Elite Female Football Research Articles

Barriers and Facilitators to Mental Health Help-Seeking in Elite Gaelic Footballers Post-Injury: A Qualitative Study

ABSTRACT Purpose: Injury can exacerbate mental health issues in athletes. However, the prevalence of mental health issues is not equivalent to the rate of professional help-seeking, with reluctance to seek-help acknowledged as one of the greatest obstacles in efficient management of mental health issues. The current study aimed to examine perceived barriers and facilitators to professional mental health help-seeking in elite male and female Gaelic footballers post-injury. Methods: Male (n = 14) and female (n = 12) elite Gaelic footballers, with a history of moderate or severe injury, were recruited to participate in a focus group. Group discussions began with a written task where participants noted perceived barriers to help-seeking followed by a group discussion of these barriers. Following discussion, participants ranked identified barriers in order of those perceived as most important in stopping a player from seeking help when experiencing mental health issues post-injury. All three tasks were repeated for help-seeking facilitators. Focus groups were audiotaped, transcribed and thematically analyzed. Results: Lack of education, stigma, negative attitudes to help-seeking and accessibility issues were identified as key barriers to help-seeking among elite Gaelic footballers. Education, the attitudes and actions of others and accessibility were perceived as factors facilitating help-seeking. Conclusions: Given the negative psychological responses that can accompany injury, there is a need for facilitation and encouragement of help-seeking among players experiencing mental health issues post-injury. Interventions for reducing the barriers to help-seeking identified in the current study are necessary.

Drop Jump? Single-Leg Squat? Not if You Aim to Predict Anterior Cruciate Ligament Injury From Real-Time Clinical Assessment: A Prospective Cohort Study Involving 880 Elite Female Athletes.

To determine whether visually assessed performances of the single-leg squat (SLS) and vertical drop jump (VDJ) were associated with future noncontact anterior cruciate ligament (ACL) injury. Prognostic accuracy cohort study. Elite female handball and football (soccer) athletes (n = 880) were tested from 2007 to 2014 and tracked through 2015. Trained physical therapists visually rated each leg during a SLS and overall control during a VDJ. Receiver operating characteristic curve, Pearson chi-square, and logistic regression analyses were used to determine the prognostic accuracy of the 2 screening tests. Sixty-five noncontact ACL injuries occurred during the follow-up period. Fourteen percent of athletes who sustained an ACL injury had poor SLS performance, compared to 17% of the noninjured athletes (P = .52 and .67 for hip and knee ratings, respectively). Side-to-side asymmetry in the SLS was not different between injured and noninjured athletes (P = .10 and .99 for hip and knee asymmetry, respectively). Twenty-one percent of athletes who sustained an ACL injury had a poor VDJ rating, compared to 27% of the noninjured athletes (P = .09). Furthermore, area under the curve values ranged from 0.43 to 0.54 for the SLS and VDJ, demonstrating no to poor prognostic accuracy. Neither SLS nor VDJ test performance distinguished between athletes who sustained a subsequent noncontact ACL injury and those who did not. J Orthop Sports Phys Ther 2021;51(7):372-378. doi:10.2519/jospt.2021.10170.

Muscle metabolism and impaired sprint performance in an elite women's football game.

The present study examined skeletal muscle metabolism and changes in repeated sprint performance during match play for n=20 competitive elite women outfield players. We obtained musculus vastus lateralis biopsies and blood samples before, after, and following intense periods in each half of a friendly match, along with 5×30-meter sprint tests and movement pattern analyses (10-Hz S5 Global Positioning System [GPS]). Muscle glycogen decreased by 39% and 42% after an intense period of the second half and after the match, respectively, compared to baseline (p<0.05). Post-match, 80% type I fibers and 69% type II fibers were almost empty or completely empty of glycogen. Muscle lactate was higher (p<0.05) after the intense period of the first half and post-match compared to baseline (14.3±4.6 (±SEM) and 12.9±5.7 vs. 6.4±3.7mmol/kg d.w.). Muscle phosphocreatine was reduced (p<0.05) by 16% and 12%, respectively, after an intense period in the first and second half compared to baseline. Blood lactate and glucose increased during the match and peaked at 8.4±2.0 and 7.9±1.2mmol/L, respectively. Mean 5×30m sprint time declined by 3.2±1.7 and 7.0±2.1% after the first and second half, respectively, and 4.7±1.6% (p<0.05) after an intense period in the first half compared to baseline. In conclusion, match play in elite female football players resulted in marked glycogen depletion in both fiber types, which may explain fatigue at the end of a match. Repeated sprint ability was impaired after intense periods in the first half and after both halves, which may be associated with the observed muscle metabolite perturbations.

Dietary supplements usage by elite female football players: an exploration of current practices.

The present study aimed to investigate the prevalence of dietary supplements usage (types, reasons for usage, sources of information, purchase venues) among elite female football players, using a self-administered questionnaire. The study participants (n=103) were recruited through team physicians during an official international tournament. Overall, 82% reported using dietary supplements at least once during the last 12months. The most common dietary supplements were vitamin D (52%), omega-3 fatty acids (49%), and protein (45%). Primary reasons for dietary supplement use were to stay healthy (66%), to accelerate recovery (58%), and to increase energy/reduce fatigue (54%). Supplement advice came mainly from medical doctors (46%), dietitians/nutritionists (43%), and coaches/fitness coaches (41%). Most dietary supplements were acquired from supplement stores (30%), a sponsor (26%), or drugstores/pharmacies (22%). Elite female football players are frequent dietary supplement users. Further research needs to explore the frequency, dose, and timing of these supplements.

First-time anterior cruciate ligament injury in adolescent female elite athletes: a prospective cohort study to identify modifiable risk factors

PurposeTo identify modifiable biomechanical and neuromuscular anterior cruciate ligament (ACL) injury risk factors for first-time ACL injury in adolescent female elite football and team handball players.MethodsAdolescent female elite football and handball players with no previous ACL injury participated in the present study. At baseline, players were tested during side-cutting manoeuvres performed in a 3-dimensional motion analysis laboratory with concomitant electromyography (EMG) measurements. Maximal isometric lower limb muscle strength was assessed by handheld dynamometry. Players were prospectively followed for 2 years after baseline testing, and all magnetic resonance imaging (MRI) verified ACL injuries were registered. The effect of 16 risk factor candidates on the relative risk (RR) of ACL injury was estimated using Poisson regression analysis.ResultsNinety players (age 16.9 ± 1.2 years) were included in the analyses. Nine first-time ACL injuries (injury incidence 10.0% (95% confidence interval (CI) 5.4–18.6%)) were registered during the 2-year follow-up period. Four risk factor candidates were significantly associated with the risk of ACL injury: (1) hip flexion angle at initial contact (IC) [RR 0.56, 95% confidence interval (CI) 0.34–0.92], (2) internal knee rotation angle at IC [RR 1.13, 95% CI 1.08–1.19], (3) semitendinosus EMG activity 50 ms prior to IC [RR: 0.62, 95% CI 0.43–0.89], and (4) external hip rotator strength [RR: 0.77, 95% CI 0.66–0.89].ConclusionFour distinct ACL injury risk factors related to the side-cutting manoeuvre were identified in a population of adolescent female elite football and team handball players with no previous ACL injury. As ACL injury typically occur during side-cutting, intervention programmes to modify these risk factors pose a promising strategy for ACL injury prevention in adolescent female elite football and team handball.Level of evidenceII.

Quantification of internal and external training load during a training camp in senior international female footballers

ABSTRACT Objective This study aimed to quantify the internal and external training load profile of an international training camp and identify any differences between positional groups or starting status. Methods 18 players were sampled using a global positioning system (GPS) and internal training load (TL) via session rate of perceived exertion (RPE). Results Internal and external training load variation was present across all six individual training sessions. Results indicated match day −7 (MD-7), had significantly (P= 0.001) less training volume (3339.5 m) than all other training sessions. MD-5 and MD-2 were the most intense (387.5 and 201 m very high speed running (VHSR) and 187.5 and 49 m sprint distance (SPD) respectively in combination with large volume (5933.5 and 5151.5 m). Differences in playing position and starting status were observed in MD-2. Forwards (FW) covered significantly greater distances of VHSR (P= 0.008) and SPD (P= 0.008) in comparison to midfielders (MF) whilst starters reported significantly (P = 0.013) higher internal training loads (TL). Conclusion This study provides the first report on training load in elite female footballers during an international training camp including a competitive fixture highlighting the undulation of training loads across the individual training sessions, playing positions and starting status.

Physical performance and loading for six playing positions in elite female football: full-game, end-game, and peak periods.

The present study investigated the position-specific match demands and heart rate response of female elite footballers, with special focus on the full-game, end-game, and peak-intensity periods. In total, 217 match observations were performed in 94 players from all eight teams of the best Danish Women's League, that is, goalkeepers (GK, n=10), central defenders (CD, n=23), full-backs (FB, n=18), central midfielders (CM, n=28), external midfielders (EM, n=18), and forwards (FW, n=11). Positional data (GPS; 10Hz Polar Team Pro) and HR responses were collected. HRmean and HRpeak were 87%-89% and 98%-99% of HRmax , for outfield players, with no positional differences. CM, EM, and FB covered 8%-14% greater (P<.001) match distances than CD. EM, FW, FB, and CM performed 40%-64% more (P<.05) high-speed running and 41%-95% more (P<.01) very-high-speed running (VHSR) than CD. From the first to the last 15-minute period, total distance, except for FW, number of VHSR, except FB, peak speed and sum of accelerations and sum of decelerations decreased (P<.05) for all outfield positions. In the most intense 5-minute period, EM, FB, and CM performed 25%-34% more (P<.01) HSR than CD, whereas EM, FW, and FB performed 36%-49% more (P<.01) VHSR than CD. In conclusion, competitive elite female matches impose high physical demands on all outfield playing positions, with high aerobic loading throughout matches and marked declines in high-speed running and intense accelerations and decelerations toward the end of games. Overall physical match demands are much lower for central defenders than for the other outfield playing positions, albeit this difference is minimized in peak-intensity periods.

Hormonal Contraceptive Use in Football Codes in Australia.

The recent launch of the new National elite women's football competitions in Australia has seen a 20–50% increase in grassroots female participation. With the growing participation across grassroots to elite competitions, understanding the health of female athletes should be prioritized. In elite level athletes, hormonal contraceptive (HC) use is common (~50%), however, little is known about the prevalence and reasons for use and disuse of HC in elite female football athletes. As such, the impact of HC use is often not considered when monitoring the health of female footballers. This study involved a subset of data collected as part of a larger questionnaire investigating menstrual cycle function, hormonal contraception use, and the interaction with training load volume and perceived performance in elite female football code athletes. A total of 177 participants completed the questionnaire across three football codes within Australia (rugby league, rugby union/sevens, Australian football). One third (n = 58) of athletes were currently using HC, predominately in the form of an oral contraceptive pill (OC, n = 47). Reasons for use included: to avoid pregnancy (71%); to control/regulate cycle (38%); and to reduce menstrual pain (36%). However, most athletes using an OC (89%) could not identify the type of pill used (e.g., mono-, bi-, or triphasic). The main reason for disuse was due to the negative side effects (n = 23), such as mood swings, weight gain, and depression/anxiety. Comparing HC users and non-users, there were no statistical differences in the number of reported menstrual symptoms, use of medication to relieve menstrual pain, or frequency for needing to adapt training due to their menstrual cycle (p > 0.05). Since most athletes were unaware of the type of OC they used, female football athletes require further education about the different types of HC, and specifically OC, available to them. Similarities in the symptoms experienced, pain management, and training adaptation requirements between groups suggests that HC use may not have the intended outcome for certain athletes. As such, greater awareness of athlete's personal experiences with the menstrual cycle, how HC may influence their experience, and acknowledgment of non-pharmacological methods to help manage menstrual cycle related symptoms are warranted.

Injury prevention knowledge, beliefs and strategies in elite female footballers at the FIFA Women’s World Cup France 2019

ObjectivesThis study assessed knowledge, beliefs and practices of elite female footballers regarding injury prevention.MethodsA survey was sent to players participating in the FIFA Women’s World Cup France 2019. Questions covered...

Technical match actions and plasma stress markers in elite female football players during an official FIFA Tournament.

This study analyzed the impact of performing four consecutive football matches separated by 48-72hours during a FIFA tournament on physical load, technical performance and plasma markers of redox state, muscle damage and inflammation in elite female players. Forty-eight players from three national teams were evaluated at seven time points: before (baseline) and throughout the tournament (after each match and before two training sessions). Only data from players who played all matches were included in the analyses (N=13). The players were divided into high-rank (N=6) and low-rank (N=7) team players according to FIFA standards. Plasma creatine kinase (CK), C-reactive protein (CRP), total antioxidant status (TAS), and uric acid (UA) were analyzed at the selected time points. Technical performance and physical load were also quantified according to team rank. Players from low-rank teams played significantly more time than high-rank players (85±10 vs 67±15minutes; P=.02; d=1.51). Low-rank team players presented higher values in technical performance actions than the high-rank team players, but most of the differences were explained by the longer match time played. UA content differed across the matches, increasing from baseline (F(4,40) =3.90; P=.01) and more in the high-rank team players (F(1,10) =20.46; P=.001), while CRP only differed across the matches (F(4,36) =2.66; P=.05), also increasing from baseline. A large time effect was shown for UA only in the high-rank players (η2 p =0.50; P=.02). Four consecutive matches did not result in considerable alterations in plasma stress markers, physical load, and technical performance in elite female football players from distinct rank levels.

Can psychological characteristics, football experience, and player status predict state anxiety before important matches in Danish elite-level female football players?

Elite football can make players feel nervous, and personality characteristics, as well as experience, affect how well pressure is handled before important games. Studying the psychological characteristics of female football players can provide information on how well psychological pressure is handled and generate knowledge on how to support players in order to improve performance. Based on a sample of 128 female elite football players from 8 top-level teams, the present study investigates whether psychological characteristics and football experience/player stus in elite female football players can predict state anxiety before important matches. Our results outline that high age and national team experience negatively predicted most of the trait anxiety subscales. In line with previous research, no psychological differences were found between goalkeepers, defenders, midfielders, and strikers while starting players revealed to have significantly lower trait anxiety. When measuring before important matches, we found that somatic state anxiety was negatively associated with senior national team experience and positively associated with worry trait anxiety and fear of failure. Cognitive state anxiety was negatively associated with hope for success and positively associated with somatic and worry trait anxiety. Self-confidence was positively associated with youth national team experience and negatively associated with worry trait anxiety. It can be concluded that psychological characteristics and national team experience are both important for optimal state anxiety before important matches in elite-level women's football. Implications for practice and future research are discussed.

Physical preparation and return to performance of an elite female football player following ACL reconstruction: a journey to the FIFA Women’s World Cup

ACL injuries are among the most severe knee injuries in elite sport, with a high injury burden and re-injury risk. Despite extensive literature on the injury and the higher incidence...

Neurocognitive performance and mental health of retired female football players compared to non-contact sport athletes

BackgroundAdverse long-term effects of playing football due to repetitive head impact exposure on neurocognition and mental health are controversial. To date, no studies have evaluated such effects in women.AimsTo (1)...

Feasibility of Injury Reporting Via Text Messaging in Club Sport Settings: A Prospective Cohort Study

A novel technique of short message service (SMS), or text message, has examined injuries in elite handball and female football and community Australian football with a response rate of over 75%. The purpose of this study was to determine if text message is a feasible method of prospectively collecting injury density data in club sports teams in the United States. Participants received a weekly text message with four questions asking about pain and participation in the past week. If the participant indicated pain in the past week, a follow-up phone interview was conducted to determine the nature of the pain/injury. The overall text message response rate was 89.8%; there were 281 responses out of 313 participant contacts over the 12-week study period. Semi-structured follow-up phone interviews were completed for 37 of the 55 reports of pain that were indicated through text message response, resulting in further injury information for 65.5% of injuries. Incidence density of reporting pain over the 12-week study was 0.88 (95% CI: 0.68–1.15) per 1,000 min of activity. In this sample, text message response rates were similar to previous studies; however, we did lose nine (25.7%) participants to follow-up.

Cardiac adaptations in elite female football- and volleyball-athletes do not impact left ventricular global strain values: a speckle tracking echocardiography study.

Cardiac adaptations to exercise on an elite level have been well studied. Strain analysis by speckle tracking echocardiography has emerged as a tool for sports cardiologists to assess the nature of hypertrophy in athletes' hearts. In prior studies, strain values generally did not change in physiological adaptations to exercise but were reduced in pathological hypertrophy. However, research in this field has focused almost solely on male athletes. Purpose of the present study is to investigate strain values in the hearts of female elite athletes in football and volleyball. In this cross-sectional study echocardiography was performed on 19 female elite football-players, 16 female elite volleyball-players and 16 physically inactive controls. Conventional echocardiographic data was documented as well as left ventricular longitudinal, radial and circumferential strain values gained by speckle tracking echocardiography. The hearts of the female athletes had a thicker septal wall, a larger overall mass and larger atria than the hearts in the control group. Global longitudinal, radial and circumferential strain values did not differ between the athletes and controls or between sporting disciplines. No correlation between septal wall thickness and global strain values could be documented. Cardiac adaptations to elite level exercise in female volleyball and football players do not influence global strain values. This has been documented for male athletes of several disciplines. The present study adds to the very limited control-group comparisons of left ventricular strain values in elite female athletes. The findings indicate that global strain values can be used when assessing the cardiac health in female athletes.

Relationship between agility, linear sprinting, and vertical jumping performance in Slovenian elite women football players

PurposeThe general goal of the study was to investigate the relationship between agility t-test (change of direction speed ability, CODS), 20-m sprint test (S20m) (linear speed ability), and countermovement jump (CMJ) test (lower limb explosive power ability).MethodsThe sample involved 18 elite female football athletes (age: 18.56 ± 2.24 years, height: 169.47 ± 6.48 cm, weight: 63.52 ± 6.85 kg). Pearson correlation coefficients were applied. Multiple linear regression served to explain the relationship between the dependent variable (CODS) and 2 independent variables (S20m and CMJ).ResultsPearson correlation analysis indicated a moderate relationship between CMJ and CODS performance (&lt;i&gt;r&lt;/i&gt; = –0.59, &lt;i&gt;p&lt;/i&gt; = 0.01) and a very strong significant relationship between S20m and CODS performance (&lt;i&gt;r&lt;/i&gt; = 0.80, &lt;i&gt;p&lt;/i&gt; = 0.00). The results of multiple linear regression proved that both independent variables (S20m and CMJ) explained about 60.0% (adjusted R2) of the total model variance in relation to the dependent variable (CODS), whereas only S20m significantly (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) explained CODS ability.ConclusionsThe study highlighted the impact of explosive power of lower limbs (CMJ) and linear speed capability (S20m) on agility performance (CODS) in our sample. It suggests that the results of agility, linear sprint, and jumping performance seem to have similar determining factors. It is worthwhile to consider these findings in the training process of female elite football players in order to focus on essential training elements of physical fitness.

I spy with my little eye … a knee about to go ‘pop’? Can coaches and sports medicine professionals predict who is at greater risk of ACL rupture?

BackgroundThe vertical drop jump (VDJ) test is widely used for clinical assessment of ACL injury risk, but it is not clear whether such assessments are valid.AimTo examine if sports medicine...

Musculoskeletal screening assessments in elite female Australian Football players

Musculoskeletal screening assessments in elite female Australian Football players

Low back pain and lumbopelvic muscles in elite female Australian football players: an exploratory study

Introduction: Low back pain is a common problem in male Australian football players which may have negative consequences on performance and is associated with increased odds of lower limb injury. Whilst deficits in trunk and hip muscle function associated with low back pain have been demonstrated in elite male Australian football and soccer players, little is known about this relationship in female Australian football players. This exploratory study aimed to examine the size and function of trunk and hip muscles in elite female AFL players with and without low back pain.

Lower limb musculoskeletal screening in elite female Australian football players

ObjectiveTo report physical characteristics of lower-limb strength, endurance, range of motion, balance, and pain during adductor squeeze in elite female Australian Football (AF) players, and to examine the effect of limb dominance, previous AF experience, age, and previous level of sports participation on these characteristics. DesignCross-sectional study. SettingThree elite AF clubs. ParticipantsEighty-five female players. All were aged ≥18, contracted for the 2018 season, and participated in pre-season training. Main outcome measuresThe physical characteristic assessments included; pain on adductor squeeze, weight-bearing lunge, side bridge, isometric hip abduction and adduction strength, and the modified star excursion balance test. ResultsThe adductor squeeze had low pain scores, with 93% of players scoring ≤2 on the numerical rating scale. Other assessment results were (mean ± SD): 10.8 ± 2.7 cm for weight-bearing lunge, 95 ± 39s for side bridge, 1.85 ± 0.23 and 1.85 ± 0.36Nm/kg for hip abduction and adduction strength respectively, and 92 ± 8% for the modified star excursion balance test. There was no clinically relevant effect of limb dominance, previous AF experience, age, or previous level of sports on physical characteristics. ConclusionsPhysical characteristics for five assessments are reported. These data can be used for comparison purposes in the screening and clinical management of elite female AF players.