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Diz JBM, Dutra MTP, Feijó IC, Sogno ALM, Silva FR, Carnevale GDEF, Moreira BDES, Silva CFM. LOW BACK PAIN ESTIMATES IN PROFESSIONAL SOCCER: A SYSTEMATIC REVIEW AND META-ANALYSIS. ACTA ORTOPEDICA BRASILEIRA 2023; 31:e266012. [PMID: 38115872 PMCID: PMC10726716 DOI: 10.1590/1413-785220233105e266012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 11/22/2022] [Indexed: 12/21/2023]
Abstract
Objective To evaluate the epidemiological and clinical characteristics of low back pain (LBP) in adult professional soccer players. Methods Systematic review and meta-analysis. Results The review included 44 studies. The pooled prevalence of LBP during ≤ 1 season was 1% (95%CI = 0-4%) in men. The pooled point prevalence of LBP was 25% (95%CI = 16-36%) in men and 28% (95%CI = 20-37%) in women. The pooled past-year prevalence of LBP was 34% (95%CI = 24-44%) in men. The pooled lifetime prevalence of LBP was 32% (95%CI = 25-39%) in men and 50% (95%CI = 32-69%) in women. The pooled frequency of LBP/total number of injuries was 2% (95%CI = 1-3%) in men and 4% (95%CI = 2-5%) in women. The pooled incidence rate of LBP/1,000 player-hours of exposure was 0.30 (95%CI = 0.17- 0.53) in men and 0.32 (95%CI = 0.06 -1.87) in women. The recurrence of LBP ranged from 3% to 63% in men. The intensity of LBP ranged from 1.68 (2.39) to 4.87 (2.14) points on a 0-10 scale (minimum = 0 and maximum = 8 points). The severity of LBP (days absent from professional activities due to pain) ranged from 2 (0) to 10 (19) days (minimum = 1 and maximum = 28 days). Conclusion Adult elite soccer players have a substantial prevalence of LBP. The frequency and incidence of LBP (compared with other conditions and sports) seems to be low. Estimates of the recurrence, intensity, and severity of LBP are uncertain. Level of Evidence II, Systematic Review of Level II Studies.
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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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Kuitunen I, Immonen V, Pakarinen O, Mattila VM, Ponkilainen VT. Incidence of football injuries sustained on artificial turf compared to grass and other playing surfaces: a systematic review and meta-analysis. EClinicalMedicine 2023; 59:101956. [PMID: 37125402 PMCID: PMC10139885 DOI: 10.1016/j.eclinm.2023.101956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/21/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Background Prior reviews have not conducted statistical synthesis of injury incidence on artificial turf in football. To analyse and compare the incidence of injuries sustained playing football (soccer) on artificial turf compared to grass and other playing surfaces. Methods This was a systematic review and meta-analysis. We searched PubMed, Scopus, SPORTDiscus, and Web of Science databases in October 2022 without filters. All observational studies (prospective or retrospective) that analysed injuries sustained playing football on artificial turf and which included a control group that played on grass or other surface were included. Studies were included if they reported the number of injuries and the exposure time for the playing surfaces. Risk of bias was assessed by Newcastle-Ottawa Scale. A random effects model was used to calculate the pooled incidence rate ratios (IRR) with 95% confidence intervals. Protocol was registered with PROSPERO on October 30th, 2022. Registration number: CRD42022371414. Findings We screened 1447 studies, and evaluated 67 full reports, and finally included 22 studies. Risk of bias was a notable issue, as only 5 of the 22 studies adjusted their analysis for potential confounders. Men (11 studies: IRR 0.82, CI 0.72-0.94) and women (5 studies: IRR 0.83, CI 0.76-0.91) had lower injury incidence on artificial turf. Professional players had a lower incidence of injury (8 studies: IRR 0.79, CI 0.70-0.90) on artificial turf, whereas there was no evidence of differences in the incidence of injury in amateur players (8 studies: IRR 0.91, CI 0.77-1.09). The incidence of pelvis/thigh (10 studies: IRR 0.72, CI 0.57-0.90), and knee injuries (14 studies: IRR 0.77, CI 0.64-0.92) were lower on artificial turf. Interpretation The overall incidence of football injuries is lower on artificial turf than on grass. Based on these findings, the risk of injury can't be used as an argument against artificial turf when considering the optimal playing surface for football. Funding No specific funding was received for this study.
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Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine and Department of Paediatrics, University of Eastern Finland, Kuopio, Finland
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
- Corresponding author. Department of Pediatrics, Kuopio University Hospital, Puijonlaaksontie 2, PL 100, 70029, Kuopio, Finland.
| | - Ville Immonen
- Boys National Teams, The Finnish Football Association, Helsinki, Finland
| | - Oskari Pakarinen
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
| | - Ville M. Mattila
- Faculty of Medicine and Health Technologies, Tampere University, Tampere, Finland
- Department of Orthopaedics and Traumatology, Tampere University Hospital, Tampere, Finland
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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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Maniar N, Carmichael DS, Hickey JT, Timmins RG, San Jose AJ, Dickson J, Opar D. Incidence and prevalence of hamstring injuries in field-based team sports: a systematic review and meta-analysis of 5952 injuries from over 7 million exposure hours. Br J Sports Med 2023; 57:109-116. [PMID: 36455927 DOI: 10.1136/bjsports-2021-104936] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE This study aimed to systematically review and meta-analyse the incidence and prevalence of hamstring injuries in field-based team sports. A secondary aim was to determine the impact of other potential effect moderators (match vs training; sport; playing surface; cohort age, mass and stature; and year when data was collected) on the incidence of hamstring injury in field-based team sports. DESIGN Systematic review and meta-analysis. DATA SOURCES CINAHL, Cochrane Library, MEDLINE Complete (EBSCO), Embase, Web of Science and SPORTDiscus databases were searched from database inception to 5 August 2020. ELIGIBILITY CRITERIA Prospective cohort studies that assessed the incidence of hamstring injuries in field-based team sports. METHOD Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against predefined criteria then assessed for methodological quality using the Critical Appraisal Tool for prevalence studies. Meta-analysis was used to pool data across studies, with meta-regression used where possible. RESULTS Sixty-three articles were included in the meta-analysis, encompassing 5952 injuries and 7 262 168 hours of exposure across six field-based team sports (soccer, rugby union, field hockey, Gaelic football, hurling and Australian football). Hamstring injury incidence was 0.81 per 1000 hours, representing 10% of all injuries. Prevalence for a 9-month period was 13%, increasing 1.13-fold for every additional month of observation (p=0.004). Hamstring injury incidence increased 6.4% for every 1 year of increased average cohort age, was 9.4-fold higher in match compared with training scenarios (p=0.003) and was 1.5-fold higher on grass compared with artificial turf surfaces (p<0.001). Hamstring injury incidence was not significantly moderated by average cohort mass (p=0.542) or stature (p=0.593), was not significantly different between sports (p=0.150) and has not significantly changed over the last 30 years (p=0.269). CONCLUSION Hamstring injury represents 10% of all injuries in field-based team sports, with 13% of the athletes experiencing a hamstring injury over a 9-month period most commonly during matches. More work is needed to reduce the incidence of hamstring injury in field-based team sports. PROSPERO REGISTRATION NUMBER CRD42020200022.
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Affiliation(s)
- Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia .,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | | | - Jack Thomas Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ryan Gregory Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
| | - Argell Joseph San Jose
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jessica Dickson
- Library and Academic Research Services, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Victoria, Australia
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Abstract
OBJECTIVE To identify risk factors for quadriceps muscle strain injury in sport. DESIGN Risk factor systematic review. LITERATURE SEARCH A systematic search was conducted in the MEDLINECINAHL, Embase, AMED, AUSPORT, SPORTDiscus, PEDro, and Cochrane Library databases (from inception to September 2021). STUDY SELECTION CRITERIA Studies reporting prospective data to evaluate risk factors related to index and/or recurrent quadriceps muscle strain injury. DATA SYNTHESIS A risk-of-bias assessment (using a modified Quality in Prognosis Studies tool) was performed, and we used best-evidence synthesis to qualitatively synthesize the data to quantify relationships between risk factors and quadriceps muscle injury. RESULTS Sixteen studies were included, capturing 2408 quadriceps injuries in 11 719 athletes. Meta-analyses were not performed due to clinical heterogeneity. The dominant kicking leg (over 3154 individuals, 1055 injuries), a previous history of quadriceps muscle injury (6208 individuals, 975 injuries), and a recent history of hamstring strain (4087 individuals, 581 injuries) were intrinsic factors associated with quadriceps injury. Extrinsic factors relating to the preseason period and competitive match play increased quadriceps injury risk; participating at higher levels of competition decreased quadriceps injury risk. Age, weight, and flexibility (intrinsic factors) had no association with quadriceps injury. CONCLUSION Previous quadriceps injury, recent hamstring injury, the dominant kicking leg, and competitive match play were the strongest risk factors for future quadriceps muscle injury in sport. J Orthop Sports Phys Ther 2022;52(6):389-400. doi:10.2519/jospt.2022.10870.
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Thompson F, Rongen F, Cowburn I, Till K. The Impacts of Sports Schools on Holistic Athlete Development: A Mixed Methods Systematic Review. Sports Med 2022; 52:1879-1917. [PMID: 35260992 PMCID: PMC9325842 DOI: 10.1007/s40279-022-01664-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Abstract
Background To understand the multiple and wide-ranging impacts of intensified youth sport, the need for a holistic approach to athlete development has recently been advocated. Sports schools are an increasingly popular operationalisation of intensified youth sport, aiming to offer an optimal environment for holistic development by combining sport and education. Yet, no study has systematically explored the impacts associated with sports schools. Objectives The aims of this mixed method systematic review were to (1) determine the characteristics and features of sports schools; (2) identify the methods used to evaluate sports school impacts, and (3) evaluate the positive and negative holistic athlete development impacts associated with sports school programme involvement. Methods Adhering to PRISMA guidelines, eight electronic databases were searched until the final return in February 2021. Forty-six articles satisfied the inclusion criteria, were analysed thematically, and synthesised using a narrative approach. The methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool. Results Findings indicated (1) sports school student-athletes receive considerable support in terms of academic and athletic services, more intensified training and competition schedules with high-level training partners, but regularly miss school; (2) multiple methods have been used to evaluate student-athlete impacts, making comparison across studies and developing consensus on the impacts of sports schools difficult; and (3) there are a multitude of immediate, short- and long-term positive and negative impacts associated with the academic/vocational, athletic/physical, psychosocial and psychological development of sports school student-athletes. Conclusions This study is the first to systematically review the research literature to understand the impacts associated with sports schools in terms of holistic athlete development. Practitioners should be aware that they can promote (positive) and negate (negative) health impacts through the design of an appropriate learning environment that simultaneously balances multiple training, academic, psychosocial and psychological factors that can be challenging for youth athletes. We recommend that practitioners aim to design and implement monitoring and evaluation tools that assess the holistic development of student-athletes within their sports schools to ensure they are promoting all-round and healthy youth athlete development.
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Affiliation(s)
- Ffion Thompson
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK. .,Queen Ethelburga's College, Thorpe Underwood, York, UK. .,Carnegie School of Sport, Leeds Beckett University, Room G07, Cavendish Hall, Headingley Campus, Leeds, LS6 3QS, UK.
| | - Fieke Rongen
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ian Cowburn
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Kevin Till
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.,Leeds Rhinos Rugby League Club, Leeds, UK
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Beaudouin F, Demmerle D, Fuhr C, Tröß T, Meyer T. Head Impact Situations in Professional Football (Soccer). Sports Med Int Open 2021; 5:E37-E44. [PMID: 33718592 PMCID: PMC7946547 DOI: 10.1055/a-1338-1402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022] Open
Abstract
To assess head impact incidents (HIIs) and to distinguish diagnosed head injuries from other incidents, a video observation analysis of match HIIs was conducted in the German Bundesliga (2017/18 season). Video recordings of each match were screened to identify the respective events. Head injury data were identified by a prospective injury registry. HII and head injury incidence rates (IR) were calculated with 95% CIs. The total number of HIIs was 1,362 corresponding to an IR of 134.9/1000 match hours (95% CI 127.9–142.2). In 123 HII (IR 12.2, 95% CI 10.2–14.5) the contact was classified as severe. Head contact with the opponent was the most frequent cause (85%). The most frequent mechanism was in 44% (combined) the arm and elbow-to-head, followed by head-to-head and hand-to-head contacts (each 13%). In 58%, the HIIs occurred during header duels. Twenty-nine head injuries were recorded (IR 2.9, 95% CI 2.0–4.1). Concussions/traumatic brain injuries accounted for 48%, head/facial fractures 24%, head/facial contusions 21%, and lacerations/abrasions 7%. The number of HIIs not classified as concussions/more severe trauma was high. Identification of HIIs and head injury severity should be improved during on-field assessment as many head injuries might go unrecognised based on the large number of HIIs.
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Affiliation(s)
- Florian Beaudouin
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Daniel Demmerle
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Christoph Fuhr
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tobias Tröß
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
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Incidence of Acute Hamstring Injuries in Soccer: A Systematic Review of 13 Studies Involving More Than 3800 Athletes With 2 Million Sport Exposure Hours. J Orthop Sports Phys Ther 2021; 51:27-36. [PMID: 33306929 DOI: 10.2519/jospt.2021.9305] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To estimate the incidence and recurrence rates of acute hamstring injuries in all levels of soccer. DESIGN Epidemiology systematic review. LITERATURE SEARCH We searched the PubMed (including MEDLINE), CINAHL, SPORTDiscus, Embase, and Cochrane Central Register of Controlled Trials electronic databases. STUDY SELECTION CRITERIA We included prospective studies of all levels of adult soccer players that registered acute hamstring injuries and provided a description of incidence of acute hamstring injuries per 1000 playing hours (or available data to calculate this). DATA SYNTHESIS Due to heterogeneity, we synthesized the data descriptively. RESULTS Thirteen studies including 3868 players met the inclusion criteria. Two of 13 included studies reported on hamstring injuries in women, and all reported the same in men. The incidence of acute hamstring injury ranged from 0.3 to 0.5 per 1000 exposure hours in women and 0.3 to 1.9 per 1000 exposure hours in men. Hamstring injuries accounted for 5% to 15% of all soccer-related injuries. Hamstring injury recurrence rates ranged from 4% to 68%, depending on the injury definition. Certainty of evidence ranged from moderate to very low. CONCLUSION The incidence of acute hamstring injury in soccer was 0.3 to 1.9 per 1000 exposure hours. The recurrence rate was 4% to 68%. The strength of the evidence was limited by a lack of methodological rigor, the use of varying definitions for acute hamstring injury, and heterogeneous methods of reporting on acute hamstring injuries. J Orthop Sports Phys Ther 2021;51(1):27-36. Epub 11 Dec 2020. doi:10.2519/jospt.2021.9305.
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The Influence of Playing Surface on the Loading Response to Soccer-Specific Activity. J Sport Rehabil 2020; 29:1166-1170. [PMID: 32028255 DOI: 10.1123/jsr.2019-0327] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/26/2019] [Accepted: 12/10/2019] [Indexed: 11/18/2022]
Abstract
CONTEXT The influence of playing surface on injury risk in soccer is contentious, and contemporary technologies permit an in vivo assessment of mechanical loading on the player. OBJECTIVE To quantify the influence of playing surface on the PlayerLoad elicited during soccer-specific activity. DESIGN Repeated measures, field-based design. SETTING Regulation soccer pitches. PARTICIPANTS Fifteen amateur soccer players (22.1 [2.4] y), injury free with ≥6 years competitive experience. INTERVENTIONS Each player completed randomized order trials of a soccer-specific field test on natural turf, astroturf, and third-generation artificial turf. GPS units were located at C7 and the mid-tibia of each leg to measure triaxial acceleration (100 Hz). MAIN OUTCOME MEASURES Total accumulated PlayerLoad in each movement plane was calculated for each trial. Ratings of perceived exertion and visual analog scales assessing lower-limb muscle soreness were measured as markers of fatigue. RESULTS Analysis of variance revealed no significant main effect for playing surface on total PlayerLoad (P = .55), distance covered (P = .75), or postexercise measures of ratings of perceived exertion (P = .98) and visual analog scales (P = .61). There was a significant main effect for GPS location (P < .001), with lower total loading elicited at C7 than mid-tibia (P < .001), but with no difference between limbs (P = .70). There was no unit placement × surface interaction (P = .98). There was also a significant main effect for GPS location on the relative planar contributions to loading (P < .001). Relative planar contributions to loading in the anterioposterior:mediolateral:vertical planes was 25:27:48 at C7 and 34:32:34 at mid-tibia. CONCLUSIONS PlayerLoad metrics suggest that playing surface does not influence mechanical loading during soccer-specific activity (not including tackling). Clinical reasoning should consider that PlayerLoad magnitude and axial contributions were sensitive to unit placement, highlighting opportunities in the objective monitoring of load during rehabilitation.
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11
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Key performance indicators at FIFA Women's World Cup in different playing surfaces. PLoS One 2020; 15:e0241385. [PMID: 33095837 PMCID: PMC7584214 DOI: 10.1371/journal.pone.0241385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to examine the key performance indicators of female professional soccer players during the 2011 and 2015 FIFA Women's World Cup, played on different surfaces (natural and artificial turf respectively). A total of 438 women from 24 national teams who participated at Canada 2015 (artificial turf) and 283 players from 16 national teams who played in Germany 2011 (natural grass) were selected for this study. The collected data were provided by OPTA Sports. Twenty-nine key performance indicators were included for analysis. The variables were calculated for the total sample and independently by positions (defense, midfielders and forwards) for matches on natural grass (2011) and artificial turf (2015). A Mann–Whitney U test was used out to identify differences between the sport surfaces. Moreover, a discriminant analysis was performed with the forced entry method to find the variables that better differentiated between the FIFA Women's World Cup 2011 (natural grass) and FIFA Women's World Cup 2015 (artificial turf). Key performance aspects were very similar between the two tournaments, but on natural grass, we observed a significantly higher number of total passes, successful dribbles, total tackles, successful tackles and interceptions. However, on artificial turf there were significantly higher percentages of success in total passes, and a higher number of fouls. This is an important factor for the choice of an elite competition surface because technical actions are crucial to the quality of the game and can influence the future behavior of spectators and fans.
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Winson DMG, Miller DLH, Winson IG. Foot injuries, playing surface and shoe design: Should we be thinking more about injury prevention. Foot Ankle Surg 2020; 26:597-600. [PMID: 31447244 DOI: 10.1016/j.fas.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 04/10/2019] [Accepted: 07/31/2019] [Indexed: 02/04/2023]
Abstract
The increasing use of artificial pitches has occurred in a multitude of sports at both professional and amateur levels. Artificial turf has become an extremely attractive option as it is felt to encourage a faster, safer and more entertaining play. However these pitches are not without controversy among sporting professionals and in the media. Foot and ankle injury in sport remains incredibly common and a significant burden on health professionals, but what impact do the new artificial surfaces have on these injuries. This review article aims to establish whether artificial turf has an impact on injury rates in the foot and ankle.
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Affiliation(s)
- Daniel M G Winson
- University Hospital of Wales, Cardiff, Heath Park, Cardiff, CF14 4XW, UK.
| | | | - Ian G Winson
- Southmead Hospital, Westbury-on-Trym, Bristol, BS10 5NB, UK.
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13
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López-Valenciano A, Ruiz-Pérez I, Garcia-Gómez A, Vera-Garcia FJ, De Ste Croix M, Myer GD, Ayala F. Epidemiology of injuries in professional football: a systematic review and meta-analysis. Br J Sports Med 2020; 54:711-718. [PMID: 31171515 PMCID: PMC9929604 DOI: 10.1136/bjsports-2018-099577] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We performed a systematic review and meta-analysis of epidemiological data of injuries in professional male football. METHOD Forty-four studies have reported the incidence of injuries in football. Two reviewers independently extracted data and assessed trial quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement and Newcastle Ottawa Scale. Studies were combined in a pooled analysis using a Poisson random effects regression model. RESULTS The overall incidence of injuries in professional male football players was 8.1 injuries/1000 hours of exposure. Match injury incidence (36 injuries/1000 hours of exposure) was almost 10 times higher than training injury incidence rate (3.7 injuries/1000 hours of exposure). Lower extremity injuries had the highest incidence rates (6.8 injuries/1000 hours of exposure). The most common types of injuries were muscle/tendon (4.6 injuries/1000 hours of exposure), which were frequently associated with traumatic incidents. Minor injuries (1-3 days of time loss) were the most common. The incidence rate of injuries in the top 5 European professional leagues was not different to that of the professional leagues in other countries (6.8 vs 7.6 injuries/1000 hours of exposure, respectively). CONCLUSIONS Professional male football players have a substantial risk of sustaining injuries, especially during matches.
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Affiliation(s)
- Alejandro López-Valenciano
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
- Universidad Internacional Isabel I de Castilla, Burgos, Spain
| | - Iñaki Ruiz-Pérez
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
| | | | | | - Mark De Ste Croix
- Faculty of Applied Sciences, University of Gloucestershire, Gloucestershire, UK
| | - Gregory D Myer
- Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
- Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Francisco Ayala
- Sports Research Centre, Miguel Hernández University of Elche, Elche, Spain
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14
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O' Leary F, Acampora N, Hand F, O' Donovan J. Association of artificial turf and concussion in competitive contact sports: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2020; 6:e000695. [PMID: 32518672 PMCID: PMC7254119 DOI: 10.1136/bmjsem-2019-000695] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2020] [Indexed: 01/27/2023] Open
Abstract
Objective To determine the incidence of head injuries and concussion in contact sports, comparing natural grass with artificial turf surfaces. Design Systematic review and meta-analysis via the RevMan V.5.3 software. Eligibility criteria for selecting studies All studies describing competitive contact sports played on both natural grass and artificial turf. The primary outcome measured was occurrence of head injury and concussion. Data sources The databases include PubMed, Embase, Cochrane, Medline and Sport Discus. The last search took place on 23 May 2019. The Newcastle-Ottawa Quality Assessment Scale evaluated the methodological quality of the selected studies with a funnel plot designed to determine publication bias. Study screening and data extraction were performed by two independent reviewers. Results Initial screening generated 42 publications, with 12 meeting criteria for inclusion. Eight studies described concussion only. The rate ratio (RR) of head injury and concussion was less on artificial turf compared with natural grass (RR=0.89, 95% CI 0.77 to 1.04) as was the rate ratio of concussion only (RR=0.72, 95% CI 0.58 to 0.89). Conclusion Analysis of published data demonstrates a decreased incidence of head injury and concussion when contact sports are played on artificial turf. This difference was most marked for sports such as rugby and American football. However, artificial turf has no association with the incidence of head injury or concussion while playing soccer.
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Affiliation(s)
- Frank O' Leary
- Department of Performance Medicine, Sport Ireland Institute, Dublin, Ireland
| | - Nic Acampora
- Faculty of Life Sciences, University of South Wales, Pontypridd, Rhondda Cynon Taff, UK
| | - Fiona Hand
- Department of Surgery, St. Vincent's University Hospital, Elm Park, Dublin, Ireland
| | - James O' Donovan
- Department of Performance Medicine, Sport Ireland Institute, Dublin, Ireland
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15
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The Influence of Soccer Playing Surface on the Loading Response to Ankle (P)Rehabilitation Exercises. J Sport Rehabil 2020; 30:105-111. [PMID: 32235001 DOI: 10.1123/jsr.2019-0199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 01/06/2020] [Accepted: 01/26/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Contemporary synthetic playing surfaces have been associated with an increased risk of ankle injury in the various types of football. Triaxial accelerometers facilitate in vivo assessment of planar mechanical loading on the player. OBJECTIVE To quantify the influence of playing surface on the PlayerLoad elicited during footwork and plyometric drills focused on the mechanism of ankle injury. DESIGN Repeated-measures, field-based design. SETTING Regulation soccer pitches. PARTICIPANTS A total of 15 amateur soccer players (22.1 [2.4] y), injury free with ≥6 years competitive experience. INTERVENTIONS Each player completed a test battery comprising 3 footwork drills (anterior, lateral, and diagonal) and 4 plyometric drills (anterior hop, inversion hop, eversion hop, and diagonal hop) on natural turf (NT), third-generation artificial turf (3G), and AstroTurf. Global positioning system sensors were located at C7 and the mid-tibia of each leg to measure triaxial acceleration (100 Hz). MAIN OUTCOME MEASURES PlayerLoad in each axial plane was calculated for each drill on each surface and at each global positioning system location. RESULTS Analysis of variance revealed a significant main effect for sensor location in all drills, with PlayerLoad higher at mid-tibia than at C7 in all movement planes. AstroTurf elicited significantly higher PlayerLoad in the mediolateral and anteroposterior planes, with typically no difference between NT and 3G. In isolated inversion and eversion hopping trials, the 3G surface also elicited lower PlayerLoad than NT. CONCLUSIONS PlayerLoad magnitude was sensitive to unit placement, advocating measurement with greater anatomical relevance when using microelectromechanical systems technology to monitor training or rehabilitation load. AstroTurf elicited higher PlayerLoad across all planes and drills and should be avoided for rehabilitative purposes, whereas 3G elicited a similar mechanical response to NT.
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16
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Philp F, Al-Shallawi A, Kyriacou T, Blana D, Pandyan A. Improving predictor selection for injury modelling methods in male footballers. BMJ Open Sport Exerc Med 2020; 6:e000634. [PMID: 32095267 PMCID: PMC7010990 DOI: 10.1136/bmjsem-2019-000634] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2019] [Indexed: 12/23/2022] Open
Abstract
Objectives This objective of this study was to evaluate whether combining existing methods of elastic net for zero-inflated Poisson and zero-inflated Poisson regression methods could improve real-life applicability of injury prediction models in football. Methods Predictor selection and model development was conducted on a pre-existing dataset of 24 male participants from a single English football team's 2015/2016 season. Results The elastic net for zero-inflated Poisson penalty method was successful in shrinking the total number of predictors in the presence of high levels of multicollinearity. It was additionally identified that easily measurable data, that is, mass and body fat content, training type, duration and surface, fitness levels, normalised period of 'no-play' and time in competition could contribute to the probability of acquiring a time-loss injury. Furthermore, prolonged series of match-play and increased in-season injury reduced the probability of not sustaining an injury. Conclusion For predictor selection, the elastic net for zero-inflated Poisson penalised method in combination with the use of ZIP regression modelling for predicting time-loss injuries have been identified appropriate methods for improving real-life applicability of injury prediction models. These methods are more appropriate for datasets subject to multicollinearity, smaller sample sizes and zero-inflation known to affect the performance of traditional statistical methods. Further validation work is now required.
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Affiliation(s)
- Fraser Philp
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
| | - Ahmad Al-Shallawi
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK.,The Engineering Technical College of Mosul, Northern Technical University, Mosul, Nineveh, Iraq
| | - Theocharis Kyriacou
- School of Computing and Mathematics, Keele University, Keele, Staffordshire, UK
| | - Dimitra Blana
- Institute of Science and Technology in Medicine, Keele University, Keele, Staffordshire, UK
| | - Anand Pandyan
- School of Health and Rehabilitation, Keele University, Keele, Staffordhire, UK
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Calloway SP, Hardin DM, Crawford MD, Hardin JM, Lemak LJ, Giza E, Forsythe B, Lu Y, Patel BH, Osbahr DC, Gerhardt MB, Mandelbaum BR, Baldwin WW. Injury Surveillance in Major League Soccer: A 4-Year Comparison of Injury on Natural Grass Versus Artificial Turf Field. Am J Sports Med 2019; 47:2279-2286. [PMID: 31306590 DOI: 10.1177/0363546519860522] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Artificial playing surfaces are becoming more common due to decreased cost of maintenance and increased field usability across different environmental conditions. The Fédération Internationale de Football Association (FIFA) has approved newer generation artificial turf for soccer competition at the elite level, but many elite-level athletes prefer to play on natural grass surfaces due to a perceived increase in injury rate, discomfort, and fatigability on artificial turf. HYPOTHESIS Injury rates and rates of individually categorized types of injury experienced on artificial turf are noninferior to rates of injury on the standard comparator, natural grass, in elite-level Major League Soccer athletes. STUDY DESIGN Cohort study; Level of evidence, 2. METHODS Over the course of 4 Major League Soccer seasons (2013-2016), athlete injury data were recorded electronically. Injury data recorded in matches between 2 Major League Soccer teams were then analyzed. Playing surface was known for each venue, and all artificial turf surfaces were rated as 2-star according to FIFA criteria. Incidence rate ratios (Artificial Turf ÷ Natural Grass) were calculated with a 95% CI (α = .05) for both overall injury incidence and individual injury subgroups. A noninferiority margin (δ) of 0.15 was used to determine noninferiority of injury incidence rates. RESULTS A total of 2174 in-game injuries were recorded during the study period, with 1.54 injuries per game on artificial turf and 1.49 injuries per game on natural grass (incidence rate ratio, 1.033; 95% CI, 0.937-1.139). Within injury subgroups, overall ankle injury, Achilles injury, and ankle fracture were found to have a statistically higher incidence on artificial turf. Artificial turf was found to be noninferior to natural grass for overall foot injury and forefoot injury. No statistically significant differences were found in knee injuries between the 2 surfaces. CONCLUSION The overall rate of injury on artificial turf was noninferior to that on natural grass. Within individual injury categories, a higher rate of ankle injury was found on artificial turf. No other injury subgroup demonstrated statistically significant differences between surfaces. CLINICAL RELEVANCE FIFA 2-star rated artificial turf is a viable alternative to natural grass in elite-level soccer competition. Innovative research methods for comparing artificial turf versus natural grass may elucidate relative advantages with respect to player safety.
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Affiliation(s)
- Sean P Calloway
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - David M Hardin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Matthew D Crawford
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - J Michael Hardin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Lawrence J Lemak
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Eric Giza
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Brian Forsythe
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Yining Lu
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Bhavik H Patel
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Daryl C Osbahr
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Michael B Gerhardt
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - Bert R Mandelbaum
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
| | - William W Baldwin
- Investigation performed at Kerlan Jobe Institute, Santa Monica, California, USA
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18
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Ekstrand J, Krutsch W, Spreco A, van Zoest W, Roberts C, Meyer T, Bengtsson H. Time before return to play for the most common injuries in professional football: a 16-year follow-up of the UEFA Elite Club Injury Study. Br J Sports Med 2019; 54:421-426. [PMID: 31182429 PMCID: PMC7146935 DOI: 10.1136/bjsports-2019-100666] [Citation(s) in RCA: 121] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2019] [Indexed: 12/12/2022]
Abstract
Objectives The objective was to describe the typical duration of absence following the most common injury diagnoses in professional football. Methods Injuries were registered by medical staff members of football clubs participating in the Union of European Football Association Elite Club Injury Study. Duration of absence due to an injury was defined by the number of days that passed between the date of the injury occurrence and the date when the medical team allowed the player to return to full participation. In total, 22 942 injuries registered during 494 team-seasons were included in the study. Results The 31 most common injury diagnoses constituted a total of 78 % of all reported injuries. Most of these injuries were either mild (leading to a median absence of 7 days or less, 6440 cases = 42%) or moderate (median absence: 7–28 days, 56% = 8518 cases) while only few (2% = 311 cases) were severe (median absence of >28 days). The mean duration of absence from training and competition was significantly different (p < 0.05) between index injuries and re-injuries for six diagnoses (Achilles tendon pain, calf muscle injury, groin adductor pain, hamstring muscle injuries and quadriceps muscle injury) with longer absence following re-injuries for all six diagnoses Conclusions The majority of all time loss due to injuries in professional football stems from injuries with an individual absence of up to 4 weeks. This article can provide guidelines for expected time away from training and competition for the most common injury types as well as for its realistic range.
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Affiliation(s)
- Jan Ekstrand
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden .,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Werner Krutsch
- Department of Trauma Surgery, Universitatsklinikum Regensburg, Regensburg, Germany
| | - Armin Spreco
- Department of Medical and Health Sciences, Athletics Research Centre, Linköping University, Linköping, Sweden
| | - Wart van Zoest
- Department of Orthopaedic Surgery, St Anna Hospital, Eindhoven, The Netherlands
| | | | - Tim Meyer
- Institute of Sports and Preventive Medicine, University of Saarland, Saarbrücken, Germany
| | - Håkan Bengtsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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19
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Abrasion injuries on artificial turf: A systematic review. J Sci Med Sport 2019; 22:550-556. [DOI: 10.1016/j.jsams.2018.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 09/09/2018] [Accepted: 11/09/2018] [Indexed: 11/20/2022]
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20
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Miyamori T, Nagao M, Sawa R, Tumilty S, Yoshimura M, Saita Y, Ikeda H, Kaneko K. Playing football on artificial turf as a risk factor for fifth metatarsal stress fracture: a retrospective cohort study. BMJ Open 2019; 9:e022864. [PMID: 30787077 PMCID: PMC6398723 DOI: 10.1136/bmjopen-2018-022864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The fifth metatarsal stress fracture is a common injury among football players. Although several risk factors have been proposed, the association between the playing surface and development of fifth metatarsal stress fractures (MT-5) has not been evaluated. We conducted an epidemiological study using a computer-based survey to investigate the association between the playing surface and development of MT-5. METHODS This study included 1854 football players, of which 41 experienced MT-5 within the past 24 months. Baseline demographic data and the percentage of time spent playing on artificial turf and clay fields were compared between the non-MT-5 and MT-5 player groups, and the risks for development of MT-5 associated with the playing surfaces were estimated by univariate and multivariate analyses. RESULTS There were significant differences in body mass index, years of play, playing categories and playing time on artificial turf between non-MT-5 and MT-5 groups (p<0.05). Generalised estimating equations analyses adjusted for multiple confounders demonstrated that relative to the risk of playing <20% of the time on each surface, the OR (OR: 95% CI) for MT-5 for playing on artificial turf >80% of the time increased (3.44: 1.65 to 7.18), and for playing on a clay field 61%-80% of the time, the OR decreased (0.25: 0.11 to 0.59). CONCLUSIONS A higher percentage of playing time on an artificial turf was a risk factor for developing MT-5 in football players. This finding could be beneficial for creating strategies to prevent MT-5.
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Affiliation(s)
- Takayuki Miyamori
- Department of Health and Welfare, School of Physical Therapy, International University of Health and Welfare, Narita, Japan
- Jones Fracture Research Group, Tokyo, Japan
| | - Masashi Nagao
- Jones Fracture Research Group, Tokyo, Japan
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
- Department of Orthopaedics and Sports Medicine, Juntendo University, Tokyo, Japan
| | - Ryuichi Sawa
- Department of Health and Welfare, School of Physical Therapy, International University of Health and Welfare, Narita, Japan
| | - Steve Tumilty
- Centre for Health, Activity and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - Masafumi Yoshimura
- Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Yoshitomo Saita
- Jones Fracture Research Group, Tokyo, Japan
- Department of Orthopaedics and Sports Medicine, Juntendo University, Tokyo, Japan
| | - Hiroshi Ikeda
- Department of Orthopaedics and Sports Medicine, Juntendo University, Tokyo, Japan
| | - Kazuo Kaneko
- Department of Orthopaedics and Sports Medicine, Juntendo University, Tokyo, Japan
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21
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Ranson C, George J, Rafferty J, Miles J, Moore I. Playing surface and UK professional rugby union injury risk. J Sports Sci 2018; 36:2393-2398. [DOI: 10.1080/02640414.2018.1458588] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Craig Ranson
- Athlete Health, English Institute of Sport, Manchester, UK
| | | | - James Rafferty
- Swansea University Medical School, Swansea University, Swansea, UK
| | - John Miles
- Medical Department, Welsh Rugby Union, Cardiff, UK
| | - Isabel Moore
- Cardiff School of Sport & Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Does the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players? Clin Orthop Relat Res 2017; 475:2447-2455. [PMID: 28389864 PMCID: PMC5599387 DOI: 10.1007/s11999-017-5342-5] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND The FIFA 11+ injury prevention program has been shown to decrease the risk of soccer injuries in men and women. The program has also been shown to decrease time loss resulting from injury. However, previous studies have not specifically investigated how the program might impact the rate of anterior cruciate ligament (ACL) injury in male soccer players. QUESTIONS/PURPOSES The purpose of this study was to examine if the FIFA 11+ injury prevention program can (1) reduce the overall number of ACL injuries in men who play competitive college soccer and whether any potential reduction in rate of ACL injuries differed based on (2) game versus practice setting; (3) player position; (4) level of play (Division I or II); or (5) field type. METHODS This study was a prospective cluster randomized controlled trial, which was conducted in 61 Division I and Division II National Collegiate Athletic Association men's soccer teams over the course of one competitive soccer season. The FIFA 11+ is a 15- to 20-minute on-the-field dynamic warm-up program used before training and games and was utilized as the intervention throughout the entire competitive season. Sixty-five teams were randomized: 34 to the control group (850 players) and 31 to the intervention group (675 players). Four intervention teams did not complete the study and did not submit their data, noting insufficient time to complete the program, reducing the number for per-protocol analysis to 61. Compliance to the FIFA 11+ program, athletic exposures, specific injuries, ACL injuries, and time loss resulting from injury were collected and recorded using a secure Internet-based system. At the end of the season, the data in the injury surveillance system were crosshatched with each individual institution's internal database. At that time, the certified athletic trainer signed off on the injury collection data to confirm their accuracy and completeness. RESULTS A lower proportion of athletes in the intervention group experienced knee injuries (25% [34 of 136]) compared with the control group (75% [102 of 136]; relative risk [RR], 0.42; 95% confidence interval [CI], 0.29-0.61; p < 0.001). When the data were stratified for ACL injury, fewer ACL injuries were reported in the intervention group (16% [three of 19]) compared with the control group (84% [16 of 19]), accounting for a 4.25-fold reduction in the likelihood of incurring ACL injury (RR, 0.236; 95% CI, 0.193-0.93; number needed to treat = 70; p < 0.001). With the numbers available, there was no difference between the ACL injury rate within the FIFA 11+ group and the control group with respect to game and practice sessions (games-intervention: 1.055% [three of 15] versus control: 1.80% [12 of 15]; RR, 0.31; 95% CI, 0.09-1.11; p = 0.073 and practices-intervention: 0% [zero of four] versus control: 0.60% [four of four]; RR, 0.14; 95% CI, 0.01-2.59; p = 0.186). With the data that were available, there were no differences in incidence rate (IR) or injury by player position for forwards (IR control = 0.339 versus IR intervention = 0), midfielders (IR control = 0.54 versus IR intervention = 0.227), defenders (IR control = 0.339 versus IR intervention = 0.085), and goalkeepers (IR control = 0.0 versus IR intervention = 0.0) (p = 0.327). There were no differences in the number of ACL injuries for the Division I intervention group (0.70% [two of nine]) compared with the control group (1.05% [seven of nine]; RR, 0.30; CI, 0.06-1.45; p = 0.136). However, there were fewer ACL injuries incurred in the Division II intervention group (0.35% [one of 10]) compared with the control group (1.35% [nine of 10]; RR, 0.12; CI, 0.02-0.93; p = 0.042). There was no difference between the number of ACL injuries in the control group versus in the intervention group that occurred on grass versus turf (Wald chi square [1] = 0.473, b = 0.147, SE = 0.21, p = 0.492). However, there were more ACL injuries that occurred on artificial turf identified in the control group (1.35% [nine of 10]) versus the intervention group (0.35% [one of 10]; RR, 0.14; 95% CI, 0.02-1.10; p = 0.049). CONCLUSIONS This program, if implemented correctly, has the potential to decrease the rate of ACL injury in competitive soccer players. In addition, this may also enhance the development and dissemination of injury prevention protocols and may mitigate risk to athletes who utilize the program consistently. Further studies are necessary to analyze the cost-effectiveness of the program implementation and to analyze the efficacy of the FIFA 11+ in the female collegiate soccer cohort. LEVEL OF EVIDENCE Level I, therapeutic study.
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23
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Chéron C, Le Scanff C, Leboeuf-Yde C. Association between sports type and overuse injuries of extremities in adults: a systematic review. Chiropr Man Therap 2017; 25:4. [PMID: 28101329 PMCID: PMC5237127 DOI: 10.1186/s12998-017-0135-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 01/04/2017] [Indexed: 01/08/2023] Open
Abstract
Background Sports injuries are often described as overuse or traumatic. Little is known about the frequency of overuse injuries and, in particular, if they vary between different types of sporting activities. Purpose To identify any differences between sports in relation to diagnoses of overuse injuries of the extremities (OIE) and anatomical areas most likely to be injured in adults and to compare these findings with those reported in youngsters, as identified in a previous review. Methods A search was made in May 2015 and again in April 2016 in PubMed, SportDiscus, PsycInfo, and Web of Sciences. Search terms were « overuse injuries OR cumulative trauma disorders OR musculoskeletal injuries » AND « extremity OR limb » AND « physical activity OR sport OR risk factor OR exercises ». Inclusion criteria were: 1) prospective, or cross-sectional study design; 2) at least 1/3 of the population should be ≥ 19 years; 3) articles must clearly state if reported cases were classified as traumatic or overuse injuries in relation to a particular sports type, 4) sample size >50, and 5) articles must not deal with specific occupational subpopulations nor with clinical populations. A blinded systematic review was conducted and results reported per anatomical site of injury and diagnosis for the different sports. Results In all, 10 of 1435 identified articles were included, studying soccer, beach-volleyball and triathlon. In general, the incidence estimates were low, never above 2.0/1000 h of practice, similar to results seen in children/adolescents. The incidence estimates and the diagnoses of OIE were given only in 4 articles on soccer, making comparisons between sports impossible. As in children/adolescents, the lower limb is more often affected than the upper but contrary to young people the injured site in adults is more often the knee and above, and there were also differences in the diagnoses for the two age groups. Conclusion The literature does not permit to identify clearly the difference in the incidence of OIE for different sports showing that more but well-designed surveillance studies are needed.
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Affiliation(s)
- Charlène Chéron
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France ; Institut Franco-Européen de Chiropraxie, 72 Chemin de la Flambère, F-31300 Toulouse, France
| | - Christine Le Scanff
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France
| | - Charlotte Leboeuf-Yde
- CIAMS, Université Paris-Sud, Université Paris-Saclay, F-91405 Orsay, Cedex France ; CIAMS, Université d'Orléans, F-45067 Orléans, France ; Institut Franco-Européen de Chiropraxie, 72 Chemin de la Flambère, F-31300 Toulouse, France
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Pangrazio O, Forriol F. Epidemiology of soccer players traumatic injuries during the 2015 America Cup. Muscles Ligaments Tendons J 2016; 6:124-30. [PMID: 27331040 DOI: 10.11138/mltj/2016.6.1.124] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM to provide an overview of the traumatic injuries sustained by players in the 2015 America Cup. MATERIAL AND METHODS we collected the medical reports on all the matches held during the 2015 America Cup, in Chile, in 2015. Twelve American teams took part in the championship, consisted of 26 matches with a total of 276 players. The physician for each team sent a request form of the traumatic injuries sustained, including the time at which the injury was produced, the location and diagnosis, its severity and the circumstances (contact injury, sanction, treatment required). RESULTS the mean number of minutes played was 233 (SD: 147) (5-570) minutes. An injury occurred every 58 minutes, which means that there were 17.25 injuries per 1,000 minutes of match time. We found 44 injuries in 30 players. There were 14 non-contact injuries, and 30 contact injuries, of which 13 were declared fouls and resulted in cards being given. Five teams had one injured player, two had 2, two had 4, and one had 25 injuries. The most frequent injuries were those to the lower limbs. The muscles strains happened in the second part of the second half of the match, the ACL rupture at the end of the first half, and the other sprains and strains in the second half. The contusions occurred at all times throughout the match, although they seemed to be concentrated towards the end of the first half, while the cases of tendinitis were caused in the first part of the second half. CONCLUSION football injuries are very common, and even though serious injuries are rare, it is increasingly necessary to set protocols for action which ensure good medical attention at all levels to address the problems that arise, both during training and in competitions, and to be prepared to treat serious injuries if these occur.
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Affiliation(s)
- Osvaldo Pangrazio
- Comisión Médica Conmebol (Confederación Su-damericana de Fútbol), Asunción, Paraguay
| | - Francisco Forriol
- Department of Clínica Sciences, University San Pablo - CEU, Boadilla del Monte, Spain
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Epidemiology of injuries sustained by players during the 16th Under-17 South American Soccer Championship. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2016.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
OBJECTIVE To describe acute lower extremity injuries and evaluate extrinsic risk factors in female youth soccer. DESIGN Nested case-control study. SETTING Youth soccer clubs in Seattle, WA. PARTICIPANTS Female soccer players (n = 351) ages 11 to 15 years randomly selected from 4 soccer clubs from which 83% of their players were enrolled with complete follow-up for 92% of players. INTERVENTIONS Injured players were interviewed regarding injury, field surface, shoe type, and position. Uninjured controls, matched on game or practice session, were also interviewed. MAIN OUTCOME MEASURES The association between risk factors and acute lower extremity injury using logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI). RESULTS One hundred seventy-three acute lower extremity injuries occurred involving primarily the ankle (39.3%), knee (24.9%), and thigh (11.0%). Over half (52.9%) recovered within 1 week, whereas 30.2% lasted beyond 2 weeks. During practices, those injured were approximately 3-fold (OR, 2.83; 95% CI, 1.49-5.31) more likely to play on grass than artificial turf and 2.4-fold (95% CI, 1.03-5.96) more likely to wear cleats on grass than other shoe and surface combinations. During games, injured players were 89% (95% CI, 1.03-4.17) more likely to play defender compared with forward. CONCLUSIONS Half of the acute lower extremity injuries affected the ankle or knee. Grass surface and wearing cleats on grass increased training injuries. CLINICAL RELEVANCE The majority, 64%, of female youth soccer players' acute injuries involve the ankle and knee and injury prevention strategies in this age group should target these areas. When considering playing surfaces for training, communities and soccer organizations should consider the third-generation artificial turf a safe alternative to grass.
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Bjørneboe J, Kristenson K, Waldén M, Bengtsson H, Ekstrand J, Hägglund M, Rønsen O, Andersen TE. Role of illness in male professional football: not a major contributor to time loss. Br J Sports Med 2016; 50:699-702. [PMID: 27034126 DOI: 10.1136/bjsports-2015-095921] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND There are limited data on the nature, type and incidence of illness in football. Previous studies indicate that gastrointestinal and respiratory tract illnesses are most common. AIM To describe the incidence and burden of illness in male professional football. METHODS Over the 4-year study period, 2011-2014, 73 professional football teams in Europe participated, with a total of 1 261 367 player-days recorded. All time-loss illnesses were recorded by the medical staff of each club. A recordable illness episode was any physical or psychological symptom (not related to injury) that resulted in the player being unable to participate fully in training or match play. RESULTS A total of 1914 illness episodes were recorded. The illness incidence was 1.5 per 1000 player-days, meaning that, on average, a player experienced an illness episode every second season, with a median of 3 days absence per illness episode. Severe illness (absence >4 weeks) constituted 2% of all illnesses. Respiratory tract illness was the most common (58%), followed by gastrointestinal illness (38%). Respiratory tract illness, gastrointestinal illness and cardiovascular illness caused the highest illness burden. CONCLUSIONS The illness incidence among male professional football players is low compared with the injury incidence. We found that the highest illness burden was caused by illness to the respiratory tract, gastrointestinal tract and cardiovascular system.
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Affiliation(s)
- John Bjørneboe
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Karolina Kristenson
- Football Research Group, Linköping University, Sweden Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Markus Waldén
- Football Research Group, Linköping University, Sweden Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Håkan Bengtsson
- Football Research Group, Linköping University, Sweden Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jan Ekstrand
- Football Research Group, Linköping University, Sweden Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Martin Hägglund
- Football Research Group, Linköping University, Sweden Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | | | - Thor Einar Andersen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
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Hägglund M, Waldén M, Ekstrand J. Injury recurrence is lower at the highest professional football level than at national and amateur levels: does sports medicine and sports physiotherapy deliver? Br J Sports Med 2016; 50:751-8. [DOI: 10.1136/bjsports-2015-095951] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2016] [Indexed: 11/03/2022]
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No association between surface shifts and time-loss overuse injury risk in male professional football. J Sci Med Sport 2016; 19:218-221. [DOI: 10.1016/j.jsams.2015.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 05/19/2015] [Accepted: 06/01/2015] [Indexed: 11/20/2022]
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Pangrazio O, Forriol F. Epidemiology of injuries sustained by players during the 16th Under-17 South American Soccer Championship. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 60:192-9. [PMID: 26838188 DOI: 10.1016/j.recot.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/19/2015] [Accepted: 12/02/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We performed an epidemiological study of the traumatic injuries during the XVI South American U-17 Football Championship, 2015. MATERIAL AND METHODS Observational surveys submitted by the 10 teams medical services of 220 players. Thirty-five games were held and 116 goals (3.31 per game) were recorded. RESULTS 103 lesions, ie, 2.94 per game or 32.7 injuries per 1,000 min were recorded. Fifty-six were from direct contact and 66 requiring treatment. 36% of the injuries were punished by fault and 26% of the injuries also saw card. Injuries were most common in the ankle (15 cases), Achilles tendon (14 cases) and thigh (14 cases), followed by trauma to the knee and foot (7 cases each), face and the lumbar region (6 cases each), being rare in the upper extremity. CONCLUSION Injuries during Soccer World Cup are difficult to predict and prevent, but serious injuries are rare. Is necessary to establish protocols that get adequate health care at all levels to solve problems produce, both in training and during the competition, and be prepared to solve the serious problems that may arise.
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Affiliation(s)
- O Pangrazio
- Comisión Médica Conmebol (Confederación Sudamericana de Fútbol), Universidad San Pablo-CEU, Madrid, España
| | - F Forriol
- Facultad de Medicina, Universidad San Pablo-CEU, Madrid, España.
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Rennie DJ, Vanrenterghem J, Littlewood M, Drust B. Can the natural turf pitch be viewed as a risk factor for injury within Association Football? J Sci Med Sport 2015. [PMID: 26209426 DOI: 10.1016/j.jsams.2015.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVES A review of the current literature is used to propose a 'conceptual model for relative pitch hardness' and how this may affect incidence of injury within Association Football. Based upon the injury risk and causation model of Meeuwisse et al. (Clin J Sport Med 2007; 17(3):215), it may provide researchers a necessary framework to guide future research investigations. DESIGN A literature review. METHODS A comprehensive search of electronic databases available until October 2014, and supplemental hand searching was conducted to identify relevant studies. Studies were deemed relevant if they met the following criteria: published in English, presented or referenced in an epidemiological study or provided data directly and/or related to the surface of the football pitch, ball or boot to surface interaction and injury. Further information was sourced on surface hardness, players' movement patterns and physiological demands within football. RESULTS Papers varied in methodological quality, with comparative studies examining injury rates on artificial versus natural turf pitches being most prevalent. No prospective studies were found that objectively measured the relationship between hardness of natural turf and injury risk within football. CONCLUSIONS The literature review into natural turf pitches and injury within football has largely been unable to confirm that pitch hardness can be viewed as a significant extrinsic risk factor. Methodological concerns, including objectivity in pitch assessment and uniformity in defining injuries undermine the efficacy of available work. Future studies are needed utilising objective assessment tools to draw more definitive conclusions regarding pitch hardness as an extrinsic factor for injury within football.
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Affiliation(s)
- David J Rennie
- Leicester City Football Club, Department of Medicine and Sports Science, King Power Stadium, England.
| | | | | | - Barry Drust
- Applied Physiology, Liverpool John Moores University, England
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Williams S, Trewartha G, Kemp SPT, Michell R, Stokes KA. The influence of an artificial playing surface on injury risk and perceptions of muscle soreness in elite Rugby Union. Scand J Med Sci Sports 2015; 26:101-8. [DOI: 10.1111/sms.12402] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2014] [Indexed: 11/30/2022]
Affiliation(s)
- S. Williams
- Department for Health; University of Bath; Bath UK
| | - G. Trewartha
- Department for Health; University of Bath; Bath UK
| | | | - R. Michell
- Department for Health; University of Bath; Bath UK
- The Rugby Players' Association; Twickenham UK
| | - K. A. Stokes
- Department for Health; University of Bath; Bath UK
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Orchard J. Research on products such as artificial turf is potentially exposed to the same types of industry bias as research on pharmaceuticals. Br J Sports Med 2013; 47:725-6. [DOI: 10.1136/bjsports-2013-092575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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