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Zhang G, Brink M, Aus der Fünten K, Tröß T, Willeit P, Meyer T, Lemmink K, Hecksteden A. The Time Course of Injury Risk After Return-to-Play in Professional Football (Soccer). Sports Med 2024:10.1007/s40279-024-02103-3. [PMID: 39276305 DOI: 10.1007/s40279-024-02103-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2024] [Indexed: 09/16/2024]
Abstract
BACKGROUND Injury risk in professional football (soccer) is increased in the weeks following return-to-play (RTP). However, the time course of injury risk after RTP (the hazard curve) as well as its influencing factors are largely unknown. This knowledge gap, which is arguably due to the volatility of instantaneous risk when calculated for short time intervals, impedes on informed RTP decision making and post-RTP player management. OBJECTIVES This study aimed to characterize the hazard curve for non-contact time-loss injuries after RTP in male professional football and to investigate the influence of the severity of the index injury and playing position. METHODS Media-based injury records from the first German football league were collected over four seasons as previously published. Time-to-event analysis was employed for non-contact time-loss injury after RTP. The Kaplan-Meier survival function was used to calculate the cumulative hazard function, from which the continuous hazard function was retrieved by derivation. RESULTS There were 1623 observed and 1520 censored events from 646 players analyzed. The overall shape of the hazard curve was compatible with an exponential decline of injury risk, from an approximately two-fold level shortly after RTP towards baseline, with a half-time of about 4 weeks. Interestingly, the peak of the hazard curve was slightly delayed for moderate and more clearly for severe index injuries. CONCLUSIONS The time course of injury risk after RTP (the hazard curve) can be characterized based on the Kaplan-Meier model. The shape of the hazard curve and its influencing factors are of practical as well as methodological relevance and warrant further investigation.
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Affiliation(s)
- Guangze Zhang
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Michel Brink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
- University Sports, Stuttgart University, Stuttgart, Germany
| | - Peter Willeit
- Institute of Health Economics, Medical University of Innsbruck, Innsbruck, Austria
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Koen Lemmink
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - Anne Hecksteden
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany.
- Department of Sport Science, Institute of Sport Science, University of Innsbruck, Fürstenweg 176, 6020, Innsbruck, Austria.
- Institute of Physiology, Medical University of Innsbruck, Innsbruck, Austria.
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Yetter TR, Halvorson RT, Wong SE, Harris JD, Allahabadi S. Management of Proximal Hamstring Injuries: Non-operative and Operative Treatment. Curr Rev Musculoskelet Med 2024; 17:373-385. [PMID: 39009901 PMCID: PMC11335994 DOI: 10.1007/s12178-024-09911-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE OF REVIEW To evaluate the current evidence and literature on treatment options for proximal hamstring injuries. RECENT FINDINGS Patients with 3-tendon complete tears with greater than 2 cm of retraction have worse outcomes and higher complication rates compared to those with less severe injuries. Endoscopic and open proximal hamstring repair both have favorable patient reported outcomes at 5-year follow up. Proximal hamstring repair in patients who are male, with isolated semimembranosus injury, and have proximal hamstring free tendon rupture are more likely to have earlier return to sports. The Parisian Hamstring Avulsion Score (PHAS) is a validated patient-reported outcome measure to predict return to sports. Proximal hamstring injuries may occur in both elite and recreational athletes and may present with varying degrees of chronicity and severity. Injuries occur most commonly during forceful eccentric contraction of the hamstrings and often present with ischial tuberosity tenderness, ecchymosis, and hamstring weakness. Treatment decision-making is dictated by the tendons involved and chronicity. Many proximal hamstring injuries can be successfully treated with non-surgical measures. However, operative treatment of appropriately indicated proximal hamstring tendon injuries can result in significantly better functional outcomes and faster and more reliable return to sports compared to nonoperative treatment. Both endoscopic and open surgical repair techniques show high satisfaction levels and excellent patient-reported outcomes at short- and mid-term follow-up. Postoperative rehabilitation protocols vary across the literature and ongoing study is needed to clarify the optimal program, though emphasis on eccentric hamstring strengthening may be beneficial.
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Nickerson M, Herickhoff P. Femoroacetabular Impingement and Groin Injuries Among Soccer Players. Sports Med Arthrosc Rev 2024; 32:120-124. [PMID: 39087700 DOI: 10.1097/jsa.0000000000000394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
Groin injuries and femoroacetabular impingement are common among soccer players and can provide a challenge in diagnosis, as well as treatment. Nonoperative and operative measures are the 2 predominant treatments. This current review investigates the recent literature on groin and femoroacetabular impingement injuries in soccer players, as well as potential treatment modalities.
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Affiliation(s)
- Morgan Nickerson
- Department of Orthopedic Surgery, Penn State Health Milton S. Hershey Medical Center, State College, PA
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Bouzigues T, Maurelli O, Imbach F, Prioux J, Candau R. A New Training Load Quantification Method at Supramaximal Intensity and Its Application in Injuries Among Members of an International Volleyball Team. J Strength Cond Res 2024; 38:1453-1463. [PMID: 38917033 DOI: 10.1519/jsc.0000000000004811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
ABSTRACT Bouzigues, T, Maurelli, O, Imbach, F, Prioux, J, and Candau, R. A new training load quantification method at supramaximal intensity and its application in injuries among members of an international volleyball team. J Strength Cond Res 38(8): 1453-1463, 2024-The quantification of training loads (TLs) is essential for optimizing jump performance and reducing the occurrence of injuries. This study aimed to (a) propose a new method for quantifying TLs in explosive exercises, (b) determine the nature of the relationship between TLs dynamics and injury occurrence, and (c) assess a TL critical for training schedule purposes, above which the risk of injury occurrence becomes unacceptable. This study was conducted with 11 male volleyball players on a national team during a 5-month international competitive period. The proposed new method for quantifying TLs is based on a weighting factor applied to relative jumping intensities, determined by the number of sustainable jumps and their intensities measured by G-Vert accelerometer. The relationship between TLs dynamics and injury occurrence was assessed using a variable dose-response model. A high coefficient of determination was found between the maximum number of jumps possible and their intensities ( r2 = 0.94 ± 0.14, p < 0.001), indicating a strong physiological relationship between jumping intensities and the constraints imposed. The occurrence of injury was dependent on TLs dynamics for 2 players ( r2 = 0.26 ± 0.01; p < 0.001). The TL critical corresponded to 11 jumps over 80% of maximum jump height during games and approximately 130 jumps at <80% of maximal jump height. The present study proposes a new approach for quantifying supramaximal exercises and provides tools for training schedules and the prevention of volleyball injuries.
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Affiliation(s)
- Théo Bouzigues
- INRA Center de Montpellier, UMR 866 Dynamique Musculaire et Métabolisme Montpellier, Languedoc-Roussillon, France
| | - Olivier Maurelli
- INRA Center de Montpellier, UMR 866 Dynamique Musculaire et Métabolisme Montpellier, Languedoc-Roussillon, France
- French Federation of Volleyball, Créteil, France
| | | | - Jacques Prioux
- Movement, Sport and Health Laboratory (EA 1274), UFR APS, University of Rennes 2, Rennes, France
| | - Robin Candau
- INRA Center de Montpellier, UMR 866 Dynamique Musculaire et Métabolisme Montpellier, Languedoc-Roussillon, France
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5
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Luijten SC, te Loo LM, Nauta J, Janssen TW, Holla JF, Otten RH, Vriend I, Verhagen E. Sports-Related Health Problems in Para-Sports: A Systematic Review With Quality Assessment. Sports Health 2024; 16:551-564. [PMID: 37337621 PMCID: PMC11195855 DOI: 10.1177/19417381231178534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
CONTEXT Participation in sports is associated with a risk of sports-related health problems. For athletes with an impairment, sports-related health problems further burden an already restricted lifestyle, underlining the importance of prevention strategies in para-sports. OBJECTIVE To provide a comprehensive overview with quality assessment of the literature on sports-related health problems, their etiology, and available preventive measures in para-sports following the steps of the Sequence of Prevention. DATA SOURCES A literature search (in PubMed, Embase, SPORTDiscus, CINAHL and the Cochrane Library) was performed up to December 8, 2021, in collaboration with a medical information specialist. STUDY SELECTION The search yielded 3006 articles, of which 64 met all inclusion criteria. STUDY DESIGN Systematic review with quality assessment. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION Two independent researchers carried out the screening process and quality assessment. One researcher extracted data, and the Sequence of Prevention categorized evidence. RESULTS A total of 64 studies were included, of which 61 reported on the magnitude and risk factors of sports-related health problems, while only 3 reported on the effectiveness of preventive measures. Of these, 30 studies were of high quality. Most studies (84%) included elite-level athletes. The reported injury incidence varied widely between sports (0-91 per 1000 athlete days) and impairment categories (1-50 per 1000 athlete days). The same applies to illness incidence with regard to different sports (3-49 per 1000 athlete days) and impairment categories (6-14 per 1000 athlete days). CONCLUSION This review shows the current vast range of reported sport-related health problems in para-sports. There is limited evidence concerning the severity of these sports-related health problems and inconclusive evidence on the risk factors. Lastly, the evidence regarding the development and effectiveness of preventive measures for para-athletes is sparse.
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Affiliation(s)
- Sietske C.M. Luijten
- Amsterdam Collaboration on Health & Safety in Sports, Amsterdam, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Leonie M. te Loo
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Joske Nauta
- Amsterdam Collaboration on Health & Safety in Sports, Amsterdam, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Thomas W.J. Janssen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands, and Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, the Netherlands
| | - Jasmijn F.M. Holla
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands, and Center for Adapted Sports Amsterdam, Amsterdam Institute of Sport Science, Amsterdam, the Netherlands
| | - René H.J. Otten
- Medical Information Specialist, Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands)
| | - Ingrid Vriend
- Amsterdam Collaboration on Health and Safety in Sports, Amsterdam, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Evert Verhagen
- Amsterdam Collaboration on Health and Safety in Sports, Amsterdam, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Kalkhoven JT. Athletic Injury Research: Frameworks, Models and the Need for Causal Knowledge. Sports Med 2024; 54:1121-1137. [PMID: 38507193 PMCID: PMC11127898 DOI: 10.1007/s40279-024-02008-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/22/2024]
Abstract
Within applied sports science and medicine research, many challenges hinder the establishment and detailed understanding of athletic injury causality as well as the development and implementation of appropriate athletic injury prevention strategies. Applied research efforts are faced with a lack of variable control, while the capacity to compensate for this lack of control through the application of randomised controlled trials is often confronted by a number of obstacles relating to ethical or practical constraints. Such difficulties have led to a large reliance upon observational research to guide applied practice in this area. However, the reliance upon observational research, in conjunction with the general absence of supporting causal inference tools and structures, has hindered both the acquisition of causal knowledge in relation to athletic injury and the development of appropriate injury prevention strategies. Indeed, much of athletic injury research functions on a (causal) model-blind observational approach primarily driven by the existence and availability of various technologies and data, with little regard for how these technologies and their associated metrics can conceptually relate to athletic injury causality and mechanisms. In this article, a potential solution to these issues is proposed and a new model for investigating athletic injury aetiology and mechanisms, and for developing and evaluating injury prevention strategies, is presented. This solution is centred on the construction and utilisation of various causal diagrams, such as frameworks, models and causal directed acyclic graphs (DAGs), to help guide athletic injury research and prevention efforts. This approach will alleviate many of the challenges facing athletic injury research by facilitating the investigation of specific causal links, mechanisms and assumptions with appropriate scientific methods, aiding the translation of lab-based research into the applied sporting world, and guiding causal inferences from applied research efforts by establishing appropriate supporting causal structures. Further, this approach will also help guide the development and adoption of both relevant metrics (and technologies) and injury prevention strategies, as well as encourage the construction of appropriate theoretical and conceptual foundations prior to the commencement of applied injury research studies. This will help minimise the risk of resource wastage, data fishing, p-hacking and hypothesising after the results are known (HARK-ing) in athletic injury research.
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Affiliation(s)
- Judd T Kalkhoven
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia.
- Human Performance Research Centre, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
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Harøy J, Bache-Mathiesen LK, Andersen TE. Lower HAGOS subscale scores associated with a longer duration of groin problems in football players in the subsequent season. BMJ Open Sport Exerc Med 2024; 10:e001812. [PMID: 38685919 PMCID: PMC11057268 DOI: 10.1136/bmjsem-2023-001812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Groin injuries represent a considerable problem in football. Although the Adductor Strengthening Programme reduced groin injury risk, players can still experience groin symptoms throughout the season. This study aimed to determine whether preseason Copenhagen Hip and Groin Outcome Score (HAGOS) and a history of previous injury can identify individuals at risk of having a longer duration of groin problems the subsequent season, using an 'any physical complaint' definition of injury. Methods Preseason HAGOS score and weekly groin problems were registered with the Oslo Sports Trauma Research Center Overuse questionnaire during one full season in 632 male semiprofessional adult players. Results The prognostic model showed a decreased number of weeks with groin problems for each increase in HAGOS score for 'groin-related quality of life' (QOL) (IRR=0.99, p=0.003). A 10-point higher 'QOL' score predicted 10% fewer weeks of groin problems. Additionally, previous hip/groin injury was associated with a 74% increase in the number of weeks with symptoms (p<0.001). Conclusion The HAGOS questionnaire applied preseason can detect players at risk of getting more weeks with groin problems the following season. The 'QOL' subscale seems to be the superior subscale for estimating subsequent groin problem duration. While HAGOS appears promising in identifying players at risk, previous groin injury is the most robust indicator, showing a substantial 74% increase in weeks with symptoms.
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Affiliation(s)
- Joar Harøy
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medicine Center, Oslo, Norway
| | - Lena Kristin Bache-Mathiesen
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Thor Einar Andersen
- Oslo Sports Trauma Research Center, Department of of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association's Sports Medicine Center, Oslo, Norway
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8
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Watts V GJ, Tai R, Joshi G, Garwood E, Saha D. Reinjury Following Return to Play. Semin Musculoskelet Radiol 2024; 28:154-164. [PMID: 38484768 DOI: 10.1055/s-0043-1778022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Radiologists are frequently called on for guidance regarding return to play (RTP) for athletes and active individuals after sustaining a musculoskeletal injury. Avoidance of reinjury is of particular importance throughout the rehabilitative process and following resumption of competitive activity. Understanding reinjury risk estimation, imaging patterns, and correlation of clinical and surgical findings will help prepare the radiologist to identify reinjuries correctly on diagnostic imaging studies and optimize management for a safe RTP.
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Affiliation(s)
- George J Watts V
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, UMass Chan Medical School, Worcester, Massachusetts
| | - Ryan Tai
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, UMass Chan Medical School, Worcester, Massachusetts
| | - Ganesh Joshi
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, UMass Chan Medical School, Worcester, Massachusetts
| | - Elisabeth Garwood
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, UMass Chan Medical School, Worcester, Massachusetts
| | - Debajyoti Saha
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, UMass Chan Medical School, Worcester, Massachusetts
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Bakal DR, Hussain FS, Dzierzawski JT, Meyer DT, Dawson HE, Olufade OA. Gender-specific hip strength disparities correlate with injury patterns in NCAA men's and women's soccer players. PM R 2024; 16:347-355. [PMID: 38529764 DOI: 10.1002/pmrj.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/02/2024] [Accepted: 01/11/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND In National Collegiate Athletic Association (NCAA) soccer athletes, men have higher rates of hip and groin strains, whereas women have higher rates of knee ligament injuries. Strength imbalances of the hip and thigh, specifically in agonist-antagonist muscles, are known risk factors for these injuries. OBJECTIVE To perform hip and thigh strength assessments in NCAA soccer players to evaluate for differences between genders and correlations with gender-specific injury patterns. DESIGN With a handheld dynamometer, weight-normalized isometric strength of six muscle groups (hip abductors, hip adductors, hip flexors, hip extensors, knee flexors, knee extensors) was calculated in NCAA soccer players. The strength ratio of each agonist-antagonist muscle was also calculated (hip abductors/adductors, hip flexors/extensors, knee extensors/flexors). PARTICIPANTS Thirty-six NCAA soccer players (18 men, 18 women) from a single NCAA Division III institution. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Weight-normalized strength of six muscle groups and their agonist-antagonist strength ratios were compared between genders using linear mixed-effects models. RESULTS Compared with male players, female players had decreased weight-normalized strength for hip abduction (0.170 vs. 0.204, p = .012) and hip extension (0.172 vs. 0.211, p = .021). Otherwise, weight-normalized strength was similar between genders. When comparing agonist-antagonist strength ratios, there was a significant difference between female and male players for hip flexion:extension (1.70 vs. 1.35, p = .008), whereas the hip abduction: adduction ratio did not reach statistical significance (1.45 vs. 1.62, p = .080). CONCLUSIONS NCAA male and female soccer players had different hip strength profiles that fit their injury patterns. Male NCAA soccer players have higher rates of hip and groin strains, and men in the cohort had strength ratios that were deficient in the hip flexors and adductors compared with women. Female NCAA soccer players have higher rates of knee sprains and anterior cruciate ligament tears, and women in the cohort had strength ratios that were deficient in the hip abductors and extensors, which function to stabilize the knee. These strength disparities could be the focus of future gender-specific soccer injury prevention programs.
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Affiliation(s)
- David R Bakal
- Department of Orthopaedic Surgery, Division of Sports Medicine, University of California San Diego School of Medicine, La Jolla, California, USA
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Farah S Hussain
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Justin T Dzierzawski
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Daniel T Meyer
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Holli E Dawson
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Oluseun A Olufade
- Department of Orthopedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Physical Medicine and Rehabilitation, Emory University School of Medicine, Atlanta, Georgia, USA
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10
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Martínez-Aranda LM, García-Esteban S, Sanz-Matesanz M, Raya-González J. Ligament Injuries in Professional Male Handball Players: A 6-Year Longitudinal Study. Healthcare (Basel) 2024; 12:201. [PMID: 38255088 PMCID: PMC10815351 DOI: 10.3390/healthcare12020201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes to a high injury rate. This study aimed to analyse ligament injuries in a professional handball team over six consecutive seasons. A total of 68 elite male Spanish handball players participated, with 54 time-loss injuries (i.e., injuries involving at least one day of absence) observed during this study period. Ligament injury information was recorded following the International Olympic Committee consensus statement. The overall incidence was 0.89 ligament injuries per 1000 h of exposure. Additionally, a higher incidence and burden of ligament injuries was observed during match-play compared to training. Most ligament injuries were classified as minor or moderate (i.e., 79.63% of the total), and 46.29% were reinjuries. A significantly higher incidence of ligament injuries was suffered in the lower limbs compared to the upper limbs (0.81 vs. 0.08 ligament injuries per 1000 h; p < 0.001). Specifically, the highest incidence was observed in the anterior talofibular ligament of the ankle (0.57 injuries per 1000 h of exposure), while the greatest burden was related to the anterior cruciate ligament (24.08 absence days per 1000 h of exposure). This study provides an overview of ligament injuries among professional handball players, highlighting the need to implement strategies with positive effects during competition (e.g., specific activation strategies or training programmes based on strength and balance) and to reduce injury recurrences.
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Affiliation(s)
- Luis Manuel Martínez-Aranda
- Physical and Sports Performance Research Centre, Faculty of Sports Sciences, Pablo de Olavide University, 41013 Seville, Spain
- SEJ-680: Science-Based Training (SBT) Research Group, Pablo de Olavide University, 41013 Seville, Spain
| | - Sergio García-Esteban
- Faculty of Health Sciences, University Isabel I, 09003 Burgos, Spain;
- Club Balonmano Villa de Aranda, Medical Department, 09400 Burgos, Spain
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11
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Mitchell A, Greig M. Peak instantaneous PlayerLoad metrics highlight movement strategy deficits in professional male soccer players. Res Sports Med 2024; 32:61-71. [PMID: 35593507 DOI: 10.1080/15438627.2022.2079985] [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: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Abstract
To investigate the influence of task, limb dominance and previous injury on single leg hop task performance and loading response, 25 professional male soccer players completed anterior, medial and lateral hop tests with an accelerometer at mid-calf. Performance outcome was defined as hop distance with loading response defined as the magnitude of, and time to peak instantaneous planar PlayerLoad. The performance was sensitive to task and previous injury (P < 0.001) but not limb dominance, with no evidence of bilateral asymmetry (P = 0.668). Despite impaired performance, previously injured players did not exhibit lower peak instantaneous PlayerLoad after impact in any plane (P ≥ 0.110). There was however a significantly (P = 0.001) longer time to peak medio-lateral loading after impact in previously injured players' affected limb. This observation was exacerbated when the injury was to the non-dominant limb (P = 0.041). Lower-limb accelerometry enhances understanding of movement strategy beyond task outcome, with practical implications in player screening and objective rehabilitation.
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Affiliation(s)
- Andy Mitchell
- Medical Department, RB Leipzig Football Club, Leipzig, Germany
| | - Matt Greig
- Sports Injuries Research Group, Edge Hill University, Ormskirk, UK
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12
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Calderón-Díaz M, Silvestre Aguirre R, Vásconez JP, Yáñez R, Roby M, Querales M, Salas R. Explainable Machine Learning Techniques to Predict Muscle Injuries in Professional Soccer Players through Biomechanical Analysis. SENSORS (BASEL, SWITZERLAND) 2023; 24:119. [PMID: 38202981 PMCID: PMC10780883 DOI: 10.3390/s24010119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/25/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
There is a significant risk of injury in sports and intense competition due to the demanding physical and psychological requirements. Hamstring strain injuries (HSIs) are the most prevalent type of injury among professional soccer players and are the leading cause of missed days in the sport. These injuries stem from a combination of factors, making it challenging to pinpoint the most crucial risk factors and their interactions, let alone find effective prevention strategies. Recently, there has been growing recognition of the potential of tools provided by artificial intelligence (AI). However, current studies primarily concentrate on enhancing the performance of complex machine learning models, often overlooking their explanatory capabilities. Consequently, medical teams have difficulty interpreting these models and are hesitant to trust them fully. In light of this, there is an increasing need for advanced injury detection and prediction models that can aid doctors in diagnosing or detecting injuries earlier and with greater accuracy. Accordingly, this study aims to identify the biomarkers of muscle injuries in professional soccer players through biomechanical analysis, employing several ML algorithms such as decision tree (DT) methods, discriminant methods, logistic regression, naive Bayes, support vector machine (SVM), K-nearest neighbor (KNN), ensemble methods, boosted and bagged trees, artificial neural networks (ANNs), and XGBoost. In particular, XGBoost is also used to obtain the most important features. The findings highlight that the variables that most effectively differentiate the groups and could serve as reliable predictors for injury prevention are the maximum muscle strength of the hamstrings and the stiffness of the same muscle. With regard to the 35 techniques employed, a precision of up to 78% was achieved with XGBoost, indicating that by considering scientific evidence, suggestions based on various data sources, and expert opinions, it is possible to attain good precision, thus enhancing the reliability of the results for doctors and trainers. Furthermore, the obtained results strongly align with the existing literature, although further specific studies about this sport are necessary to draw a definitive conclusion.
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Affiliation(s)
- Mailyn Calderón-Díaz
- Faculty of Engineering, Universidad Andres Bello, Santiago 7550196, Chile;
- Ph.D. Program in Health Sciences and Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
- Millennium Institute for Intelligent Healthcare Engineering (iHealth), Valparaiso 2362735, Chile
| | - Rony Silvestre Aguirre
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Juan P. Vásconez
- Faculty of Engineering, Universidad Andres Bello, Santiago 7550196, Chile;
| | - Roberto Yáñez
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Matías Roby
- Laboratorio de Biomecánica, Centro de Innovación Clínica MEDS, Santiago 7691236, Chile; (R.S.A.); (R.Y.); (M.R.)
| | - Marvin Querales
- School of Medical Technology, Universidad de Valparaiso, Valparaiso 2362735, Chile;
| | - Rodrigo Salas
- Ph.D. Program in Health Sciences and Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
- Millennium Institute for Intelligent Healthcare Engineering (iHealth), Valparaiso 2362735, Chile
- School of Biomedical Engineering, Universidad de Valparaiso, Valparaiso 2362735, Chile
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13
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Yousufy U, Chimera NJ. Is There an Association Between Injury History and Lower Extremity Joint Injury During Canada Games Competition? Int J Sports Phys Ther 2023; 18:1308-1319. [PMID: 38050547 PMCID: PMC10693481 DOI: 10.26603/001c.89273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/12/2023] [Indexed: 12/06/2023] Open
Abstract
Background Injuries during elite level competition like the Canada Games, occur frequently and injury history is one of the strongest predictors of future injury; however, this association is unknown in the Canada Games. Purpose To determine the association between injury history and incidence of lower extremity joint injury during Canada Games competition. Methods Data from the 2009 - 2019 Canada Games (8710 male and 8391 female athletes) competitions were de-identified by the Canada Games Council for analysis. Injury data were cleaned and categorized for previous injury and injury type and location. Injury history was self-reported and included concussion, major surgical procedure, neck and back, trauma to joint or bone, and trauma to ligament or tendon. Injury from the Canada Games competitions were categorized to include ankle, knee, hip, and patellofemoral joint injuries. Chi-Square (χ2 ) test of independence determined association between injury history and incidence of lower extremity joint injury during Canada Games competition. IBM SPSS (Version 26) was used for statistical analysis (p-value < 0.05). Results Four hundred and seventy-five ankle, 503 knee, 253 hip, and 106 patellofemoral joint injuries were reported during 10 years of Canada Games competitions. There were significant associations between history of neck and back injuries with ankle injuries and knee injuries, history of trauma and overuse of ligament or tendon with hip injuries and history of trauma or overuse of joint or bone with patellofemoral joint injuries. Conclusion These findings support previous literature suggesting that injury history is associated with future injury. Level of Evidence 3.
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Affiliation(s)
- Umar Yousufy
- Faculty of Applied Health Science Brock University
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14
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Ekenros L, Fridén C, von Rosen P. Does injury risk increase when youth athletes start to study at a sports high school? BMJ Open Sport Exerc Med 2023; 9:e001686. [PMID: 37937308 PMCID: PMC10626774 DOI: 10.1136/bmjsem-2023-001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
Background/aim The injury risk is high in adolescent elite athletes. However, little is known about how the injury risk changes when young talented athletes start studying at a sports high school. The primary aim was therefore to explore the risk of injury when the athlete starts to study at a sports high school. A secondary aim was to identify risk factors for injury. Methods A total of 489 athletes (age 15-16 years) were followed for 20 weeks, including 10 weeks before and 10 weeks after the athlete had started to study at a sports high school. Substantial injury was monitored in adolescent elite athletes using the Oslo Sports Trauma Research Centre Questionnaire. Results The results showed that the mean difference (md) in injury prevalence was significantly (p=0.001) higher across the 10 weeks after school had started (md 3.6; 95% CI 1.5 to 5.8), compared with the 10 weeks before. Female athletes had significantly (p<0.001) higher injury prevalence (md 6.4%; 95% CI 3.0 to 9.8) across the 10 weeks after school had started, whereas male athletes (md 0.9%; 95% CI -1.8 to 3.6) had not (p=0.530). Three significant (p<0.05) risk factors were identified; previous injury within the past 12 months (OR 3.23), higher training volume (OR 0.97) and lower well-being (OR 0.71). Conclusions Our results provide supporting evidence for increased injury risk in female adolescent elite athletes after the athletes had started to study at a sports high school.
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Affiliation(s)
- Linda Ekenros
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
| | - Cecilia Fridén
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- School of Health, Care and Social Welfare, Physiotherapy, Mälardalen University, Mälardalen, Västerås, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Huddinge, Sweden
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15
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Gashi F, Kovačič T, Shalaj I, Haxhiu B, Boshnjaku A. Injuries in professional women's elite soccer players in Kosovo: epidemiological injury study. BMC Sports Sci Med Rehabil 2023; 15:131. [PMID: 37828567 PMCID: PMC10571249 DOI: 10.1186/s13102-023-00746-9] [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: 02/22/2023] [Accepted: 10/05/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND An emphasis has been given lately towards women's engagement together with their potential in soccer. As this sport develops with athletes becoming more physically fit and skilled, it is unclear what the consequences in terms of injuries are. Having this in mind, this study aimed to investigate the major injuries that occur in women's soccer players. METHODS This descriptive epidemiological study invited all 286 women's soccer players from the 12 participating women clubs in the Kosovo 1st Soccer League (elite football level) during the 2021/2022 season, out of which 142 from 12 clubs participated. Exposure time for 1000 h of playing and training were recorded in addition to the anthropometric data, playing position, and prior injury history during the end of the season, practice, and match. The exact type of injury, severity, and post-injury recovery time, as well as the circumstances surrounding the injuries, were recorded. RESULTS In total 84 injuries were registered with an overall injury ratio (IR) being 3.21 (CI: 2.56, 3.98) injuries/1000 exposure hours. During the competitive season, each player sustained 1.4 injuries on average. IRs were significantly higher during competition (n = 50; IR = 1.57; CI: 1.52, 1.62) compared to training (n = 34; IR = 0.26, CI: 0.25, 0.27). Out of a total of 142 women players, 84 (59.2%) injuries occurred, and no record of injuries was made in 58 (40.8%) players. The overall IR was observed to be 3.21 (CI: 1.24, 3.27), with moderate and severe injuries accounting for 38.1% of total injuries (each), followed by mild (16.7%) and minimal (7.1%) injuries. CONCLUSION The women IR in Kosovo women's soccer players is low while being circa 11% below the international average. Almost 2 out of every 4 injuries were categorized as traumatic, with the IRs being more than 5-fold larger during games than during training. Additionally, these findings emphasize the higher rate of injuries amongst younger athletes, suggesting caution to be taken by the coaches when planning for the match. The collected data may help coaches and trainers create more targeted women's soccer injury prevention programs.
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Affiliation(s)
- Feim Gashi
- Physiotherapy Program, Faculty of Medicine, Alma Mater Europaea -ECM, Maribor, Slovenia.
- Physiotherapy Department, Faculty of Medical Sciences, Alma Mater Europaea Campus College Rezonanca, Prishtina, Kosovo.
| | - Tine Kovačič
- Physiotherapy Department, Faculty for Health Science, University of Ljubljana, Ljubljana, Slovenia
| | - Ismet Shalaj
- Physiotherapy Department, Faculty of Medical Sciences, Alma Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Bekim Haxhiu
- Physiotherapy Department, Faculty of Medical Sciences, Alma Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
| | - Arben Boshnjaku
- Physiotherapy Department, Faculty of Medical Sciences, Alma Mater Europaea Campus College Rezonanca, Prishtina, Kosovo
- Physiotherapy Program, Faculty of Medicine, University "Fehmi Agani" in Gjakova, 50000, Gjakova, Kosovo
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16
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Sonesson S, Lindblom H, Hägglund M. Higher age and present injury at the start of the season are risk factors for in-season injury in amateur male and female football players-a prospective cohort study. Knee Surg Sports Traumatol Arthrosc 2023; 31:4618-4630. [PMID: 37542529 PMCID: PMC10471640 DOI: 10.1007/s00167-023-07517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/14/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE To describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players. METHODS This prospective study followed adolescent and adult amateur football players over one season March-October 2020. The study was completed by 462 players (130 men, age 20.0 ± 5.7, 14-46 years) who answered a baseline survey and a weekly web survey during the season. A total of 1456 weekly surveys were registered from males and 5041 from females. Injuries were recorded with the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O2). Potential baseline risk factors (age, performance of strength/conditioning training, participation in other sports, perceived importance of sporting success, self-rated training and match load, perceived balance between training/match load and recovery, previous/present injury at start of season, and injury beliefs) and their association with injury were analysed with Poisson regressions within each sex. RESULTS Males reported 95 injuries (262 injury weeks, weekly prevalence 18.0% (95% CI 16.1-20.1)) and females 350 injuries (1206 injury weeks, weekly prevalence 23.9% (95% CI 22.8-25.1)). Gradual-onset injuries accounted for 57% of the injuries in males and 66% in females. For males, substantial injuries were most common in the hip/groin (weekly prevalence 3.8%), ankle (2.1%), posterior thigh (2.0%), and knee (2.0%); and for females, in the knee (4.3%), ankle (2.5%), and lower leg/Achilles tendon (2.0%). Significant risk factors for injury were higher age (rate ratio males 1.05 per year increase (95% CI 1.02-1.08), females 1.03 (95% CI 1.01-1.05)), and present injury at baseline (males 1.92 (95% CI 1.27-2.89), females 1.58 (95% CI 1.19-2.09)). CONCLUSION At any given week, almost one in five male and one in four female amateur football players reported new or ongoing injuries. Hip/groin injuries were more frequent in males, while female players had a higher prevalence of knee injuries. Older players and those with an existing injury at the start of the season were more prone to new injury during the season. Rehabilitation of pre-season injury and complaints are key to reduce the injury burden in amateur football. LEVEL OF EVIDENCE Level II. Trial registration number NCT04272047, Clinical trials.
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Affiliation(s)
- Sofi Sonesson
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hanna Lindblom
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Unit of Physiotherapy, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Sport Without Injury ProgrammE (SWIPE), Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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17
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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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18
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Weishorn J, Jaber A, Zietzschmann S, Spielmann J, Renkawitz T, Bangert Y. Injury Patterns and Incidence in an Elite Youth Football Academy-A Prospective Cohort Study of 138 Male Athletes. J Clin Med 2023; 12:6138. [PMID: 37834782 PMCID: PMC10573676 DOI: 10.3390/jcm12196138] [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: 08/07/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury. METHODS A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season. RESULTS A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7-30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2-41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01). CONCLUSION In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention.
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Affiliation(s)
- Johannes Weishorn
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany; (J.W.); (A.J.); (S.Z.); (T.R.)
| | - Ayham Jaber
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany; (J.W.); (A.J.); (S.Z.); (T.R.)
| | - Severin Zietzschmann
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany; (J.W.); (A.J.); (S.Z.); (T.R.)
| | - Jan Spielmann
- TSG ResearchLab gGmbH, Horrenberger Straße 58, 74939 Zuzenhausen, Germany;
| | - Tobias Renkawitz
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany; (J.W.); (A.J.); (S.Z.); (T.R.)
| | - Yannic Bangert
- Department of Orthopaedics, Heidelberg University Hospital, Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany; (J.W.); (A.J.); (S.Z.); (T.R.)
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Gashi F, Kovacic T, Gashi AI, Boshnjaku A, Shalaj I. Predicting Risk Factors of Lower Extremity Injuries in Elite Women's Football: Systematic Review and Meta-Analysis. Sports (Basel) 2023; 11:187. [PMID: 37755864 PMCID: PMC10537545 DOI: 10.3390/sports11090187] [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: 08/03/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
This study identified and analyzed the risk factors of lower extremity injuries (LEI) in elite women football players to improve career and health outcomes. To address this aim, a systematic review and meta-analysis methodology was used. In total, four relevant research articles were identified through database searching and screening using the PRISMA flow diagram. From these articles, eight predictors were identified that influence the risk of LEI among elite women football players: higher body mass index (OR 1.51, 95% CI); previous knee injury (OR 3.57, 95% CI); low normalized knee separation (≤10th percentile) (RR 1.92, 95% CI); all previous injury (previous ACL tear: OR 5.24, 95% CI; ankle sprain: 1.39, 95% CI; knee sprain: 1.50, 95% CI); and previous injury in the lower body (OR 2.97, 95% CI). Meanwhile, lower knee valgus angle in a drop-jump landing (OR 0.64, 95% CI) was found to decrease the risk of LEI among elite women football players.
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Affiliation(s)
- Feim Gashi
- Physiotherapy Program, Faculty of Medicine, Alma Mater Europaea—ECM, 2000 Maribor, Slovenia;
| | - Tine Kovacic
- Physiotherapy Department, Faculty for Health Science, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Arbnore Ibrahimaj Gashi
- Physiotherapy Program, Faculty of Medicine, University “Hasan Prishtina”, 10000 Pristina, Kosovo;
| | - Arben Boshnjaku
- Physiotherapy Program, Faculty of Medicine, University “Fehmi Agani”, 50000 Gjakova, Kosovo;
| | - Ismet Shalaj
- Physiotherapy Department, Faculty of Medical Sciences, Alma Mater Europaea Campus College Rezonanca, 10000 Prishtina, Kosovo
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20
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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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Kamandulis S, Cadefau JA, Snieckus A, Mickevicius M, Lukonaitiene I, Muanjai P, Satkunskiene D, Molina V, de Blas Foix X, Conte D. The effects of high-velocity hamstring muscle training on injury prevention in football players. Front Physiol 2023; 14:1219087. [PMID: 37670769 PMCID: PMC10475598 DOI: 10.3389/fphys.2023.1219087] [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: 05/08/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background: Explosive and fast body movements, sprints, jumps and quick changes of direction, which are characteristic of the football training, place considerable strain on the hamstring muscles. Due to the high occurrence of hamstring injuries, new preventive strategies are required that focus on high-velocity training. The purpose was to assess the effectiveness of high-velocity elastic-band training in reducing the occurrence of hamstring injuries in football players. Methods: Male football players from 15 teams (n = 319) playing in national competitions participated in this study. The players were involved in a 5-week exercise period in either the intervention group (INT) or the control group (CON), with a follow-up period of ∼4 months where hamstring injuries and exposure time were recorded. The INT group had two to three sessions per week of elastic-band training with low-load, high-velocity leg curls while lying prone; the CON group performed self-paced football-specific drills. Results: The incidence rate of hamstring injuries was 6.5% in the INT group (8 out of 123 players) and 9.2% in the CON group (18 out of 196 players). Although the INT group showed almost 1/3 reduction in hamstring injury incidence compared to the CON group, the difference was not statistically significant (p > 0.05). Moreover, no differences (p > 0.05, odds ratio [OR] = trivial-to-small) in distribution between the groups were found in hamstring injury characteristics (leg dominance and mechanism) except for the distribution of injuries that occurred during matches or training (p = 0.036; OR = 6.14, moderate). Conclusion: The program of high-velocity elastic-band training did not prove to be effective in preventing hamstring muscle injuries in football players despite displaying some positive indications that could be considering when creating injury prevention programs.
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Affiliation(s)
- Sigitas Kamandulis
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Joan Aureli Cadefau
- National Institute of Physical Education (INEFC), Barcelona University, Barcelona, Spain
| | - Audrius Snieckus
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Mantas Mickevicius
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Inga Lukonaitiene
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Pornpimol Muanjai
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chon Buri, Thailand
| | - Danguole Satkunskiene
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Victor Molina
- National Institute of Physical Education (INEFC), Barcelona University, Barcelona, Spain
| | - Xavier de Blas Foix
- Faculty of Psychology Education Sciences and Sport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Daniele Conte
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
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22
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Lloyd EM, Pinniger GJ, Murphy RM, Grounds MD. Slow or fast: Implications of myofibre type and associated differences for manifestation of neuromuscular disorders. Acta Physiol (Oxf) 2023; 238:e14012. [PMID: 37306196 DOI: 10.1111/apha.14012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
Many neuromuscular disorders can have a differential impact on a specific myofibre type, forming the central premise of this review. The many different skeletal muscles in mammals contain a spectrum of slow- to fast-twitch myofibres with varying levels of protein isoforms that determine their distinctive contractile, metabolic, and other properties. The variations in functional properties across the range of classic 'slow' to 'fast' myofibres are outlined, combined with exemplars of the predominantly slow-twitch soleus and fast-twitch extensor digitorum longus muscles, species comparisons, and techniques used to study these properties. Other intrinsic and extrinsic differences are discussed in the context of slow and fast myofibres. These include inherent susceptibility to damage, myonecrosis, and regeneration, plus extrinsic nerves, extracellular matrix, and vasculature, examined in the context of growth, ageing, metabolic syndrome, and sexual dimorphism. These many differences emphasise the importance of carefully considering the influence of myofibre-type composition on manifestation of various neuromuscular disorders across the lifespan for both sexes. Equally, understanding the different responses of slow and fast myofibres due to intrinsic and extrinsic factors can provide deep insight into the precise molecular mechanisms that initiate and exacerbate various neuromuscular disorders. This focus on the influence of different myofibre types is of fundamental importance to enhance translation for clinical management and therapies for many skeletal muscle disorders.
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Affiliation(s)
- Erin M Lloyd
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Gavin J Pinniger
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Robyn M Murphy
- Department of Biochemistry and Chemistry, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, Victoria, Australia
| | - Miranda D Grounds
- Department of Anatomy, Physiology and Human Biology, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia
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23
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Evans SL, Whittaker G, Elphinstone Davis O, Jones ES, Hardy J, Owen JA. Noncontact Injury Distribution and Relationship With Preseason Training Load and Nonmodifiable Risk Factors in Rugby Union Players Across Multiple Seasons. J Strength Cond Res 2023; 37:1456-1462. [PMID: 36445853 DOI: 10.1519/jsc.0000000000004402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
ABSTRACT Evans, SL, Whittaker, G, Elphinstone Davis, E, Jones, ES, Hardy, J, and Owen, JA. Noncontact injury distribution and relationship with preseason training load and non-modifiable risk factors in Rugby Union players across multiple seasons. J Strength Cond Res 37(7): 1456-1462, 2023-This study examined the distribution of noncontact injury during phases of the competitive season and the association between preseason training load (TL) and nonmodifiable risk factors on injury risk during these phases. Injury data were recorded from 1 senior academy team over 3 seasons (2017-2020) and analyzed across early-season, midseason, and late-season phases. A generalized estimating equation was used to model risk factors with noncontact injury for selected phases. The highest noncontact injury incidence occurred in the late-season phase (22.2 per 1,000 hours) compared with early (13.7 per 1,000 hours, p < 0.001) and midseason phases (15.5 per 1,000 hours, p = 0.001). Low preseason TL (8,949-12,589 arbitrary units; odds ratio [OR], 95% confidence interval [CI] = 4.7, 1.0-21.6; p = 0.04) and low preseason TL combined with high early-season TL and injury in the early-season phase (OR, 95% CI = 6.5, 1.1-35.5; p = 0.03) were associated with greater midseason noncontact injury risk. In addition, low preseason TL combined with previous injury was associated with increased risk of noncontact injury risk in the late season (OR, 95% CI = 12.2, 0.9-15.6, p = 0.05). Our results suggest players are at a greater injury risk during the late-season phase, with low preseason cumulative loads combined with a history of previous injury associated with increased in-season injury risk. Strength and conditioning coaches should therefore monitor cumulative preseason TL alongside screening for previous injury history to identify athletes at greater risk of noncontact injury risk during the competitive season.
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Affiliation(s)
- Seren L Evans
- School of Human and Behavioural Sciences, Institute for Applied Human Physiology, Bangor University, Bangor, United Kingdom
| | | | | | - Eleri S Jones
- School of Human and Behavioural Sciences, Institute for Psychology of Elite Performance, Bangor University, Bangor, United Kingdom
| | - James Hardy
- School of Human and Behavioural Sciences, Institute for Psychology of Elite Performance, Bangor University, Bangor, United Kingdom
| | - Julian A Owen
- School of Human and Behavioural Sciences, Institute for Applied Human Physiology, Bangor University, Bangor, United Kingdom
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24
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Kwakye SK, Mostert K, Garnett D, Masenge A. Risk factors associated with football injury among male players from a specific academy in Ghana: a pilot study. Sci Rep 2023; 13:8070. [PMID: 37202453 DOI: 10.1038/s41598-023-34826-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/09/2023] [Indexed: 05/20/2023] Open
Abstract
There seems to be no information on the incidence of injury and associated risk factors for academy football players in Ghana. We determine the risk factors associated with match and training injuries among male football players at an academy in Ghana. Preseason measurements of players' height, weight, and ankle dorsiflexion (DF) range of motion (ROM) were measured with a stadiometer (Seca 213), a digital weighing scale (Omron HN-289), and tape measure, respectively. The functional ankle instability (FAI) of players was measured using the Cumberland Ankle Instability Tool (CAIT), and dynamic postural control was measured with the Star Excursion Balance Test. Injury surveillance data for all injuries were collected by resident physiotherapists throughout one season. Selected factors associated with injury incidence were tested using Spearman's rank correlation at a 5% significance level. Age was negatively associated with overall injury incidence (r = - 0.589, p = 0.000), match (r = - 0.294, p = 0.008), and training incidence (r = - 0.314, p = 0.005). Previous injury of U18s was associated with training injuries (r = 0.436, p = 0.023). Body mass index (BMI) was negatively associated with overall injury incidence (r = - 0.513, p = 0.000), and training incidence (r = - 0.395, p = 0.000). CAIT scores were associated with overall injury incidence (n = 0.263, p = 0.019) and match incidence (r = 0.263, p = 0.029). The goalkeeper position was associated with match incidence (r = 0.241, p = 0.031) while the U16 attacker position was associated with training incidence. Exposure hours was negatively associated with overall injury incidence (r = - 0.599, p = 0.000). Age, BMI, previous injury, goalkeeper and attacker positions, ankle DF ROM, and self-reported FAI were associated with injury incidence among academy football players in Ghana.
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Affiliation(s)
- Samuel Koranteng Kwakye
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - Karien Mostert
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Daniel Garnett
- Department of Sport, Health Sciences and Social Work, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Pretoria, South Africa
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25
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Alkhathami KM. Using the Y-balance Test as a Predictor Tool for Evaluating Non-contact Injuries in University League Football Players: A Prospective Longitudinal Study. Cureus 2023; 15:e39317. [PMID: 37351231 PMCID: PMC10282161 DOI: 10.7759/cureus.39317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/24/2023] Open
Abstract
Background Football is a highly competitive sport, and participants can experience various contact and non-contact sports injuries in the sporting process. In any elite sport, screening players using different scientific tools is an important injury prevention strategy. The Y- Balance test (YBT) was found to be a predictive tool for non-contact injury. However, the use of criteria from these tests to predict injuries has not been substantiated and should be further investigated. Purpose The aim of this study was to determine the predictors for injury among athletes using baseline YBT, number of matches, and minutes of physical activity; the cutoff scores for predictors of injury, including baseline YBT, number of matches, and minutes of physical activity; and the clinical prediction rules for predicting injury in this population. Methods A total of 39 young student football players were included in this study. The mean age was 20.28 years, and the mean body mass index (BMI) was 23.83 kg/m2. A baseline assessment of the participant's characteristics was taken and each participant performed the YBT once before starting the league. After the university league football players had finished their tournament, we asked them questions related to non-contact injuries. Results The results showed that the prevalence of injury was 17.95% among this population. An increase in the YBT score was significantly associated with a decrease in the odds of having an injury [odds ratio (OR) 95% confidence interval (CI): 0.94 (0.88, 0.99), p = 0.047). In addition, the number of matches was significantly associated with an increase in the odds of having an injury p = 0.012. However, the minutes of physical activity were not statistically significant p = 0.065. The highest Youden index was ≤97.89, with a sensitivity of 87.50% and specificity of 71.43%, for the posterior medial reach and ≤92.88, with a sensitivity of 90.62% and specificity of 57.14%, for the posterior lateral reach. The clinical prediction rule was an area under the curve (AUC) of 0.88. Conclusions The results of the study provide evidence for the potential utility of the YBT as a predictor tool for evaluating non-contact injuries in university league football players. By identifying players with lower YBT scores who were at higher risk for injury, targeted interventions could be implemented to address functional movement deficits and potentially reduce injury risk.
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26
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Martínez-Silván D, Wik EH, Arnáiz J, Farooq A, Mónaco M. Association Between Magnetic Resonance Imaging Findings and Time to Return to Sport After Muscle Injuries in High-Level Youth Athletes. Clin J Sport Med 2023; 33:225-232. [PMID: 37042815 DOI: 10.1097/jsm.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/04/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To describe the relationship between magnetic resonance imaging (MRI) findings and time to return to sport (RTS) from muscle injuries in youth athletes. DESIGN Prospective collection of injury surveillance data over 6 seasons (2014-2015 to 2019-2020) and reanalysis of MRIs by a radiologist blinded to RTS time after the data collection period. SETTING National sports academy and sports medicine hospital. PARTICIPANTS Male youth (11-19 years) athletes participating in the football (soccer) or athletics (track and field) programs with a muscle injury. INDEPENDENT VARIABLES Magnetic resonance imaging findings (eg, grade and location) in time-loss muscle injuries. MAIN OUTCOME VARIABLES Injury incidence, distributions, and RTS time. RESULTS In total, 353 time-loss muscle injuries were recorded for 1089 athlete-seasons, of which 85 satisfied our inclusion criteria (MRI within 14 days). Return to sport time was significantly longer for reinjuries compared with index injuries. Associations between MRI findings and RTS time were specific to the muscle group, with significant differences in RTS time observed between categories of structure, location, and grade. The largest number of injuries was to the hamstrings (n = 46), where injuries involving the tendon were more severe than those involving the myotendinous junction and muscle, proximal injuries were more severe than mid-portion and distal, and longer RTS time was observed for higher injury grade ( P < 0.05). CONCLUSIONS Muscle injuries in youth are diverse and cannot be treated as a single injury type. Specific injury durations can be expected depending on injury characteristics such as reinjury, location, structure, and grade.
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Affiliation(s)
- Daniel Martínez-Silván
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Eirik Halvorsen Wik
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Rylaan, Tygerberg, South Africa
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Rylaan, Tygerberg, South Africa; and
| | - Javier Arnáiz
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- School of Medicine-Qatar, Weill Cornell University, Doha, Qatar
| | - Abdulaziz Farooq
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Mauricio Mónaco
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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27
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Kelley EA, Hogg JA, Gao L, Waxman JP, Shultz SJ. Demographic Factors and Instantaneous Lower Extremity Injury Occurrence in a National Collegiate Athletic Association Division I Population. J Athl Train 2023; 58:393-400. [PMID: 35789230 PMCID: PMC11220903 DOI: 10.4085/1062-6050-0673.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Temporal prediction of the lower extremity (LE) injury risk will benefit clinicians by allowing them to better leverage limited resources and target those athletes most at risk. OBJECTIVE To characterize the instantaneous risk of LE injury by demographic factors of sex, sport, body mass index (BMI), and injury history. DESIGN Descriptive epidemiologic study. SETTING National Collegiate Athletic Association Division I athletic program. PATIENTS OR OTHER PARTICIPANTS A total of 278 National Collegiate Athletic Association Division I varsity student-athletes (119 males, 159 females; age = 19.07 ± 1.21 years, height = 175.48 ± 11.06 cm, mass = 72.24 ± 12.87 kg). MAIN OUTCOME MEASURE(S) Injuries to the LE were tracked for 237 ± 235 consecutive days. Sex-stratified univariate Cox regression models were used to investigate the association between time to first LE injury and sport, BMI, and LE injury history. The instantaneous LE injury risk was defined as the injury risk at any given point in time after the baseline measurement. Relative risk ratios and Kaplan-Meier curves were generated. Variables identified in the univariate analysis were included in a multivariate Cox regression model. RESULTS Female athletes displayed similar instantaneous LE injury risk to male athletes (hazard ratio [HR] = 1.29; 95% CI= 0.91, 1.83; P = .16). Overweight athletes (BMI >25 kg/m2) had similar instantaneous LE injury risk compared with athletes with a BMI of <25 kg/m2 (HR = 1.23; 95% CI = 0.84, 1.82; P = .29). Athletes with previous LE injuries were not more likely to sustain subsequent LE injury than athletes with no previous injury (HR = 1.09; 95% CI = 0.76, 1.54; P = .64). Basketball (HR = 3.12; 95% CI = 1.51, 6.44; P = .002) and soccer (HR = 2.78; 95% CI = 1.46, 5.31; P = .002) athletes had a higher risk of LE injury than cross-country athletes. In the multivariate model, instantaneous LE injury risk was greater in female than in male athletes (HR = 1.55; 95% CI = 1.00, 2.39; P = .05), and it was greater in male athletes with a BMI of >25 kg/m2 than that in all other athletes (HR = 0.44; 95% CI = 0.19, 1.00; P = .05), but these findings were not significantly different. CONCLUSIONS In a collegiate athlete population, previous LE injury was not a contributor to the risk of future LE injury, whereas being female or being male with a BMI of >25 kg/m2 resulted in an increased risk of LE injury. Clinicians can use these data to extrapolate the LE injury risk occurrence to specific populations.
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Affiliation(s)
| | - Jennifer A. Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga
| | - Lani Gao
- Department of Mathematics, University of Tennessee at Chattanooga
| | | | - Sandra J. Shultz
- Department of Kinesiology, University of North Carolina at Greensboro
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28
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Ekstrand J, Hallén A, Marin V, Gauffin H. Most modifiable risk factors for hamstring muscle injury in women's elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women's Elite Club Injury Study. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07429-5. [PMID: 37121935 DOI: 10.1007/s00167-023-07429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European women's professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average and higher-than-average hamstring injury burden. METHODS The CMOs of eleven European professional women's football clubs were initially asked to suggest modifiable risk factors for hamstring injury. These risk factors were rated in according with their perceived importance on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2020/21 season. The LOW group consisted of six teams that had a lower-than-average hamstring injury burden. The HIGH group consisted of five teams that had a higher-than-average hamstring injury burden. RESULTS Twenty-one risk factors were suggested, most of which were extrinsic in nature, hence associated with the coaching staff, the team or the club organization rather than with the players themselves. The risk factors with the highest average importance were: "lack of communication between medical staff and coaching staff" and "load on players" (each with a weighted average of 3.9), followed by "lack of regular exposure to high-speed football actions during training" and "playing matches 2-3 times a week" (weighted average of 3.8 and 3.7). Differently from the LOW group, the HIGH group perceived the coaching factors (style of coach leadership, training/exercise surveillance by coaching staff) as more important. CONCLUSION In accordance to the eleven CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic in nature and associated with the club, the team, and the coaching staff, and not the players themselves. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Jan Ekstrand
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Platensgatan 19, S-582 20, Linköping, Sweden.
- Football Research Group, Linköping, Sweden.
| | - Anna Hallén
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Platensgatan 19, S-582 20, Linköping, Sweden
- Football Research Group, Linköping, Sweden
| | - Vittoria Marin
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
| | - Håkan Gauffin
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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29
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Beaudouin F, Tröss T, Hadji A, Steendahl IB, Meyer T, Fünten KAD. Do Sports-related Concussions Induce Subsequent Injuries in Elite Male Football Players? Int J Sports Med 2023. [PMID: 36347430 DOI: 10.1055/a-1974-3965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
To assess the players' risk of a subsequent injury after sustaining concussive injuries and their return-to-competition in German professional men's football. A prospective injury database in the 1st Bundesliga was created encompassing 7 seasons (2014/15-2020/21). Cox proportional hazard model analyzed whether a concussive injury increased the risk of a subsequent injury in the first year after the index injury. 6,651 injuries were reported (n=182 concussive injuries). The incidence rate was 0.15 (95% CI 0.13-0.17) per 1000 football hours. A concussive injury was associated with only a slightly numerical higher risk of 7% (HR=1.07, 95% CI 0.78-1.47) in the subsequent year after the injury compared to a randomly selected non-concussive injury, but the effect was not significant. The risk was higher after 6-12 months post-SRC reaching 70% (HR=1.70, 95% CI 1.15-2.52). For 0-3 months (HR=0.76, 95% CI 0.48-1.20) and 3-6 months (HR=0.97, 95% CI 0.62-1.50) the injury risk was lower. The present data do not confirm previously published investigations about an increased injury risk after SRC. Contrasting effects of lower hazard ratios were found early after SRC, followed by an increase after 6-12 months. Further research should look into compliance rates with regards to return-to-competition protocols.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröss
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Abed Hadji
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Ida Bo Steendahl
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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30
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aus der Fünten K, Tröß T, Hadji A, Beaudouin F, Steendahl IB, Meyer T. Epidemiology of Football Injuries of the German Bundesliga: A Media-Based, Prospective Analysis over 7 Consecutive Seasons. SPORTS MEDICINE - OPEN 2023; 9:20. [PMID: 36867257 PMCID: PMC9982794 DOI: 10.1186/s40798-023-00563-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND This study describes the implementation of a standardised, prospective injury database covering the entire 1st male German football league ("Bundesliga") based on publicly available media data. For the first time, various media sources were used simultaneously as the external validity of media-generated data was low in the past compared to data obtained by way of the "gold standard", i.e. by the teams' medical staffs. METHODS The study covers 7 consecutive seasons (2014/15-2020/21). The primary data source was the online version of the sport-specific journal "kicker Sportmagazin™" complemented by further publicly available media data. Injury data collection followed the Fuller consensus statement on football injury studies. RESULTS During the 7 seasons, 6653 injuries occurred, thereof 3821 in training and 2832 in matches. The injury incidence rates (IRs) per 1000 football hours were 5.5 [95% CI 5.3-5.6], 25.9 [25.0-26.9] per 1000 match, and 3.4 [3.3-3.6] per 1000 training hours. Twenty-four per cent of the injuries (n = 1569, IR 1.3 [1.2-1.4]) affected the thigh, 15% (n = 1023, IR 0.8 [0.8-0.9]) the knee, and 13% (n = 856, IR 0.7 [0.7-0.8]) the ankle. Muscle/tendon injuries contributed 49% (n = 3288, IR 2.7 [2.6-2.8]), joint/ligament injuries 17% (n = 1152, IR 0.9 [0.9-1.0]), and contusions 13% (n = 855, IR 0.7 [0.7-0.8]). Compared to studies using injury reports from the clubs' medical staff, media data revealed similar proportional distributions of the injuries, but the IRs tended towards the lower end. Obtaining specific locations or diagnosis especially with regard to minor injuries is difficult. CONCLUSIONS Media data are convenient for investigating the quantity of injuries of an entire league, for identifying injuries for further subanalysis, and for analysing complex injuries. Future studies will focus on the identification of inter- and intraseasonal trends, players' individual injury histories, and risk factors for subsequent injuries. Furthermore, these data will be used in a complex system approach for developing a clinical decision support system, e.g. for return to play decisions.
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Affiliation(s)
- Karen aus der Fünten
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany
| | - Tobias Tröß
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany ,grid.5719.a0000 0004 1936 9713University Sports, Stuttgart University, Stuttgart, Germany
| | - Abed Hadji
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany
| | - Florian Beaudouin
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany
| | - Ida Bo Steendahl
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany
| | - Tim Meyer
- grid.11749.3a0000 0001 2167 7588Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B. 8.2, 66123 Saarbrücken, Germany
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Zilles G, Grim C, Wegener F, Engelhardt M, Hotfiel T, Hoppe MW. [Groin pain in sports games: a systematic review]. SPORTVERLETZUNG SPORTSCHADEN : ORGAN DER GESELLSCHAFT FUR ORTHOPADISCH-TRAUMATOLOGISCHE SPORTMEDIZIN 2023; 37:18-36. [PMID: 36878218 DOI: 10.1055/a-1912-4642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
BACKGROUND In sports games, epidemiological data show that groin pain is relatively common and can lead to repeated loss of time. Consequently, it is essential to be aware of the evidence-based prevention strategies. The aim of this systematic review was to examine risk factors and prevention strategies for groin pain and to rank them based on their evidence in sports games. METHODS The review was conducted according to the PRISMA guidelines, using a PICO-scheme in the PubMed, Web of Science and SPOLIT databases. We included all available intervention and observational studies on the influence of risk factors and prevention strategies on groin pain in sports games. The methodological quality and level of evidence was assessed using the PEDro-Scale and OCEBM model, respectively. Finally, the quantity, quality and level of evidence was used to rank each risk factor for its grade. RESULTS Moderate evidence was found for four risk factors that significantly influence the risk of groin pain: male sex, previous groin pain, hip adductor strength and not participating in the FIFA 11+ Kids. Moreover, moderate evidence was found for the following non-significant risk factors: older age, body height and weight, higher BMI, body fat percentage, playing position, leg dominance, training exposure, reduced hip abduction, adduction, extension, flexion, and internal rotation-ROM, hip flexor strength, hip abductor, adductor, flexor and core strengthening with balance exercises, clinical hip mobility tests and physical capacities. CONCLUSION The identified risk factors can be considered when developing prevention strategies to reduce the risk of groin pain in sports games. Thereby, not only the significant, but also the non-significant risk factors should be considered for prioritisation.
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Affiliation(s)
- Gabriel Zilles
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Casper Grim
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Florian Wegener
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
| | - Martin Engelhardt
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Thilo Hotfiel
- Osnabrücker Zentrum für Muskuloskelettale Chirurgie, Klinikum Osnabrück, Osnabrück, GERMANY
| | - Matthias Wilhelm Hoppe
- Bewegungs- und Trainingswissenschaft, Sportwissenschaftliche Fakultät, Universität Leipzig, Leipzig, GERMANY
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Jakobsen JR, Mackey AL, Koch M, Imhof T, Hannibal J, Kjaer M, Krogsgaard MR. Larger interface area at the human myotendinous junction in type 1 compared with type 2 muscle fibers. Scand J Med Sci Sports 2023; 33:136-145. [PMID: 36226768 PMCID: PMC10091713 DOI: 10.1111/sms.14246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 08/13/2022] [Accepted: 10/01/2022] [Indexed: 01/11/2023]
Abstract
The myotendinous junction (MTJ) is structurally specialized to transmit force. The highly folded muscle membrane at the MTJ increases the contact area between muscle and tendon and potentially the load tolerance of the MTJ. Muscles with a high content of type II fibers are more often subject to strain injury compared with muscles with type I fibers. It is hypothesized that this is explained by a smaller interface area of MTJ in type II compared with type I muscle fibers. The aim was to investigate by confocal microscopy whether there is difference in the surface area at the MTJ between type I and II muscle fibers. Individual muscle fibers with an intact MTJ were isolated by microscopic dissection in samples from human semitendinosus, and they were labeled with antibodies against collagen XXII (indicating MTJ) and type I myosin (MHCI). Using a spinning disc confocal microscope, the MTJ from each fiber was scanned and subsequently reconstructed to a 3D-model. The interface area between muscle and tendon was calculated in type I and II fibers from these reconstructions. The MTJ was analyzed in 314 muscle fibers. Type I muscle fibers had a 22% larger MTJ interface area compared with type II fibers (p < 0.05), also when the area was normalized to fiber diameter. By the new method, it was possible to analyze the structure of the MTJ from a large number of human muscle fibers. The finding that the interface area between muscle and tendon is higher in type I compared with type II fibers suggests that type II fibers are less resistant to strain and therefore more susceptible to injury.
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Affiliation(s)
- Jens Rithamer Jakobsen
- Section for Sports Traumatology M51, Department of Orthopaedic Surgery, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Abigail Louise Mackey
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark.,Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manuel Koch
- Institute for Dental Research and Oral Musculoskeletal Biology, and Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany.,Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Thomas Imhof
- Institute for Dental Research and Oral Musculoskeletal Biology, and Center for Biochemistry, Medical Faculty, University of Cologne, Cologne, Germany
| | - Jens Hannibal
- Department of Clinical Biochemistry, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Michael Kjaer
- Department of Orthopaedic Surgery M, Institute of Sports Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Michael Rindom Krogsgaard
- Section for Sports Traumatology M51, Department of Orthopaedic Surgery, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
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Ekstrand J, Ueblacker P, Van Zoest W, Verheijen R, Vanhecke B, van Wijk M, Bengtsson H. Risk factors for hamstring muscle injury in male elite football: medical expert experience and conclusions from 15 European Champions League clubs. BMJ Open Sport Exerc Med 2023; 9:e001461. [PMID: 36726776 PMCID: PMC9884908 DOI: 10.1136/bmjsem-2022-001461] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 01/26/2023] Open
Abstract
Objectives To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European male professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average hamstring injury burden and teams with a higher than average hamstring injury burden. Methods First, CMOs of 15 European professional male football clubs were asked to suggest risk factors for hamstring injury in their club. The perceived importance of the suggested risk factors was then rated by all participants on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2019/2020 and 2020/2021 seasons. The LOW group consisted of seven teams that had a lower than average hamstring injury burden. The HIGH group consisted of eight teams that had a higher-than-average hamstring injury burden. Results Twenty-one risk factors were suggested. The majority were extrinsic in nature, associated with coaching staff, team or club rather than players themselves. 'Lack of communication between medical staff and coaching staff' had the highest average importance (weighted average=3.7) followed by 'Lack of regular exposure to high-speed football during training sessions' (weighted average=3.6). The HIGH group perceived the player factors fatigue and wellness as more important than the LOW group. Conclusion According to CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic and associated with the club and coaching staff, and not the players themselves.
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Affiliation(s)
- Jan Ekstrand
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | | | - Wart Van Zoest
- PSV Eindhoven, Eindhoven, The Netherlands,Department of Sports and Orthopaedic Surgery, Anna Hospital, Eindhoven, The Netherlands
| | | | - Bruno Vanhecke
- Football Club Brugge, Brugge, Belgium,Department of Physical and Rehabilitation Medicine, AZ Delta Hospitals, Brugge, Belgium
| | | | - Håkan Bengtsson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden,Football Research Group, Linköping, Sweden
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Hughes T, Riley R, Callaghan MJ, Sergeant JC. Can prognostic factors for indirect muscle injuries in elite football (soccer) players be identified using data from preseason screening? An exploratory analysis using routinely collected periodic health examination records. BMJ Open 2023; 13:e052772. [PMID: 36693686 PMCID: PMC9884927 DOI: 10.1136/bmjopen-2021-052772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In elite football, periodic health examination (PHE) may be useful for injury risk prediction. OBJECTIVE To explore whether PHE-derived variables are prognostic factors for indirect muscle injuries (IMIs) in elite players. DESIGN Retrospective cohort study. SETTING An English Premier League football club. PARTICIPANTS 134 outfield elite male players, over 5 seasons (1 July 2013-19 May 2018). OUTCOME AND ANALYSIS The outcome was any time-loss, lower extremity index IMI (I-IMI). Prognostic associations were estimated using odds ratios (ORs) and corresponding statistical significance for 36 variables, derived from univariable and multivariable logistic regression models. Missing data were handled using multiple imputation. Non-linear associations were explored using fractional polynomials. RESULTS During 317 participant-seasons, 138 I-IMIs were recorded. Univariable associations were determined for previous calf IMI frequency (OR 1.80, 95% CI 1.09 to 2.97), hamstring IMI frequency (OR 1.56, 95% CI 1.17 to 2.09), if the most recent hamstring IMI occurred >12 months but <3 years prior to PHE (OR 2.95, 95% CI 1.51 to 5.73) and age (OR 1.12 per 1-year increase, 95% CI 1.06 to 1.18). Multivariable analyses showed that if a player's most recent previous hamstring IMI was >12 months but <3 years prior to PHE (OR 2.24, 95% CI 1.11 to 4.53), this was the only variable with added prognostic value over and above age, which was a confirmed prognostic factor (OR 1.12 per 1-year increase, 95% CI 1.05 to 1.18). Allowing non-linear associations conferred no advantage over linear associations. CONCLUSION PHE has limited use for injury risk prediction. Most variables did not add prognostic value over and above age, other than if a player experienced a hamstring IMI >12 months but <3 years prior to PHE. However, the precision of this prognostic association should be confirmed in future. TRIAL REGISTRATION NUMBER NCT03782389.
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Affiliation(s)
- Tom Hughes
- Football Medicine and Science Department, Manchester United Football Club, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Richard Riley
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK
| | - Michael J Callaghan
- Football Medicine and Science Department, Manchester United Football Club, Manchester, UK
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Jamie C Sergeant
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- Centre for Biostatistics, Manchester Academic Health Science Centre, Manchester, UK
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Fridén C, Ekenros L, von Rosen P. Previous injury, sex and well-being are associated with injury profiles in 422 adolescent elite athletes of age 15-16 years: a 20-week longitudinal study. BMJ Open Sport Exerc Med 2023; 9:e001485. [PMID: 36643407 PMCID: PMC9835953 DOI: 10.1136/bmjsem-2022-001485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
Background Adolescent elite athletes have a high injury risk and many risk factors for injury have been suggested. However, there is a lack of prospective studies in adolescent elite athletes of age 15-16 years. Aim The aim of the study was to prospectively explore risk factors associated with different injury prevalence profiles in adolescent elite athletes. Methods Substantial injury was monitored in adolescent elite athletes (n=422) using the validated Oslo Sports Trauma Research Center Questionnaire over 20 weeks. Athletes were categorised in tertiles based on injury prevalence. Results The median substantial injury prevalence for all athletes was 10% (IQR 0%-20%). Compared with the 'no injury' group, previous injury (p<0.001, OR 3.91) and well-being (p<0.001, OR 0.93) were associated with the 'high injury' group, and previous injury (p=0.006, OR 1.96) and being a female athlete (p=0.002, OR 2.08) with the 'low injury' group. A female athlete with a previous injury and low perceived well-being (25th percentile) had a 48% risk (95% CI 36% to 59%) of belonging to the 'high injury' group, compared with 7% (95% CI 4% to 12%) for a male athlete with no previous injury and high well-being (75th percentile). Conclusion Medical personnel should be aware of the high injury risk and risk factors for injury in adolescent elite athletes, and closely monitor the rehabilitation post-injury as a previous injury is such a strong risk factor for a new injury.
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Affiliation(s)
- Cecilia Fridén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden,Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Linda Ekenros
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
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36
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Luxenburg D, Wasserman NA, Geller JS, Perez JR, Burke J, Kaplan LD. Hamstring injuries in the national football league: An epidemiological study. J Orthop 2023; 35:111-114. [PMID: 36467428 PMCID: PMC9708442 DOI: 10.1016/j.jor.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background While numerous studies have evaluated National Football League injuries, there is limited literature evaluating hamstring injuries sustained in games. Our primary aim is to analyze the effect of player position on the relative incidence of hamstring injuries in the National Football League. Our secondary aims are to analyze the effects of field surface, week of the season, and short rest weeks. Methods Official National Football League game books containing injury data from the 2013-2016 regular seasons were used. Data were analyzed to determine the incidence of hamstring injuries by field surface, rest, and week of the season. Field surface was considered either turf or grass. Short rest was considered four days. Relative incidence of hamstring injuries by position was performed with standardized incidence ratios. P values < 0.05 were considered statistically significant. Results Seventy-eight qualifying hamstring injuries were identified and included in our analysis. Linebackers had the highest relative incidence per play with a standardized incidence ratio of 2.02 (CI: 1.14-2.91), followed by Defensive Backs (1.62; 95% CI: 1.14-1.62). Offensive linemen and defensive linemen had standardized incidence ratios significantly less than 1. Fifty-seven percent of hamstring injuries occurred on turf fields (p = 0.082). There was no significant difference between the proportion of hamstring injuries that occurred on short rest and the proportion of games played on short rest (p = 0.959). Hamstring injuries were not more likely to occur than the pooled group of all other types of injuries on short rest (p = 0.861). With a 17-week season, the mean week of hamstring injury was 8.05 (95% CI: 7.06-9.04), while the median week was 7.5. Conclusions Linebackers and Defensive Backs have the highest relative incidence of hamstring injuries compared to other position groups, while offensive and defensive linemen have the lowest. Field surface and a short rest period did not show significance.
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Affiliation(s)
- Dylan Luxenburg
- University of Miami Department of Orthopaedics, United States
| | | | | | - Jose R. Perez
- University of Miami Department of Orthopaedics, United States
| | - Jonathan Burke
- University of Miami Department of Orthopaedics, United States
| | - Lee D. Kaplan
- University of Miami Department of Orthopaedics, United States
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Ota S, Kimura M. Statistical injury prediction for professional sumo wrestlers: Modeling and perspectives. PLoS One 2023; 18:e0283242. [PMID: 36930622 PMCID: PMC10022813 DOI: 10.1371/journal.pone.0283242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
In sumo wrestling, a traditional sport in Japan, many wrestlers suffer from injuries through bouts. In 2019, an average of 5.2 out of 42 wrestlers in the top division of professional sumo wrestling were absent in each grand sumo tournament due to injury. As the number of injury occurrences increases, professional sumo wrestling becomes less interesting for sumo fans, requiring systems to prevent future occurrences. Statistical injury prediction is a useful way to communicate the risk of injuries for wrestlers and their coaches. However, the existing statistical methods of injury prediction are not always accurate because they do not consider the long-term effects of injuries. Here, we propose a statistical model of injury occurrences for sumo wrestlers. The proposed model provides the estimated probability of the next potential injury occurrence for a wrestler. In addition, it can support making a risk-based injury prevention scenario for wrestlers. While a previous study modeled injury occurrences by using the Poisson process, we model it by using the Hawkes process to consider the long-term effect of injuries. The proposed model can also be applied to injury prediction for athletes of other sports.
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Affiliation(s)
- Shuhei Ota
- Department of Industrial Engineering and Management, Kanagawa University, Yokohama, Kanagawa, Japan
- * E-mail:
| | - Mitsuhiro Kimura
- Department of Industrial and Systems Engineering, Hosei University, Faculty of Science & Engineering, Tokyo, Japan
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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: 16] [Impact Index Per Article: 16.0] [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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Mehrab M, Wagner RK, Vuurberg G, Gouttebarge V, de Vos RJ, Mathijssen NMC. Risk Factors for Musculoskeletal Injury in CrossFit: A Systematic Review. Int J Sports Med 2022; 44:247-257. [PMID: 36174660 PMCID: PMC10072928 DOI: 10.1055/a-1953-6317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The objective of this systematic review was to identify potential risk factors for injury in CrossFit participants. Embase, Medline, Web of Science, Cochrane, CINAHL, Google Scholar, and SportDiscuss databases were all searched up to June 2021. Cohort studies that investigated risk factors for CrossFit injuries requiring medical attention or leading to time loss in sports were included. A best-evidence synthesis was performed combining all the outcomes from prospective cohort studies. From 9,452 publications identified, we included three prospective cohort studies from which two had a low risk of bias and one a high risk of bias. The studies examined 691 participants of whom 172 sustained an injury. There was limited evidence that switching between prescribed and scaled loads during training is associated with increased injury risk and that increased duration of participation is a protective factor for injury. This could mean that novice CrossFit athletes and those increasing their training load should have closer supervision by CrossFit coaches. These risk factors should be considered when developing preventive interventions.
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Affiliation(s)
- Mirwais Mehrab
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, Netherlands
| | - Robert Kaspar Wagner
- Department of Orthopaedic Surgery, Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands, Amsterdam, Netherlands
| | - Gwendolyn Vuurberg
- Department of Orthopaedic Surgery, Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands, Amsterdam, Netherlands
| | - Vincent Gouttebarge
- Department of Orthopaedic Surgery, Amsterdam UMC location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands, Amsterdam, Netherlands.,Academic Center for Evidence-based Sports medicine (ACES), Amsterdam, The Netherlands, Amsterdam, Netherlands.,Section Sports Medicine, University of Pretoria, Pretoria, South Africa
| | - Robert-Jan de Vos
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Centre, Rotterdam, Netherlands
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Al Attar WSA, Ghulam H, Al Arifi S, Alomar AI, Alhosaini S, Alharbi S, Alraddadi Y, Sanders RH. Injury prevention programs including balance exercises with compliance and follow-up reduce the incidence of knee injuries in athletes: A systematic review and meta-analysis. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND: The knee is one of the most common injuries in sports. However, the incidence of knee injuries can be decreased by enhancing balance and neuromuscular control. OBJECTIVE: The aim of this systematic review and meta-analysis was to investigate how injury prevention programs (IPPs) that include balance training influence knee injury rates in athletes. METHODS: Data were obtained from different databases (1985–2021). Only randomised controlled trials that used IPPs that include balance training, were considered. Two investigators extracted data from the qualifying documents. The critical outcome data elements derived from the included studies were the number of ACL/knee injuries, ACL/knee injury rates, exposure hours, compliance rate, and follow-up duration. RESULTS: Compared to the control groups, those who participated in the IPP had a 54% lower risk of knee injuries per 1000 hours of exposure (IRR 0.457 (95% CI 0.346–0.603), P= 0.001) and a 60% lower risk of ACL injuries per 1000 hours of exposure (IRR 0.401 (95% CI 0.215–0.750), P= 0.004). CONCLUSIONS: IPPs that include balance training may reduce the risk of knee injuries.
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Affiliation(s)
- Wesam Saleh A. Al Attar
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
| | - Hussain Ghulam
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Najran University, Najran, Saudi Arabia
| | - Saud Al Arifi
- Department of Physical Therapy, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Ahmed I. Alomar
- Department of Physical Therapy, Security Forces Hospital, Dammam, Saudi Arabia
| | - Saad Alhosaini
- Department of Physical Therapy, King Fahd Central Hospital, Jazan, Saudi Arabia
| | - Sami Alharbi
- Department of Physical Therapy, Medical Rehabilitation Hospital, Medina, Saudi Arabia
| | - Yasser Alraddadi
- Department of Physical Therapy, Medical Rehabilitation Hospital, Medina, Saudi Arabia
| | - Ross H. Sanders
- Discipline of Exercise and Sport Sciences, Faculty of Medicine and Health Sciences, The University of Sydney, Sydney, Australia
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41
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Flore Z, Hambly K, De Coninck K, Welsch G. Time-loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta-analysis. Scand J Med Sci Sports 2022; 32:1690-1709. [PMID: 35904448 PMCID: PMC9804772 DOI: 10.1111/sms.14217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/07/2022] [Accepted: 07/24/2022] [Indexed: 01/09/2023]
Abstract
A literature search was conducted to systematically review and meta-analyze time-loss and recurrence rate of lateral ankle sprains (LAS) in male professional football players. Six electronic databases (PubMed, Scopus, Web of Science, PEDRO, CINAHL, and Cochrane) were searched independently, separately both for time-loss and recurrence from inception until April 30, 2021. In addition, reference lists were screened manually to find additional literature. Cohort studies, case reports, case-control studies and RCT in English language of male professional football players (aged more than 16 years) for which data on time-loss or recurrence rates of LAS were available were included. A total of 13 (recurrence) and 12 (time-loss) studies met the inclusion criteria. The total sample size of the recurrence studies was 36,201 participants (44,404 overall initial injuries; 7944 initial ankle sprain [AS] injuries, 1193 recurrent AS injuries). 16,442 professional football players (4893 initial AS injuries; 748 recurrent AS injuries) were meta-analyzed. A recurrence rate of 17.11% (95% CI: 13.31-20.92%; df = 12; Q = 19.53; I2 = 38.57%) based on the random-effects model was determined. A total of 7736 participants were part of the time-loss studies (35,888 total injuries; 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time-loss was 15 days (weighted mean: 15.92; median: 14.95; min: 9.55; max: 52.9). We determined a priori considerable heterogeneity (CI: 18.15-22.08; df = 11; Q = 158; I2 = 93%), so that the data on time-loss are only presented descriptively. There is an average time-loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with higher recurrence rates than ACL injuries (9%-12%) in professional football players. Nevertheless, the focus of research in recent years has been mostly on ACL injuries. However, the high recurrence rates and long-term consequences show the necessity for research in the field of LAS in elite football. Yet, heterogeneous data lead to difficulties concerning the aspect of comparability.
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Affiliation(s)
- Zacharias Flore
- University of Kent, School of Sport and Exercise SciencesCanterburyUK,Hamburger SV, Fußball AGHamburgGermany,University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany
| | - Karen Hambly
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Kyra De Coninck
- University of Kent, School of Sport and Exercise SciencesCanterburyUK
| | - Götz Welsch
- University Medical Center Hamburg‐EppendorfUKE‐AthleticumHamburgGermany,Department of Trauma and Orthopaedic SurgeryUniversity Medical Center Hamburg‐EppendorfHamburgGermany
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Pulici L, Certa D, Zago M, Volpi P, Esposito F. Injury Burden in Professional European Football (Soccer): Systematic Review, Meta-Analysis, and Economic Considerations. Clin J Sport Med 2022; 33:00042752-990000000-00071. [PMID: 36730365 DOI: 10.1097/jsm.0000000000001107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/21/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis to evaluate the injury burden and the related economic cost in European professional male football players. DATA SOURCES Multiple database research was performed up to August 5, 2022 (PubMed, EMbase, Scopus, Cochrane Library), including only studies that reported severity in the number of days of absence for each injury, incidence reported in the number of injuries/1000 hours, or reported number of injuries and exposure time and adult male football players, professionals from European clubs. Two reviewers extracted data and assessed paper quality with the Strengthening the Reporting of Observational Studies in Epidemiology statement and the Newcastle-Ottawa Scale. MAIN RESULTS Twenty-two studies have reported incidence, severity, and burden of injuries in professional football. The highest injury burden was found for ligament-joint injuries (37.9 days/1000 hours; 222 397 €/1000 hours) and for muscle injuries (34.7 days/1000 hours; 203 620 €/1000 hours). Injury locations with high burden were knee injuries (34.8 days/1000 hours; 20 4206 €/1000 hours)-mainly anterior cruciate ligament injuries (14.4 days/1000 hours; 84 499 €/1000 h)-followed by thigh injuries (25.0 days/1000 hours; 146 700 €/1000 hours), hamstrings injuries (15.4 days/1000 hours; 90 367 €/1000 hours), hip-and-groin injuries (16.1 days/1000 hours; 94 475 €/1000 hours), primarily adductor muscles injuries (9.4 days/1000 hours; 55 159€/1000 hours), and ankle injuries (13.1 days/1000 h; 76 871 €/1000 hours) with ankle sprains (7.4 days/1000 hours; 43 423 €/1000 hours). CONCLUSIONS Being exposed to injury risk has serious consequences for individual and club performance and economy. This review identified the most relevant targets in injury management, compared their injury data with reference values, and provided economic evidence when trying to gain buy-in from the key decision makers.
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Affiliation(s)
| | - Denis Certa
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
| | - Matteo Zago
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
| | - Piero Volpi
- Knee Surgery and Sport Traumatology Unit, Humanitas Clinical and Research Center, IRCCS Rozzano, Milan, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; and
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Romero V, Lahti J, Castaño Zambudio A, Mendiguchia J, Jiménez Reyes P, Morin JB. Effects of Fatigue Induced by Repeated Sprints on Sprint Biomechanics in Football Players: Should We Look at the Group or the Individual? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14643. [PMID: 36429363 PMCID: PMC9691012 DOI: 10.3390/ijerph192214643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to analyse the influence of fatigue on sprint biomechanics. Fifty-one football players performed twelve maximal 30 m sprints with 20 s recovery between each sprint. Sprint kinetics were computed from running speed data and a high-frequency camera (240 Hz) was used to study kinematic data. A cluster analysis (K-mean clustering) was conducted to classify individual kinematic adaptations. A large decrease in maximal power output and less efficiency in horizontally orienting the ground reaction force were observed in fatigued participants. In addition, individual changes in kinematic components were observed, and, according to the cluster analysis, five clusters were identified. Changes in trunk, knee, and hip angles led to an overall theoretical increase in hamstring strain for some players (Cluster 5, 20/51) but to an overall decrease for some others (Cluster 1, 11/51). This study showed that the repeated sprint ability (RSA) protocol had an impact on both kinetics and kinematics. Moreover, fatigue affected the kinematics in a different way for each player, and these individual changes were associated with either higher or lower hamstring length and thus strain.
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Affiliation(s)
- Valentin Romero
- Centre for Sport Studies, Rey Juan Carlos University, 28942 Madrid, Spain
| | - Johan Lahti
- Laboratory of Human Motricity, Education Sport and Health (LAMHESS), Université Côte d’Azur, F-06200 Nice, France
| | | | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, 31010 Barañain, Spain
| | | | - Jean-Benoît Morin
- Inter-University Laboratory of Human Movement Biology (LIBM EA 7424), University of Lyon, University Jean Monnet, F-42023 Saint Etienne, France
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de Almeida KY, Cetolin T, Marrero AR, Aguiar Junior AS, Mohr P, Kikuchi N. A Pilot Study on the Prediction of Non-Contact Muscle Injuries Based on ACTN3 R577X and ACE I/D Polymorphisms in Professional Soccer Athletes. Genes (Basel) 2022; 13:2009. [PMID: 36360246 PMCID: PMC9690673 DOI: 10.3390/genes13112009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 09/28/2023] Open
Abstract
Muscle injuries are among the main reasons for medical leavings of soccer athletes, being a major concern within professional teams and their prevention associated with sport success. Several factors are associated with a greater predisposition to injury, and genetic background is increasingly being investigated. The aim of this study was to analyze whether ACTN3 R577X and ACE I/D polymorphisms are predictors of the incidence and severity of muscle injury in professional soccer athletes from Brazil, individually and in association. Eighty-three professional athletes from the first and second divisions of the Brazilian Championship were evaluated regarding the polymorphisms through blood samples. Nighty-nine muscle injuries were identified during the seasons of 2018, 2019 and 2020 and categorized according to severity. ACTN3 XX individuals had a higher frequency of severe injuries compared to the RX and RR genotypes (p = 0.001), and in the dominant model (compared to RX+RR), with p < 0.001. The trend p-value test showed an increased number of injuries/season following the order XX > RX > RR (p = 0.045). Those with the ACE II genotype had almost 2 fold the number of injuries per season compared to those with the ID+DD genotypes (p = 0.03). Logistic regression showed that the polymorphisms are predictors of the development of severe injury (ACTN3 R577X model with p = 0.004, R2: 0.259; ACE I/D model with p = 0.045, R2: 0.163), where ACTN3 XX individuals were more likely to suffer from severe injury (OR: 5.141, 95% CI: 1.472-17.961, p = 0.010). The combination of the ACTN3 577X allele and the ACE II genotype showed an increased number of injuries per season, enhanced by 100% (1.682 injuries/season versus 0.868 injuries/season, p = 0.016). Our findings suggest that both polymorphisms ACTN3 R577X and ACE I/D (and their interaction) are associated with the susceptibility and severity of non-contact muscle injury in soccer players.
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Affiliation(s)
- Kathleen Y. de Almeida
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
| | - Tiago Cetolin
- Graduate Program in Neurosciences, Federal University of Santa Catarina, Araranguá 88905-120, Brazil
| | - Andrea Rita Marrero
- Graduate Program in Cell and Developmental Biology, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | | | - Pedro Mohr
- Sports Center, Federal University of Santa Catarina, Florianópolis 88040-900, Brazil
| | - Naoki Kikuchi
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan
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Robles-Palazón FJ, López-Valenciano A, De Ste Croix M, Oliver JL, García-Gómez A, Sainz de Baranda P, Ayala F. Epidemiology of injuries in male and female youth football players: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:681-695. [PMID: 34700052 PMCID: PMC9729930 DOI: 10.1016/j.jshs.2021.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/10/2021] [Accepted: 07/21/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND To conduct a systematic review and meta-analysis of epidemiological data of injuries in male and female youth football players. METHODS Searches were performed in MEDLINE/PubMed, Web of Science, Cochrane Library, and SPORTDiscus databases. Studies were considered if they reported injury incidence rate in male and female youth (≤19 years old) football players. Two reviewers (FJRP and ALV) extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and the Newcastle Ottawa Scale. The Grading of Recommendations Assessment, Development, and Evaluation approach determined the quality of evidence. Studies were combined using a Poisson random effects regression model. RESULTS Forty-three studies were included. The overall incidence rate was 5.70 injuries/1000 h in males and 6.77 injuries/1000 h in females. Match injury incidence (14.43 injuries/1000 h in males and 14.97 injuries/1000 h in females) was significantly higher than training injury incidence (2.77 injuries/1000 h in males and 2.62 injuries/1000 h in females). The lower extremity had the highest incidence rate in both sexes. The most common type of injury was muscle/tendon for males and joint/ligament for females. Minimal injuries were the most common in both sexes. The incidence rate of injuries increased with advances in chronological age in males. Elite male players presented higher match injury incidence than sub-elite players. In females, there was a paucity of data for comparison across age groups and levels of play. CONCLUSION The high injury incidence rates and sex differences identified for the most common location and type of injury reinforce the need for implementing different targeted injury-risk mitigation strategies in male and female youth football players.
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Affiliation(s)
- Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | | | - Mark De Ste Croix
- School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
| | - Jon L Oliver
- Youth Physical Development Centre, School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; Sport Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, Auckland 0632, New Zealand
| | - Alberto García-Gómez
- Operative Research Centre, Miguel Hernández University of Elche, Elche 03202, Spain
| | - Pilar Sainz de Baranda
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain
| | - Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia 30720, Spain; School of Sport and Exercise, University of Gloucestershire, Gloucester GL2 9HW, UK
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46
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Marigi EM, Cummings PE, Marigi IM, Burgos W, Gillett J, Camp CL, Krych AJ, Okoroha KR. Hamstring Injuries: Critical Analysis Review of Current Nonoperative Treatments. JBJS Rev 2022; 10:01874474-202211000-00002. [PMID: 36574459 DOI: 10.2106/jbjs.rvw.22.00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
➢ Hamstring injuries are common among active and athletic individuals, especially those involved in high-speed running, distance running, or sports requiring sudden directional changes. Acute hamstring strains often occur as an eccentric strain during running or a stretch-type injury caused by simultaneous hip flexion and knee extension. Proximal hamstring tendinopathy is an overuse injury of the hamstring tendon as a result of chronic cicatrization of the musculotendinous unit. ➢ Repeated stress to the hamstring tendon leads to increased cellularity of tendon fibers, disruption of collagen, and subsequent microinjury of the tissue that attaches the tendon to bone. ➢ Management of hamstring injuries generally begins with nonoperative modalities consisting of eccentric rehabilitative exercise programs. Although various other treatment modalities are available, the comparative efficacy of these supportive measures is not well differentiated at this time. ➢ In this article, we review the current literature with regard to the nonoperative treatment of hamstring injuries, specifically focusing on acute hamstring muscle strains and proximal hamstring tendinopathy in order to provide supplementary insight on the effectiveness of current modalities.
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Affiliation(s)
- Erick M Marigi
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Paige E Cummings
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ian M Marigi
- School of Medicine, Washington University in St. Louis, St. Louis, Missouri
| | - William Burgos
- Minnesota Timberwolves Basketball Club, Minneapolis, Minnesota
| | - Javair Gillett
- Minnesota Timberwolves Basketball Club, Minneapolis, Minnesota
| | | | - Aaron J Krych
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
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Nawasreh ZH, Yabroudi MA, Darwish AA, Debes WA, Bashaireh KM. Player Sex and Playing Surface Are Individual Predictors of Injuries in Professional Soccer Players. PATHOPHYSIOLOGY 2022; 29:619-630. [PMID: 36412633 PMCID: PMC9680497 DOI: 10.3390/pathophysiology29040048] [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: 09/05/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The factors contributing to soccer injuries and their influence on the occurrence of injury are controversial and inconclusive. This study aimed to determine the association between player characteristics and playing factors with injuries in professional soccer players. Methods: One hundred and fifty-two professional soccer players completed a self-administered questionnaire that asked about demographic information and injury profile, the type of playing surface on which they sustained their injury, medical treatment, and the time lost due to soccer injury at the end of the soccer season. Results: The injury rate was 44.74% (n = 68; males: 61.50% (n = 56), females: 19.70% (n = 12)). Players’ age (OR: 1.15, 95%CI: 1.05−1.25, p < 0.002) and BMI (OR: 1.21, 95%CI: 1.06−1.38, p < 0.003) were significantly associated with soccer injuries. After adjusting for age and BMI, players’ sex (OR: 5.39, 95%CI: 2.11−13.75, p < 0.001), previous soccer injury (OR: 3.308, 95%CI: 2.307−29.920, p < 0.001), and playing surfaces (OR: 11.07, 95%CI: 4.53−27.03, p < 0.001) were the significant predictors of soccer injuries. Conclusion: Players’ age, BMI, sex, previous soccer injury, and playing surface were associated with injuries among professional soccer players. Old male athletes with high BMI, previous soccer injuries, and playing on natural grass were more likely to sustain soccer injuries than young female players with low BMI who had no previous injuries and played on synthetic surfaces.
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Affiliation(s)
- Zakariya H. Nawasreh
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
- Correspondence: ; Tel.: +962-27201000 (ext. 26937)
| | - Mohammad A. Yabroudi
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Ahmad A. Darwish
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Wesam A. Debes
- Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Khaldoon M. Bashaireh
- Department of Special Surgery, College of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, P.O. Box 63001, Irbid 22110, Jordan
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Campbell P, Pope R, Simas V, Canetti E, Schram B, Orr R. The Effects of Early Physiotherapy Treatment on Musculoskeletal Injury Outcomes in Military Personnel: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13416. [PMID: 36293997 PMCID: PMC9602812 DOI: 10.3390/ijerph192013416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
The risks and incidence rates of musculoskeletal injuries among military personnel are high, and the importance of physiotherapy in treating these injuries is well established. However, what is less clear is whether the timing of commencement of physiotherapy treatment affects musculoskeletal injury outcomes in military personnel. This lack of clarity is exacerbated by the known underreporting of injuries among military personnel, and the resulting self-management of musculoskeletal injuries using analgesics, non-steroidal anti-inflammatories and other means. This narrative review was designed to identify and synthesize current evidence regarding the effects of timing of physiotherapy treatment on musculoskeletal injury outcomes, focusing on potential benefits of early versus typical or delayed commencement of physiotherapy treatment. Overall, current evidence suggests early physiotherapy treatment of musculoskeletal injuries offers distinct advantages over typical or delayed commencement of physiotherapy treatment in military settings. Specifically, it appears early treatment expedites recovery in early phases following injury onset and benefits longer term mental health and well-being. It may also reduce the need for more invasive and costly health care interventions and enable earlier return to training and operational service. Importantly, a cultural shift within military contexts to ensure early reporting of musculoskeletal injuries is required if the benefits of early commencement of physiotherapy treatment are to be achieved.
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Affiliation(s)
- Patrick Campbell
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
| | - Rodney Pope
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, NSW 2640, Australia
| | - Vinicius Simas
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
| | - Elisa Canetti
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
- Faculty of Health Science and Medicine, Bond University, Robina, QLD 4229, Australia
| | - Benjamin Schram
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
- Faculty of Health Science and Medicine, Bond University, Robina, QLD 4229, Australia
| | - Robin Orr
- Tactical Research Unit, Bond University, Robina, QLD 4229, Australia
- Faculty of Health Science and Medicine, Bond University, Robina, QLD 4229, Australia
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Chaari F, Boyas S, Sahli S, Fendri T, Harrabi MA, Rebai H, Rahmani A. Postural balance asymmetry and subsequent noncontact lower extremity musculoskeletal injuries among Tunisian soccer players with groin pain: A prospective case control study. Gait Posture 2022; 98:134-140. [PMID: 36115130 DOI: 10.1016/j.gaitpost.2022.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent studies reported postural balance disorders in patients and soccer players with groin pain (GP) compared to controls. Since postural balance asymmetry identified after an initial injury contributes for subsequent injuries, identification of this asymmetry in soccer players with GP may highlight the risk of sustaining subsequent noncontact lower extremity musculoskeletal injuries in these players. Therefore, the aims of this study were to (i) examine static and dynamic unipedal postural balance asymmetry in soccer players with GP compared to healthy ones, and (ii) quantify the risk of subsequent noncontact lower extremity injuries in these players. RESEARCH QUESTION Do soccer players with GP exhibit higher static and dynamic unipedal postural balance asymmetry, and higher risk of sustaining subsequent injuries compared to controls? METHODS In this prospective case control study, 27 soccer players with non-time loss GP (GP group: GPG), and 27 healthy ones (control group: CG) were enrolled. Static and dynamic unipedal postural balance asymmetry were evaluated with a force platform using symmetry index (SI), and Y-balance test (Y-BT), respectively. Additionally, subsequent noncontact lower extremity musculoskeletal injuries were tracked for 10 months. RESULTS The GPG revealed higher (p < 0.01) SI in eyes closed condition, higher (p < 0.001) side-to-side asymmetry in anterior, posteromedial and posterolateral reach distances and in composite Y-BT score compared to CG. They showed lower (p < 0.001) composite score for injured limb and higher (p < 0.001) side-to-side asymmetry in posteromedial reach distance compared to the cut-off values of 89.6 % and 4 cm, respectively. Moreover, GPG exhibited higher odds (OR= 7.48; 95 % CI = 2.15, 26.00; p < 0.01) of sustaining subsequent injuries compared to CG. SIGNIFICANCE The Y-BT should be instituted into existing pre-participation physical examinations to screen for soccer players with non-time loss GP at an elevated risk of sustaining subsequent injuries. This could help coaches and clinicians make valid return to play decisions.
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Affiliation(s)
- Fatma Chaari
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sébastien Boyas
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
| | - Sonia Sahli
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Thouraya Fendri
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Mohammed A Harrabi
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Haithem Rebai
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Abderrahmane Rahmani
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
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50
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Torpey D, Murray E, Hughes T, Sergeant J, Callaghan M. The reliability of and agreement between devices used to measure eccentric hamstring strength: a systematic review protocol. Syst Rev 2022; 11:204. [PMID: 36151582 PMCID: PMC9502956 DOI: 10.1186/s13643-022-02070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Isokinetic dynamometry (IKD) is considered as the gold standard method of eccentric hamstring strength measurement, but other devices are more portable, cost-effective, provide real-time data and are thus better suited to the mass testing required in sport. This review aims to synthesise the evidence related to the reliability of and agreement between devices that measure eccentric hamstring strength and isokinetic dynamometers in adults. METHODS The MEDLINE, EMBASE, PubMed, CINAHL and Sport Discus databases, alongside a search of grey and pre-print literature (from inception to 2021), are used. Forward and backward snowballing will also be used. Studies will be included if the reliability and/or agreement between devices used to quantify eccentric hamstring strength in healthy, recreationally active or amateur/elite sportspeople has been investigated. Studies will be excluded if (1) participants were injured or unwell at the time of testing and (2) concentric strength measurements or if non-hamstring muscle groups were investigated. The COnsenus-based Standards for the selection of health Measurement INstruments (COSMIN) tool will be used to assess the quality of reporting of included studies. If possible, data will be pooled and a meta-analysis and/or meta-regression may be performed if appropriate. We will aim to conduct a narrative synthesis using an adapted Grading of Recommendation, Assessment, Development and Evaluation (GRADE). DISCUSSION This systematic review will aim to analyse the reliability of devices that measure eccentric hamstring strength, and the agreement of these devices with isokinetic dynamometers when used in an adult population. It is anticipated that the results of this review could be used to inform clinicians regarding suitable devices that can be employed to monitor eccentric hamstring strength in clinical practice. No ethics approval is required. It is anticipated that this review will be submitted to a leading peer-reviewed journal in this field for publication consideration. SYSTEMATIC REVIEW REGISTRATION www.researchregistry.com (reviewregistry1070).
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Affiliation(s)
- Daniel Torpey
- Manchester United Football Club, AON Training Complex, Birch Rd off Isherwood, Road, Manchester, M31 4BH, UK.
| | - Eoghan Murray
- Academy Medical Department, Manchester United Football Club, Manchester, UK
| | - Tom Hughes
- Academy Medical Department, Manchester United Football Club, Manchester, UK.,Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Jamie Sergeant
- Centre for Biostatistics, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Michael Callaghan
- Academy Medical Department, Manchester United Football Club, Manchester, UK.,Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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