A congested football calendar and the wellbeing of players: correlation between match exposure of European footballers before the World Cup 2002 and their injuries and performances during that World Cup

Microdosing Plyometric Training Enhances Jumping Performance, Reactive Strength Index, and Acceleration among Youth Soccer Players: A Randomized Controlled Study Design

Microdosing can facilitate better accommodation to the training stimulus while aligning with the scheduling needs of teams. In this study, the effectiveness of microdosing exposure was investigated by comparing the effects of microdosing plyometric jump training (microPJT) with those of regular plyometric jump training (regPJT) and a control group not exposed to plyometric training. The comparison focused on the effects on jumping performance, reactive strength index (RSI), and acceleration over a 10-meter distance. Fifty-two male youth soccer players (16.3 ± 0.6 years old) from under-17 teams participated in a randomized controlled study, with interventions lasting 8 weeks. Assessments were conducted twice, before and after the intervention, measuring squat jump (SJ), countermovement jump (CMJ), RSI during drop jumps, and acceleration in a 10-meter sprint test. The regPJT group completed 34 bilateral jumps and 48 unilateral jumps per week over two weekly sessions, totaling 82 jumps. Conversely, the microPJT group performed 17 bilateral jumps and 24 unilateral jumps weekly over 4 sessions week, totaling 41 jumps. Significant interactions between groups and time were observed concerning SJ (p < 0.001; η2= 0.282), CMJ (p < 0.001; η2= 0.368), RSI (p < 0.001; η2= 0.400) and 10-m sprint time (p < 0.001; η2 = 0.317). Between-group analysis indicated that both the microPJT (p < 0.001) and regPJT (p < 0.001) groups exhibited significant better results compared to the control group in post-intervention evaluation of SJ, CMJ, RSI and 10-m sprint time, while no significant differences were found between experimental groups (p > 0.050). In conclusion, this study has revealed that both microPJT and regPJT are equally effective in enhancing jumping performance and acceleration time in soccer players. This suggests that a smaller training volume, distributed more frequently across the week, can effectively induce improvements in soccer players.

Recovery during Successive 120-min Football Games: Results from the 120-min Placebo/Carbohydrate Randomized Controlled Trial

PURPOSE

This study aimed to examine the recovery kinetics (i.e., time-dependent changes) of performance-related variables between two 120-min male football games performed 3 d apart with and without carbohydrate supplementation.

METHODS

Twenty male players (20 ± 1 yr; body fat, 14.9% ± 5.1%; maximal oxygen consumption, 59.4 ± 3.7 mL·kg -1 ·min -1 ) participated in two 120-min football games (G1, G2) according to a randomized, two-trial, repeated-measures, crossover, double-blind design. Participants received carbohydrate/placebo supplements during recovery between games. Field activity was monitored during the games. Performance testing and blood sampling were performed before and at 90 and 120 min of each game. Muscle biopsies were collected at baseline and at 90 and 120 min of G1 and pre-G2.

RESULTS

Compared with G1, G2 was associated with reduced total distance (10,870 vs 10,685 m during 90 min and 3327 vs 3089 m during extra 30 min; P = 0.007-0.038), average (6.7 vs 6.2 km/h during extra 30-min game-play; P = 0.007) and maximal speed (32.2 vs 30.2 km/h during 90 min and 29.0 vs 27.9 km/h during extra 30 min; P < 0.05), accelerations/decelerations ( P < 0.05), and mean heart rate ( P < 0.05). Repeated sprint ability ( P < 0.001), jumping ( P < 0.05), and strength ( P < 0.001) performance were compromised before and during G2. Muscle glycogen was not restored at G2 baseline ( P = 0.005). Extended game-play reduced lymphocyte, erythrocyte counts, hematocrit, hemoglobin, reduced glutathione ( P < 0.05) and increased delayed onset of muscle soreness, creatine kinase activity, blood glycerol, ammonia, and protein carbonyls ( P < 0.05) before and during G2. Pax7 + ( P = 0.004) and MyoD + cells ( P = 0.019) increased at baseline G2. Carbohydrate supplementation restored performance and glycogen, reduced glycerol and delayed onset of muscle soreness responses, and increased leukocyte counts and Pax7 + and MyoD + cells.

CONCLUSIONS

Results suggest that extended football games induce a prolonged recovery of performance, which may be facilitated by carbohydrate supplementation during a congested game fixture.

Goal scoring patterns in the FIFA World Cup 2022 group stage: more goals by substitute players, but no effect of more stoppage time

BACKGROUND

The 2022 World Cup introduced new substitution rules, tournament periods and stoppage time calculation methods. Thus, the aim of this study was to analyze the goal time characteristics during the FIFA World Cup 2022 group stage in comparison with those of the 2018 event, exploring the potential influence on the goal times after the new substitution rules, stoppage time calculation method, and tournament periods.

METHODS

A total of 242 goals were used for analysis. The timing, zones and ways of goals scored were used for the analyses by χ2 Test with a significance level set at P<0.05.

RESULTS

More goals were scored in the second half than in the first half (64.2% vs. 35.8%; χ2=9.633, P<0.05) and a significant difference in the goals scored in 15 minutes intervals in 2022 World Cup group stage (χ2=16.000, P<0.05). No difference were observed in the goal scoring time in two World Cups in terms of the different intervals, results, areas, and ways (P>0.05), but more open play goals were scored in the 2022 event (χ2=10.200, P<0.05) and substitutes scored more goals in the 2022 World Cup group stage as compared to those in the 2018 event (χ2=5.161, P<0.05). Despite more stoppage time in the 2022 event than in the 2018 event (11.6 vs. 7.3 min), no differences were observed in the number of goals scored in stoppage time (χ2=0.953, P>0.05).

CONCLUSIONS

This study highlights the importance of the insight of goal scoring pattern. Practitioners need to allocate physical fitness to tactical arrangements in a reasonable manner according to the time of the game, improve open play scoring ability and increase substitution awareness.

Epidemiology of Injuries in Professional and Amateur Football Men (Part II)

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.

Prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of German first and lower leagues

BACKGROUND

While several studies on mental health of elite athletes were published in recent years, few compared the prevalence with the general population and none included field hockey players.

AIMS

To analyze the prevalence of symptoms of depression and generalized anxiety disorder in field hockey players of different skill levels and to compare it to the general population.

METHODS

Male and female hockey players from different leagues were asked to answer questions on player characteristics, the Centre of Epidemiologic Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7).

RESULTS

One hundred and eighty-seven players (incl. 54 first and 28 second league players) participated in the study (response rate 97.4%). More than a third (n = 64; 35.0%) reported to be affected by an injury/health complaint, but 157 (86.3%) were able to train and play without limitations. The CES-D score indicated depression symptoms in more female (n = 15; 18.3%) than male (n = 5; 4.8%) players (χ2=8.8; p < 0.01). No male and one female player had symptoms of generalized anxiety disorder. Players who played 60 or more matches in the previous 12 months had on average significantly higher depression (t = 2.3; p < 0.05) and generalized anxiety scores (t = 4.2; p < 0.001) than players who played fewer matches. The prevalence of depression and of generalized anxiety symptoms was similar to or lower than in the general population. Although 20 (10.7%) players had depression symptoms, only 4 (2.2%) received psychological counseling or psychotherapy.

CONCLUSION

It is recommended to provide routine screening of mental health problems and low-threshold access to adequate treatment for elite athletes.

Epidemiology of Injuries in Elite Male Futsal Players

OBJECTIVE

This study aimed to describe and characterize injuries sustained by elite male futsal players in Portugal.

DESIGN

Prospective cohort study.

SETTING

Top-tier Portuguese league in the 2019 to 2020 season.

PARTICIPANTS

One hundred sixty-seven players from 9 elite/international-level (tier 4) futsal teams.

INDEPENDENT VARIABLES

The location, type, body side, body part, mechanism of injury, severity, occurrence, days lost, training, and match exposure were collected.

MAIN OUTCOME MEASURES

Injury incidence, prevalence, and burden.

RESULTS

The study was conducted during an 8-month season. A total of 133 injuries were recorded, and 92 (67.6%) players sustained injuries. The overall time-loss injury incidence was 4.5 injuries per 1000 hours of exposure. Injury incidence during matches was higher than during training sessions (25.9 vs 3.0 per 1000 hours of exposure, respectively). Average time loss was 9 days, and moderate injuries were the most frequent (44%), followed by mild injuries (24%). Injury burden was 73.8 days lost per 1000 hours of total player exposure. Sprains/ligament (29%) and muscle rupture/tear/strains (32%) were the most common injuries. The groin (19%), thigh (17%), knee (19%), and ankle (15%) were the most affected body areas. Noncontact injuries were the most reported mechanism (65%), and 24% were overuse injuries.

CONCLUSIONS

This study showed that elite/international-level (tier 4) male futsal players are more prone to noncontact injuries, primarily affecting the lower limbs. The incidence during match play increased by 9-fold compared with training sessions.

Epidemiology of Injuries in Men's Professional and Amateur Football (Part I)

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.

Incidence, prevalence and nature of injuries in padel: a systematic review

Objective

It is unclear what the incidence, prevalence and nature of injuries are that can occur during playing padel. This study aimed to systematically review the incidence, prevalence and nature of injuries in padel.

Method

A literature search was performed up to December 2022 through MEDLINE Ovid, PubMed, Cochrane Library, SportsDiscus and CINAHL. Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria. Studies were assessed for methodological quality. Data on injuries' prevalence, incidence and nature of injuries were extracted, analysed and described in a descriptive statistical manner which did not include a pooling strategy as part of a formal meta-analysis.

Results

Eight studies with 2022 participants were included (range of mean age: 31-57). The incidence rate was 3 injuries per 1000 hours of padel training and 8 injuries per 1000 matches of padel practice. The overall prevalence range was 40%-95%. The elbow was the most common anatomical site of injury, followed by the knee, shoulder and lower back. Tendinous and muscular injuries were the most reported injury types.

Conclusion

Injuries are common among padel players, with an incidence rate of 3 per 1000 hours of padel training and 8 per 1000 matches of padel practice-as based on limited literature. The overall prevalence range was 40%-95%. The elbow was the most frequently reported anatomical region concerning location injury distribution, and injuries were mainly of tendinous or muscular origin.

Acute Rupture of the Plantar Fascia in a Soccer Player

Acute rupture of the plantar fascia is a rare but potentially debilitating injury in athletes, particularly those involved in running and jumping sports. Early recognition and prompt treatment are crucial for a successful recovery and return to play. Conservative treatment, including rest, immobilization, and physical therapy, may be effective in most cases, while surgical intervention may be required in those that are nonresponsive to conservative treatment. We report a case of plantar fascia rupture in a 22-year-old male semi-professional football player who presented with sudden severe pain in the sole of his right foot during a match, followed by a popping sensation and inability to weight bear. The athlete was healthy and had no history of previous injury in the right foot. MRI confirmed a complete rupture of the plantar fascia. The player was treated conservatively and underwent a rehabilitation program. The player returned to full competition after nine weeks, with no limitations.

Effect of Increasing the Number of Substitutions on Physical Performance during Periods of Congested Fixtures in Football

(I) This study aimed to evaluate the impact on physical demands induced by FIFA's new rule implemented based on the number of substitutions caused by COVID-19. (II) Sixty-six matches were analysed in peak periods (microcycles of three matches in a week) in the competition period before and after the pandemic. The variables collected were organised by team (22 from LaLiga^TM SmartBank 2019-2020) for a total of 132 team records and 1077 player performance reports using a multi-camera tracking system and Mediacoach^® software. Physical performance variables were analysed in the first half, second half and whole match, thus determining the individual and collective performances of the team. (III) This study shows how, despite the increase in substitutions allowed with the new rule, physical performance increased in some variables in the congested periods (e.g., total distance run and distance run in the first and second halves). Additionally, the players' physical performance involved in a substitution was greater than it was for players who completed the game. (IV) The new substitution rule helps to maintain and even improve physical performance. This measure could improve intensity levels in both individual and team performance. It could even safeguard the physical integrity of the players by reducing the risk of injury, as fewer players have to play the full match.

Efectos del COVID-19 en la carga externa en el fútbol de alto nivel

Analizamos el efecto del cese de la competición por COVID-19 en el rendimiento físico de jugadores de fútbol de la 1ª división española). La muestra se estratificó en tres grupos: rondas 1ª-3ª; 25ª-27ª y 28ª-30ª. Las comparaciones por pares fueron Student-t y Mann-Whitney U. Usamos un valor p de ?0.05 como criterio para la significación estadística. Los valores de umbral para evaluar las magnitudes del tamaño del efecto se realizaron a través (d de Cohen). Tras el parón, las distancias recorridas aumentaron en los equipos locales y visitantes. Hubo un ligero descenso de los esfuerzos de alta intensidad entre el post-confinamiento y las jornadas (25ª-27ª). Comparados el 1er y 3er periodo, los valores fueron ligeramente superiores (rondas 28ª-30ª). Eso mismo se observó en las de aceleraciones y desaceleraciones, con mayores diferencias entre los periodos (1º y 3º). Hubo diferencias, cuando se comparó la reanudación con las jornadas previas al parón.

A Systematic Review of the Relationship between Workload and Injury Risk of Professional Male Soccer Players

The number of studies on the relationship between training and competition load and injury has increased exponentially in recent years, and it is also widely studied by researchers in the field of professional soccer. In order to provide practical guidance for workload management and injury prevention in professional athletes, this study provides a review of the literature on the effect of load on injury risk, injury prediction, and interpretation mechanisms. The results of the research show that: (1) It appears that short-term fixture congestion may increase the match injury incidence, while long-term fixture congestion may have no effect on both the overall injury incidence and the match injury incidence. (2) It is impossible to determine conclusively whether any global positioning system (GPS)-derived metrics (total distance, high-speed running distance, and acceleration) are associated with an increased risk of injury. (3) The acute:chronic workload ratio (ACWR) of the session rating of perceived exertion (s-RPE) may be significantly associated with the risk of non-contact injuries, but an ACWR threshold with a minimum risk of injury could not be obtained. (4) Based on the workload and fatigue recovery factors, artificial intelligence technology may possess good predictive power regarding injury risk.

Biochemical and Physical Performance Responses to a Soccer Match after a 72-Hour Recovery Period

The physiological and neuromuscular responses at 72 h post-match are not widely researched, despite evidence showing substantial changes in recovery markers at 72 h post-match. Consequently, the aim of this study was to determine the biochemical and physical performance responses to a soccer match after a 72-h recovery period. Male soccer players of a semiprofessional team participated in this study. Before playing a friendly match, blood values of testosterone, cortisol, the testosterone-to-cortisol ratio and urea were collected and the squat jump and the Bangsbo Repeated Sprint Ability test were performed. These measurements were considered as baseline (pre match) and were obtained again after a 72-h recovery period. Results indicate that physical performance at 72 h post-match was similar to baseline (squat jump: p = 0.974; total Repeated Sprint Ability time: p = 0.381; Repeated Sprint Ability fatigue index: p = 0.864). However, perturbations in the biochemical milieu derived from the soccer match metabolic and physiological stress were still evident at this time point. While no significant differences compared to pre match were obtained in testosterone and urea concentrations after the recovery period, cortisol and testosterone-to-cortisol ratio values were significantly higher (14.74 ± 3.68 µg/dL vs. 17.83 ± 2.65 µg/dL; p = 0.045; ES 0.92 [0.00; 1.84], very likely) and lower (39.08 ± 13.26 vs. 28.29 ± 7.45; p = 0.038; ES −0.96 [−1.89; −0.04], very likely), respectively. In conclusion, soccer players have similar physical performance to the pre match after a 72-h recovery period, even with signs of biochemical and physiological stress.

Analysis of Injury Patterns in Men's Football between the English League and the Spanish League

BACKGROUND

Injuries in professional football lead to reduced team performance and large financial losses. The aim of this study was to analyse injuries in the two best team competitions in the world (LaLiga and Premier League), establishing similarities and differences, as well as determining injury causation patterns.

METHODS

A total of 277 on-field injuries requiring a substitution were analysed (142 in the Spanish league and 135 in the English league). The analysis was performed using traditional statistical tests (frequency analysis, chi-square test) with SPSS 25 and a T-Patterns sequence analysis with THEME 5.0.

RESULTS

In the Spanish league, there were a similar number of injuries in the first part of the season as in the second part of the season, while in the English league, they are more frequent in the first part of the season. In the Spanish league, injuries are more frequent in the first half of the match, while in the English league, they are more frequent in the second half. The type of player most frequently injured was the defender. Most of the injuries occurred without the presence of an opponent. The accumulated minutes during the season affect injuries of the muscular type.

CONCLUSIONS

The most common type of injury in both leagues was a strain, followed by a sprain and a contusion. Although common injury patterns can be established between the two leagues, there are notable differences. One of the factors is determined by the English league calendar (many matches at Christmas). In Spain, there were more muscular injuries that were not caused by the opponent, while in England there were more tackling injuries. Age is a risk factor in the Spanish league. In this league, there is a moderately significant relationship between the number of injuries and the points won.

Still poorly adopted in male professional football: but teams that used the Nordic Hamstring Exercise in team training had fewer hamstring injuries – a retrospective survey of 17 teams of the UEFA Elite Club Injury Study during the 2020–2021 season

Objectives

The primary objective was to study the adoption of the NHE programme in European football teams in the 2020/21 season and to compare it to the previous study. A second objective was to compare hamstring injury rates between teams that used the NHE programme in the team training and teams that used the NHE only for players with previous or current hamstring injuries.

Methods

Data about the implementation of the NHE programme and injury rates were included for 17 teams participating in the Elite Club Injury Study during the 2020/2021 season.

Results

One team (6%) used the full original NHE programme, and another four teams used it for all or most players in the team (team training group, n=5). Eleven teams used NHE only for players with a previous or current hamstring injury (individual training group), and one team did not use NHE. The team training group had fewer hamstring injuries (5 vs 11 per team, p=0.008) and a lower injury burden (12 vs 35 lay-off days per 1000 hours, p=0.003) than the individual training group.

Conclusion

Similar to previous reports, low adoption of the NHE programme was seen in the 2020/2021 season. The low adoption rate (13%) relates to the number of teams fully or partly using NHE programmes. Teams that used NHE for the whole team or most players had a lower hamstring injury burden than teams that used NHE only for individual players.

The Uptake of Nordic Hamstring Exercise Program for Injury Prevention in Major League Soccer and Its Barriers to Implementation in Practice

CONTEXT

It is well demonstrated that Nordic hamstring (NH) program has poor compliance across European soccer clubs, but little is known about its implementation in Major League Soccer (MLS). The authors aimed to investigate MLS hamstring prevention practices and compliance with the NH program and understand the reasons for its inclusion or exclusion.

DESIGN

A cross-sectional electronic survey was completed by 24 of the 26 (92%) MLS top-division soccer clubs.

METHODS

The survey, based on the Reach, Efficacy, Adoption, Implementation, and Maintenance framework, was sent to team medical staff. Medical staff were also asked for opinions on barriers to implementation.

RESULTS

Eighteen clubs (75%) reported a formal hamstring injury prevention program, with eccentric exercises (94%; 95% CI [confidence interval], 74%-99%), high-speed running (94%; 95% CI, 74%-99%), and NH exercises (89%; 95% CI, 67%-97%) the most common strategies adopted. Fifteen clubs partially implemented the NH program, but only 5 (21%; 95% CI, 9%-40%) completed the full program and were classed as compliant. A total of 20 respondents reported that player perception and muscle soreness (83%; 95% CI, 64%-93%) were barriers to the implementation of the NH program. On a 5-point Likert scale, respondents "partially agreed" (4.13 [0.80]) that the NH exercise could substantially reduce injuries and would be "effective" at their own club (3.88 [0.61]).

CONCLUSIONS

The NH exercise was valued, but negative player perception and muscular soreness were identified as barriers to implementing the full program. Manipulation of volume and frequency should inform future "effectiveness" research to prospectively assess such modifications in the context of MLS.

Prolonged restricted training, fixture congestion and player rotation: what the COVID-19 pandemic taught us about injury risk in professional collision sport

Objectives

The COVID19-induced suspension of the 2019-20 professional England rugby union season resulted in players being exposed to an extended restricted training period, coupled with a congested match schedule once competition resumed. We assessed the impact of these changes on match and training injuries in the final 20-weeks of the season following competition resumption.

Design

Epidemiological study.

Methods

The 2019-20 season was compared to the previous three seasons (2016-19).

Results

There was no significant difference in the mean incidence, severity and burden of training and match injuries in 2019-20 compared to 2016-19 period mean. The 2019-20 post-suspension mean match injury rate [77/1000 h (95%CIs [confidence intervals]: 67-89)] was comparable to the 2019-20 pre-suspension [93/1000 h (95%CIs: 85-101)] and significantly lower than the 2016-19 equivalent post-suspension period [97/1000 h (95CIs: 90-104) IRR [incidence rate ratio] 0.8 p=0.002]. In the 2019-20 season, there was a significantly higher rate of training injury post-suspension in comparison to pre-suspension [3.8/1000 h (95CIs: 3.3-4.4) vs 2.7/1000 h (95% CIs: 2.5-3.1) IRR 1.4 p=0.005]. There was no significant difference in the overall incidence, severity or burden of injuries sustained in fixtures with shorter (<6 days) turnarounds but there was a significantly higher burden of soft tissue injuries.

Conclusions

This is the first study to assess the effect of restricted training on injury risk in collision sports. Players were at an increased risk of training injury when returning from the suspension, but 10-weeks of preparatory training meant the incidence of match injury was not higher when competition resumed.

Epidemiology of injuries in elite male and female futsal: a systematic review and meta-analysis

The main purpose of this study was to conduct a systematic review and meta-analysis quantifying the incidence of injuries in futsal players. A systematic search was conducted using MEDLINE, PubMed, Web of Science and Scopus databases and subsequently, six studies (14 cohorts) were selected. Separate meta-analyses for male and female players were conducted using a Poisson random-effect regression model approach. The overall and match incidence rates in elite male futsal players were 6.8 (95% CI = 0.0-15.2) and 44.9 (95% CI = 17.2-72.6) injuries/1000 hours of exposure. Pooled training injury rate in male players was not calculated due to the lack of studies reporting training injuries in this cohort. For females, an overall, training and match incidence rates of 5.3 (95% CI = 3.5-7), 5.1 (95% CI = 2.7-7.6) and 10.3 (95% CI = 0.6-20.1) injuries/1000 hours of exposure were reported. In males, match incidence rate in International tournaments was 8.5 times higher than in national leagues (77.2 [95% CI = 60.0-94.5] vs 9.1 [95% CI = 0.0-19.3] for international tournaments and national leagues, respectively). Elite male and female futsal players are exposed to a substantial risk of sustaining injuries, especially during matches.

The use of recovery strategies by Spanish first division soccer teams: a cross-sectional survey

OBJECTIVES

different active and passive post-exercise recovery techniques such as massage, foam rolling, stretching or ice baths among others, are used by elite athletes to promote effective physiological, physical, and mental restoration. However, limited research is available investigating the use of recovery strategies in professional soccer. As such, we aimed to explore and describe the use of strategies by professional teams throughout the season, describing competitive and preparatory phases.

METHODS

the present study collected data from all professional Spanish soccer teams who played in 'LaLiga' (The Spanish first division), during the season 2018-2019 (n = 20) and the ones promoted for the season 2019-2020 (n = 3). A six-section online survey was responded once.

RESULTS

teams used different recovery protocols and combinations, although natural and physical strategies such as sleep/nap, food/fluid replacement, cold/ice bath/shower/immersion, and massage were always present. However, there is no agreement in the protocols and timings employed. Three physical strategies showed a higher presence in the recovery protocols after competition: cold/ice bath/shower/immersion, massage and foam rolling; always used by seventeen teams (74%), sixteen (70%) and thirteen (57%) respectively. The design and supervision of recovery are multidisciplinary tasks in 87% of the teams. Our findings also demonstrate that although there is a body of scientific evidence on recovery, a gap between theory and practice exists with 13% of the teams acknowledging that insufficient logistics and economic resources limit the use of some strategies, and two teams (9%) not periodizing or individualizing recovery.

CONCLUSION

the investigation provided insight into the current use of recovery strategies by 'LaLiga' teams, highlighting that all clubs used them to one extent or another, but also that significant variability responding to individualized perceptions exists. Moreover, this study provides relevant contextual information that may be useful for professional soccer staff concerning the use of recovery strategies.

Peak running speed can be used to monitor neuromuscular fatigue from a standardized running test in team sport athletes

This study compared the sensitivity of peak running speed (PRS) measured during a submaximal run test (SRT) with a countermovement jump (CMJ) test to provide an alternate method of measuring neuromuscular fatigue (NMF). The study involved 20 semi-professional academy soccer players who performed a SRT and CMJ test, 24-hours pre-match, 24-, 48-, 72- and 96-hours post-match. Moderate decreases (effect-size (ES) ± 90% confidence intervals) were observed 24-hours post-match for CMJ_H; ES -0.70 ± 0.19, CMJ_PV; ES -0.92 ± 0.27 and PRS; ES -0.58 ± 0.11 with small decreases in CMJ_H; ES -0.36 ± 0.13 and PRS; ES -0.27 ± 0.23 still evident 48-hours post-match before returning to baseline 72-hours post-match. The results confirm PRS as an inexpensive alternate method of measuring NMF which, allows instantaneous real-time feedback on NMF. This can allow changes to be made immediately on-field within the post-match recovery phase without the need for further analysis or equipment.

Perceptual and Biochemical Responses in Relation to Different Match-Day +2 Training Interventions in Soccer Players

The aim of this study was to examine the impact of two different post-match training interventions on the subsequent recovery of perceptual and biochemical parameters after the game. In a crossover design, eight sub-elite players underwent a soccer-specific training (SST) and an active recovery (AR) regimen on the second day after a match (+48 h). Muscle soreness as well as muscle damage (creatine kinase, CK), inflammatory (C-reactive protein and interleukin 6), immunological (e.g., lymphocytes, neutrophils, and monocytes), and endocrine (cortisol) markers were obtained at baseline (-72 h), immediately after (0 h), and 72 h post-match (+72 h). AR promoted a higher restoration of muscle soreness values (P = 0.004, η2 p = 0.49) together with a better restoration of CK within 72 h post-match compared with SST (P = 0.04, η2 p = 0.36). Conversely, no significant (P > 0.05, η2 p < 0.91) differences were observed in the recovery timeframe of inflammatory, immunological, and endocrine responses between SST and AR. Overall, AR elicited a quicker muscle soreness and CK restoration compared to SST intervention at 72 h post-match. Such information provides novel evidence-based findings on the appropriateness of different recovery strategies and may aid to improve the practitioners' decision-making process when two consecutive games are played within 3 days.

Varying Demands and Quality of Play Between In-Conference and Out-of-Conference Games in Division I Collegiate Women's Soccer

Bozzini, BN, McFadden, BA, Walker, AJ, and Arent, SM. Varying demands and quality of play between in-conference and out-of-conference games in Division I collegiate women's soccer. J Strength Cond Res 34(12): 3364-3368, 2020-The purpose of this study was to assess differences in physical workloads, physiological responses, and performance variables between in-conference (IC) and out-of-conference (OC) games during a collegiate women's soccer season. Female field players (N = 11), who played a minimum of 45 minutes for >50% of games, were evaluated using an integrative GPS and HR monitoring system to determine training load (TL), exercise energy expenditure (EEE), total distance covered (DIS), sprints, time spent in HR zones 4 and 5 (HRZ4 = 80-89% HRmax; HRZ5 = 90-100% HRmax), and distance covered in speed zones 4 and 5 (DISZ4 = 15.0-19.9 km·h; DISZ5 = ≥20 km·h). In addition, percent passing accuracy (PA%), dribbling success (DS%), tackling success (TS%), and challenges won (CW%) were generated for all games. Workload data were analyzed as a rate per minute playing time (PT) per game to account for differences in game duration and PT between OC (n = 7) and IC games (n = 11). Repeated-measures multivariate analyses of variance with univariate follow-ups and effect sizes (Hedges' g) were conducted to compare conditions (OC vs. CON) (p < 0.05). There were significantly greater TL, DIS, EEE, and HRZ5 per minute PT in OC versus IC games (Hedges' g: TL = 0.48; DIS = 0.20, EEE = 0.55; HRZ5 = 0.83; p < 0.05). Further analysis found significant differences in first half play favoring OC games (p < 0.05), but not second half play (p > 0.05). Based on these findings, OC games seem to be more demanding compared to IC, particularly during first half play. Emphasis should be placed on tailoring TL to the accumulating in-season demands through athlete-monitoring technology to prevent declines in performance in the latter half of the season.

Physical Demands of U10 Players in a 7-a-Side Soccer Tournament Depending on the Playing Position and Level of Opponents in Consecutive Matches Using Global Positioning Systems (GPS)

The aim of this study was to analyse the physical demands of U10 players in a 7-a-side-soccer tournament based on the playing positions in 6 consecutive matches by global positioning systems (GPS). Variables of total distance, relative distance in different speed zones, maximum speed, time interval between accelerations, maximum speed acceleration, maximum acceleration, acceleration distance and the number of high-intensity accelerations were analysed. Differences between playing positions were found in the total distance covered by the midfielders. They covered higher total distances than the defenders (+1167 m; 95% CI: 411 to 1922 m; effect size (ES) = 1.41; p < 0.05) and forwards (+1388 m; CI 95%: 712 a 2063 m; TE = 0.85; p < 0.05). The total covered distance increased in the final rounds with respect to the group stage (p < 0.05; ES: 0.44 to 1.62), and high-intensity actions, such as the number of accelerations, were greater in the final rounds compared to the group stage (p < 0.05; ES: 0.44 to 1.62). The physical performance of young football players in a tournament with consecutive matches on a 40 × 62 m football field on the same day is influenced by the playing position and dependent on the level difference between opponents.

Post-competition recovery strategies in elite male soccer players. Effects on performance: A systematic review and meta-analysis

Aims

The main aim of the present review was to update the available evidence on the value interest of post-competition recovery strategies in male professional or semi-professional soccer players to determine its effect on post-game performance outcomes, physiological markers, and wellness indicators.

Methods

A structured search was carried out following the PRISMA guidelines using six online databases: Pubmed, Scopus, SPORTDiscus, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials. The risk of bias was completed following the Cochrane Collaboration Guidelines. Meta-analyses of randomized controlled trials were conducted to determine the between and within-group effects of different recovery strategies on performance, physiological markers and wellness data. Final meta-analyses were performed using the random-effects model and pooled standardized mean differences (SMD).

Results

Five randomized controlled trials that used Compression Garments (n = 3), Cold Water Immersion (n = 1), and acute Sleep Hygiene Strategy (n = 1) were included. Greater CMJ values at 48h for the intervention group (SMD = 0.70; 95% CI 0.14 to 1.25; p = 0.001; I² = 10.4%) were found. For the 20-m sprint and MVC, the results showed no difference either at 24h or 48h. For physiological markers (CK and CRP) and wellness data (DOMS), small to large SMD were present in favor of the intervention group both at 24h (-0.12 to -1.86) and 48h (-0.21 to -0.85). No heterogeneity was present, except for MVC at 24h (I² = 90.4%; p = 0.0012) and CALF DOMS at 48h (I² = 93.7%; p = 0.013).

Conclusion

The use of recovery strategies offers significant positive effects only in jumping performance (CMJ), with no effects on the 20-m sprint or MVC. Also, the use of recovery strategies offers greater positive effects on muscle damage (physiological markers and wellness data), highlighting the importance of post-match recovery strategies in soccer.

Managing Load to Optimize Well-Being and Recovery During Short-Term Match Congestion in Elite Basketball

In elite basketball, players are exposed to intensified competition periods when participating in both national and international competitions. How coaches manage training between matches and in reference to match scheduling for a full season is not yet known.

PURPOSE

First, to compare load during short-term match congestion (ie, ≥2-match weeks) with regular competition (ie, 1-match weeks) in elite male professional basketball players. Second, to determine changes in well-being, recovery, neuromuscular performance, and injuries and illnesses between short-term match congestion and regular competition.

METHODS

Sixteen basketball players (age 24.8 [2.0] y, height 195.8 [7.5] cm, weight 94.8 [14.0] kg, body fat 11.9% [5.0%], VO2max 51.9 [5.3] mL·kg-1·min-1) were monitored during a full season. Session rating of perceived exertion (s-RPE) was obtained, and load was calculated (s-RPE × duration) for each training session or match. Perceived well-being (fatigue, sleep quality, general muscle soreness, stress levels, and mood) and total quality of recovery were assessed each training day. Countermovement jump height was measured, and a list of injuries and illnesses was collected weekly using the adapted Oslo Sports Trauma Research Center Questionnaire on Health Problems.

RESULTS

Total load (training sessions and matches; P < .001) and training load (P < .001) were significantly lower for ≥2-match weeks. Significantly higher well-being (P = .01) and less fatigue (P = .001) were found during ≥2-match weeks compared with 1-match weeks.

CONCLUSION

Total load and training load were lower during short-term match congestion compared with regular competition. Furthermore, better well-being and less fatigue were demonstrated within short-term match congestion. This might indicate that coaches tend to overcompensate training load in intensified competition.

Is It High Time to Increase Elite Soccer Substitutions Permanently?

Rules determine how team sport matches occur. Match-induced fatigue is specific to each sport, and may be associated with injury incidence. For example, the injury rate in soccer is distinctly higher during matches than in training sessions. Understanding the differences between team sports rules might be useful for enhancing rules (e.g., safer sport). Therefore, this study aimed to evaluate the impact of the rule-induced physical demands between soccer, futsal, basketball, and handball, focusing on substitution rules. Data from the elite team sports' rules (e.g., absolute and relative court dimensions; the number of players, substitutions allowed, total game time, time-outs) were collected, including the changes due to the coronavirus disease (COVID-19) pandemic in soccer substitutions, and comparisons were performed. The data showed that soccer has higher rule-induced physical demands: e.g., substantially lower substitution rate, higher dimensions in absolute (eight to fifteen times), and relative (four to eight times) values. Simulations also showed that soccer has extremely large differences, even considering COVID-19 substitution changes (from three to up to five). We conclude that elite soccer has remarkably higher overall rule-induced physical demands than elite futsal, basketball and handball, and increasing soccer substitutions permanently (e.g., unlimited) might mitigate overall soccer demands.

The Interplay Between Plasma Hormonal Concentrations, Physical Fitness, Workload and Mood State Changes to Periods of Congested Match Play in Professional Soccer Players

Background

The regular assessment of hormonal and mood state parameters in professional soccer are proposed as good indicators during periods of intense training and/or competition to avoid overtraining.

Objective

The aim of this study was to analyze hormonal, psychological, workload and physical fitness parameters in elite soccer players in relation to changes in training and match exposure during a congested period of match play.

Methods

Sixteen elite soccer players from a team playing in the first Tunisian soccer league were evaluated three times (T1, T2, and T3) over 12 weeks. The non-congested period of match play was from T1 to T2, when the players played 6 games over 6 weeks. The congested period was from T2 to T3, when the players played 10 games over 6 weeks. From T1 to T3, players performed the Yo-Yo intermittent recovery test level 1 (YYIR1), the repeated shuttle sprint ability test (RSSA), the countermovement jump test (CMJ), and the squat jump test (SJ). Plasma Cortisol (C), Testosterone (T), and the T/C ratio were analyzed at T1, T2, and T3. Players had their mood dimensions (tension, depression, anger, vigor, fatigue, confusion, and a Total Mood Disturbance) assessed through the Profile of Mood State questionnaire (POMS). Training session rating of perceived exertion (sRPE) was also recorded on a daily basis in order to quantify internal training load and elements of monotony and strain.

Results

Significant performance declines (T1 < T2 < T3) were found for SJ performance (p = 0.04, effect size [ES] ES_1–2 = 0.15−0.06, ES_2–3 = 0.24) from T1 to T3. YYIR1 performance improved significantly from T1 to T2 and declined significantly from T2 to T3 (p = 0.001, ES_1–2 = 0.24, ES_2–3 = −2.54). Mean RSSA performance was significantly higher (p = 0.019, ES_1–2 = −0.47, ES_2–3 = 1.15) in T3 compared with T2 and T1. Best RSSA performance was significantly higher in T3 when compared with T2 and T1 (p = 0.006, ES_2–3 = 0.47, ES_1–2 = −0.56), but significantly lower in T2 when compared with to T1. T and T/C were significantly lower in T3 when compared with T2 and T1 (T: p = 0.03, ES_3–2 = −0.51, ES_3–1 = −0.51, T/C: p = 0.017, ES_3–2 = −1.1, ES_3–1 = −1.07). Significant decreases were found for the vigor scores in T3 when compared to T2 and T1 (p = 0.002, ES_1–2 = 0.31, ES_3–2 = −1.25). A significant increase was found in fatigue scores in T3 as compared to T1 and T2 (p = 0.002, ES_1–2 = 0.43, ES_2–3 = 0.81). A significant increase was found from T1 < T2 < T3 intension score (p = 0.002, ES_1–2 = 1.1, ES_2–3 = 0.2) and anger score (p = 0.03, ES_1–2 = 0.47, ES_2–3 = 0.33) over the study period. Total mood disturbance increased significantly (p = 0.02, ES_1–2 = 0.91, ES_2–3 = 1.1) from T1 to T3. Between T1-T2, significant relationships were observed between workload and changes in T (r = 0.66, p = 0.003), and T/C ratio (r = 0.62, p = 0.01). There were significant relationships between performance in RSSA_best and training load parameters (workload: r = 0.52, p = 0.03; monotony: r = 0.62, p = 0.01; strain: r = 0.62, p = 0.009). Between T2-T3, there was a significant relationship between Δ% of total mood disturbance and Δ% of YYIR1 (r = −0.54; p = 0.04), RSSA_best (r = 0.58, p = 0.01), SJ (r = −0,55, p = 0.01), T (r = 0.53; p = 0.03), and T/C (r = 0.5; p = 0.04).

Conclusion

An intensive period of congested match play significantly compromised elite soccer players’ physical and mental fitness. These changes were related to psychological but not hormonal parameters; even though significant alterations were detected for selected measures. Mood monitoring could be a simple and useful tool to determine the degree of preparedness for match play during a congested period in professional soccer.

Epidemiology of injuries in professional football: a systematic review and meta-analysis

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.

A Possible Antioxidant Role for Vitamin D in Soccer Players: A Retrospective Analysis of Psychophysical Stress Markers in a Professional Team

The health benefits of physical activity are recognized, however, high levels of exercise may lead to metabolic pathway imbalances that could evolve into pathological conditions like the increased risk of neurological disease observed in professional athletes. We analyzed the plasma/serum levels of 29 athletes from a professional soccer team playing in the Italian first league and tested the levels of psychophysical stress markers (vitamin D, creatine kinase, reactive oxygen species (ROS) and testosterone/cortisol ratio) during a period of 13 months. The testosterone/cortisol ratio was consistent with an appropriate training program. However, most of the athletes showed high levels of creatine kinase and ROS. Despite the large outdoor activity, vitamin D values were often below the sufficiency level and, during the “vitamin D winter”, comparable with those of the general population. Interestingly, high vitamin D values seemed to be associated to low levels of ROS. Based on the results of our study we proposed a vitamin D supplementation as a general practice for people who perform high levels of physical exercise. Beside the known effect on calcium and phosphate homeostasis, vitamin D supplementation should mitigate the high reactivity of ROS which might be correlated to higher risk of neurodegenerative diseases observed in professional athletes.

Effect of vibration vs non-vibration foam rolling techniques on flexibility, dynamic balance and perceived joint stability after fatigue

Background

Foam roller and vibration techniques are currently used to assist in recovery after fatigue. The main purpose of this study was to determine the effects of the use of a foam roller with and without vibration on dynamic balance, ankle dorsiflexion, hamstring and lumbar spine flexibility and perceived knee and ankle stability after an induced fatigue protocol.

Methods

A total of 24 healthy recreationally active participants (17 males and seven females) were recruited to a randomized cross over trial consisting of; no treatment (NT), foam roller treatment (FR) and vibration foam roller treatment (VFR). The assessments included; the Sit & Reach test, Y balance test and post-treatment perceived knee and ankle stability. Measurements were taken after a standardized warm up (baseline) and repeated following an exercise-induced muscle fatigue protocol consisting of repeated lunges until volitional fatigue. The three treatment conditions were assessed on three separate days in a randomized order. A 3 × 3 repeated measures ANOVA was used to investigate differences between the three treatments over the three time points and a one factor repeated measures ANOVA was used to determine any differences between treatments using the Global Rate of Change scale when considering perceived stability.

Results

FR and VFR conditions both showed a greater ankle dorsiflexion range of motion (ROM) (p < 0.001), greater posteromedial and posterolateral reach distances (p < 0.001) and a better knee and ankle perceived stability (p < 0.001) when compared to the NT condition. A trend toward significance was observed in the hamstring and lumbar spine flexibility (p = 0.074) in both treatment conditions when compared to the NT condition. However, no differences were seen between the FR and VFR conditions.

Conclusions

Both FR conditions seem to assist in exercise-induced muscle fatigue recovery with improvements in ROM, balance and perceived stability.

Perspectives in football medicine

The high injury rate among men's professional football players is well-known. Therefore, the Union of European Football Associations (UEFA) launched an injury study already in 2001. This study, the UEFA Elite Club Injury Study (ECIS), currently includes data from a total of 51 clubs from 18 European countries with more than 14,000 registered injuries. With the 21^st World Cup (WC) in Russia just around the corner, we have from our study identified a higher match injury rate and a higher proportion of severe injuries in the European Championships compared to the preceding club competitive seasons. Moreover, we have also recently showed that the muscle injury rate is higher when players are given a recovery window of five days or less between two matches. Considering the congested match schedule of the upcoming WC, it is therefore likely that injuries and fatigue once again will be a topic of discussion this summer.

Protein-Based Supplementation to Enhance Recovery in Team Sports: What is the Evidence?

Protein supplementation is a major nutritional practice among professional and amateur team-sport athletes representing a market of $5 billion in the USA alone. This practice, however, may not be supported by evidence-based science. Our objective as to present a thorough review of literature investigating the effects of protein supplementation on performance recovery and exercise-induced muscle damage following team-sport activity. PubMed-derived, full English language articles investigating the effects of protein-based supplementation/feeding on skeletal muscle performance, muscle damage and inflammatory status during recovery following team-sport activity were included. Studies investigated professional or amateur team-sport athletes participating in regular training and competition as well as examining the impact of protein supplementation on performance, muscle damage/soreness and inflammatory markers after team-sport activity. Finally, ten articles (150 participants) met the inclusion criteria. Experimental designs were evaluated for confounders. All protocols employing team-sport activity increased systemic muscle damage indicators and inflammatory markers and deteriorated performance during recovery. Protein-based supplementation attenuated the rise in muscle damage markers and enhanced performance recovery in six (60% of the studies included) and three (30% of the studies included) out of 10 studies, respectively. In contrast, immunity and muscle soreness remained unaffected by protein ingestion, independent of dosage and distribution pattern. In conclusion, there are limited and inconsistent data showing that protein supplementation may enhance performance recovery following team-sport activity despite an attenuation of indirect markers of muscle damage. Interpretation of results is limited by small sample sizes, high variability in tested supplements, participants' training level, length of recovery periods, absence of direct measurement of myofibrillar disruption, protein turnover and protein metabolism, and lack of dietary monitoring during experimentation.

Seasonal Accumulated Workloads in Collegiate Men's Soccer: A Comparison of Starters and Reserves

Curtis, RM, Huggins, RA, Benjamin, CL, Sekiguchi, Y, Arent, S, Armwald, B, Pullara, JM, West, CA, and Casa, DJ. Seasonal accumulated workloads in collegiate men's soccer: a comparison of starters and reserves. J Strength Cond Res XX(X): 000-000, 2019-The purpose of this investigation was to quantify and compare player's season total-, match-, and training-accumulated workload by player status characteristics (i.e., starter vs. reserve) in American collegiate men's soccer. Global positioning system (GPS) and heart rate (HR)-derived workloads were analyzed from 82 collegiate male soccer athletes from 5 separate teams over the 2016 and 2017 seasons. Differences in total physical and physiological workloads (i.e., total distance, accelerations, and weighted HR-zone training impulse [TRIMP] score) as well as workloads over a range of intensity zones were examined using multilevel mixed models, with mean difference (MD) and effect size (ES) reported. Starters accumulated substantially more total distance (MD = 82 km, ES = 1.23), TRIMP (MD = 2,210 au, ES = 0.63), and total accelerations (MD = 6,324 n, ES = 0.66) over the season. Total accumulated distance in all velocity zones (ES [range] = 0.87-1.08), all accelerations zones (ES [range] = 0.54-0.74), and time spent at 70-90% HRmax (ES [range] = 0.60-1.12) was also greater for starters. Reserves accumulated substantially more total distance (MD = 20 km, ES = 0.43) and TRIMP (MD = 1,683 au, ES = 0.79) during training. Although reserves show elevated physical and physiological loads during training compared with starters, there is an imbalance in overall workloads between player roles, with starters incurring substantially more match and total seasonal workloads. These results indicate managing player workloads in soccer requires attention to potential imbalances between players receiving variable match times. Coaches and practitioners in collegiate men's soccer may consider implementing strategies to reduce discrepancies in loading between starters and reserves. Individualized monitoring of training and match workloads may assist in the implementation of more balanced load management programs.

Circulating, Cell-Free DNA for Monitoring Player Load in Professional Football

Purpose: Player monitoring in elite sport settings is becoming increasingly important. Questionnaire-based methods and biomarkers such as circulating, cell-free DNA (cfDNA) are suggested for load monitoring. cfDNA concentrations were shown to increase depending on total distance covered in football and were associated with overtraining in weight lifters. Thus, the objective of this study was to examine whether cfDNA is feasible as a monitoring tool in elite football players. Methods: Capillary blood samples from 22 male elite football players were collected over 4 mo of a regular season. Sampling was conducted the day before, 1 day after, or several days after regular-season games and/or training. In addition, each player filled in a visual analogue scale (VAS) questionnaire including the items "general perceived exertion," "muscular fatigue," and "mental fatigue." Performance during training and games was tracked by the Catapult system and with the OPTA system, respectively. Results: cfDNA values were significantly elevated in players the day after regular-season games (1.4-fold; P = .0004) in line with the scores of the VAS. Both parameters showed significantly higher values during midweek-game weeks. cfDNA concentrations correlated with training data, and VAS was correlated with the tracking of the season games. However, cfDNA and VAS did not correlate with each other. Conclusions: cfDNA concentrations at rest and VAS scores are influenced by previous load in professional football players. Future studies will reveal whether cfDNA might serve as a practically applicable marker for player load in football players.

Intra-seasonal variation of injury patterns among German Bundesliga soccer players

OBJECTIVE

High fluctuations in injury-risk during the playing season in soccer have been reported. As seasons are structured in periods with homogenous loads and intensities, we investigated injury-risk over season periods, contrarily to previous studies adopting a month-based approach.

DESIGN

Cohort study; Level of evidence, 2.

METHODS

Incidence-rate ratios (IRRs) for match and training injuries were compared across six consecutive seasons of German Bundesliga, divided into six periods each: Pre-season (PS), winter-break (WB), quarter 1-4: (Q1-Q4).

RESULTS

Significant variations in injury-risk were observed for match and training injuries. IRRs in matches was 1.30 (95% CI: 1.11-1.53) times higher in Q3 and 1.53 (95% CI: 1.31-1.78) higher in Q4 compared to Q1. For training injuries, IRR peaked in Q1 and Q3 followed by a marked decrease in each subsequent quarter. Compared to Q4, IRR was 1.62 (95% CI: 1.40-1.86) times higher during Q3 and 1.78 (95% CI: 1.53-2.07) times higher in Q1. IRR was significantly higher in the competitive season compared to pre-season across match (IRR: 2.00, 95% CI: 1.30-3.00) and training (IRR: 1.27, 95% CI: 1.11-1.43) injuries.

CONCLUSIONS

The increased match IRRs later during the season indicate that, in practice, coaches should consider putting even more emphasis on recovery in the last part of the season. Moreover, training injuries seem to indicate a carry-over effect. Further studies need to investigate how training during preparatory phases can be implemented in a way that prevents injuries during the competitive season.

Injury prevalence and risk factors in a Greek team's professional football (soccer) players: a three consecutive seasons survey

This study investigated the prevalence and risk factors of injuries on a cohort of 123 Greek team's professional football players during three consecutive seasons, 2015/16-to-2017/18. Injuries were assessed and regression analysis was used to evaluate the potential risk factors. Three-quarters of the players were recorded as injured with 2.3 injuries/injured player, and the injury incidence was 55 injuries/1,000 match-playing-exposure-hours. The mean rehabilitation days were 29.3/injured player (95%CI 22.4-36.8) and 13.0/injury (95%CI 8.6-17.4). The majority of injured players has been found to have moderate-to-major/severe injuries and most of the injuries were traumatic than overuse (p < 0.05). The number of injuries were related to the recurrence of injury (beta = 0.646, p < 0.001) and the rehabilitations days (beta = 0.271, p < 0.001). High prevalence of injuries was found as the recurrence of injury and rehabilitation days were their main predictive risk factors. In order to reduce the risk of injuries, continuous effort is required in the rehabilitation of players.

Elite football teams that do not have a winter break lose on average 303 player-days more per season to injuries than those teams that do: a comparison among 35 professional European teams

OBJECTIVE

To compare injury rates among professional men's football teams that have a winter break in their league season schedule with corresponding rates in teams that do not.

METHODS

56 football teams from 15 European countries were prospectively followed for seven seasons (2010/2011-2016/2017)-a total of 155 team-seasons. Individual training, match exposure and time-loss injuries were registered. Four different injury rates were analysed over four periods within the season, and linear regression was performed on team-level data to analyse the effect of winter break on each of the injury rates. Crude analyses and analyses adjusted for climatic region were performed.

RESULTS

9660 injuries were reported during 1 447 011 exposure hours. English teams had no winter break scheduled in the season calendar: the other European teams had a mean winter break scheduled for 10.0 days. Teams without a winter break lost on average 303 days more per season due to injuries than teams with a winter break during the whole season (p<0.001). The results were similar across the three periods August-December (p=0.013), January-March (p<0.001) and April-May (p=0.050). Teams without a winter break also had a higher incidence of severe injuries than teams with a winter break during the whole season (2.1 severe injuries more per season for teams without a winter break, p=0.002), as well as during the period January-March (p=0.003). A winter break was not associated with higher team training attendance or team match availability. Climatic region was also associated with injury rates.

CONCLUSIONS

The absence of a scheduled winter break was associated with a higher injury burden, both before and during the two periods following the time that many European teams take a winter break. Teams without a winter break (English clubs) had a higher incidence of severe injuries following the time of the year that other teams (other European clubs) had their scheduled break.

Pre-season Fitness Level and Injury Rate in Professional Soccer - A Prospective Study

The aim of the present study was to assess prospectively the effect of pre-season fitness on injury rate during the competitive season among professional soccer players. Thirty-one players participated in the study during two consecutive competitive seasons (2015-16 and 2016-17; a squad of 22 players in each season). During the 6-week pre-season training period (8 training sessions and a friendly match every week, 14-18 training hours/week) there was a significant improvement in VO ₂ max, a significant increase in ideal and total sprint time and no change in vertical jump, flexibility and repeated sprint-test performance decrement. During the two consecutive seasons, 28 injuries were recorded. Ten injuries were classified as mild (missing 3-7 days of practice/match), 8 as moderate (missing 8-28 days) and 10 as severe (missing >28 days). The rate of match injuries was higher (9.4 per 1000 match hours) compared to practice injuries (4.7 per 1000 training hours). Most injuries were overuse injuries (72%) of the lower limbs (71%). Most of match injuries occurred during the last 15 min of each half. There were no differences in fitness characteristics in the beginning of pre-season training between injured and non-injured players. However, improvements in VO ₂ max during the pre-season training period were significantly lower among injured players (0.9±5.5%) compared to non-injured players (10.4±6.5%, p<0.05). Our results emphasize the importance of pre-season training in professional soccer players not only for improvement in fitness but also for injury prevention during the following competitive season.

Training Load and Fatigue Marker Associations with Injury and Illness: A Systematic Review of Longitudinal Studies

Background

Coaches, sport scientists, clinicians and medical personnel face a constant challenge to prescribe sufficient training load to produce training adaption while minimising fatigue, performance inhibition and risk of injury/illness.

Objective

The aim of this review was to investigate the relationship between injury and illness and longitudinal training load and fatigue markers in sporting populations.

Methods

Systematic searches of the Web of Science and PubMed online databases to August 2015 were conducted for articles reporting relationships between training load/fatigue measures and injury/illness in athlete populations.

Results

From the initial 5943 articles identified, 2863 duplicates were removed, followed by a further 2833 articles from title and abstract selection. Manual searching of the reference lists of the remaining 247 articles, together with use of the Google Scholar ‘cited by’ tool, yielded 205 extra articles deemed worthy of assessment. Sixty-eight studies were subsequently selected for inclusion in this study, of which 45 investigated injury only, 17 investigated illness only, and 6 investigated both injury and illness. This systematic review highlighted a number of key findings, including disparity within the literature regarding the use of various terminologies such as training load, fatigue, injury and illness. Athletes are at an increased risk of injury/illness at key stages in their training and competition, including periods of training load intensification and periods of accumulated training loads.

Conclusions

Further investigation of individual athlete characteristics is required due to their impact on internal training load and, therefore, susceptibility to injury/illness.

A review advocating caution with Major League Soccer expansion and investment in more rehabilitation professionals

BACKGROUND AND PURPOSE

Major League Soccer (MLS) has aggressively expanded from 10 teams to 23 teams. With the addition of more teams, the league will have to dictate a schedule that maximizes the league's popularity, while also maintaining the health of the players. A longer season and congested game schedule could increase the risk of injury for players. The purpose of this commentary is to make recommendations for the prevention of injuries among MLS players with respect to proposed league expansion.

DESCRIPTION OF TOPIC

MLS has lengthened the regular season with each expansion in teams. An increase in season length was seen in conjunction with the MLS expansion from 14 to 19 teams during the 2008 through 2013 seasons. Data from the inaugural MLS season found injury rates were higher in games compared to practices and more injuries occurred later in the season. With the expansion of MLS, anterior cruciate ligament tears appeared to have increased each year.

DISCUSSION

Current evidence suggests the implementation of a proper preseason in addition to the once-per-week game frequency would best promote player health and well-being. Players may benefit from in-season injury prevention training and weekly load monitoring.