Nine typical injury patterns in German professional male football (soccer): a systematic visual video analysis of 345 match injuries

Shoulder, arm, and elbow injuries in soccer players

Soccer is a global widespread sport with a high injury rate, mostly to the lower limbs. Even though upper limb injuries are much less common among soccer players, their prevalence has increased in recent years. This is due to several reasons/factors, including new and more aggressive tactics, a rise in the number of younger players with different levels of skeletal maturation, and due to the growth of women's participation in sports, which is in line with the fast progression in the degree of professionalism in women's soccer. This review paper aims to (a) describe the most common injuries in the shoulder, arm, and elbow in soccer players and (b) to show the role of different imaging modalities in diagnosing upper extremity injuries that can occur in this sport. Familiarity with these injuries and their mechanisms will lead to a quicker diagnosis and correct reporting of imaging of soccer players.

Patterns of ankle injury in soccer: MRI clues to traumatic mechanism

Understanding the traumatic mechanisms of ankle injuries in soccer is crucial for an accurate and complete MRI diagnosis. Many ankle injuries share universal mechanisms seen in other athletic activities, but certain patterns are found to be more specific and relatively unique to soccer. Ankle impingement syndromes encountered in soccer encompass a spectrum of disorders that include anterior and posterior impingement categories, with anterior impingement representing pathology relatively specific to soccer. Lateral ligamentous sprains are one of the most common injuries; however, there is a higher rate of injuries to the medial structures in soccer as compared to other sports. Ankle fractures are uncommon in soccer while bone contusions and chondral and osteochondral injuries frequently accompany ligamentous sprains. Tendon abnormalities in soccer most commonly result from overuse injuries and typically affect peroneal tendons, posterior and anterior tibialis tendons, and Achilles tendon. Acute Achilles tendon ruptures occur in both recreational players and elite soccer athletes. Tibialis anterior friction syndrome may mimic tibial stress fractures. Long-term sequelae of acute traumatic and chronic overuse ankle injuries in professional soccer players manifest as ankle osteoarthritis that is more prevalent compared to not only the general population, but also to former elite athletes from other sports. This article examines the most common and specific injuries in soccer in order of their frequency.

Return-to-play criteria following a hamstring injury in professional football: a scoping review

The present scoping review aims to describe the available criteria to determine Return-To-Play (RTP), propose methodological considerations and new research questions, and provide information to help practitioners in professional football make informed decisions regarding RTP following a hamstring strain injury (HSI) in professional male football. The following electronic databases were searched: PubMed, MEDLINE, web of science and SPORTDiscus using keywords related to HSI in elite football. All types of studies in English reporting at least one RTP criterion for professional football players who sustained an HSI were included. In total, 19 studies met the inclusion criteria. RTP criteria were divided into three categories: clinical, strength and performance criteria. Clinical criteria were also divided into sub-categories: absence of pain, hamstring flexibility, medical staff clearance, psychological readiness, surgeon's opinion and imaging. Practitioners working in professional male football could benefit from using a combination of criteria in their RTP battery of tests.

A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns

The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.

The Effect of Traditional Strength Training on Sprint and Jump Performance in 12- to 15-Year-Old Elite Soccer Players: A 12-Month Controlled Trial

ABSTRACT

Skratek, J, Kadlubowski, B, and Keiner, M. The effect of traditional strength training on sprint and jump performance in 12- to 15-year-old elite soccer players: a 12-month controlled trial. J Strength Cond Res 38(11): 1900-1910, 2024-The aim of the study was to evaluate the effect of traditional strength training on maximum strength (1 repetition maximum in front squat [FS] and back squat [BS]), jump (squat and countermovement jump), and linear sprint (LS) performance (5, 10, and 30 m) in elite young soccer players. A 12-month longitudinal design was chosen, and 48 elite male youth soccer players (age: 12-15 years) were included. The subjects were divided in 2 groups (a strength training group [STG] and a control group [CG]). The intervention group trained for 1 year over a competitive soccer season with additional sessions to their regular soccer practice (4 sessions per week), while the CG did not complete any additional sessions to the regular soccer training (4 sessions per week). The additional strength training (2 sessions per week [each approximately 30 minutes]) consisted of either parallel FS or BS. The squat variants switched in each session. Data were analyzed using a 2 × 3 (group × time) repeated-measures analysis of variance. The main findings of this study were that the STG resulted in significant pretest and post-test improvements in maximum strength ( d = 3.75-5.58), jump ( d = 0.84-1.14), and LS performance ( d = -0.25 to 0.44), while for the CG, smaller increases or performance decreases were measured (maximum strength: d = 1.64-2.7; jump: d = 0.12-0.31; sprint: d = 0.00-025). A significant interaction effect in all variables indicated significant ( p < 0.05) stronger performance improvements compared with the CG. Traditional strength training in elite youth soccer players is recommended to increase strength and speed-strength (jump and sprint performance) and should be considered in long-term athletic development programs.

What do we know about beach soccer injuries? Systematic video analysis of four consecutive years with 580 match injuries

The aim of the present study was to evaluate the characteristics of match injury in male beach soccer players. Video recordings of all official beach soccer tournaments in which the European national male beach soccer teams participated from 2018 to 2021 were analysed by two sports medicine specialists retrospectively. Regarding each injury, data including the mechanism, location of the injury, whether the injury led to time-loss, and the relationship of the injury to the bicycle kick (BK), etc. were documented. A total of 632 injuries were documented, corresponding to 234.9 injuries/1000 player hours. Video footage was available for 580 injuries. Whilst 79.8% of medical attention injuries occurred due to opponent contact, 19.5% of time-loss injuries occurred due to non-contact, and 12.2% of indirect opponent contact (p < 0.01). The most common location of the BK related injury was the head/neck (68.7%), whereas most common location of the BK unrelated injury was the lower extremity (54.1%) (p < 0.01). The findings demonstrated that beach soccer injury incidence was quite high; the most common injury location was head/neck and head/neck injuries were associated with BK. In light of these results, some rule regulations, particularly those associated with BK, and the use of protective equipment should be considered to prevent these injuries.

A comparative video analysis of hamstring injuries mechanism and situational pattern in men's and women's football (soccer)

PURPOSE

To describe the injury mechanism and situational patterns of severe (absence >28 days) hamstring muscle injuries in professional male and female football (soccer) players.

METHODS

The data for males were sourced from Serie A clubs participating in both national and international competitions from 2018 to 2021. For the female cohort, hamstring injuries were identified during matches of the top national/international competitions from 2017 to 2023. Video footage was obtained, and three raters categorised injury mechanisms and situational patterns. Injuries were also examined according to the month, minute and location.

RESULTS

A total of 129 severe hamstring injuries were identified, with 64 occurring in females and 65 in males. Video analysis was possible for 29 (45%) female cases and 61 (94%) male cases. Female injuries had longer lay-off times (97.8 ± 77.1 days) than males (39.6 ± 20.9 days). Females had a higher proportion of indirect contact injuries (34%) than males (13%) and a lower proportion of non-contact injuries (66% vs. 87%). Four situational patterns were identified: running was the most common for both sexes, representing 59% of female injuries and 41% of male injuries. Over-stretching injuries were split across open and CKC scenarios but collectively explained nearly half (48%) of male injuries but only one in five (21%) female injuries. Kicking injuries had a higher proportion in females (17%) than males (10%). Injuries were more common in the second half for females and the first half for males.

CONCLUSION

Females had a higher proportion of indirect contact, running and kicking injuries and a lower proportion of non-contact and stretch-type injuries than males. Understanding injury patterns can inform tailored prevention programs, considering sex-specific differences.

LEVEL OF EVIDENCE

Level IV.

Systematic video analysis of shoulder dislocations in professional male football (soccer): Injury mechanisms, situational and kinematic patterns

Purpose

Shoulder dislocations in professional football are severe injuries with an increasing incidence and considerable layoff times. Unlike other football injuries, the mechanisms leading to shoulder dislocations are not well understood, which limits the development of targeted preventive measures. Thus, the aims of this study were: (1) to analyse injury mechanisms of shoulder dislocations in professional football, (2) to evaluate situational and (3) to assess kinematic patterns by performing a systematic video analysis.

Methods

The study included all shoulder dislocations occurring in official matches within Germany's top two professional male football (soccer) leagues (1. and 2. Bundesliga) from the 2012/2013 to the 2022/2023 seasons. A systematic video analysis was performed using the official Bundesliga video database. Two independent reviewers assessed injury-related, situational and kinematic parameters.

Results

A total of 37 shoulder dislocations in 36 players (mean age 25 years) were analysed. Two primary injury mechanisms were identified: Type 1 mechanisms, caused by direct contact to the upper extremity (n = 14), and Type 2 mechanisms, caused by catching a fall (n = 22). Only one case did not fit these categories. Median layoff times were 94 days for Type 1 and 56 days for Type 2, but this difference was not statistically significant. Statistically significant differences between the two types were found in player action (p < 0.001) and type of contact (p = 0.005), while factors like player's speed, movement direction, football-specific actions, ball possession and pitch location showed no statistically significant differences. On-field treatment methods varied, but there were no statistically significant differences in repositioning attempts or reduction techniques (n.s.). Trunk position, shoulder joint version, shoulder elevation, and rotation, as well as elbow and wrist joint positions at the moment of dislocation, were similar between the two types (n.s.).

Conclusion

Shoulder dislocations in professional football typically occur through direct contact or catching a fall, indicating a potential role for specific preventive measures.

Level of Evidence

Level III.

Four distinct patterns of anterior cruciate ligament injury in women's professional football (soccer): a systematic video analysis of 37 match injuries

BACKGROUND

To identify mechanisms and patterns of anterior cruciate ligament (ACL) injury in adult women's professional football by means of video match analysis.

METHODS

ACL match injuries sustained in Germany's first women's league during the 2016-2017 to 2022-2023 seasons were prospectively analysed by three expert raters using a standardised observation form. Epidemiological and injury data, as well as the medical history of ACL tears, were obtained from media reports and the statutory accident insurance for professional athletes.

RESULTS

Thirty-seven ACL injuries sustained in official football matches were included in the video analysis, of which 24 (65%) had associated knee injuries, mainly meniscus and collateral ligament injuries. According to the categorised contact mechanisms, 17 (46%) were non-contact injuries, 14 indirect contact injuries (38%) and six direct contact injuries (16%). Of the 17 non-contact injuries, seven (41%) occurred during the first 15 min of the match. Contact mechanisms did not differ between primary and secondary ACL injuries to the same or the contralateral side. Most injuries (80%) of field players occurred during horizontal movements such as sprinting (n=9, 26%), change-of-direction manoeuvres (n=7, 19%), stopping (n=5, 14%) and lunging (n=5, 14%). Four distinct repetitive patterns of ACL match injuries were identified: (1) non-contact 'pressing ACL injury' (n=9), (2) indirect contact 'parallel sprinting and tackling ACL injury' (n=7), (3) direct contact 'knee-to-knee ACL injury' (n=6) and (4) non-contact 'landing ACL injury' (n=4).

CONCLUSION

Most of the identified patterns of ACL injuries in women's professional football have great potential for prevention.

[Injury prevention in football : A challenge for team doctors and coaching team]

High injury rates and long injury-related downtimes demonstrate the need for effective and differentiated injury prevention strategies in football. Preventive measures should take place in various fields and should not be reduced to training programmes or medical approaches. The so-called "Big 6 of injury prevention" provide an overview of the key areas that should be addressed. In modern sports medicine, it should be a matter of course that the team doctor already participates in the primary prevention strategies and does not only get involved in the post-traumatic treatment. Similarly, a decision on a player's return to play after an injury should not be based solely on the medical assessment of the team doctor. Good communication and interdisciplinary cooperation, therefore, form the basis for successful prevention.

Injury mechanisms and situational patterns of severe lower limb muscle injuries in male professional football (soccer) players: a systematic video analysis study on 103 cases

OBJECTIVE

The objective of this study is to describe the mechanism of injury and situational patterns (based on ball possession and playing action leading to injury) of severe (lay-off time >28 days) lower limb muscle injuries in professional male football (soccer) players during match play.

METHODS

Players experiencing a severe muscle injury of the lower limb during Italian first (Serie A) division male football matches over three consecutive seasons (2018-2021) were identified. Video footage was obtained and three raters independently categorised injury mechanism and situational patterns using a standardised checklist. Injury epidemiology (month), timing of injuries within the match and location of injuries on the pitch were also examined.

RESULTS

We identified 121 lower limb severe muscle injuries. Videos of sufficient quality were available for 103 (85%) cases, including 61 (60%) hamstring, 17 (16%) calf, 16 (15%) adductor and 9 (9%) quadricep muscle injuries. Nearly two-thirds of injuries involved the dominant/kicking leg (n=65, 63%). Eighty-five (83%) injuries were non-contact and 18 (17%) indirect contact. Four main situational patterns were identified and accounted for 88% of injuries: (1) running/acceleration (n=35, 34%); (2) closed kinetic chain stretching (n=21, 20%); (3) open kinetic chain stretching (n=19, 18%) and (4) kicking (n=16, 16%), with differences between muscle groups. 71% of injuries occurred in the first half of the match (p<0.01), with a gradual increase through the first half.

CONCLUSION

Most severe muscle injuries during football matches were non-contact and occurred in the first half during running/acceleration, open and closed kinetic chain stretching, or kicking.

Traumatic muscle injury

Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.

Indirect Rectus Femoris Injury Mechanisms in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings

OBJECTIVE

To describe injury mechanisms and magnetic resonance imaging (MRI) findings in acute rectus femoris (RF) injuries of soccer players using a systematic video analysis.

DESIGN

Descriptive case series study of consecutive RF injuries from November 2017 to July 2022.

SETTING

Two specialized sports medicine hospitals.

PARTICIPANTS

Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after a RF injury, with an available video footage of the injury and a positive finding on an MRI.

INDEPENDENT VARIABLES

Rectus femoris injury mechanisms (specific scoring based on standardized models) in relation to RF muscle injury MRI findings.

MAIN OUTCOME MEASURES

Rectus femoris injury mechanism (playing situation, player/opponent behavior, movement, and biomechanics), location of injury in MRI.

RESULTS

Twenty videos of RF injuries in 19 professional male soccer players were analyzed. Three different injury mechanisms were seen: kicking (80%), sprinting (10%), and change of direction (10%). Isolated single-tendon injuries were found in 60% of the injuries. Of the kicking injuries, 62.5% included complete tendon ruptures, whereas both running injuries and none of the change of direction injuries were complete ruptures. The direct tendon was involved in 33% of the isolated injuries, and the common tendon was affected in all combined injuries.

CONCLUSIONS

Rectus femoris injuries typically occur during kicking among football players. Most of the RF injuries involve a complete rupture of at least one tendon. Kicking injuries can also affect the supporting leg, and sprinting can cause a complete tendon rupture, whereas change of direction seems not to lead to complete ruptures.

Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings

OBJECTIVE

To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute hamstring injuries of male soccer players using a systematic video analysis.

DESIGN

Descriptive case series study of consecutive acute hamstring injuries from September 2017 to January 2022.

SETTING

Two specialized sports medicine hospitals.

PARTICIPANTS

Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after an acute hamstring injury, with an available video footage of the injury and positive finding on MRI.

INDEPENDENT VARIABLES

Hamstring injury mechanisms (specific scoring based on standardized models) in relation to hamstring muscle injury MRI findings.

MAIN OUTCOME MEASURES

Hamstring injury mechanism (playing situation, player/opponent behavior, movement, and biomechanical body positions) and MRI injury location.

RESULTS

Fourteen videos of acute hamstring injuries in 13 professional male soccer players were analyzed. Three different injury mechanisms were seen: mixed-type (both sprint-related and stretch-related, 43%), stretch-type (36%), and sprint-type (21%). Most common actions during injury moments were change of direction (29%), kicking (29%), and running (21%). Most injuries occurred at high or very high horizontal speed (71%) and affected isolated proximal biceps femoris (BF) (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45-90 degrees (57%), and knee flexion <45 degrees (93%). Magnetic resonance imaging findings showed that 79% were isolated single-tendon injuries.

CONCLUSIONS

According to a video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon-most often BF-hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.

Programming High-Speed and Sprint Running Exposure in Football: Beliefs and Practices of More Than 100 Practitioners Worldwide

PURPOSE

To gain knowledge on the beliefs and practices of football practitioners applying high-speed and sprint running exposure programming strategies.

METHODS

One hundred two football practitioners from 22 different countries participated in a study consisting of a survey including 5 domains: demographic and professional characteristics (Who); importance of high-speed and sprint running exposure for physical-capability development, preparation for competition, and injury-prevention strategies (Why); exposure timing (When); methodological procedures for exposure monitoring and training scheduling (What); and effectiveness of common training practices (How). Data were analyzed using a combination of descriptive statistics, generalized mixed effects, and multinomial logistic regression models.

RESULTS

Data revealed 5 main findings: (1) overall agreement on the importance of exposure for physical-capability development, preparation for competition, and injury-prevention strategies; (2) different exposure timing and selective training scheduling for starting and nonstarting players across typical and congested weeks; (3) lack of consensus on the conceptual constructs defining high-speed and sprint running metrics and the methodological procedures used for monitoring; (4) a probable association between match-related outcomes and exposure strategies used in training; and (5) a broad range of training methods considered effective to elicit exposure.

CONCLUSIONS

This study provides actionable insights into the planning, implementing, and monitoring strategies for high-speed and sprint running exposure in football. While some conform with the evidence on high-speed and sprint running training in football, further research and professional debate are warranted to develop empirical knowledge and provide pragmatic recommendations to help practitioners in adopting evidence-informed decisions.

Video analysis of Achilles tendon ruptures in professional male football (soccer) reveals underlying injury patterns and provides strategies for injury prevention

PURPOSE

In professional football (soccer), Achilles tendon ruptures are severe injuries. Video analysis promotes a better understanding of the underlying situational and biomechanical patterns, and provides a roadmap for future research to improve the management and prevention of Achilles tendon ruptures. The purpose of this study was to identify injury patterns contributing to acute Achilles tendon ruptures in professional male football players.

METHODS

Professional male football players with an acute Achilles tendon rupture were identified using an online database. For every in-competition injury, the corresponding football match was detected. Video footage of the injury was accessed using Wyscout.com or publicly available video databases. Situational patterns and injury biomechanics of the injury frame were independently analysed by two reviewers using a standardised checklist and a motion analysis software. Finally, consensus was reached to describe the main injury patterns of Achilles tendon ruptures in professional male football players.

RESULTS

The search identified video footage of 80 Achilles tendon ruptures in 78 players. Most injuries (94%) occurred through indirect or non-contact mechanisms. The kinematic analysis revealed characteristic joint positions at the time of injury consisting of hip extension, knee extension, ankle dorsiflexion, foot abduction, and foot pronation in most cases. The underlying direction of movement was from flexion to extension (knee) and from plantarflexion to dorsiflexion (ankle). Player actions identified as main injury patterns were stepping back (26%), landing (20%), running/sprinting (18%), jumping (13%), and starting (10%).

CONCLUSION

Most Achilles tendon ruptures in professional male football players are closed-chain indirect or non-contact injuries. Sudden loading to the plantarflexor musculotendinous unit remains to be the main component for most cases. By achieving a better understanding of underlying injury mechanisms, this study provides new strategies for the prevention of Achilles tendon ruptures.

LEVEL OF EVIDENCE

Level IV.

Quantifying Exposure and Intra-Individual Reliability of High-Speed and Sprint Running During Sided-Games Training in Soccer Players: A Systematic Review and Meta-analysis

BACKGROUND

Sided games (i.e., small sided, medium sided, large sided) involve tactical, technical, physical, and psychological elements and are commonly implemented in soccer training. Although soccer sided-games research is plentiful, a meta-analytical synthesis of external load exposure during sided games is lacking.

OBJECTIVE

The objective of this systematic review and meta-analysis was to: (1) synthesize the evidence on high-speed and sprint running exposure induced by sided games in adult soccer players, (2) establish pooled estimates and intra-individual reliability for high-speed and sprint running exposure, and (3) explore the moderating effects of game format and playing constraints.

METHODS

A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Four databases (PubMed/MEDLINE, Scopus, SPORTDiscus, Web of Science Core Collection) were systematically searched up to 25 January, 2022. Eligibility criteria were adult soccer players (population); training programs incorporating sided games (intervention); game manipulations including number of players, pitch dimension, and game orientation (comparator); and high-speed, very high-speed, and sprint relative (m[Formula: see text]min^-1) running distances and associated intra-individual reliability (outcome). Eligible study risk of bias was evaluated using RoBANS. Pooled estimates for high-speed and sprint running exposure, and their intra-individual reliability, along with the moderating effect of tracking device running velocity thresholds, pitch dimension (i.e., area per player), and game orientation (i.e. score or possession), were determined via a multi-level mixed-effects meta-analysis. Estimate uncertainty is presented as 95% compatibility intervals (CIs) with the likely range of relative distances in similar future studies determined via 95% prediction intervals.

RESULTS

A total of 104 and 7 studies met our eligibility criteria for the main and reliability analyses, respectively. The range of relative distances covered across small-sided games, medium-sided games, and large-sided games was 14.8 m[Formula: see text]min^-1 (95% CI 12.3-17.4) to 17.2 m[Formula: see text]min^-1 (95% CI 13.5-20.8) for high-speed running, 2.7 m[Formula: see text]min^-1 (95% CI 1.8-3.5) to 3.6 m[Formula: see text]min^-1 (95% CI 2.3-4.8) for very high-speed running, and 0.2 m[Formula: see text]min^-1 (95% CI 0.1-0.4) to 0.7 m[Formula: see text]min^-1 (95% CI 0.5-0.9) for sprinting. Across different game formats, 95% prediction intervals showed future exposure for high-speed, very high-speed running, and sprinting to be 0-46.5 m[Formula: see text]min^-1, 0-14.2 m[Formula: see text]min^-1, and 0-2.6 m[Formula: see text]min^-1, respectively. High-speed, very high-speed running, and sprinting showed poor reliability with a pooled coefficient of variation of 22.8% with distances being moderated by device speed thresholds, pitch dimension, and game orientation.

CONCLUSIONS

This review is the first to provide a detailed synthesis of exposure and intra-individual reliability of high-speed and sprint running during soccer sided games. Our estimates, along with the moderating influence of common programming variables such as velocity thresholds, area per player, and game orientation should be considered for informed planning of small-sided games, medium-sided games, and large-sided games soccer training.

CLINICAL TRIAL REGISTRATION

Open Science Framework available through https://osf.io/a4xr2/ .

Injury-Inciting Activities in Male and Female Football Players: A Systematic Review

BACKGROUND

A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer).

METHODS

A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria.

RESULTS

We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent.

CONCLUSIONS

A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury.

REGISTRATION

The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).

Football Game Video Analysis Method with Deep Learning

Football is a beloved sport, and its wide audience makes football video one of the most analytically valuable types of video. Researchers have achieved certain research results in football video content analysis. How to locate interesting event clips from a complete long video is an urgent issue to be addressed in football game video analysis. The granularity of sports event detection results with traditional machine learning is relatively coarse, and the types of events that can be detected are limited. In recent years, deep learning has made good progress in the research of video single-person events and action detection, but there are few achievements in the detection of sports video events. In response to this problem, this work uses a deep learning method to build an event detection model to detect events contained in football videos. The whole model is divided into two stages, in which the first stage is utilized to generate candidate event fragments. It divides the football video to be detected into a sequence of frames of a certain length and scans using a sliding window. Multiple frame sequences within a sliding window form a segment, and each segment is a prediction unit. The frame sequence features within the segment are obtained through a three-dimensional convolutional neural network, which is used as the input of each time point of the bidirectional recurrent neural network and further integrated to generate the event prediction of the segment. The second stage is to further process the above results to remove all segments predicted as nonevents. The thresholds are set according to the detection effect of various events to filter out event fragments with higher probability values, obtain the start and end positions of the events through merging, classify and mark them, and finally output complete event fragments. This work has carried out comprehensive and systematic experiments to verify correctness of the proposed method.

An Evaluation of 7279 Sports Injuries from a Level 1 Trauma Center with a Focus on Gender Differences

Purpose: Hardly any other topic is as current as the gender-conscious medical treatment of every individual. Similarly, in sports, there are crucial differences that should be considered in order to treat everyone appropriately, with the aim to prevent injuries according to their needs. The objective of this study is to show that the differences between biological males and females are so significant that they require both specific injury prevention and therapy programs. Methods: This study is a retrospective analysis of letters from a department of orthopedics and trauma surgery between the years 2000 and 2015. Results: The analysis of 20,567 inpatient and outpatient letters of a level 1 trauma center in Germany revealed that 5455 patients suffered 7279 injuries; 1475 of the patients were female and suffered 2035 injuries, and 3890 patients were male and suffered 5244 injuries. Conclusion: The results show the differences between males and females with regard to sport-specific injuries, pointing out the sex differences in the sport-specific area in relation to the body region.

Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases

OBJECTIVE

To closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis.

METHODS

Video footage from four seasons (2014-2019) of the two highest divisions in German male football was searched for moderate and severe (ie, time loss of >7 days) acute non-contact and indirect contact match hamstring injuries. Two raters independently categorised inciting events using a standardised procedure to determine specific injury patterns and kinematics.

RESULTS

52 cases of hamstring injuries were included for specific pattern analysis. The pattern analysis revealed 25 sprint-related (48%) and 27 stretch-related hamstring injuries (52%). All sprint-related hamstring injuries occured during linear acceleration or high-speed running. Stretch-related hamstring injuries were connected with closed chain movements like braking or stopping with a lunging or landing action and open chain movements like kicking. The kinematic analysis of stretch-related injuries revealed a change of movement involving knee flexion to knee extension and a knee angle of <45° at the assumed injury frame in all open and closed chain movements. Biceps femoris was the most affected muscle (79%) of all included cases.

CONCLUSION

Despite the variety of inciting events, rapid movements with high eccentric demands of the posterior thigh are likely the main hamstring injury mechanism. This study provides important data about how hamstring injuries occur in professional male football and supports the need for demand-specific multicomponent risk reduction programmes.

Collision with opponents-but not foul play-dominates injury mechanism in professional men's basketball

Background

To identify injury patterns and mechanisms in professional men’s basketball by means of video match analysis.

Methods

In Germany, injuries are registered with the statutory accident insurance for professional athletes (VBG) by clubs or club physicians as part of occupational accident reporting. Moderate and severe injuries (absence of > 7 days) sustained during basketball competition in one of four seasons (2014–2017 and 2018–2019) in the first or second national men’s league in Germany were prospectively analyzed using a newly developed standardized observation form. Season 2017–2018 was excluded because of missing video material.

Results

Video analysis included 175 (53%) of 329 moderate and severe match injuries. Contact patterns categorized according to the different body sites yielded eight groups of typical injury patterns: one each for the head, shoulders, and ankles, two for the thighs, and three for the knees. Injuries to the head (92%), ankles (76%), shoulders (70%), knees (47%), and thighs (32%) were mainly caused by direct contact. The injury proportion of foul play was 19%. Most injuries (61%) occurred in the central zone below the basket. More injuries occurred during the second (OR 1.8, p = 0.018) and fourth quarter (OR 1.8, p = 0.022) than during the first and third quarter of the match.

Conclusion

The eight identified injury patterns differed substantially in their mechanisms. Moderate and severe match injuries to the head, shoulders, knees, and ankles were mainly caused by collision with opponents and teammates. Thus, stricter rule enforcement is unlikely to facilitate safer match play.

[Employees in professional European football: comparison of the personnel structure in sports medicine, sports sciences and physiotherapy between Bundesliga, La Liga, Serie A and Premier League]

INTRODUCTION

Regional and league-specific differences in injury risk and time loss have been observed in professional European football. Besides time of play or different pre-season preparations, possible reasons may also include medical and sport-scientific support. A survey of what UEFA deems to be the best four football clubs has therefore been conducted to investigate the personnel status in the fields of medicine, physiotherapy, massage, sports science and athletic and "strength and conditioning" coaching in order to compare the Erste Bundesliga with the first leagues of the other countries.

METHODS

The study is based on a survey of all 78 teams in the highest football leagues of Germany (Bundesliga), Spain (La Liga), Italy (Serie A) and England (Premier League). The teams were contacted directly and a questionnaire concerning their personnel deployment in the different fields was handed out.

RESULTS

The Bundesliga was found to have a significantly lower total number of employees compared with the other European leagues (6.9 vs. 11.02; p < 0.0001). The number of physicians in the Bundesliga is significantly higher (2.2 vs. 1.76; p = 0.0259), but the number of physicians dedicating more than 80 % of their total medical practice to the team was significantly lower in the Bundesliga (0.2 vs. 1.45; < 0.0001). In the group of physiotherapists (1.8 vs. 3.6; p < 0.001), massage therapists (2.1 vs. 2.69; p = 0.0094), sports scientists (0.3 vs. 1.12; p < 0.0001) and athletic and "strength and conditioning" coaches (0.5 vs. 1.83; p < 0.0001), there were also significant differences between the staff structure in the Bundesliga compared with the grouped results of the other leagues.

CONCLUSION

The personnel structure and the personnel employment in the Bundesliga in sports medicine and sports sciences differs significantly from La Liga, Serie A and the Premier League with the latter three leagues having more personnel and the personnel having closer ties to their teams. Further investigation is necessary to find out if this may be a reason for the differences in injury rates observed between these leagues. A special focus should be placed on country-specific differences in the professions including education and scope of work.

Decision-making to stop or continue playing after football injuries - a systematic video analysis of 711 injury situations in amateur football

Scientific injury registration via video analysis is lacking in amateur football. The purpose of this study was to analyse match injury situations with a focus on the decisions made by players and referees after sustaining a football trauma. In a retrospective cohort study, traumatic injuries sustained in any of the 305 matches of the highest amateur level (4th league) in Germany in the 2015-16 season were assessed by means of video analysis and a standardised video protocol. In total, 711 traumatic incidents at 919 different body regions had been recorded. The three most frequently injured body regions were the ankles (34.1%), the head (17.5%) and the knees (17.0%). 90% (n = 156) of head injuries were direct contact injuries, this percentage was significantly higher than that of contact injuries on ankle (68.4%; p < 0.001) or knee (52.6%; p = 0.001). Referees decided on foul play significantly more often in case of knee injuries (57.1%; p = 0.002) or ankle injuries (64.5%; p < 0.001) than in head injuries (39.8%). Only 26.1% of players with a head injury opted for substitution, which was lower than after ankle (27.8%; p = 0.78) and knee injuries (34.0%; p = 0.13). In conclusion, amateur football is associated with a considerable number of injury situations that are followed by match interruptions and the substitution of players. Players and referees decided to continue playing more often after a head injury than after an injury to other body regions. An advanced education programme on the risks and management of head injuries in football is required to prevent long-term health consequences.