Letter to the editor: re introduction to the special issue on soccer injuries.

An evidence base for the management and prevention of shoulder injuries in soccer is lacking. The aim of this study was to demonstrate the type, mechanism and recovery time after surgery associated with serious shoulder injuries sustained in professional soccer to build an evidence base foundation. Fifty-two professional soccer players underwent shoulder surgery for injuries sustained during match play. Of these, 25 fulfilled the inclusion criteria. Data were collected for injury mechanism and type; clinical, radiological and surgical findings and procedures; and return to full participation. Subjects were all managed by the same surgeon. Labral injuries represented the most common injury type affecting 21 (84 %) subjects; two rotator cuff (8 %) and two combined labral/rotator cuff (8 %) injuries were less common. Fourteen (56 %) subjects sustained a high-energy trauma injury in a combined abduction and external rotation position. Six (24 %) subjects sustained a low-energy trauma mechanism in variable positions, while five (20 %) had a gradual onset of symptoms. Twenty-two (88 %) subjects reported a dislocation as a feature of their presentation. All of the subjects with high- and low-energy trauma mechanisms reported a dislocation occurring at the time of injury. Eight (32 %) subjects had sustained a previous significant shoulder injury to the ipsilateral side. Goalkeepers did not sustain low-energy trauma injuries. Outfield players returned to full participation in a mean time of 11.6 weeks, while goalkeepers did so in 11.1 weeks post-surgery. Return to participation time ranged from 7 to 24 weeks with a median of 11 weeks. Professional soccer players can expect a return to participation within 12 weeks post-surgery. The majority of serious shoulder injuries in soccer occur at a positional extreme of external rotation and abduction in high-energy situations, while a significant number occur in low-energy situations away from this position. Most serious shoulder injuries in professional soccer are dislocations. Previous shoulder injury is considered a risk factor. IV.

Background Few descriptive epidemiologic studies of injury in soccer are of community-level players. Although many sports injury surveillance systems have been described in the scientific literature, only 1 has been implemented in community-level soccer and that was restricted to adolescent players in a single club. Purpose The objective of this study was to develop a method for undertaking routine surveillance of injury in community-level soccer. Study Design Cohort study; Level of evidence, 2. Methods A cohort of 880 community-level players aged 13 years and over was followed over 1 winter competitive season. Each week, each player was contacted by telephone and an interview conducted to collect data on participation in matches and training sessions, injuries, and adherence to injury prevention measures. Results Seventy-five percent (n = 510) of the cohort was male and the median age was 16 years. Data were collected on 11 268 player-matches totaling 13 483 player-match hours and 11 540 player-training sessions totaling 16 031 player-training hours. A total of 677 match injury events were reported, giving overall incidence rates of 50.2 injury events per 1000 player-match hours and 6.0 injury events per 100 player-matches. The incidence rate for match injury events was significantly higher for females than for males (63.9 vs 46.9). A total of 145 training injury events were reported, giving overall incidence rates of 9.0 injury events per 1000 player-training hours and 1.3 injury events per 100 player-training sessions. The most common injuries were sprains and strains of the lower limb, and tackling was the most common cause of injury. Conclusion This study has shown that routine injury surveillance, using a cohort design with exposure measurement, can be successfully implemented in community-level soccer.

Eccentric hamstring muscle training can prevent hamstring injuries in soccer players

Costs resulting from nonprofessional soccer injuries in Switzerland: A detailed analysis

Read, PJ, Oliver, JL, Croix, MS, Myer, GD, and Lloyd, RS. A review of field-based assessments of neuromuscular control and their utility in male youth soccer players. J Strength Cond Res 33(1): 283-299, 2019-Lower-extremity injuries in male youth soccer are common and equate to a substantial time loss from training and competitions during the course of a season. Extended periods of absence will impact player involvement in skill and physical development activities, as well as participation in competitive match play. Neuromuscular risk factors for lower-extremity injury in male youth soccer players can be categorized into quadriceps dominance, leg dominance, ligament dominance, trunk dominance, and reduced dynamic stability. Valid screening methods to identify risk factors that are practically viable are needed for youth athletes who may be at a greater risk of injury in soccer. Although field-based tests of neuromuscular control provide a reliable option for the assessment of injury risk in adults and females, less data are available in male youth soccer players, and further research is required to examine their ability to predict injury risk. This article provides a review of the current literature pertaining to field-based screening tests and critically appraises their suitability for use with male youth soccer players. Currently, the only method that has been validated in male youth soccer players is the landing error scoring system. Asymmetrical anterior reach measured during the Y-Balance test may also be considered because of its strong predictive ability in male youth basketball players; however, further research is required to fully support its use with soccer players.

Female soccer has become increasingly popular during the last two decades. According to the International Football Association (FIFA) there are approximately 40 million registered female soccer players in the world. Three studies in elite soccer have shown an injury incidence during games ranging from 12.6 to 23.3 injuries per 1,000 h. A very high incidence of ACL-injuries ranging from 0.31 to 2.2 per 1,000 game hours has also been shown. We followed the Norwegian female elite series during the 2001 season to estimate the incidence and characteristics of injuries. A total of 181 female soccer players on ten teams were followed during the 2001 elite season in Norway. We recorded baseline data, match and training exposure and injury data as type of injury, location and severity of injury. The mean age of the players was 23 years (range 17-34). A total of 189 injuries were recorded and 19 (10%) of these were overuse injuries; 89 (47%) occurred during games and 100 (53%) during training sessions. The incidence of acute injuries was 23.6 per 1,000 game hours and 3.1 per 1,000 training hours. The majority of the injuries occurred in the lower extremities (81%), but there were also a significant number of head injuries (6.3%). The most common injury type was ankle sprain (17.2%). Half of the injuries were minor, with training or game absence of less than 7 days. Midfielders sustained the most injuries (32.6%) with an incidence of 42.4 per 1,000 game hours. We recorded two ACL-injuries and two PCL-injuries during the season. They all occurred during games, and the incidence was therefore calculated to 0.6 per 1,000 game hours for both injury types. The incidences of injuries reported for female soccer varies considerably, with the highest numbers reported from Germany and the present study. These studies have also the highest incidence of minor injuries registered. The location of the injuries is quite similar compared to other reports, but the number of ankle sprains seems to be higher in our study, whereas the number of knee and thigh injuries is lower. There has been much attention to ACL injuries in team handball and hamstring injuries in soccer in Norway, and this could have influenced the team's pre-season training, resulting in a reduction in the incidence of these injury types. The high number of ankle injuries has to be addressed to see whether this is a result of inadequate rehabilitation routines leading to re-injuries, or other factors. The high number of ACL-injuries in these reports is alarming and needs special attention in the future.

Background: Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play. Methods: This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play. Results: Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days). Conclusions: Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those “simple” ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains. Level of Evidence: Level IV, retrospective cohort study.

Soccer is among the most played and most popular sports in the world. The average incidence of injuries per game is 2.7 and that an adult soccer player has at...

Groin injuries and chronic pain are relatively common in soccer and other contact sports. Our aim was to define the gender-related frequency of both acute and chronic groin injuries in soccer compared to non-contact endurance sports. A 12-month study of 613 professional athletes was conducted in 2006. Premier league soccer players (77 males and 90 females) answered retrospectively 70 multi-choice questions of sport injuries. Factors related to groin injuries were compared with corresponding data of elite-level swimmers (n = 154), long-distance runners (n = 143) and cross-country skiers (n = 149). In soccer, 125/167 players had 375 injuries (274 acute and 101 overuse injuries) and the number of acute injuries were 146/274 (53%) in males and 128/274 (47%) in females (p = 0.368). Acute groin injury was reported in 15/167 (9.0%) of elite soccer players compared to 3/154 (2.0%) in swimmers (p = 0.006) and 1.4% in both long-distance running (n = 2) and skiing (n = 2, p = 0.003). Male soccer players had acute groin injuries nearly three times more frequently than females. Chronic persistent groin pain was found in only one male and two female soccer players and no athletes in endurance sports. Almost every tenth soccer player had an acute groin injury. Long-standing groin pain was not frequent in soccer and it was not found in non-contact endurance sport at the elite-level.

The main aim of the present study was to evaluate whether players in different positional roles were sustaining different types and numbers of injuries in Serbian professional soccer. During the 2001 season (from the spring through the fall), the same medical doctor (a certified sports medicine specialist) evaluated all sports injuries seen in the sports medicine ambulance. After the evaluation, the sports medicine specialist completed a standardized injury report for each injury, and injury reports were retrospectively compiled and categorized by team position and anatomic site of injury. There were an average of 8.7 injuries sustained by each subject. During the period of this study, goalkeepers were the most frequently injured players (p < 0.05); other positional roles were injured less frequently. The most frequent injury site was the ankle (p < 0.05). The main finding of the present study was that goalkeepers are the most frequently injured players in professional soccer during the season, whereas other positions are less likely to be injured. This injury pattern could give coaches, athletic trainers, and team physicians better working knowledge to help plan prevention and treatment.

The physical and demanding style of play in soccer places these athletes at an elevated risk for hip and groin injuries. Several studies have examined hip and groin injuries in professional and youth soccer in European countries, but few have involved American counterparts. Hip injury data were analyzed retrospectively from the National Collegiate Athletic Association Injury Surveillance Program for the 2004 to 2014 academic years for collegiate men's soccer. This study found that hip and groin injuries among collegiate male soccer players were most often new injuries (87.8%; n=527) that were noncontact in nature (77.3%; n=464) and resulted in time loss of less than 7 days (67.5%; n=405). Hip injuries were significantly more likely during the pre-season (5.72 per 1000 athlete exposures) relative to in-season (injury proportion ratio, 1.64; 95% confidence interval, 1.39-1.94) and post-season (injury proportion ratio, 1.69; 95% confidence interval, 1.18-2.41). Further, they were more likely in competition relative to practice (injury proportion ratio, 2.33; 95% confidence interval, 1.98-2.74). The most common injuries were adductor strains (46.5%; n=279) followed by hip flexor strains (27.3%; n=164) and hip contusions (10.8%; n=65). Among these injuries, adductor (73.1%; n=204) and hip flexor (59.8%; n=98) strains were more commonly noncontact related and occurred in practice, whereas hip contusions were due to contact and during competition. The study of the complex and lingering nature of hip and groin injuries in soccer players is critical because these injuries not only are prevalent but also have multifactorial risks associated with coexisting pathologies that make them difficult to prevent and treat effectively. [Orthopedics. 2018; 41(6):e831-e836.].

Return to play (RTP) decision making in professional soccer is crucial for minimising re-injury risk, reducing financial burdens on clubs, and optimising player performance. Despite its significance, there is a lack of objective criteria and consensus on RTP for adductor longus injuries, one of the most common muscle injuries in soccer. The aim of the present consensus was to validate an RTP protocol based on clinical, functional, and performance criteria through expert evaluation. This study hypothesises that a validated RTP protocol for adductor longus injuries will enhance decision making, reduce re-injury rates, and improve player performance upon return. An observational survey was designed to validate an RTP protocol through an expert panel. A total of 63 injury-management professionals (strength and conditioning coaches, physiotherapists, doctors, and rehabilitation fitness coaches) with an average experience of 12.02 ± 6.87 years participated in validating a 20-criteria RTP protocol. The protocol, divided into clinical, functional, and performance criteria, was assessed using a 5-point Likert scale. Aiken's V coefficient was calculated for content validity, with criteria validated if Aiken's V ≥ 0.75. Out of 20 initial RTP criteria, 14 were validated by the expert panel, with Aiken's V ranging from 0.77 to 0.94 (overall range: 0.61-0.98). Key validated criteria included pain on palpation, flexibility, imaging, athlete feedback, strength assessments, movement quality, pre-injury GPS data, and performance under simulated match conditions. Criteria such as the Copenhagen adduction exercise and specific agility tests were not validated. The expert-validated RTP protocol for adductor longus injuries provides a structured approach to decision making, potentially reducing re-injury risk, improving rehabilitation strategies, and enhancing player performance. These findings could be integrated into clinical sports-medicine practices to enhance rehabilitation effectiveness and RTP decisions in professional soccer.

Background:Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play.Methods:This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play.Results:Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days).Conclusions:Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those “simple” ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains.Level of Evidence:Level IV, retrospective cohort study.

Purpose: The purpose of this systematic review was (I) to determine the quality of evidence from studies evaluating the effects of strength training on the incidence of ankle injuries in soccer and (II) to determine the effectiveness of strength training on the incidence of ankle injuries in soccer. Methods: Preferred Reporting Items for Systematic Reviews (PRISMA) statements were considered using keywords associated with ankle injuries, strength training, and soccer. The following four databases were used: PubMed, Web of Science, Scopus, and SPORTDiscus. The quality of evidence for the articles included in this review was assessed using the PEDro scale. Results: Of the 721 articles retrieved, two were included in this study. The total population included in the review was 132 male participants, including professional soccer players and youth players. Strength training in young soccer players could reduce the risk of injury and improve parameters related to sports performance; however, the two articles included in this review found no statistically significant differences in injury incidence between the proprioceptive training and control groups. Conclusions: The articles included in this review had a high risk of bias, indicating low quality of evidence. In addition, it was impossible to determine whether strength training effectively reduced ankle injuries in the soccer players. Keywords: Sports, ankle sprains, athletic injuries, resistance training

Review question / Objective: To determine the quality of evidence of studies evaluating the effects of strength training on the incidence of ankle injuries in soccer (II) to determine the effectiveness of strength training on the incidence of ankle injuries in soccer. Condition being studied: Effectiveness of strength training on the incidence of ankle injuries in soccer. Eligibility criteria: Studies that used ergogenic drugs or aidsConference presentations, theses, books, editorials, review articles, and expert opinions. Missing full text or incomplete data on outcome indicators.