Injuries of football referees: a representative survey of Swiss referees officiating at all levels of play

The purpose of this study was to investigate the frequency and characteristics of injury and musculo-skeletal complaints in Swiss football referees of all levels. A representative sample of 489 Swiss referees was interviewed regarding their socio-demographic characteristics, refereeing qualifications, time spent in training and in matches, history of injuries and musculo-skeletal complaints caused by training or refereeing, and other medical problems. A total of 110 referees (22.5%) reported having suffered at least one injury related to officiating, and 126 referees (25.8%) at least one refereeing-related musculo-skeletal complaint. Thigh strains and ankle sprains were the most frequent injuries, with the most frequent locations of complaints being the knee and lower back. The incidence of match injuries in the last 12 months was on average 2.06 per 1000 match hours; the incidence of training injuries was substantially lower (0.09 per 1000 training hours). The injury rates were similar for referees officiating at an adult level, but lower at a junior level. In comparison with elite football referees, the incidence of training injuries and the prevalence of musculo-skeletal complaints were lower in amateur referees. Nevertheless, preventive programs are indicated for referees at all levels, especially when considering the length of a referee's career.

Injuries and musculoskeletal complaints in referees and assistant referees selected for the 2006 FIFA World Cup: retrospective and prospective survey

BACKGROUND

There is a considerable amount of scientific literature on football, but few studies have focused on referees, despite their key role in this sport. Existing studies focus on the physiological demands and training of referees.

PURPOSE

To analyse injuries and musculoskeletal complaints in referees and assistant referees selected for the 2006 FIFA World Cup.

STUDY DESIGN

Retrospective survey and prospective study.

METHODS

During the preparation camps for the 2006 FIFA World Cup in Germany, all 123 referees pre-selected for the tournament completed a questionnaire on injuries and musculoskeletal complaints. During the tournament, the characteristics and consequences of all injuries and complaints incurred by the 63 officiating referees were documented.

RESULTS

More than 40% of the referees reported having incurred an injury and more than 60% having had musculoskeletal complaints during their career. About 20% of the group reported having suffered from musculoskeletal complaints in the last match. During the World Cup, 14 referees (22%) incurred an injury and more than 30% had musculoskeletal complaints. This prospectively collected data showed an incidence of 20.8 injuries per 1000 match hours (95% CI: 4.17 to 37.4). The most common acute injuries were hamstring strains, calf strains, and ankle sprains, while the most frequent locations of complaints were the low back, hamstring and knee.

CONCLUSION

Considering the injury profile, the prevalence of associated musculoskeletal complaints, and the high physiological demands of refereeing, it appears that injury prevention programmes should be developed and integrated into the fitness training routine of the referee.

Development of a German version of the knee outcome survey for daily activities

INTRODUCTION

The knee outcome survey-activities of daily living scale (KOS-ADLS) is a patient-reported specific measure of knee function. The KOS-ADLS includes items related to both symptoms and functional limitations experienced during ADL. The purpose of this study was to examine the reliability and validity of a cross-culturally adapted German version of the KOS-ADLS.

MATERIALS AND METHODS

108 consecutive knee patients (n = 57 males/51 females) scheduled for outpatient physical therapy at an orthopedic hospital were enrolled in the investigation. For the reliability analysis, 50 patients were asked to complete the questionnaire on two non-consecutive days. To assess the validity of the KOS-ADLS, 58 additional patients answered the questionnaire in addition to performing a series of other related tests: (1) visual analogue scale for knee pain intensity, (2) The Get-up-and Go, and (3) time for ascending/descending stairs. The functional tests were selected because they directly related to specific items in the questionnaire and were thought to reflect the major areas of disability for this patient group.

RESULTS

The reliability analysis demonstrated that the German version of the KOS-ADLS had a good reliability (ICC range 0.94-0.97) and internal consistency (alpha 0.89). The functional tests (e.g. Get-up and Go, ascending/descending stairs) showed moderate correlations, whereas the visual analogue pain scale was highly correlated with the subscores and total score of the KOS-ADLS.

CONCLUSION

The psychometric characteristics of the German version of the KOS-ADLS produced reliable and valid results, as the original version, in detection of an individual's symptom and function related knee joint impairment.

[Rehabilitation guidelines after total knee arthroplasty]

Rehabilitation programs after total knee arthroplasty vary as much as do the surgical procedures employed. The postoperative range of motion of the knee is considered to be one of the primary indicators of the success of arthroplasty surgery. Protocols focusing on improving range of motion have been widely investigated: the end result does not seem to depend on using specific devices or exercises. There are no prospective randomized clinical trials evaluating the differences in outcome after total knee arthroplasty between patients following different rehabilitation programs. What are the needs of the patient after this surgery? Rehabilitation should focus on physical and functional limitations, and guidance of the patient during this process is important. The patient follows an individual program comprising a sensorimotor progression in weight-bearing positions to allow for improved functional knee stabilization. In knee osteoarthritis, and also after total knee arthroplasty, the neuromuscular system undergoes various adaptations during gait and other activities. Because of this, rehabilitation should not attempt to achieve hypothetical norms, but to help the patient in the motor learning process of acquiring improved motion patterns and stabilization strategies.