ABSTRACT The objective of this study was to describe the experiences of clinicians working within the top 50 FIFA ranked senior men’s and women’s international football teams regarding (i) feasible best practice in delivering medical care and (ii) the related challenges. A qualitative study was conducted by means of semi-structured interviews. Participants were clinicians from seven men’s and five women’s FIFA top-50 ranked international football teams, including nine doctors and three physiotherapists. Data analysis applied thematic analysis utilising a pragmatic realist stance. The results of this study are represented by five main themes: (1) communication and relationships, (2) governance, (3) navigating risk-taking, (4) delivering medical care abroad, and (5) resource impact. Concepts relating to clinician-perceived best practice included building relationships with technical staff members, effective communication, and relationships with club medical teams, adherence to practices such as medical screening and emergency scenario preparation, maintaining consent and confidentiality, shared decision-making with players, logistically planning for travel, and supporting staff psychological wellbeing. Challenges included conflict with technical staff and club medical teams, unsatisfactory handovers, club agendas, risk-taking approaches, travel, resource limitations in women’s football and staff wellbeing. Clinician experiences of best practice and challenges in the context of medical care in international football have been identified in this study. These findings provide practice-informed insights that may guide improvements in international football medicine.

ABSTRACT To evaluate the incidence and characteristics of injuries and illnesses among elite-level national male beach soccer players over a seven-year-period. Injuries and illnesses were documented in accordance with the ‘Football-Specific Extension of the IOC Consensus Statement: Methods for Recording and Reporting Epidemiological Data on Injury and Illness in Sport’. A sports medicine physician recorded all cases during training camps and tournaments of the Turkish national male beach soccer team from 1 January 2018, to 1 January 2025. Across 36 camps (382 days, 90 matches, 338 training sessions), 282 injuries (72 time-loss) and 180 illnesses (9 time-loss) were recorded among 45 players. Time-loss injury incidence rates were 51.7/1000 hours (h) in matches and 6.8/1000 h in training. The thigh was the most frequently injured body area leading to time-loss during matches (18.45/1000 h), while the foot was most affected in training (1.76/1000 h). Muscle/tendon injuries were the leading cause of time-loss in both settings (18.45 and 3.52 injuries/1000 h, respectively). Concussion incidence in matches was 7.38/1000 h. Fractures and meniscus injuries resulted in the highest injury burden (132.72 and 129.03 days/1000 h, respectively). The time-loss illness incidence was 1.6 illnesses/1000 player-days. This study highlights the relatively unique injury patterns of beach soccer, with the thigh and foot most frequently affected areas and muscle/tendon injuries the leading cause of time-loss in both matches and training. The findings also emphasize the high burden of knee and head injuries, particularly concussions, and suggest tailored prevention strategies are needed. Future research with more diverse cohorts is warranted.

ABSTRACT Understanding the most common injuries in beach soccer and their risk factors is essential for ensuring player safety. We aimed to describe the injury patterns and identify factors associated with the risk of injury in men’s beach soccer. We prospectively recorded injuries reported by players at an on-site aid station during the Japanese National Beach Soccer Championships between 2013 and 2023 (9 tournaments). Match exposure was recorded through video review. We described the injury types and sites, andthe factors associated with the injury risk using generalized estimating equations in negative binomial models adjusted for confounders. In total, 796 participants played for 1360.5 player-hours. We observed 144 injuries, with an incidence rate of 106.0/1000 player-hours (95% CI: 89.9–125.0), representing 153 diagnoses. The most frequent injury sites were as follows: foot (n = 40), thigh (n = 24), and lower leg (n = 21). The most frequent injury type was contusion (n = 75). Of the 83 injuries caused by a contact with another player, 24 resulted in a foul. There were 35 injuries associated with time loss (incidence rate 25.7/1000 player-hours, 95% CI: 18.6–35.7), mainly in the foot (n=10) and the thigh (n=8). The risk of injury was lower for goalkeepers and higher in players with time-loss injuries in the past year, with trends towards higher risk for players with lower BMI and history of severe injuries. Lower limb contusions are the predominant injuries in men’s beach soccer. Our findings raise the question of protective foot gear to reduce foot contusions and fractures and can inform playing schedules of players at risk.

ABSTRACT To explore the effects of Ramadan on proxy measures of match physical performance in professional Muslim football players competing in the Qatar Stars League using a three-phase interrupted time-series design. We examined total, high-speed running ( > 15 km·h−1), very-high speed running ( > 20 km·h−1), and sprinting ( > 25 km·h−1) distances covered (m) by 45 professional Muslim football players tracked during official matches (322 individual measurements over 10 consecutive league rounds) and training (1168 individual observations) in periods preceding, during, and after Ramadan 1445. Separate multivariable-adjusted random-effects generalized additive models quantified the phase-specific effects of Ramadan on match running distances interpreted against the random match-to-match variability in total, high-speed running, very-high speed running, and sprinting distance of ± 494 m (95% confidence interval [CI], 480 to 508 m), ±200 m (95% CI, 195 to 206 m), ±102 m (95% CI, 99 to 105 m), and ± 60 m (95% CI, 58 to 61 m), respectively. Model-based phase-specific effects of Ramadan indicated mean reductions of 254 m (95% CI, 138 to 370 m) in total distance, 92 m (95%CI, 59 to 123 m) in high-speed running, and 31 m (95% CI, 12 to 50 m) in very high-speed running distance that were indistinguishable from random within-subject match-to-match variability. Effects for sprinting distance were inconsistent. Running distances covered during training were materially equivalent across study phases. In Muslim-majority environments like the State of Qatar, professional Muslim football players seem able to cope with Ramadan without experiencing substantial impairments in match physical performance or reductions in training load.

ABSTRACT This study aimed at exploring the exposure of head impacts, i.e. headers and non-headers, in top-level female football players. The study included all teams (n = 10) and players (n = 238) in the Norwegian Women’s Premier League during the 2023 season. Video analysis was used to register headers and non-headers in the 135 matches of the season. Potential head injuries were compared between video signs and medical reports. The header and non-header incidences were estimated per 90 match minutes with 95% confidence intervals (CI). We observed 9364 headers and 233 non-headers in 135 matches. Nine non-headers resulted in a head injury (all concussions), players’ time loss ranging from 5 to 87 days. The highest number of headers performed by a single player in a match was 22. The total number of headers performed during a match varied between 34 and 125. Defenders had an estimated 4.2 (CI = 3.9–4.3), midfielders 2.9 (CI = 2.7–3.0), and forwards 2.6 (CI = 2.5–3.1) headers per match. There was a positive correlation between heading frequency and age. Forwards were the players most exposed to non-headers, with an estimated 0.09 per match. Most non-headers were caused by unintentional head-to-ball contact. We found that defenders had the highest header frequency. Header frequencies varied substantially between players and from match to match. Forwards had the highest risk of non-headers. Nine non-headers resulted in head injuries.

ABSTRACT This prospective cohort study aimed to longitudinally assess the brain injury biomarker plasma neurofilament light (NfL) and its relationship with football heading exposure in female football players during a competitive season. Forty-nine collegiate female football players were recruited to participate in the study, 29 voluntarily consented and enrolled. Blood samples were collected every 3–4 weeks during season: preseason, midseason 1, 2, and postseason. Heading exposure was estimated every two weeks via HeadCount questionnaire. Linear mixed models for repeated measures were used to determine differences in plasma NfL during the season. Spearman’s rank correlation analysis determined the relationship between NfL changes and heading exposure. For analysis, participants were excluded if unable to participate in ≥ 80% of team activities or experienced a concussion during the season; thus, six were excluded resulting in 23 participants’ data analyzed. NfL at mid- and postseason did not differ from preseason (mid1: p = 0.57; mid2: p = 0.88; postseason: p = 0.07). Changes in NfL from preseason were unrelated to gameplay heading exposure at any time points and cumulative exposure at midseason 1, 2. Changes in NfL and cumulative heading exposure from pre- to postseason were positively correlated (r = 0.434, p = 0.039), with lower exposures associated with reductions in NfL and higher exposures showing minimal to no elevations. In conclusion, plasma NfL did not elevate in collegiate female football players during a competitive season of heading exposure. However, whether these findings reflect no subtle brain injury or NfL’s insensitivity in detecting said injury in young female players remains unclear.

ABSTRACT Academy soccer coaches evaluate players’ skilfulness to inform talent identification and development, focusing on technical proficiency, adaptability, decision-making, and influence. However, limited research has explored coaches’ perceptions of skilfulness after completing an assessment. Furthermore, little is known about the potential overlap between current skill performance and future potential, or how coaches consider the skilfulness sub-dimensions. This mixed methods study explored how experienced Australian male youth soccer coaches (n = 5) and academy directors (n = 10) (M age = 42.5 ± 13.8 years; M experience = 19.2 ± 9.8 years) rated players’ skill performance and potential, their emphasis on sub-dimensions, and perceptions of evaluating them. Participants completed an online survey with pre-recorded small-sided game videos. Quantitatively, they rated players’ skill performance and potential and emphasis on each sub-dimension using five-point Likert scales. Qualitatively, they responded to open-ended questions. Quantitative data were analysed using Spearman Rank Correlations and a Wilcoxon Signed Rank Test. Qualitative responses were explored via content analysis. Coaches’ ratings were partially supported by their reflections on evaluating skill, as they reported feeling competent in rating players’ skill performance but required more information on players’ backgrounds to assess potential. Given a high overall correlation between coaches’ ratings of skill performance and potential (r = 0.79, p = < .001), coaches may have inferred potential from players’ performance, possibly explaining their desire for contextual information. While all sub-dimensions were rated as equally important for performance and potential, coaches described using unique criteria for each, highlighting the need for distinct information from skill assessments.

ABSTRACT Wearable inertial measurement units (IMUs) may improve the objective analysis and load monitoring of skilled actions during team-sports, such as Australian Rules football (AF) kicking. This study aimed to determine the concurrent validity of a foot-mounted IMU to detect and quantify AF kicking output. Video footage compared kicks observed with kicks detected within the IMU. This study consisted of two phases; 1) On-Field Phase: Kicking actions were captured from n = 11 male and n = 25 female, professional AF participants throughout nine and five regular training sessions, respectively. 2) Protocol Phase consisted of n = 6 male and n = 8 female, semi-professional AF participants who performed a controlled kicking protocol, during a single testing session. Overall, the IMU exhibited good concurrent validity (Accuracy = 92% and 79%, Sensitivity = 0.92 and 0.79) in the On-Field and Protocol Phases, respectively. Kick intensities ranged from 6.30 m⋅s−1 to 24.30 m⋅s−1. This study demonstrates the potential of the IMU to automate the detection and quantification of kicking output, such as volumes and intensities in AF.