frequency of severe diagnoses, such as strains, tears and cramps of the thigh muscles, ankle ligament sprains and hip/groin muscle strain requires the establishment of adequate programs to prevent them, especially in amateur football players, who are more prone to serious injuries.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania;
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iasi, 700454 Iasi, Romania;
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
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Gurau TV, Gurau G, Voinescu DC, Anghel L, Onose G, Iordan DA, Munteanu C, Onu I, Musat CL. Epidemiology of Injuries in Men's Professional and Amateur Football (Part I). J Clin Med 2023; 12:5569. [PMID: 37685638 PMCID: PMC10488230 DOI: 10.3390/jcm12175569] [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: 08/01/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
Background (1): Football is the most popular sport among men, associated with a certain risk of injury, which leads to short- and long-term health consequences. While the injury profile of professional footballers is known, little is known about the injury profile of amateur footballers; amateur football is a major and diverse area, the development of which should be a priority for football associations around the world and UEFA. The aim of this study was to perform a systematic review of epidemiological literature data on injuries in professional and amateur football players belonging to certain leagues. Methods (2): A systematic review according to the PRISMA guidelines was performed until June 2023 in the databases PubMed, Web of Science, Google Academic, Google Scholar, and Diva portal. Forty-six studies reporting injury incidence in professional and amateur men's football were selected and analyzed. Two reviewers independently extracted data and assessed study quality using an adapted version of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale (NOS) to assess risk of bias for the quality of external validity. Results (3): The overall incidence of injuries in professional male football players was 7.75 ± 2.28, 95% confidence interval, injuries/1000 h of exposure and that of amateur football players was 7.98 ± 2.95, 95% confidence interval, injuries/1000 h of exposure. The incidence of match injuries (30.64 ± 10.28, 95% confidence interval, injuries/1000 exposure hours) was 7.71 times higher than the training injury incidence rate (3.97 ± 1.35, 95% confidence interval, injuries/1000 h) in professional football players and 5.45 times higher in amateurs (17.56 ± 6.15 vs. 3.22 ± 1.4, 95% confidence interval, injuries/1000 h). Aggregate lower extremity injuries had the highest prevalence in both categories of footballers, being 83.32 ± 4.85% in professional footballers and 80.4 ± 7.04% in amateur footballers: thigh, ankle, and knee injuries predominated. Conclusions (4): Professional and amateur football players are at substantial risk of injury, especially during matches that require the highest level of performance. Injury rates have implications for players, coaches, and sports medicine practitioners. Therefore, information on football injuries can help develop personalized injury risk mitigation strategies that could make football safer for both categories of football players. The current findings have implications for the management, monitoring, and design of training, competition, injury prevention, especially severe injury, and education programs for amateur football players.
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Affiliation(s)
- Tudor Vladimir Gurau
- Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania;
| | - Gabriela Gurau
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Lucretia Anghel
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Gelu Onose
- Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Ar-Seni”, 041915 Bucharest, Romania;
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Daniel Andrei Iordan
- Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, ‘Dunarea de Jos’ University of Galati, 800008 Galati, Romania
- Center of Physical Therapy and Rehabilitation, ‘Dunărea de Jos’ University of Galati, 800008 Galati, Romania
| | - Constantin Munteanu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Ilie Onu
- Department of Biomedical Sciences, Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iaşi, 700454 Iaşi, Romania;
| | - Carmina Liana Musat
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (G.G.); (C.L.M.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galați, Romania; (D.C.V.); (L.A.)
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Gilhooly M, Cahalan R, O'Sullivan K, Norton C. A systematic literature review of injury epidemiology and surveillance practices in elite adult female field-based team sport. J Sci Med Sport 2023:S1440-2440(23)00080-4. [PMID: 37210318 DOI: 10.1016/j.jsams.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/16/2023] [Accepted: 04/30/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVES To describe injury incidence and surveillance practices in elite adult female field-based team sports. DESIGN Systematic literature review. METHODS This review was prospectively registered (PROSPERO CRD42022318642). CINAHL, PubMed, MEDLINE, Scopus, SPORTDiscus, Web of Science, Open Grey and Google Scholar were searched from inception to 30th June inclusive. Peer reviewed original research articles that reported the incidence of injury sustained by females aged ≥18 years in elite field-based team sports were included. The Newcastle Ottawa Scale was used to assess the risk of bias. RESULTS Twenty prospective cohort studies investigating injury incidence in Australian football, American football, soccer, field hockey, rugby, rugby-7s and cricket were eligible. A higher injury incidence in match play compared to training was reported with the highest match and training incidence (132.7 and 42.1/1000 h of exposure respectively) in Australian football. The majority of the reported injuries were to the lower limb and involved muscle/tendon or joint/ligaments. There was heterogeneity in definitions of injury, severity and exposure, variations in methods of injury data collection and reporting with, not all data being collected/reported optimally, which limited comparison of studies. CONCLUSIONS This review highlights the lack of and need for injury data specific to this cohort. Establishing the incidence of injury with a robust injury surveillance system is the first step in the sequence of injury prevention. It requires consistency in definitions and methodologies, providing accurate and useful injury data, to guide targeted injury prevention strategies.
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Affiliation(s)
- Marese Gilhooly
- School of Allied Health, University of Limerick, Ireland; Department of Sport and Health Sciences, Faculty of Science and Health, Technological University of the Shannon: Midlands Midwest, Ireland.
| | - Roisin Cahalan
- School of Allied Health, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Kieran O'Sullivan
- School of Allied Health, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland; Sports and Human Performance Research Centre, University of Limerick, Ireland
| | - Catherine Norton
- Health Research Institute, University of Limerick, Ireland; Department of Physical Education and Sport Sciences, University of Limerick, Ireland; Sports and Human Performance Research Centre, University of Limerick, Ireland
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Kuitunen I, Immonen V, Pakarinen O, Mattila VM, Ponkilainen VT. Incidence of football injuries sustained on artificial turf compared to grass and other playing surfaces: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101956. [PMID: 37125402 PMCID: PMC10139885 DOI: 10.1016/j.eclinm.2023.101956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Background Prior reviews have not conducted statistical synthesis of injury incidence on artificial turf in football. To analyse and compare the incidence of injuries sustained playing football (soccer) on artificial turf compared to grass and other playing surfaces. Methods This was a systematic review and meta-analysis. We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in October 2022 without filters. All observational studies (prospective or retrospective) that analysed injuries sustained playing football on artificial turf and which included a control group that played on grass or other surface were included. Studies were included if they reported the number of injuries and the exposure time for the playing surfaces. Risk of bias was assessed by Newcastle-Ottawa Scale. A random effects model was used to calculate the pooled incidence rate ratios (IRR) with 95% confidence intervals. Protocol was registered with PROSPERO on October 30th, 2022. Registration number: CRD42022371414. Findings We screened 1447 studies, and evaluated 67 full reports, and finally included 22 studies. Risk of bias was a notable issue, as only 5 of the 22 studies adjusted their analysis for potential confounders. Men (11 studies: IRR 0.82, CI 0.72-0.94) and women (5 studies: IRR 0.83, CI 0.76-0.91) had lower injury incidence on artificial turf. Professional players had a lower incidence of injury (8 studies: IRR 0.79, CI 0.70-0.90) on artificial turf, whereas there was no evidence of differences in the incidence of injury in amateur players (8 studies: IRR 0.91, CI 0.77-1.09). The incidence of pelvis/thigh (10 studies: IRR 0.72, CI 0.57-0.90), and knee injuries (14 studies: IRR 0.77, CI 0.64-0.92) were lower on artificial turf. Interpretation The overall incidence of football injuries is lower on artificial turf than on grass. Based on these findings, the risk of injury can't be used as an argument against artificial turf when considering the optimal playing surface for football. Funding No specific funding was received for this study.
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Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Paediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
- Corresponding author. Department of Pediatrics, Kuopio University Hospital, Puijonlaaksontie 2, PL 100, 70029, Kuopio, Finland.
| | - Ville Immonen
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
| | - Oskari Pakarinen
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
| | - Ville M. Mattila
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
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Maniar N, Carmichael DS, Hickey JT, Timmins RG, San Jose AJ, Dickson J, Opar D. Incidence and prevalence of hamstring injuries in field-based team sports: a systematic review and meta-analysis of 5952 injuries from over 7 million exposure hours. Br J Sports Med 2023; 57:109-116. [PMID: 36455927 DOI: 10.1136/bjsports-2021-104936] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports. DESIGN Systematic review and meta-analysis. DATA SOURCES CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020. ELIGIBILITY CRITERIA Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports. METHOD Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible. RESULTS Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269). CONCLUSION Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports. PROSPERO REGISTRATION NUMBER CRD42020200022.
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Affiliation(s)
- Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia .,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Jack Thomas Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ryan Gregory Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Argell Joseph San Jose
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jessica Dickson
- Library and Academic Research Services, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
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Horan D, Büttner F, Blake C, Hägglund M, Kelly S, Delahunt E. Injury incidence rates in women's football: a systematic review and meta-analysis of prospective injury surveillance studies. Br J Sports Med 2022; 57:471-480. [PMID: 36229168 DOI: 10.1136/bjsports-2021-105177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review the literature to establish overall, match and training injury incidence rates (IIRs) in senior (≥18 years of age) women's football (amateur club, elite club and international). DESIGN Systematic review and meta-analysis of overall, match and training IIRs in senior women's football, stratified by injury location, type and severity. DATA SOURCES MEDLINE via PubMed; EMBASE via Ovid; CINAHL via EBSCO and Web of Science were searched from earliest record to July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES (1) football players participating in a senior women's football league (amateur club or elite club) or a senior women's international football tournament; (2) the study had to report IIRs or provide sufficient data from which this outcome metric could be calculated through standardised equations; (3) a full-text article published in a peer-reviewed journal before July 2021; (4) a prospective injury surveillance study and (5) case reports on single teams were ineligible. RESULTS 17 articles met the inclusion criteria; amateur club (n=2), elite club (n=10), international (n=5). Overall, match and training 'time-loss' IIRs are similar between senior women's elite club football and international football. 'Time-loss' training IIRs in senior women's elite club football and international football are approximately 6-7 times lower than their equivalent match IIRs. Overall 'time-loss' IIRs stratified by injury type in women's elite club football were 2.70/1000 hours (95% CI 1.12 to 6.50) for muscle and tendon, 2.62/1000 hours (95% CI 1.26 to 5.46) for joint and ligaments, and 0.76/1000 hours (95% CI 0.55 to 1.03) for contusions. Due to the differences in injury definitions, it was not possible to aggregate IIRs for amateur club football. CONCLUSION Lower limb injuries incurred during matches are a substantial problem in senior women's football. The prevention of lower limb joint, ligament, muscle and tendon injuries should be a central focus of injury prevention interventions in senior women's amateur club, elite club and international football. PROSPERO REGISTRATION NUMBER CRD42020162895.
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Affiliation(s)
- Dan Horan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland .,High Performance Department, Football Association of Ireland, Dublin, Ireland
| | - Fionn Büttner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Martin Hägglund
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Football Research Group, Linköping University, Linköping, Sweden
| | - Seamus Kelly
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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10
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Xiao M, Lemos JL, Hwang CE, Sherman SL, Safran MR, Abrams GD. Increased Risk of ACL Injury for Female but Not Male Soccer Players on Artificial Turf Versus Natural Grass: A Systematic Review and Meta-Analysis. Orthop J Sports Med 2022; 10:23259671221114353. [PMID: 35990873 PMCID: PMC9382072 DOI: 10.1177/23259671221114353] [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: 04/01/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Both natural grass (NG) and artificial turf (AT) are popular playing surfaces
for soccer. Biomechanical studies have found increased frictional forces on
AT that may lead to anterior cruciate ligament (ACL) injury. The increased
risk of ACL injury during soccer in female participants may amplify this
effect. Purpose: To systematically review the literature for studies comparing ACL injury risk
in soccer players on AT versus NG and to specifically determine whether
there were differences in injury risk in male versus female players when
considering the playing surface. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review was performed using PRISMA (Preferred Reporting Items for
Systematic Reviews and Meta-Analyses) guidelines. Three databases were
searched for studies with evidence level 1 to 3 that compared the incidence
of ACL injuries on AT versus NG in soccer players. Data recorded included
study characteristics, sex, competition level, exposure setting (games or
practices), turf type, and ACL injury information. Study methodological
quality was analyzed using the methodological index for non-randomized
studies (MINORS) score, and incidence rate ratios (IRRs) were
calculated. Results: Included were 7 articles (3 studying professional soccer, 3 collegiate
soccer, 1 youth-level soccer; 4 male cohorts, 2 female cohorts, and 1 male
and female cohort; mean MINORS score, 20 ± 0.8). Pooled ACL injury IRRs
demonstrated no significant differences in overall ACL injury risk when
playing soccer on AT compared with NG (IRR = 0.57 [95% CI, 0.21-1.53];
P = .31). A significantly increased risk of ACL injury
in games played on AT compared with NG was detected for female (IRR = 1.18
[95% CI, 1.05-1.31]; P = .004) but not for male players
(IRR = 1.18 [95% CI, 0.97-1.42]; P = .09). Subgroup
analyses showed no significant differences in injury risk for games (IRR =
1.07 [95% CI, 0.97-1.18]; P = .20) or practices (IRR = 0.21
[95% CI, 0.04-1.23]; P = .09). Conclusion: Findings indicated that female soccer players had a significantly higher risk
of ACL injury when playing games on AT versus NG, whereas no significant
difference was seen in male players. No differences were found for the
combined male/female cohort or for soccer games or training sessions played
on AT compared with NG.
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Affiliation(s)
- Michelle Xiao
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Jacie L Lemos
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Calvin E Hwang
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Seth L Sherman
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Marc R Safran
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Geoffrey D Abrams
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California, USA
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11
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Abstract
OBJECTIVE To identify risk factors for quadriceps muscle strain injury in sport. DESIGN Risk factor systematic review. LITERATURE SEARCH A systematic search was conducted in the MEDLINECINAHL, Embase, AMED, AUSPORT, SPORTDiscus, PEDro, and Cochrane Library databases (from inception to September 2021). STUDY SELECTION CRITERIA Studies reporting prospective data to evaluate risk factors related to index and/or recurrent quadriceps muscle strain injury. DATA SYNTHESIS A risk-of-bias assessment (using a modified Quality in Prognosis Studies tool) was performed, and we used best-evidence synthesis to qualitatively synthesize the data to quantify relationships between risk factors and quadriceps muscle injury. RESULTS Sixteen studies were included, capturing 2408 quadriceps injuries in 11 719 athletes. Meta-analyses were not performed due to clinical heterogeneity. The dominant kicking leg (over 3154 individuals, 1055 injuries), a previous history of quadriceps muscle injury (6208 individuals, 975 injuries), and a recent history of hamstring strain (4087 individuals, 581 injuries) were intrinsic factors associated with quadriceps injury. Extrinsic factors relating to the preseason period and competitive match play increased quadriceps injury risk; participating at higher levels of competition decreased quadriceps injury risk. Age, weight, and flexibility (intrinsic factors) had no association with quadriceps injury. CONCLUSION Previous quadriceps injury, recent hamstring injury, the dominant kicking leg, and competitive match play were the strongest risk factors for future quadriceps muscle injury in sport. J Orthop Sports Phys Ther 2022;52(6):389-400. doi:10.2519/jospt.2022.10870.
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12
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Zech A, Hollander K, Junge A, Steib S, Groll A, Heiner J, Nowak F, Pfeiffer D, Rahlf AL. Sex differences in injury rates in team-sport athletes: A systematic review and meta-regression analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:104-114. [PMID: 34052518 PMCID: PMC8847930 DOI: 10.1016/j.jshs.2021.04.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/15/2021] [Accepted: 04/19/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Team-sport players have a particularly high injury risk. Although female sex is considered a risk factor, it is still unknown whether female and male team-sport players, in fact, differ in their injury rates. We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries. METHODS Studies that prospectively collected injury data for high-level female and male players (age ≥16 years) in basketball, field hockey, football (soccer), handball, rugby (union and sevens), and volleyball were included. Two reviewers (AZ and ALR) independently assessed study quality and extracted data for overall, match, training, and severe injuries (>28 days' time loss) as well as data regarding injury locations and types. Incidence rate ratios (IRRs) were pooled in a meta-analysis, and meta-regression analysis was performed when 10 or more studies were available. RESULTS Of 20 studies, 9 studies reported injury data from football, 3 studies from rugby, 3 studies from handball, 1 study from basketball, 1 study from field hockey, 2 studies from volleyball, and 1 study from basketball and field hockey. For overall injuries, the pooled IRR = 0.86 (95% confidence interval (95%CI): 0.76-0.98) indicated significantly more injuries in male than in female players. For injury location, the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity, hip/groin, thigh, and foot injuries. Female players had a significantly higher rate of anterior cruciate ligament injuries (IRR = 2.15, 95%CI: 1.27-3.62) than male players. No significant sex-specific differences in IRR were found for match, training, severe injuries, concussions, or ankle sprains. CONCLUSION Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports. Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.
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Affiliation(s)
- Astrid Zech
- Department of Human Movement Science and Exercise Physiology, Friedrich Schiller University Jena, Jena 07749, Germany.
| | | | - Astrid Junge
- MSH Medical School Hamburg, Hamburg 20457, Germany; Swiss Concussion Center, Schulthess Klinik, Zürich 8008, Switzerland
| | - Simon Steib
- Department of Human Movement, Training and Active Aging, Heidelberg University, Heidelberg 69117, Germany
| | - Andreas Groll
- Department of Statistics, Technical University of Dortmund, Dortmund 44227, Germany
| | - Jonas Heiner
- Department of Statistics, Technical University of Dortmund, Dortmund 44227, Germany
| | - Florian Nowak
- Department of Human Movement Science and Exercise Physiology, Friedrich Schiller University Jena, Jena 07749, Germany
| | - Daniel Pfeiffer
- Department of Human Movement Science and Exercise Physiology, Friedrich Schiller University Jena, Jena 07749, Germany
| | - Anna Lina Rahlf
- Department of Sports and Exercise Medicine, Institute of Human Movement Science, University of Hamburg, Hamburg 20146, Germany
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13
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Bakarman MA, Tashkandi M, Mohammed NS. An intervention plan for preventing and handling amateur soccer players' injuries. Niger J Clin Pract 2022; 25:1816-1822. [DOI: 10.4103/njcp.njcp_237_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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14
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Horan D, Blake C, Hägglund M, Kelly S, Roe M, Delahunt E. Injuries in elite-level women's football-a two-year prospective study in the Irish Women's National League. Scand J Med Sci Sports 2021; 32:177-190. [PMID: 34719066 DOI: 10.1111/sms.14062] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/11/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
We investigated the pattern of injuries in elite-level women's football in Ireland, during a two-season prospective injury surveillance study in the Women's National League (WNL). Seven out of the eight clubs (271 players) in the WNL were followed prospectively during the 2018 and 2019 seasons. The injury incidence rate in matches (19.2/1000 h) was 7.5 times higher than in training (2.5/1000 h). Players, on average, sustained 0.69 injuries per season (266 injuries/383 player seasons), which equates to 15 time-loss injuries per season for a squad of 22 players. The majority of the injuries sustained by players were lower extremity injuries (85%), of which, 46% had a non-contact injury mechanism. Muscle, ligament, and contusion injuries were the most common injury types, while the ankle, knee, and thigh were the most commonly injured body sites. The most common injuries sustained over the two seasons were lateral ankle sprains (13.9%), hamstring strains (12.4%), knee meniscus/cartilage injuries (7.5%), adductor strains (6%), quadriceps strains (4.5%), and ankle contusions (4.5%). The injuries with the highest injury burden were ACL injuries (59 days lost/1000 h), knee meniscus/cartilage injuries (23/1000 h), lateral ankle sprains (21/1000 h), hamstring strains (12/1000 h), MCL sprains (11/1000 h), and quadriceps strains (11/1000 h). There were 8 ACL tears documented over the 2 seasons, which accounted for 28% of all time lost to injury with a mean days lost per injury of 247. We recommend that clubs in the WNL in Ireland should implement injury risk mitigation strategies, with a particular focus on injuries with a high injury burden.
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Affiliation(s)
- Dan Horan
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,High Performance Department, Football Association of Ireland, Dublin, Ireland
| | - Catherine Blake
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Martin Hägglund
- Football Research Group, Linköping University, Linköping, Sweden.,Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Seamus Kelly
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Mark Roe
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Sport and Health, University College Dublin, Dublin, Ireland
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15
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Injury risk among athletes on artificial turf: a review of current literature. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Sghir M, Guedria M, Haj Salah A, Haddada I, Ben Fredj M, Kessomtini W. Ankle and foot injuries among Tunisian male amateur soccer players: A cross-sectional study. Sci Sports 2021. [DOI: 10.1016/j.scispo.2020.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Randell RK, Clifford T, Drust B, Moss SL, Unnithan VB, De Ste Croix MBA, Datson N, Martin D, Mayho H, Carter JM, Rollo I. Physiological Characteristics of Female Soccer Players and Health and Performance Considerations: A Narrative Review. Sports Med 2021; 51:1377-1399. [PMID: 33844195 PMCID: PMC8222040 DOI: 10.1007/s40279-021-01458-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
Female soccer has seen a substantial rise in participation, as well as increased financial support from governing bodies over the last decade. Thus, there is an onus on researchers and medical departments to develop a better understanding of the physical characteristics and demands, and the health and performance needs of female soccer players. In this review, we discuss the current research, as well as the knowledge gaps, of six major topics: physical demands, talent identification, body composition, injury risk and prevention, health and nutrition. Data on female talent identification are scarce, and future studies need to elucidate the influence of relative age and maturation selection across age groups. Regarding the physical demands, more research is needed on the pattern of high-intensity sprinting during matches and the contribution of soccer-specific movements. Injuries are not uncommon in female soccer players, but targeting intrinsically modifiable factors with injury prevention programmes can reduce injury rates. The anthropometric and physical characteristics of female players are heterogeneous and setting specific targets should be discouraged in youth and sub-elite players. Menstrual cycle phase may influence performance and injury risk; however, there are few studies in soccer players. Nutrition plays a critical role in health and performance and ensuring adequate energy intake remains a priority. Despite recent progress, there is considerably less research in female than male soccer players. Many gaps in our understanding of how best to develop and manage the health and performance of female soccer players remain.
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Affiliation(s)
- Rebecca K Randell
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Thomas Clifford
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Barry Drust
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samantha L Moss
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- Department of Sport and Exercise Sciences, University of Chester, Chester, UK
| | - Viswanath B Unnithan
- Institute of Clinical Exercise and Health Science, Division of Sport and Exercise, School of Health and Life Sciences, University of the West of Scotland, Hamilton, Scotland, UK
| | | | - Naomi Datson
- Institute of Sport, University of Chichester, Chichester, UK
| | - Daniel Martin
- School of Sport and Exercise Science, University of Lincoln, Lincoln, UK
| | - Hannah Mayho
- Sports Science Department, Manchester City Football Club, Manchester, UK
| | - James M Carter
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
| | - Ian Rollo
- Gatorade Sports Science Institute, Life Sciences R&D, PepsiCo, Leicester, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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18
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Paliobeis A, Sivasundaram L, Knapik DM, Labelle MW, Olson M, Karns MR, Salata MJ, Voos JE. Injury incidence is higher on artificial turf compared with natural grass in high school athletes: a retrospective cohort study. CURRENT ORTHOPAEDIC PRACTICE 2021. [DOI: 10.1097/bco.0000000000001012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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19
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Abstract
ABSTRACT Advancements in technology and the economic desires to maximize use of athletic playing surfaces have led to the development of various playing surfaces across the spectrum of sports. Each of these surfaces possesses specific safety profiles which are sport and population specific. Despite the growing medical literature on outdoor playing surfaces, inconsistent data exist on both orthopedic injuries and general medical concerns, such as surface component exposure toxicity and infection risk. Unfortunately, there is a paucity of data regarding various indoor playing surfaces and their effects on injury risk; this is an area ripe for further medical investigation. Understanding the differences in various play surfaces and their associated injury and health concerns is crucial for all medical staff providing care to athletes across the spectrum of skill and competition.
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Affiliation(s)
| | - T Jason Meredith
- University of Nebraska Medical Center Family Medicine Residency, Omaha, NE
| | - Peter Mitchell Martin
- University of Nebraska Medical Center & Offutt Air Force Base Family Medicine Residency, Omaha, NE
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20
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Injury Profile in Women's Football: A Systematic Review and Meta-Analysis. Sports Med 2021; 51:423-442. [PMID: 33433863 DOI: 10.1007/s40279-020-01401-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Football is the most popular sport among women; however, little is known about the injury profile in this population. This information would help design tailored injury risk mitigation strategies that may make football safer for women. OBJECTIVE The aim of this study was to perform a systematic review and meta-analysis of epidemiological data of injuries in women´s football. METHODS A systematic review following PRISMA guidelines was performed up to January 2020 in PubMed, Web of Science, Sportdiscus and the Cochrane Library databases. Twenty-two studies reporting the incidence of injuries in women football were analysed. Two reviewers independently extracted data (intraclass correlation coefficient [ICC] for inter-reviewer reliability = 0.87) and assessed study quality using the STROBE statement, GRADE approach, Newcastle Ottawa Scale and Downs and Black assessment tools. Studies were combined in pooled analyses (injury incidence and injury proportion) using a Poisson random effects regression model. RESULTS The overall incidence of injuries in female football players was 6.1 injuries/1000 h of exposure. Match injury incidence (19.2 injuries/1000 h of exposure) was almost six times higher than training injury incidence rate (3.5 injuries/1000 h of exposure). Lower extremity injuries had the highest incidence rates (4.8 injuries/1000 h of exposure). The most common types of injuries were muscle/tendon (1.8 injuries/1000 h of exposure) and joint (non-bone) and ligament (1.5 injuries/1000 h of exposure), which were frequently associated with traumatic incidents. Slight/minimal injuries (1-3 days of time loss) were the most common. The incidence rate of injuries during matches in the top five world ranking leagues was higher than the rest of the leagues (19.3 vs 10.7 injuries/1000 h of exposure, respectively). The weighted injury proportion was 1.1 (95% confidence interval = 0.6-1.7) whereby on average players sustained more than one injury per season. CONCLUSIONS Female football players are exposed to a substantial risk of sustaining injuries, especially during matches that require the highest level of performance. To markedly reduce overall injury burden, efforts should focus on introducing and evaluating preventative measures that target match specific dynamics to make football players more capable of responding to the challenges that they have to deal with during match play. REGISTRATION This systematic review was registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42019118152).
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21
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Geertsema C, Geertsema L, Farooq A, Harøy J, Oester C, Weber A, Bahr R. Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women's World Cup France 2019. Br J Sports Med 2021; 55:801-806. [PMID: 33397672 DOI: 10.1136/bjsports-2020-103131] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention. METHODS A survey was sent to players participating in the FIFA Women's World Cup France 2019. Questions covered three injury prevention domains: (1) knowledge; (2) attitudes and beliefs; (3) prevention practices in domestic clubs. Additionally, ACL injury history was assessed. RESULTS Out of 552 players, 196 women responded (35.5%). More than 80% of these considered injury risk to be moderate or high. Players listed knee, ankle, thigh, head and groin as the most important injuries in women's football. The most important risk factors identified were low muscle strength, followed by poor pitch quality, playing on artificial turf, too much training, reduced recovery and hard tackles. In these elite players, 15% did not have any permanent medical staff in their domestic clubs, yet more than 75% had received injury prevention advice and more than 80% performed injury prevention exercises in their clubs. Players identified the two most important implementation barriers as player motivation and coach attitude. Two-thirds of players used the FIFA 11+ programme in their clubs. CONCLUSIONS This diverse group of elite players demonstrated good knowledge of risk level and injury types in women's football. Of the risk factors emphasised by players, there was only one intrinsic risk factor (strength), but several factors out of their control (pitch quality and type, training volume and hard tackles). Still players had positive attitudes and beliefs regarding injury prevention exercises and indicated a high level of implementation, despite a lack of medical support.
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Affiliation(s)
- Celeste Geertsema
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar .,Weill Cornell Medical College, Doha, Qatar
| | - Liesel Geertsema
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar.,Weill Cornell Medical College, Doha, Qatar
| | - Abdulaziz Farooq
- Athlete Health and Performance Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Joar Harøy
- Senter for idrettsskadeforskning, Norges Idrettshøgskole, Oslo, Norway.,Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway
| | - Chelsea Oester
- Federation Internationale de Football Association, Zurich, Switzerland
| | - Alexis Weber
- Medicine & Science, Federation Internationale de Football Association, Zurich, Zürich, Switzerland
| | - Roald Bahr
- Oslo Sports Trauma Research Centre, Norwegian School of Sport Sciences, Oslo, Norway.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
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22
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The Influence of Playing Surface on the Loading Response to Soccer-Specific Activity. J Sport Rehabil 2020; 29:1166-1170. [PMID: 32028255 DOI: 10.1123/jsr.2019-0327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/26/2019] [Accepted: 12/10/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT The influence of playing surface on injury risk in soccer is contentious, and contemporary technologies permit an in vivo assessment of mechanical loading on the player. OBJECTIVE To quantify the influence of playing surface on the PlayerLoad elicited during soccer-specific activity. DESIGN Repeated measures, field-based design. SETTING Regulation soccer pitches. PARTICIPANTS Fifteen amateur soccer players (22.1 [2.4] y), injury free with ≥6 years competitive experience. INTERVENTIONS Each player completed randomized order trials of a soccer-specific field test on natural turf, astroturf, and third-generation artificial turf. GPS units were located at C7 and the mid-tibia of each leg to measure triaxial acceleration (100 Hz). MAIN OUTCOME MEASURES Total accumulated PlayerLoad in each movement plane was calculated for each trial. Ratings of perceived exertion and visual analog scales assessing lower-limb muscle soreness were measured as markers of fatigue. RESULTS Analysis of variance revealed no significant main effect for playing surface on total PlayerLoad (P = .55), distance covered (P = .75), or postexercise measures of ratings of perceived exertion (P = .98) and visual analog scales (P = .61). There was a significant main effect for GPS location (P < .001), with lower total loading elicited at C7 than mid-tibia (P < .001), but with no difference between limbs (P = .70). There was no unit placement × surface interaction (P = .98). There was also a significant main effect for GPS location on the relative planar contributions to loading (P < .001). Relative planar contributions to loading in the anterioposterior:mediolateral:vertical planes was 25:27:48 at C7 and 34:32:34 at mid-tibia. CONCLUSIONS PlayerLoad metrics suggest that playing surface does not influence mechanical loading during soccer-specific activity (not including tackling). Clinical reasoning should consider that PlayerLoad magnitude and axial contributions were sensitive to unit placement, highlighting opportunities in the objective monitoring of load during rehabilitation.
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23
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Winson DMG, Miller DLH, Winson IG. Foot injuries, playing surface and shoe design: Should we be thinking more about injury prevention. Foot Ankle Surg 2020; 26:597-600. [PMID: 31447244 DOI: 10.1016/j.fas.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/10/2019] [Accepted: 07/31/2019] [Indexed: 02/04/2023]
Abstract
The increasing use of artificial pitches has occurred in a multitude of sports at both professional and amateur levels. Artificial turf has become an extremely attractive option as it is felt to encourage a faster, safer and more entertaining play. However these pitches are not without controversy among sporting professionals and in the media. Foot and ankle injury in sport remains incredibly common and a significant burden on health professionals, but what impact do the new artificial surfaces have on these injuries. This review article aims to establish whether artificial turf has an impact on injury rates in the foot and ankle.
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Affiliation(s)
- Daniel M G Winson
- University Hospital of Wales, Cardiff, Heath Park, Cardiff, CF14 4XW, UK.
| | | | - Ian G Winson
- Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
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24
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Howard M, Solaru S, Kang HP, Bolia IK, Hatch GFR, Tibone JE, Gamradt SC, Weber AE. Epidemiology of Anterior Cruciate Ligament Injury on Natural Grass Versus Artificial Turf in Soccer: 10-Year Data From the National Collegiate Athletic Association Injury Surveillance System. Orthop J Sports Med 2020; 8:2325967120934434. [PMID: 32743012 PMCID: PMC7376298 DOI: 10.1177/2325967120934434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 03/04/2020] [Indexed: 01/13/2023] Open
Abstract
Background: Anterior cruciate ligament (ACL) injury is prevalent among National
Collegiate Athletic Association (NCAA) soccer players. Controversy remains
regarding the effect of the surface type on the rate of ACL injury in soccer
players, considering differences in sex, type of athletic exposure, and
level of competition. Hypothesis: Natural grass surfaces would be associated with decreased ACL injury rate in
NCAA soccer players. Sex, type of athletic exposure (match vs practice), and
level of competition (Division I-III) would affect the relationship between
playing surface and ACL injury rates. Study Design: Cohort study; Level of evidence, 3. Methods: Using the NCAA Injury Surveillance System (ISS) database, we calculated the
incidence rate of ACL injury in men and women from 2004-2005 through
2013-2014 seasons. The incidence was normalized against athletic exposure
(AE). Additional data collected were sex, athletic activity at time of
injury (match vs practice), and level of competition (NCAA division) to
stratify the analysis. Statistical comparisons were made by calculating
incidence rate ratios (IRR). Statistical significance was set at an alpha of
.05. Results: There were 30,831,779 weighted AEs during the study period. The overall
injury rate was 1.12 ACL injuries per 10,000 AEs (95% CI, 1.08-1.16). Women
comprised 57% of the match data (10,261 games) and 55% of practice data
(26,664 practices). The overall injury rate was significantly higher on
natural grass (1.16/10,000 AEs; 95% CI, 1.12-1.20) compared with artificial
turf (0.92/10,000 AEs [95% CI, 0.84-1.01]; IRR, 1.26 [95% CI, 1.14-1.38])
(P < .0001). This relationship was demonstrated
consistently across all subanalyses, including stratification by NCAA
division and sex. The injury rate on natural grass (0.52/10,000 AEs; 95% CI,
1.11-1.26) was significantly greater than the injury incidence during
practice on artificial turf (0.06/10,000 AEs; 95% CI, 0.043-0.096). Players
were 8.67 times more likely to sustain an ACL injury during practice on
natural grass compared with practice on artificial turf (95% CI, 5.43-12.13;
P < .0001). No significant difference was found in
injury rates between matches played on grass versus turf (IRR, 0.93; 95% CI,
0.84-1.03; P = .15). Conclusion: NCAA soccer players who practice on natural grass have increased risk of ACL
injury compared with the risk of those practicing on an artificial surface,
regardless of sex or NCAA division of play. No difference in risk of ACL
injury between playing surfaces was detected during matches. Further
research is necessary to examine the effect of multiple factors when
evaluating the effect of the surface type on the risk of ACL injury in
soccer players.
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Affiliation(s)
- Mark Howard
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Samantha Solaru
- University of Southern California, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Hyunwoo P Kang
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Ioanna K Bolia
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - George F R Hatch
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - James E Tibone
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Seth C Gamradt
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
| | - Alexander E Weber
- USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, California, USA
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Lee I, Jeong HS, Lee SY. Injury Profiles in Korean Youth Soccer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5125. [PMID: 32708572 PMCID: PMC7400017 DOI: 10.3390/ijerph17145125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 11/24/2022]
Abstract
We aimed to analyze injury profiles and injury severity in Korean youth soccer players. Data on all injuries that occurred in U-15 youth soccer players during the 2019 season were collected from 681 players of 22 teams through a medical questionnaire. The questionnaire was based on injury surveillance procedures of the Federation International de Football Association Medical and Research Centre and International Olympic Committee, and it comprised questions on demographic characteristics, training conditions, and injury information. Among all players, defenders accounted for 33.0%, followed by attackers (30.7%), midfielders (26.8%), and goalkeepers (7.9%). Most players played soccer on artificial grounds (97.4%). Injuries occurred more frequently during training (56.3%) than during matches (43.7%). Recurrent injury rate was 4.4% and average days to return to full activities were 22.58. The ankle (26.6%) and knee joints (14.1%) were the most common injury locations, and ligament sprains (21.0%), contusions (15.6%), and fractures (13.9%) were the most frequent injury types. In conclusion, Korean youth soccer players have a high injury risk. Therefore, researchers and coaching staff need to consider these results as a key to prevent injuries in youth soccer players and injury prevention programs may help decrease injury rate by providing injury management.
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Affiliation(s)
- Inje Lee
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
| | - Hee Seong Jeong
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
| | - Sae Yong Lee
- Department of Physical Education, Yonsei University, Seoul 03722, Korea;
- International Olympic Committee Research Centre KOREA, Yonsei University, Seoul 03722, Korea
- Institute of Convergence Science, Yonsei University, Seoul 03722, Korea
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López-Valenciano A, Ruiz-Pérez I, Garcia-Gómez A, Vera-Garcia FJ, De Ste Croix M, Myer GD, Ayala F. Epidemiology of injuries in professional football: a systematic review and meta-analysis. Br J Sports Med 2020; 54:711-718. [PMID: 31171515 PMCID: PMC9929604 DOI: 10.1136/bjsports-2018-099577] [Citation(s) in RCA: 144] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis of epidemiological data of injuries in professional male football. METHOD Forty-four studies have reported the incidence of injuries in football. Two reviewers independently extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement and Newcastle Ottawa Scale. Studies were combined in a pooled analysis using a Poisson random effects regression model. RESULTS The overall incidence of injuries in professional male football players was 8.1 injuries/1000 hours of exposure. Match injury incidence (36 injuries/1000 hours of exposure) was almost 10 times higher than training injury incidence rate (3.7 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (6.8 injuries/1000 hours of exposure). The most common types of injuries were muscle/tendon (4.6 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Minor injuries (1-3 days of time loss) were the most common. The incidence rate of injuries in the top 5 European professional leagues was not different to that of the professional leagues in other countries (6.8 vs 7.6 injuries/1000 hours of exposure, respectively). CONCLUSIONS Professional male football players have a substantial risk of sustaining injuries, especially during matches.
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Affiliation(s)
- Alejandro López-Valenciano
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
- Universidad Internacional Isabel I de Castilla, Burgos, Spain
| | - Iñaki Ruiz-Pérez
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | | | | | - Mark De Ste Croix
- Faculty of Applied Sciences, University of Gloucestershire, Gloucestershire, UK
| | - Gregory D Myer
- Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
- Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Francisco Ayala
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
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O' Leary F, Acampora N, Hand F, O' Donovan J. Association of artificial turf and concussion in competitive contact sports: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2020; 6:e000695. [PMID: 32518672 PMCID: PMC7254119 DOI: 10.1136/bmjsem-2019-000695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2020] [Indexed: 01/27/2023] Open
Abstract
Objective To determine the incidence of head injuries and concussion in contact sports, comparing natural grass with artificial turf surfaces. Design Systematic review and meta-analysis via the RevMan V.5.3 software. Eligibility criteria for selecting studies All studies describing competitive contact sports played on both natural grass and artificial turf. The primary outcome measured was occurrence of head injury and concussion. Data sources The databases include PubMed, Embase, Cochrane, Medline and Sport Discus. The last search took place on 23 May 2019. The Newcastle-Ottawa Quality Assessment Scale evaluated the methodological quality of the selected studies with a funnel plot designed to determine publication bias. Study screening and data extraction were performed by two independent reviewers. Results Initial screening generated 42 publications, with 12 meeting criteria for inclusion. Eight studies described concussion only. The rate ratio (RR) of head injury and concussion was less on artificial turf compared with natural grass (RR=0.89, 95% CI 0.77 to 1.04) as was the rate ratio of concussion only (RR=0.72, 95% CI 0.58 to 0.89). Conclusion Analysis of published data demonstrates a decreased incidence of head injury and concussion when contact sports are played on artificial turf. This difference was most marked for sports such as rugby and American football. However, artificial turf has no association with the incidence of head injury or concussion while playing soccer.
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Affiliation(s)
- Frank O' Leary
- Department of Performance Medicine, Sport Ireland Institute, Dublin, Ireland
| | - Nic Acampora
- Faculty of Life Sciences, University of South Wales, Pontypridd, Rhondda Cynon Taff, UK
| | - Fiona Hand
- Department of Surgery, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - James O' Donovan
- Department of Performance Medicine, Sport Ireland Institute, Dublin, Ireland
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The Influence of Soccer Playing Surface on the Loading Response to Ankle (P)Rehabilitation Exercises. J Sport Rehabil 2020; 30:105-111. [PMID: 32235001 DOI: 10.1123/jsr.2019-0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 01/06/2020] [Accepted: 01/26/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Contemporary synthetic playing surfaces have been associated with an increased risk of ankle injury in the various types of football. Triaxial accelerometers facilitate in vivo assessment of planar mechanical loading on the player. OBJECTIVE To quantify the influence of playing surface on the PlayerLoad elicited during footwork and plyometric drills focused on the mechanism of ankle injury. DESIGN Repeated-measures, field-based design. SETTING Regulation soccer pitches. PARTICIPANTS A total of 15 amateur soccer players (22.1 [2.4] y), injury free with ≥6 years competitive experience. INTERVENTIONS Each player completed a test battery comprising 3 footwork drills (anterior, lateral, and diagonal) and 4 plyometric drills (anterior hop, inversion hop, eversion hop, and diagonal hop) on natural turf (NT), third-generation artificial turf (3G), and AstroTurf. Global positioning system sensors were located at C7 and the mid-tibia of each leg to measure triaxial acceleration (100 Hz). MAIN OUTCOME MEASURES PlayerLoad in each axial plane was calculated for each drill on each surface and at each global positioning system location. RESULTS Analysis of variance revealed a significant main effect for sensor location in all drills, with PlayerLoad higher at mid-tibia than at C7 in all movement planes. AstroTurf elicited significantly higher PlayerLoad in the mediolateral and anteroposterior planes, with typically no difference between NT and 3G. In isolated inversion and eversion hopping trials, the 3G surface also elicited lower PlayerLoad than NT. CONCLUSIONS PlayerLoad magnitude was sensitive to unit placement, advocating measurement with greater anatomical relevance when using microelectromechanical systems technology to monitor training or rehabilitation load. AstroTurf elicited higher PlayerLoad across all planes and drills and should be avoided for rehabilitative purposes, whereas 3G elicited a similar mechanical response to NT.
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Strutzenberger G, Edmunds R, Nokes LDM, Mitchell ID, Mellalieu SD, Irwin G. Player–surface interactions: perception in elite soccer and rugby players on artificial and natural turf. Sports Biomech 2020; 21:1021-1031. [DOI: 10.1080/14763141.2020.1720279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Gerda Strutzenberger
- Department of Sport Science and Kinesiology/USI, University of Salzburg, Salzburg, Austria
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Rob Edmunds
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Ian D. Mitchell
- People and Team Development, the Football Association, Burton Upon Trent, UK
| | - Stephen D. Mellalieu
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Gareth Irwin
- School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Philp F, Al-Shallawi A, Kyriacou T, Blana D, Pandyan A. Improving predictor selection for injury modelling methods in male footballers. BMJ Open Sport Exerc Med 2020; 6:e000634. [PMID: 32095267 PMCID: PMC7010990 DOI: 10.1136/bmjsem-2019-000634] [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] [Accepted: 12/15/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This objective of this study was to evaluate whether combining existing methods of elastic net for zero-inflated Poisson and zero-inflated Poisson regression methods could improve real-life applicability of injury prediction models in football. Methods Predictor selection and model development was conducted on a pre-existing dataset of 24 male participants from a single English football team's 2015/2016 season. Results The elastic net for zero-inflated Poisson penalty method was successful in shrinking the total number of predictors in the presence of high levels of multicollinearity. It was additionally identified that easily measurable data, that is, mass and body fat content, training type, duration and surface, fitness levels, normalised period of 'no-play' and time in competition could contribute to the probability of acquiring a time-loss injury. Furthermore, prolonged series of match-play and increased in-season injury reduced the probability of not sustaining an injury. Conclusion For predictor selection, the elastic net for zero-inflated Poisson penalised method in combination with the use of ZIP regression modelling for predicting time-loss injuries have been identified appropriate methods for improving real-life applicability of injury prediction models. These methods are more appropriate for datasets subject to multicollinearity, smaller sample sizes and zero-inflation known to affect the performance of traditional statistical methods. Further validation work is now required.
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Affiliation(s)
- Fraser Philp
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
| | - Ahmad Al-Shallawi
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK.,The Engineering Technical College of Mosul, Northern Technical University, Mosul, Nineveh, Iraq
| | - Theocharis Kyriacou
- School of Computing and Mathematics, Keele University, Keele, Staffordshire, UK
| | - Dimitra Blana
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK
| | - Anand Pandyan
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
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Abstract
Participation in youth soccer in the United States continues to increase steadily, with a greater percentage of preadolescent participants than perhaps any other youth sport. Despite the wide-ranging health benefits of participation in organized sports, injuries occur and represent a threat to the health and performance of young athletes. Youth soccer has a greater reported injury rate than many other contact sports, and recent studies suggest that injury rates are increasing. Large increases in the incidence of concussions in youth soccer have been reported, and anterior cruciate ligament injuries remain a significant problem in this sport, particularly among female athletes. Considerable new research has identified a number of modifiable risk factors for lower-extremity injuries and concussion, and several prevention programs have been identified to reduce the risk of injury. Rule enforcement and fair play also serve an important role in reducing the risk of injury among youth soccer participants. This report provides an updated review of the relevant literature as well as recommendations to promote the safe participation of children and adolescents in soccer.
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Affiliation(s)
- Andrew Watson
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin; and
| | - Jeffrey M Mjaanes
- Department of Orthopedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Serrano C, Sánchez-Sánchez J, López-Fernández J, Hernando E, Gallardo L. Influence of the playing surface on changes of direction and plantar pressures during an agility test in youth futsal players. Eur J Sport Sci 2019; 20:906-914. [DOI: 10.1080/17461391.2019.1677780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Carlos Serrano
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Javier Sánchez-Sánchez
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
- School of Sport Science, European University, Madrid, Spain
| | - Jorge López-Fernández
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
- Centre for Innovative Research across the Life Course (CIRAL), Coventry University, Coventry, UK
| | - Enrique Hernando
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Leonor Gallardo
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
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Calloway SP, Hardin DM, Crawford MD, Hardin JM, Lemak LJ, Giza E, Forsythe B, Lu Y, Patel BH, Osbahr DC, Gerhardt MB, Mandelbaum BR, Baldwin WW. Injury Surveillance in Major League Soccer: A 4-Year Comparison of Injury on Natural Grass Versus Artificial Turf Field. Am J Sports Med 2019; 47:2279-2286. [PMID: 31306590 DOI: 10.1177/0363546519860522] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Artificial playing surfaces are becoming more common due to decreased cost of maintenance and increased field usability across different environmental conditions. The Fédération Internationale de Football Association (FIFA) has approved newer generation artificial turf for soccer competition at the elite level, but many elite-level athletes prefer to play on natural grass surfaces due to a perceived increase in injury rate, discomfort, and fatigability on artificial turf. HYPOTHESIS Injury rates and rates of individually categorized types of injury experienced on artificial turf are noninferior to rates of injury on the standard comparator, natural grass, in elite-level Major League Soccer athletes. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Over the course of 4 Major League Soccer seasons (2013-2016), athlete injury data were recorded electronically. Injury data recorded in matches between 2 Major League Soccer teams were then analyzed. Playing surface was known for each venue, and all artificial turf surfaces were rated as 2-star according to FIFA criteria. Incidence rate ratios (Artificial Turf ÷ Natural Grass) were calculated with a 95% CI (α = .05) for both overall injury incidence and individual injury subgroups. A noninferiority margin (δ) of 0.15 was used to determine noninferiority of injury incidence rates. RESULTS A total of 2174 in-game injuries were recorded during the study period, with 1.54 injuries per game on artificial turf and 1.49 injuries per game on natural grass (incidence rate ratio, 1.033; 95% CI, 0.937-1.139). Within injury subgroups, overall ankle injury, Achilles injury, and ankle fracture were found to have a statistically higher incidence on artificial turf. Artificial turf was found to be noninferior to natural grass for overall foot injury and forefoot injury. No statistically significant differences were found in knee injuries between the 2 surfaces. CONCLUSION The overall rate of injury on artificial turf was noninferior to that on natural grass. Within individual injury categories, a higher rate of ankle injury was found on artificial turf. No other injury subgroup demonstrated statistically significant differences between surfaces. CLINICAL RELEVANCE FIFA 2-star rated artificial turf is a viable alternative to natural grass in elite-level soccer competition. Innovative research methods for comparing artificial turf versus natural grass may elucidate relative advantages with respect to player safety.
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Affiliation(s)
- Sean P Calloway
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - David M Hardin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Matthew D Crawford
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - J Michael Hardin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Lawrence J Lemak
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Eric Giza
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Brian Forsythe
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Yining Lu
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Bhavik H Patel
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Daryl C Osbahr
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Michael B Gerhardt
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Bert R Mandelbaum
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - William W Baldwin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
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McMurtry S, Fiedler G. Comparison of lower limb segment forces during running on artificial turf and natural grass. J Rehabil Assist Technol Eng 2019; 6:2055668319835701. [PMID: 31245032 PMCID: PMC6582296 DOI: 10.1177/2055668319835701] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 02/11/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction: Artificial turf, soon after being introduced in the 1980s, became associated
with an increased injury incidence in football players. While more recent
generations of artificial turf have mitigated the problem, perception of the
material is still widely negative. So, the decision to play the 2015
Fe'de'ration Internationale de Football Association Women s World Cup in
Canada on artificial turf was met with vocal criticism by many players. One
common approach is to assess injury incidence to quantify risk differences
in playing surfaces. This, however, does not account for possible
confounding variables or chronic injuries. Direct measurement of ground
reaction forces is difficult because conventional multicamera-based motion
capture and force plate equipment are limited in its use outside of
dedicated laboratories. Methods: We describe a method of generating realistic force data by using miniature
load cells that are installed directly into the weight-bearing structure of
the body. Results: Pilot data show a significant (p<0.01) difference in peak forces on
artificial turf (272% of body weight) and natural grass (229% of body
weight). Discussion: Invasive surgical procedures were avoided by installing the load cell into
the prosthesis of an athlete with lower limb loss. As modern prosthetic
devices allow a close approximation of able-bodied kinematics and kinetics,
such prosthesis-based data are transferable to a general population.
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Affiliation(s)
- Shea McMurtry
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA
| | - Goeran Fiedler
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA
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Abrasion injuries on artificial turf: A systematic review. J Sci Med Sport 2019; 22:550-556. [DOI: 10.1016/j.jsams.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 09/09/2018] [Accepted: 11/09/2018] [Indexed: 11/20/2022]
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Putukian M, Echemendia RJ, Chiampas G, Dvorak J, Mandelbaum B, Lemak LJ, Kirkendall D. Head Injury in Soccer: From Science to the Field; summary of the head injury summit held in April 2017 in New York City, New York. Br J Sports Med 2019; 53:1332. [DOI: 10.1136/bjsports-2018-100232] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
There has been an increased focus and awareness of head injury and sport-related concussion (SRC) across all sports from the medical and scientific communities, sports organisations, legislators, the media and the general population. Soccer, in particular, has been a focus of attention due to the popularity of the game, the frequency of SRC and the hypothesised effects of repetitive heading of the ball. Major League Soccer, US Soccer and the National Women’s Soccer League jointly hosted a conference entitled, ‘Head Injury in Soccer: From Science to the Field’, on 21–22 April 2017 in New York City, New York. The mission of this conference was to identify, discuss and disseminate evidence-based science related to the findings and conclusions of the fifth International Conference on Concussion in Sport held by the Concussion in Sport Group and apply them to the sport of soccer. In addition, we reviewed information regarding the epidemiology and mechanism of head injuries in soccer at all levels of play, data regarding the biomechanics and effects of repetitive head impacts and other soccer-specific considerations. We discussed how to release the information raised during the summit to key stakeholders including athletes, parents, coaches and healthcare providers. We identified future areas for research and collaboration to enhance the health and safety of soccer (football) players.
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Epidemiology of Head Injuries Focusing on Concussions in Team Contact Sports: A Systematic Review. Sports Med 2018; 48:953-969. [PMID: 29349651 DOI: 10.1007/s40279-017-0854-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Although injuries to the head represent a small proportion of all sport injuries, they are of great concern due to their potential long-term consequences, which are even suspected in mild traumatic brain injuries. OBJECTIVE The aim of this review was to compare the incidence of concussions and other head injuries in elite level football, rugby, ice hockey and American Football. METHODS Four electronic databases (CINAHL, PsycINFO, Web of Science, PubMed) were searched. Prospective cohort studies on the incidence of concussion in elite athletes aged 17 years or older that were published in an English-language peer-reviewed journal since 2000 were included. Two authors independently evaluated study eligibility and quality. The extracted data on concussions were pooled in a meta-analysis using an inverse-variance fixed-effects model. The extracted data on head injuries were reported in a narrative and tabular summary. RESULTS The search yielded 7673 results of which 70 articles were included in the qualitative and 47 in the quantitative analysis. In our meta-analysis, we found the highest concussion incidences in rugby match play (3.89 and 3.00 concussions per 1000 h and athletic exposures (AEs), respectively), and the lowest in men's football training (0.01 and 0.08 per 1000 h and AEs, respectively). Overall, concussions and all head injuries were rare in training when compared to match play. Female players had an increased concussion risk in football and ice hockey when compared to male players. CONCLUSION Future research should focus on concussion in women's contact sports, as there is little evidence available in this area. Methodological deficits are frequent in the current literature, especially regarding sample size and study power, and should be avoided.
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Mears AC, Osei-Owusu P, Harland AR, Owen A, Roberts JR. Perceived Links Between Playing Surfaces and Injury: a Worldwide Study of Elite Association Football Players. SPORTS MEDICINE-OPEN 2018; 4:40. [PMID: 30128862 PMCID: PMC6102163 DOI: 10.1186/s40798-018-0155-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 08/07/2018] [Indexed: 12/01/2022]
Abstract
Background Injuries in association football (soccer) are debilitating for players and can also be detrimental to the success of a team or club. The type or condition of a playing surface has been empirically linked to injuries, yet results are inconclusive. The overall purpose of this study was to analyse elite football players’ perceived links between playing surfaces and injury from a worldwide cohort of players. The results of this study can help to inform areas for future playing surface research aimed at trying to alleviate user concerns and meet user (i.e. the player) needs. Methods Quantitative data were collected from 1129 players across the globe to address the aim of this study. Results Ninety-one percent of players believed the type or condition of a surface could increase injury risk. Abrasive injuries, along with soreness and pain, were perceived to be greater on artificial turf. Surface type, surface properties and age were all potential risk factors identified by the players and linked to the playing surfaces. Conclusions The results identified three areas where future research should be focussed to help develop surfaces that alleviate user concerns and meet user (i.e. player) needs: (i) current reporting of soreness, pain or fatigue as injuries, (ii) contribution of surface properties to injury; and (iii) surface experience of players from different countries differentiates their views of injury risk.
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Affiliation(s)
- Aimée C Mears
- Sports Technology Institute, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK.
| | - Paul Osei-Owusu
- Sports Technology Institute, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK
| | - Andy R Harland
- Sports Technology Institute, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK
| | - Alun Owen
- Faculty of Engineering, Environment and Computing, Coventry University, Coventry, UK
| | - Jonathan R Roberts
- Sports Technology Institute, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Loughborough, UK
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Błażkiewicz A, Grygorowicz M, Białostocki A, Czaprowski D. Characteristics of goalkeeping injuries: a retrospective, self-reported study in adolescent soccer players. J Sports Med Phys Fitness 2018; 58:1823-1830. [PMID: 29479994 DOI: 10.23736/s0022-4707.18.07849-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Characteristic types of actions and training/matches loads of soccer goalkeepers show that goalkeeper's performance differs from other soccer's formations. Such situation may predispose to the occurrence of other kinds of injuries in this position. The aim of this study was to analyze epidemiology of injuries in young soccer goalkeepers. METHODS Forty-eight soccer goalkeepers (aged:15.2±1.9 years) filled the questionnaire aimed at collecting information about all injuries sustained within 12 months before the data collection. The anthropometric data, soccer experience and information regarding the injury types and occurrence were analyzed. The injury rate proportion for acute and overuse injuries and values of injuries including the burden of the match game and training were evaluated. The level of significance was set at P<0.05. RESULTS Thirty-three (68.8%) questionnaires were given back. Twenty-four (72.7%) goalkeepers reported the history of soccer related injury within a year before the survey. 52 injuries were reported. Significantly higher number of acute (76.9%) vs. overuse (23.1%) injuries was described (P=0.0012). Acute injuries involved fractures/subluxations of the fingers and thigh muscle strain/tears. The group of overuse injuries was dominated by trauma of the knee and pelvic girdle muscles. Majority of injuries occurred during training (88.5% of all injuries), and there was significant higher number of injuries sustained on artificial vs. natural grass for all, acute and overuse types of injuries (P<0.0001). CONCLUSIONS Young soccer goalkeepers suffer mostly acute injuries (within the fingers of hands and muscles of thighs). It might be associated with specific characteristic of performance related to goalkeeper's position.
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Affiliation(s)
- Aleksander Błażkiewicz
- Department of Rehabilitation, Józef Piłsudski University of Physical Education, Warsaw, Poland - .,Rehasport Clinic, FIFA Medical Center of Excellence, Poznań, Poland -
| | - Monika Grygorowicz
- Rehasport Clinic, FIFA Medical Center of Excellence, Poznań, Poland.,Department of Spondylo-orthopedics and Biomechanics of the Spine, Karol Marcinkowski Poznań University of Medical Sciences, Poznań, Poland
| | | | - Dariusz Czaprowski
- Department of Physiotherapy, Józef Rusiecki University College, Olsztyn, Poland.,Center of Body Posture, Olsztyn, Poland
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Eijnde WVD, Masen M, Lamers E, van de Kerkhof P, Peppelman M, Erp PV. The load tolerance of skin during impact on artificial turf using ex-vivo skin as the readout system. SCI MED FOOTBALL 2017. [DOI: 10.1080/24733938.2017.1390593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Wilbert van den Eijnde
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Marc Masen
- Department of Mechanical Engineering, Imperial College London, London, United Kingdom
| | | | - Peter van de Kerkhof
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Malou Peppelman
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Piet Van Erp
- Department of Dermatology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Fleaca R, Roman M, Bățagă T, Feier AM, Prejbeanu R, Predescu V, Zuh SG, Gergely I, Russu O. Prevention of Primary ACL Injuries: A Novel, Innovative Approach. JOURNAL OF INTERDISCIPLINARY MEDICINE 2017. [DOI: 10.1515/jim-2017-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Anterior cruciate ligament (ACL) injuries are increasing amongst professional and recreational athletes, and creating prevention programs to reduce the occurrence of ACL damages is becoming a necessity. To prevent an ACL tear, it is necessary to comprehend the mechanisms and the risk factors of injury. Biomechanical and clinical studies try to understand these complex mechanisms in order to identify factors that can be improved and to develop training programs to prevent at least non-contact ACL injuries. There are several promising programs, but there are still many questions to answer. This paper analyzes the risk factors for ACL injuries and some aspects of the modern programs developed to decrease the rate of ACL tears.
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Affiliation(s)
- Radu Fleaca
- “Victor Papillan” Faculty of Medicine , “Lucian Blaga” University , Sibiu , Romania
| | - Mihai Roman
- “Victor Papillan” Faculty of Medicine , “Lucian Blaga” University , Sibiu , Romania
| | - Tiberiu Bățagă
- University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | | | - Radu Prejbeanu
- “Victor Babeş” University of Medicine and Pharmacy , Timişoara , Romania
| | - Vlad Predescu
- “Carol Davila” University of Medicine and Pharmacy , Bucharest , Romania
| | | | - István Gergely
- University of Medicine and Pharmacy , Tîrgu Mureş , Romania
| | - Octav Russu
- University of Medicine and Pharmacy , Tîrgu Mureş , Romania
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Meyers MC. Incidence, Mechanisms, and Severity of Match-Related Collegiate Men's Soccer Injuries on FieldTurf and Natural Grass Surfaces: A 6-Year Prospective Study. Am J Sports Med 2017; 45:708-718. [PMID: 27872124 DOI: 10.1177/0363546516671715] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous injuries have been attributed to playing on artificial turf. More recently, newer generations of artificial turf have been developed to duplicate the playing characteristics of natural grass. Although artificial turf has been deemed safer than natural grass in some studies, few long-term studies have been conducted comparing match-related collegiate soccer injuries between the 2 playing surfaces. HYPOTHESIS Collegiate male soccer athletes do not experience any difference in the incidence, mechanisms, or severity of match-related injuries between FieldTurf and natural grass. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Male soccer athletes from 11 universities were evaluated over 6 seasons. Demographic features and predictors included player position, cleat design, player weight, turf age, and environmental factors. Outcomes of interest included injury incidence, injury category, time loss, injury mechanism and situation, type of injury, injury grade and anatomic location, injury severity, head and lower extremity trauma, and elective medical procedures. All match-related injuries were evaluated by the attending head athletic trainer and team physicians on site and subsequently in the physician's office when further follow-up and treatment were deemed necessary. In sum, 765 collegiate games were evaluated for match-related soccer injuries sustained on FieldTurf or natural grass during 6 seasons. RESULTS Overall, 380 team games (49.7%) were played on FieldTurf versus 385 team games (50.3%) played on natural grass. A total of 722 injuries were documented, with 268 (37.1%) occurring on FieldTurf and 454 (62.9%) on natural grass. Multivariate analysis per 10 team games indicated a significant playing surface effect: F2,720 = 7.260, P = .001. A significantly lower total injury incidence rate (IIR) of 7.1 (95% CI, 6.6-7.5) versus 11.8 (95% CI, 11.3-12.2; P < .0001) and lower rate of substantial injuries, 0.7 (95% CI, 0.5-1.0) versus 1.9 (95% CI, 1.5-2.3; P < .03), were documented on FieldTurf versus natural grass, respectively. Analyses also indicated significantly less trauma on FieldTurf when comparing injury category, time loss, player position, injury mechanism and situation, injuries under various environmental conditions, cleat design, turf age, anatomic location, and elective medical procedures. No significant difference (F11,710 = 0.822, P = .618) between surfaces by knee injury was observed, with the majority of knee injuries involving patellar tendinopathies/syndromes followed by medial collateral ligament injuries on both surfaces. CONCLUSION Although similarities existed between FieldTurf and natural grass during competitive match play, FieldTurf is, in many cases, safer than natural grass when comparing injuries in collegiate men's soccer. The findings of this study, however, may not be generalizable to other levels of competition or to other artificial surfaces.
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Affiliation(s)
- Michael C Meyers
- Human Performance Laboratory, Department of Sport Science and Physical Education, Idaho State University, Pocatello, Idaho, USA
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Kulessa DJ, Gollhofer A, Gehring D. The influence of football shoe characteristics on athletic performance and injury risk – a review. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1284273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
| | - Dominic Gehring
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
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Chéron C, Le Scanff C, Leboeuf-Yde C. Association between sports type and overuse injuries of extremities in adults: a systematic review. Chiropr Man Therap 2017; 25:4. [PMID: 28101329 PMCID: PMC5237127 DOI: 10.1186/s12998-017-0135-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023] Open
Abstract
Background Sports injuries are often described as overuse or traumatic. Little is known about the frequency of overuse injuries and, in particular, if they vary between different types of sporting activities. Purpose To identify any differences between sports in relation to diagnoses of overuse injuries of the extremities (OIE) and anatomical areas most likely to be injured in adults and to compare these findings with those reported in youngsters, as identified in a previous review. Methods A search was made in May 2015 and again in April 2016 in PubMed, SportDiscus, PsycInfo, and Web of Sciences. Search terms were « overuse injuries OR cumulative trauma disorders OR musculoskeletal injuries » AND « extremity OR limb » AND « physical activity OR sport OR risk factor OR exercises ». Inclusion criteria were: 1) prospective, or cross-sectional study design; 2) at least 1/3 of the population should be ≥ 19 years; 3) articles must clearly state if reported cases were classified as traumatic or overuse injuries in relation to a particular sports type, 4) sample size >50, and 5) articles must not deal with specific occupational subpopulations nor with clinical populations. A blinded systematic review was conducted and results reported per anatomical site of injury and diagnosis for the different sports. Results In all, 10 of 1435 identified articles were included, studying soccer, beach-volleyball and triathlon. In general, the incidence estimates were low, never above 2.0/1000 h of practice, similar to results seen in children/adolescents. The incidence estimates and the diagnoses of OIE were given only in 4 articles on soccer, making comparisons between sports impossible. As in children/adolescents, the lower limb is more often affected than the upper but contrary to young people the injured site in adults is more often the knee and above, and there were also differences in the diagnoses for the two age groups. Conclusion The literature does not permit to identify clearly the difference in the incidence of OIE for different sports showing that more but well-designed surveillance studies are needed.
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Affiliation(s)
- Charlène Chéron
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France ; Institut Franco-Européen de Chiropraxie, 72 Chemin de la Flambère, F-31300 Toulouse, France
| | - Christine Le Scanff
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France
| | - Charlotte Leboeuf-Yde
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France ; Institut Franco-Européen de Chiropraxie, 72 Chemin de la Flambère, F-31300 Toulouse, France
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Silva DC, Santos R, Vilas-Boas JP, Macedo R, Montes A, Sousa AS. The influence of different soccer cleat type on kinetic, kinematic and neuromuscular ankle variables in artificial turf. FOOTWEAR SCIENCE 2016. [DOI: 10.1080/19424280.2016.1240246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Diogo C.F. Silva
- Área Científica de Ciências Funcionais, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - Rubim Santos
- Área Científica de Física, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - J. Paulo Vilas-Boas
- CIFI2D, Universidade de Desporto e Laboratório de Biomecênica do Porto, Universidade do Porto, Porto, Portugal
| | - Rui Macedo
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - António Montes
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
| | - Andreia S.P. Sousa
- Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Centro de Estudos de Movimento e Atividade Humana, Rua Valente Perfeito, Vila Nova de Gaia, Portugal
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Bianco A, Spedicato M, Petrucci M, Messina G, Thomas E, Nese Sahin F, Paoli A, Palma A. A Prospective Analysis of the Injury Incidence of Young Male Professional Football Players on Artificial Turf. Asian J Sports Med 2016; 7:e28425. [PMID: 27217929 PMCID: PMC4870829 DOI: 10.5812/asjsm.28425] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/27/2015] [Accepted: 05/30/2015] [Indexed: 11/16/2022] Open
Abstract
Background: The effects of synthetic surfaces on the risk of injuries is still debated in literature and the majority of published data seems to be contradictory. For such reasons the understanding of injury incidence on such surfaces, especially in youth sport, is fundamental for injury prevention. Objectives: The aim of this study was to prospectively report the epidemiology of injuries in young football players, playing on artificial turfs, during a one sports season. Patients and Methods: 80 young male football players (age 16.1 ± 3.7 years; height 174 ± 6.6 cm; weight 64.2 ± 6.3 kg) were enrolled in a prospective cohort study. The participants were then divided in two groups; the first included players age ranging from 17 to 19 (OP) whereas the second included players age ranging from 13 to 16 (YP). Injury incidence was recorded prospectively, according to the consensus statement for soccer. Results: A total of 107 injuries (35 from the OP and 72 from the YP) were recorded during an exposure time of 83.760 hours (incidence 1.28/1000 per player hours); 22 during matches (incidence 2.84/1000 per player hours, 20.5%) and 85 during training (incidence 1.15/1000 per player hours, 79.5%). Thigh and groin were the most common injury locations (33.6% and 21.5%, respectively) while muscle injuries such as contractures and strains were the most common injury typologies (68.23%). No statistical differences between groups were displayed, except for the rate of severe injuries during matches, with the OP displaying slightly higher rates compared to the YP. Severe injuries accounted for 10.28% of the total injuries reported. The average time lost due to injuries was 14 days. Re-injuries accounted for 4.67% of all injuries sustained during the season. Conclusions: In professional youth soccer injury rates are reasonably low. Muscle injuries are the most common type of injuries while groin and thigh the most common locations. Artificial turf pitches don’t seem to contribute to injury incidence in young football players.
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Affiliation(s)
- Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | | | - Marco Petrucci
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
- U.S. Città di Palermo Football Club, Palermo, Italy
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
- Postura Lab Research Institute, Palermo, Italy
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
- Corresponding author: Ewan Thomas, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy. Tel: +39-09123896910, Fax: +39-09123860894, E-mail:
| | - Fatma Nese Sahin
- Faculty of Physical Education and Sport, Ankara University, Ankara, Turkey
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, Padova, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
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Abstract
OBJECTIVE To describe acute lower extremity injuries and evaluate extrinsic risk factors in female youth soccer. DESIGN Nested case-control study. SETTING Youth soccer clubs in Seattle, WA. PARTICIPANTS Female soccer players (n = 351) ages 11 to 15 years randomly selected from 4 soccer clubs from which 83% of their players were enrolled with complete follow-up for 92% of players. INTERVENTIONS Injured players were interviewed regarding injury, field surface, shoe type, and position. Uninjured controls, matched on game or practice session, were also interviewed. MAIN OUTCOME MEASURES The association between risk factors and acute lower extremity injury using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS One hundred seventy-three acute lower extremity injuries occurred involving primarily the ankle (39.3%), knee (24.9%), and thigh (11.0%). Over half (52.9%) recovered within 1 week, whereas 30.2% lasted beyond 2 weeks. During practices, those injured were approximately 3-fold (OR, 2.83; 95% CI, 1.49-5.31) more likely to play on grass than artificial turf and 2.4-fold (95% CI, 1.03-5.96) more likely to wear cleats on grass than other shoe and surface combinations. During games, injured players were 89% (95% CI, 1.03-4.17) more likely to play defender compared with forward. CONCLUSIONS Half of the acute lower extremity injuries affected the ankle or knee. Grass surface and wearing cleats on grass increased training injuries. CLINICAL RELEVANCE The majority, 64%, of female youth soccer players' acute injuries involve the ankle and knee and injury prevention strategies in this age group should target these areas. When considering playing surfaces for training, communities and soccer organizations should consider the third-generation artificial turf a safe alternative to grass.
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No association between surface shifts and time-loss overuse injury risk in male professional football. J Sci Med Sport 2016; 19:218-221. [DOI: 10.1016/j.jsams.2015.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 05/19/2015] [Accepted: 06/01/2015] [Indexed: 11/20/2022]
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Lanzetti RM, Ciompi A, Lupariello D, Guzzini M, De Carli A, Ferretti A. Safety of third-generation artificial turf in male elite professional soccer players in Italian major league. Scand J Med Sci Sports 2016; 27:435-439. [DOI: 10.1111/sms.12654] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- R. M. Lanzetti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. Ciompi
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - D. Lupariello
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - M. Guzzini
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. De Carli
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
| | - A. Ferretti
- Orthopaedic Unit and “Kirk Kilgour” Sports Injury Centre; S. Andrea Hospital; University of Rome “La Sapienza”; Rome Italy
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