Time-loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta-analysis

Injury epidemiology in Australian women's professional football

OBJECTIVE

To describe the injury epidemiology of the Australian women's professional football (soccer) league (A-League W) over 7 consecutive seasons.

DESIGN

Prospective observational cohort study.

METHODS

Match-loss injury data was collected from each A-League W club (n = 8-9) for each competition round (n = 12/season) over 7 seasons (2013/14-2019/20). Data was collected by the head physiotherapist in each club based on the governing body regulations and after initial familiarisation with collection methods. Injuries were collected weekly through a standardised protocol for all clubs and were classified by setting, mechanism, severity, the type and location on the body based on club, round and season. Generalised Linear Models were used to estimate the injury incidences (injury/round/season), whilst rate ratios were reported for total injuries and within abovementioned injury classifications for the change between seasons.

RESULTS

Injury incidence rate ranged between 0.68 (95 % CI: 0.27-1.74) and 1.17 (95 % CI: 0.59-2.34) injuries/match/round across the 7 seasons analysed. There was no significant change over time in injuries by occurrence (i.e. match, training or other), mechanism (contact or non-contact), type or region. The most common injuries were joint and ligament injuries (0.24 (95 % CI: 0.05-1.17)-0.85 (95 % CI: 0.38-1.91) injuries/round/season), ankle injuries (0.13 (95 % CI: 0.02-0.95)-0.41 (95 % CI: 0.13-1.32) injuries/round/season) and non-contact mechanisms (0.48 (95 % CI: 0.18-1.27)-1.07 (95 % CI: 0.52-2.2) injuries/round/season).

CONCLUSIONS

Injury incidence trends did not show a significant change over the seven seasons of the A-League W reported here. Key areas of concern for female players remain injuries to the ankle, thigh and knee. Whilst specific to the Australian environment, these outcomes provide further understanding of the type and rate of injury trends in female footballers.

Time-loss and recurrence rate of lateral ankle sprains in male professional football players depending on the severity grade: do we trivialise LAS?

Objectives

Lateral ankle sprains (LAS) are among the most common injuries in professional football (soccer). Despite this, the severity and possible long-term consequences of LAS remain trivialised. This multicentre observational study in German elite football provides insights into time-loss and recurrence rates after LAS. Time-loss and recurrence rates are outcome measures vital for the future evaluation of rehabilitation protocols.

Methods

798 male football players representing 34 teams from 13 professional German football clubs participated in this study during the 2021-2022 season, followed by a 12-month follow-up period. Data collection and reporting were carried out in accordance with the UEFA recommendations for the standardised collection of data on football injuries. Time-loss, recurrence rate and standardised severity grades (I-III) after LAS were recorded for professionals, U23, U19 and U17, respectively.

Results

A total of 187 ankle injuries were reported, with 115 out of the total being analysed. The overall time-loss was 29.89 days, with significant differences between youth elite players and professionals (32.96 vs 15.53 days lost; p<0.001). Professional players demonstrated the shortest time-loss in all LAS injury grades. Time-loss decreased with advancing age (R 2=0.03, F(1, 106)=3.16, p=0.078). Grade I LAS's time-loss differs significantly from grades II and III (p<0.001). A recurrent LAS was recorded in 34 players. The overall LAS recurrence rate was 25.6%.

Conclusion

This study provides data on time-loss and recurrence, which serve as reference values for future evaluation of rehabilitation concepts after LAS in elite football players.

Impact of lateral ankle sprains on physical function, range of motion, isometric strength and balance in professional soccer players

Objective

Lateral ankle sprains (LASs) are prevalent in soccer and can affect long-term performance, injury recurrence and risk for chronic ankle instability. This case-control study examined functional impairments associated with LAS in professional soccer players aged 17-21.

Methods

40 players were divided into 2 groups: 21 with a history of LAS and 19 healthy matched controls. Functional assessments included the Foot and Ankle Ability Measure (FAAM), Y Balance Test (YBT), Weight Bearing Lunge Test, Heel Rise Test, Side Hop Test, and ankle and hip isometric strength measurements.

Results

Soccer players with a history of LAS exhibited significant deficits in dynamic balance, particularly in the anterior and composite YBT scores, with moderate effect sizes (p<0.05). FAAM scores also revealed functional limitations in daily activities and sports performance for the LAS group. No significant differences were observed in strength or mobility measures, including the Heel Rise, Side Hop and isometric tests. There were also no differences between injured and non-injured legs in the LAS group in the performance tests.

Conclusions

These findings highlight the persistent deficits in dynamic balance following LAS, emphasising the need for targeted rehabilitation to mitigate the risk of reinjury and enhance performance in soccer players.

An injury burden heat map of all men's and women's teams of a professional football club over a decade

The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green - yellow-red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers.

A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines

Lateral ankle sprain (LAS) is one of the most common types of injury in professional football (soccer) players with high risk of recurrence. The rehabilitation after LAS in professional football players is often still time-based and relies on anecdotal experience of clinicans. There is still a lack of utilization of criteria-based rehabilitation concepts after LAS in professional football. The aims of this clinical commentary are (1) to critically discuss the need for criteria-based rehabilitation concepts after LAS in professional football players, (2) to highlight the current lack of these approaches and (3) to present a novel clinical guideline-based rehabilitation algorithm. Short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS in professional football. Despite consequences for many stakeholders involved (players, teams, clubs, insurers), there is still a lack of of criteria-based, step-by-step approaches. The use of a criteria-based rehabilitation approach might reduce the high recurrence rate after LAS in professional football players and will lead, in turn, to increased long-term player availability. Practical experiences of he authors demonstrate the feasibility of such an approach. The effectiveness of this novel rehabilitation algorithm remains to be evaluated in future studies. Level of Evidence: 5.

Do we underestimate the frequency of ankle sprains in running? A systematic review and meta-analysis

OBJECTIVE

To provide a systematic review and meta-analysis of the proportion of ankle sprains in running practices.

DESIGN

Systematic review and meta-analysis.

MAIN OUTCOME MEASURES

We calculated the weighted summary proportion and conducted meta-analyses for runners, considering levels (elite/recreational) and disciplines (distance, track, cross-country, trail, and orienteering).

RESULTS

32 studies were included in the systematic review and 19 were included in the meta-analysis with a level of quality ranging from poor to good. Proportion of ankle sprains in runners was 13.69% (95%CI = 7.40-21.54; I2 = 98.58%) in global, 12.20% (95%CI = 5.24-21.53; I2 = 89.31%) in elite, 19.40% (95%CI = 10.05-30.90; I2 = 99.09%) in recreational, 8.51% (95%CI = 4.22-14.12; I2 = 96.15%) in distance, 67.42% (95%CI = 0.50-82.85; I2 = 99.36%) in track, 27.07% (95%CI = 12.48-44.81; I2 = 97.97%) in cross-country, and 25.70% (95%CI = 19.87-32.14; I2 = 0.00) in orienteering.

CONCLUSIONS

Running practice results in significant proportion rate of ankle sprains. Recreational runners exhibit higher proportion than elite. Running disciplines, especially track, cross-country, and orienteering, influence reported ankle sprain rates, surpassing those of distance runners.

[Treatment of acute ankle distortion in footballers : Are we doing it particularly right or particularly wrong?]

BACKGROUND

Despite the high incidence of ankle sprains, the ideal treatment is controversial and a significant percentage of patients who have suffered an ankle sprain never fully recover. Even professional athletes are affected by this post-traumatic complication. There is strong evidence that permanent impairment after an ankle injury is often due to an inadequate rehabilitation and training program and too early return to sport.

THERAPY AND REHABILITATION

Therefore, athletes should start a criteria-based rehabilitation after ankle sprain and gradually progress through the programmed activities, including e.g. cryotherapy, edema reduction, optimal load management, range of motion exercises to improve ankle dorsiflexion and digital guidance, stretching of the triceps surae with isometric exercises and strengthening of the peroneus muscles, balance and proprioception training, and bracing/taping. The fact that this is professional sport does not exempt it from consistent, stage-appropriate treatment and a cautious increase in load. However, there are a number of measures and tools that can be used in the intensive care of athletes to improve treatment and results.

Comparative Efficacy of Micro-Needle-Knife Therapy and Acupuncture in Acute Ankle Sprains: A Randomized Controlled Trial

BACKGROUND Micro-needle knife (MNK) therapy releases the superficial fascia to alleviate pain and improve joint function in patients with acute ankle sprains (AAS). We aimed to evaluate the efficacy and safety of MNK therapy vs that of acupuncture. MATERIAL AND METHODS This blinded assessor, randomized controlled trial allocated 80 patients with AAS to 2 parallel groups in a 1: 1 ratio. The experimental group received MNK therapy; the control group underwent conventional acupuncture treatment at specified acupoints. Clinical efficacy differences between the 2 groups before (time-point 1 [TP1]) and after treatment (TP2) were evaluated using the visual analogue scale (VAS) and Kofoed ankle score. Safety records and evaluations of adverse events were documented. One-month follow-up after treatment (TP3) was conducted to assess the intervention scheme's reliability. RESULTS VAS and Kofoed ankle scores significantly improved in both groups. No patients dropped due to adverse events. At TP1, there were no significant differences between the 2 groups in terms of VAS and Kofoed scores (P>0.05). However, at TP2, efficacy of MNK therapy in releasing the superficial fascia was significantly superior to that of acupuncture treatment (P<0.001). At TP3, no significant differences in scores existed between the groups (P>0.05). CONCLUSIONS This study demonstrates that 6 sessions of MNK therapy to release the superficial fascia safely and effectively alleviated pain and enhanced ankle joint function in patients with AAS, surpassing the efficacy of conventional acupuncture treatment. Future studies should increase the sample size and introduce additional control groups to further validate the superior clinical efficacy of this intervention.

Absorption function loss due to the history of previous ankle sprain explored by unsupervised machine learning

BACKGROUND

Ankle sprains are common and cause persistent ankle function reduction. To biomechanically evaluate the ankle function after ankle sprains, the ground reaction force (GRF) measurement during the single-legged landing had been used. However, previous studies focused on discrete features of vertical GRF (vGRF), which largely ignored vGRF waveform features that could better identify the ankle function.

PURPOSE

To identify how the history of ankle sprain affect the vGRF waveform during the single-legged landing with unsupervised machine learning considering the time-series information of vGRF.

METHODS

Eighty-seven currently healthy basketball athletes (12 athletes without ankle sprain, 49 athletes with bilateral, and 26 athletes with unilateral ankle sprain more than 6 months before the test day) performed single-legged landings from a 20 centimeters (cm) high box onto the force platform. Totally 518 trials vGRF data were collected from 87 athletes of 174 ankles, including 259 ankle sprain trials (from previous sprain ankles) and 259 non-ankle sprain trials (from without sprain ankles). The first 100 milliseconds (ms) vGRF waveforms after landing were extracted. Principal component analysis (PCA) was applied to the vGRF data, selecting 8 principal components (PCs) representing 96% of the information. Based on these 8 PCs, k-means method (k = 3) clustered the 518 trials into three clusters. Chi-square test assessed significant differences (p < 0.01) in the distribution of ankle sprain and non-ankle sprain trials among clusters.

FINDINGS

The ankle sprain trials accounted for a significantly larger percentage (63.9%) in Cluster 3, which exhibited rapidly increased impulse vGRF waveforms with larger peaks in a short time.

SIGNIFICANCE

PCA and k-means method for vGRF waveforms during single-legged landing identified that the history of previous ankle sprains caused a loss of ankle absorption ability lasting at least 6 months from an ankle sprain.

Soccer's AI transformation: deep learning's analysis of soccer's pandemic research evolution

Introduction

This paper aims to identify and compare changes in trends and research interests in soccer articles from before and during the COVID-19 pandemic.

Methods

We compared research interests and trends in soccer-related journal articles published before COVID-19 (2018-2020) and during the COVID-19 pandemic (2021-2022) using Bidirectional Encoder Representations from Transformers (BERT) topic modeling.

Results

In both periods, we categorized the social sciences into psychology, sociology, business, and technology, with some interdisciplinary research topics identified, and we identified changes during the COVID-19 pandemic period, including a new approach to home advantage. Furthermore, Sports science and sports medicine had a vast array of subject areas and topics, but some similar themes emerged in both periods and found changes before and during COVID-19. These changes can be broadly categorized into (a) Social Sciences and Technology; (b) Performance training approaches; (c) injury part of body. With training topics being more prominent than match performance during the pandemic; and changes within injuries, with the lower limbs becoming more prominent than the head during the pandemic.

Conclusion

Now that the pandemic has ended, soccer environments and routines have returned to pre-pandemic levels, but the environment that have changed during the pandemic provide an opportunity for researchers and practitioners in the field of soccer to detect post-pandemic changes and identify trends and future directions for research.