Injuries In Professional Football Players Research Articles

ATUAÇÃO FISIOTERAPÊUTICA NA PREVENÇÃO DE LESÃO MENISCAL EM JOGADORES DE FUTEBOL: UMA REVISÃO BIBLIOGRÁFICA INTEGRATIVA

Meniscal injuries are common among football players due to the high physical demands and repetitive movements required by the sport. Given the importance of preventing and treating these injuries, this study aims to explore physiotherapeutic treatment in football, as the role of physiotherapists has been gradually expanding in sports, seeking more effective approaches to prevent these injuries. The objective was to analyze the role of physiotherapy in preventing meniscal injuries in professional football players of both sexes. An integrative literature review was conducted using the PICO methodology, covering studies published in the last five years. The results indicate that 193 articles were initially identified, of which 5 randomized clinical trials were selected after applying inclusion criteria. Physical therapy, through muscle strengthening exercises, proprioception, and other techniques, can be as effective as surgery in the recovery of athletes. In addition to helping prevent new injuries, physical therapy can, in some cases, replace the need for surgical interventions. It is concluded that physiotherapy is a viable strategy for preventing and treating meniscal injuries, although more research is needed to understand its long-term effects.

Influence of the External Workload on Calf Muscle Strain Injuries in Professional Football Players: A Pilot Study.

The influence of external workload variables on the development of calf muscle strainsin football players has not been previously explored. Overloaded players would have an increased risk of calf muscle strain injury. Prospective observational study. Level 4. A total of 41 professional football players from 1 team were monitored for 2 consecutive seasons. Total distance covered (TD), and distances covered at high-intensity running, high sprint running, low (LACC) and high (HACC) acceleration, low (LDEC) and high (HDEC) deceleration, and at high metabolic load distance (HMLD) were monitored with GPS units. Accumulated players' external workload in the week before injury was compared with the weekly mean value of the 6 weeks before injury occurred for each player. Ten players (24.3%) suffered 16 calf muscle strain injuries (3.1 injuries per 1000 hours of match play; 0.5 injuries per 1000 hours of training exposure). Players with a calf muscle injury were older (p = 0.03), with higher body weight (p = 0.01) and height (p = 0.03). Injured players displayed substantially higher total training volume (p < 0.01), TD (p < 0.01), LACC (p < 0.01), LDEC (p < 0.01), HACC (p < 0.01), HDEC (p < 0.01), and HMLD (p = 0.03) in the week before injury, in comparison with the mean values of these variables in the 6 weeks before injury. A week with a higher-than-habitual external workload might increase the risk of calf muscle strain injury in professional football players. Calf muscle injuries were preceded by a week with unusually high workloads associated with accelerating and decelerating distances and higher training volumes. Monitoring external workload indicators may be helpful in determine players with a higher risk of calf muscle strain injury due to excessive workload during training/competition.

Hamstring muscle injury is preceded by a short period of higher running demands in professional football players.

The aim of this study was to examine match running patterns before a hamstring muscle injury occurs during a match in male professional football players. A total of 281 male professional football players belonging to 7 teams from LaLiga were prospectively monitored over three seasons. Among these, 36 players suffered a non-contact hamstring muscle injury during an official match. The injuries were recorded by the medical staff, including the minute when the injury occurred. Running distances at different speed thresholds for 5 min and 15 min before the injury were compared to mean values of the previous 5 matches for the same time points. There were a total of 44 non-contact hamstring muscle injuries, which represents a hamstring muscle injury incidence of 3.34 injuries/1000 h of match exposure. The average time loss for these injuries was 33 ± 28 days (range 7 to 117 days). In the 15 min prior to the injury, players ran a similar distance as in control matches (p from 0.22 to 0.08). However, players ran a greater distance in the 5-min period before the injury than in control matches at 21.0-23.9 km/h (p < 0.001) and at ≥ 24 km/h (p < 0.001). The odds ratio for a hamstring muscle injury was 7.147 for those players who ran > 30.0 m at ≥ 21 km/h in a 5-min period (p < 0.001). Hamstring muscle injuries during competition were preceded by 5 min of higher running demands at > 21 km/h, compared with control matches. This suggests that a short period of unusual running increases the risk of hamstring muscle injury in professional football players.

Magnetic resonance imaging predicts the days lost from training and competition: evaluation of 56 indirect muscle injuries in professional football players.

Lower limb muscle injuries have a strong impact in training and official competitions stoppage for professional football players. This study aimed to explore the relationship between oedema-like changes found on magnetic resonance imaging (MRI) in acute indirect thigh injuries muscles and the time required for the athlete to return to individual training - "return to training" (RTT) and for full availability for official competitions - "return to play" (RTP). Professional football players from 2017/2018 to 2021/2022 seasons top league team with clinical and ultrasound (US) diagnosis of acute hamstrings or quadriceps muscle injury, confirmed on 48/72h subsequent MRI, were included. MRI images were retrospectively re-evaluated. MRI parameters evaluated were cross-sectional area (CSA), cranio-caudal extension (CCE), distance to nearest insertion (DI) and volume (V). Univariate and multivariate analysis was performed to find factors related to RTT, RTP, and episodes of reinjuries. Thirty-four first traumatic muscle injuries met the inclusion criteria. The mean time to RTT and RTP was 22 (4-49) and 25 (4-55) days, respectively. CCE and V resulted as independent predictive MRI variables for the time to RTT (P=0.012) and RTP (P=0.02), respectively. Thresholds of CCE≥11.31 cm and V ≥19.5cc can predict a time to RTT≥22 days (Odds Ratio [OR] 9.5) and RTP≥25 days (OR 4.583), respectively. The decision on the time required for RTP is based on clinic and imaging evaluation; CCE and V of the MRI oedema-like changes help to define the prognosis of the injury.

Creatine kinase concentration on the second post-match day is not associated with risk of subsequent muscle injury in professional football players: a four-season cohort study

ABSTRACT Objective The objective of this study was to examine the relationship between creatine kinase (CK) concentration following official matches and the risk of subsequent muscle injury in professional male football (soccer) players. Methods Blood samples were collected on the second post-match day for CK analysis over four consecutive seasons in a professional football club. Players were then followed for five days to observe any occurrence of indirect muscle injury (structural or functional in nature). Players exposed to at least 45 minutes in two consecutive matches within seven days were considered valid cases for analysis. Results Eighty players participated in the study, generating 1,656 cases eligible for analysis, of which 229 resulted in muscle injuries. The hamstrings were the most frequently injured muscle group (54%), followed by the adductor (21%), triceps surae (19%), quadriceps (5%), and psoas (1%). While CK concentration was higher in muscle injury cases [783 ± 507 U/L (95%CI, 717 to 849; min–max, 105–2,800)] compared with uninjured cases [688 ± 446 U/L (95%CI, 665 to 711; min–max, 100–2,950)], it was not an accurate predictor of subsequent muscle injury risk in professional football players (sensitivity = 56%; specificity = 55%; odds ratio = 1.00; area under curve = 0.557). Conclusion CK concentration on the second post-match day cannot be used to effectively screen subsequent muscle injury risk in professional male football players.

The British Athletics Muscle Injury Classification grading system as a predictor of return to play following hamstrings injury in professional football players

ObjectivesInvestigate the British Athletics Muscle Injury Classification (BAMIC) grading system as a predictor of return to play (RTP) following primary hamstring strain injury (HSI) and its agreement with the Peetron's classification system in professional footballers. MethodsA retrospective cohort study of 39 hamstrings strains in a professional English football club were identified. Two musculoskeletal radiologists reviewed historical MRI's and classified them against the BAMIC and Peetron's grading system. Classification, oedema length and cross-sectional area were compared against RTP. ResultsPearson's correlation coefficient demonstrated a weak but statistically significant correlation between BAMIC and RTP (r = 0.32; 95%CI 0.01 to 0.58; p = 0.05). Maximum length of intramuscular oedema demonstrated weak correlations with RTP (r = 0.3; 95%CI -0.02 to 0.56; p = 0.06). Percentage cross sectional demonstrated a weak correlation with RTP (r = 0.02; 95%CI -0.3 to 0.33; p = 0.91). Multiple regression demonstrated that 16% of the variance in RTP was explained by the model. Kappa for the agreement between BAMIC and Peetron's was 0.21 (95%CI 0 to 0.42). ConclusionsA significant association between the grade of HSI on the BAMIC system and RTP was found. Findings suggest BAMIC could provide valuable prognostic information on the RTP.

Video analysis of Achilles tendon rupture in male professional football (soccer) players: injury mechanisms, patterns and biomechanics

BackgroundAchilles tendon rupture (ATR), while rare in football, is a severe career-threatening injury associated with long-layoff times. To date, no study has documented ATR’s mechanism in professional football players.AimTo describe...

Sex-related differences in muscular factors previously identified in the literature as potentially associated with hamstring strain injury in professional football players

Sex-related differences in muscular factors previously identified in the literature as potentially associated with hamstring strain injury in professional football players

Lower limb risk prevention in athletes: evaluation and strategies

Risk prevention of sports-related lower limb musculoskeletal injuries in adult and youth athletes is an important topic encompassing health and economic factors. For example, muscle injuries in professional football players could expose these athletes to recurrence, creating a significant economic problem for the football club. Such observations have led to the development of prevention programs, predominantly exercise-based injury prevention strategies, which may be multi-component or single-component. These programs focus on intrinsic risk factors, such as strength deficits, lack of flexibility, poor balance, coordination, endurance, previous injury, body size, anatomical alignment issues, foot shape, age, and sex. The FIFA 11+ program is an important example of an exercise-based program. It was developed under the leadership of the Fédération Internationale de Football Association with the aim of evaluating and, where necessary, implementing preventive training routines for soccer players. Despite the program being designed for soccer players, it has shown efficacy in other sports too. Many studies also emphasize the importance of identifying and avoiding extrinsic risk factors related to type and level of activity, shoe type, bracing equipment, etc. Understanding of the incidence, the severity, and the etiology of a specific injury is required in order to provide adequate prevention measures and to reduce the need for surgery. The present study focuses explicitly on identifying and evaluating possible interventions for lower limb injuries.

Influence of the Weekly and Match-play Load on Muscle Injury in Professional Football Players.

The aim of this investigation was to examine the impact of the weekly training load and the match running patterns prior to a muscle injury as potential risk factors of muscle injury in professional football players. Forty male professional football players participated in the investigation. Running distances at different intensities 5 min and 15 min prior to the injury were compared to the same time-points in official matches of the same player with no injury events. Furthermore, the cummulative session rating of perceived exertion (sRPE) and training load of the week prior to the injury were compared to a control week (mean value of training weeks without injury). Nineteen players suffered 31 non-contact muscle injuries during matches. The distance covered at 21-24 km/h (p<0.001; effect size (ES)=0.62) and at>24 km/h (p=0.004; ES=0.51) over the 5-min period prior to the injury was greater than in matches without injury. The cumulative sRPE (p=0.014; ES=1.33) and training volume (p=0.002; ES=2.45) in the week prior to the injury was higher than in a control week. The current data suggest that the combination of a training week with a high load and a short period of high intensity running during the match might increase the risk of muscle injury in professional footballers.

Role of ultrasound and magnetic resonance imaging in the prognosis and classification of muscle injuries in professional football players: correlation between imaging and return to sport time

PurposeTo study distractive muscle injuries applying US and MRI specific classifications and to find if any correlation exists between the results and the return to sport (RTS) time. The second purpose is to evaluate which classification has the best prognostic value and if the lesions extension correlates with the RTS time.MethodsA total of 26 male, professional soccer players (age 21.3 ± 5.6), diagnosed with traumatic muscle injury of the lower limbs, received ultrasound and MRI evaluation within 2 days from the trauma. Concordance between US and MRI findings was investigated. The relationships between MRI and US based injury grading scales and RTS time were evaluated. Correlation between injuries’ longitudinal extension and RTS time was also investigated.ResultsThe correlation between US and MRI measurements returned a Spearman value of rs = 0.61 (p = .001). Peetrons and Mueller-Wohlfahrt grading scales correlations with RTS time were r = 0.43 (p = .02) and r = 0.83 (p = < .001). The lesion’s extension correlation with RTS time was r = 0.63 (p < .001). The correlation between the site of the lesion and its location with the RTS time were rs = 0.2 and rs = 0.25.ConclusionsBoth US and MRI can be used as prognostic indicators along with the Peetrons (US) and the Mueller-Wohlfahrt (MRI) classifications. MRI is more precise and generates more reproducible results. The lesion craniocaudal extension must be considered as a prognostic indicator, while the injury location inside the muscle or along its major axis has doubtful significance.

Correlation of Hip Passive Range of Motion with Lower Limbs Injuries in Iranian Professional Football Players

Introduction: Football is a popular sport with a high injury rate. Lower limb injuries are accounted for 85% of injuries in professional football players. It is important to identify the predisposing factors in professional football players for screening players at an increased risk of injury. Limited hip range of motion (ROM) is one of these factors. This study aimed to evaluate the association between hip passive ROM and lower limb injury in Iranian professional football players. Results: The most common lower limb injuries were ankle and foot injuries (12.4%), groin pain (11.5%) and muscle strain (10.9%), respectively. Non-injured athletes had a significantly higher left abduction and bilateral internal rotation (IR) ROM. right side injury was associated with higher contralateral flexion and external rotation (ER) and left side injury was associated with a significantly higher contralateral extension, abduction, and IR. Restricted hip IR was associated with a higher incidence of groin pain (OR = 2.06), ACL injury (OR = 2.56), and knee injuries (OR = 4.18). A significant correlation was observed between decreased hip ER with muscle strain (OR = 1.89) and knee injuries (OR = 4.25). The higher knee and ACL injuries were also associated with reduced hip abduction (OR = 4.76 and 9.01, respectively). There was no association between ankle and foot injuries and hip passive ROM. Conclusions: This study showed that the hip passive ROM could be used to identify football players at a higher risk of lower limb injuries. Hip rotational ROM and abduction limitation were significantly associated with the incidence of several common football injuries, including groin pain, muscle strain and ACL/knee injuries and precedes their development and could be used as a screening tool for professional athletes.

Is there a relationship between lower-extremity injuries and foot postures in professional football players? A prospective cohort study

ABSTRACT Background: Lower extremity injuries are an ongoing concern for professional football players. This study aims to evaluate the relationship between foot posture and lower extremity injuries in professional football players. Method: In this prospective cohort study, 420 male players of the Iran Premium football league were evaluated during the 2015-2016 season. The players were assessed for their foot types based on optical and static foot scans and foot posture index (FPI). The trained club physicians recorded all injuries during the season. Result: The analyzed data of 244 players showed the highest rate of lower extremity injury in hamstrings, ankle, and groin, respectively. These injuries led to 46% of time loss. The probability of hamstrings injuries was higher among pronated players based on static, optic, FPI, and visual examination, 2.1, 1.8, 1.8, and 2.3, respectively. Medial Collateral Ligament (MCL) injuries were associated with subtalar joint abnormality defined by visual observation. An increased relative risk of leading-to-absence injuries among the flat foot group was significant based on optic scanning, FPI, and visual observation. Conclusion: Abnormal foot postures in professional football players may increase the risk of hamstring and MCL injuries and time loss due to lower extremity injuries.

Evaluation of Muscle Injuries in Professional Football Players: Does Coach Replacement Affect the Injury Rate?

To assess the incidence and characteristics of muscle injuries in professional football players and to assess if coach dismissal may be related with muscle injuries within 1-month period from the dismissal. Prospective cohort study during 3 consecutive seasons. Turkish Super League football teams. One hundred eighteen male football players. Data on time-loss muscle injuries confirmed using magnetic resonance imaging were recorded, including type, body part, duration, and lay-off time, and training session and match exposure times. The muscle injury rate was evaluated at 2 weeks and 30 days after coach dismissal. In total, 124 muscle injuries were recorded, with injury incidences of 2.3 muscle injuries per 1000 hours of exposure overall, 1.2 in training sessions, and 13.6 in matches. Injury time loss ranged from 3 to 67 days (median, 13 days). Eighteen percent of the injuries (n = 23) were recurrent; no association was found between recurrence rate and the player's age or position (P = 0.15, P = 0.27, respectively). Recurrent injuries caused more severe injuries (26.1%, P = 0.02) and longer median lay-off time (P = 0.01). During the study, teams A and B replaced 7 and 3 coaches, respectively. The injury incidence increased to 5.3 per 1000 hours of exposure in the 2 weeks after the coach dismissal, and decreased to 4.5 within 1 month of coach dismissal. Given the link between coach dismissal and increased rates of muscle strain injuries, increased attentiveness to preventing muscle injuries during coaching transitions and to the impact of new training regimens is required by trainers and medical teams.

Does Overexertion Correlate With Increased Injury? The Relationship Between Player Workload and Soft Tissue Injury in Professional American Football Players Using Wearable Technology.

The relationship of training load to injury using wearable technology has not been investigated in professional American football players. The primary objective of this study was to determine the correlation between player workload and soft tissue injury over the course of a football season utilizing wearable global positioning system (GPS) technology. Increased training load is associated with a higher incidence of soft tissue injuries. Case-control study. Level 3. Player workloads were assessed during preseason and regular-season practice sessions using GPS tracking and triaxial accelerometry from 2014 to 2016. Soft tissue injuries were recorded during each season. Player workload during the week of injury (acute) and average weekly workload during the 4 weeks (chronic) prior to injury were determined for each injury and in uninjured position-matched controls during the same week. A matched-pairs t test was used to determine differences in player workload. Subgroup analysis was also conducted to determine whether observed effects were confounded by training period and type of injury. In total, 136 lower extremity injuries were recorded. Of the recorded injuries, 101 injuries with complete GPS and clinical data were included in the analysis. Injuries were associated with greater increases in workload during the week of injury over the prior month when compared with uninjured controls. Injured players saw a 111% (95% CI, 66%-156%) increase in workload whereas uninjured players saw a 73% (95% CI, 34%-112%) increase in workload during the week of injury (P = 0.032). Individuals who had an acute to chronic workload ratio higher than 1.6 were 1.5 times more likely to sustain an injury relative to time- and position-matched controls (64.6% vs 43.1%; P = 0.004). Soft tissue injuries in professional football players were associated with sudden increases in training load over the course of a month. This effect seems to be especially pronounced during the preseason when player workloads are generally higher. These results suggest that a gradual increase of training intensity is a potential method to reduce the risk of soft tissue injury. Preseason versus regular-season specific training programs monitored with wearable technology may assist team athletic training and medical staff in developing programs to optimize player performance.

Increasing Incidence of Pectoralis Major Ruptures in NFL Players

Objectives: Pectoralis major ruptures are considered an uncommon injury in football. A previous study showing that only 10 compete ruptures occurred in the NFL between the years 2000-2010. The purpose of the study is to report the incidence of pectoralis ruptures in National Football League (NFL) players from 2010-2017 and identify any characteristics that could have contributed. We hypothesized that incidence of pectoralis major ruptures would increase over the past eight years. Methods: Using publicly available reports from websites such as ESPN.com and NFL.com, pectoralis major injuries in professional football players were identified during the years 2010-2017. Details about age, position played, injury setting, performance enhancing drug (PED) suspensions, and combine performance were obtained from NFL Combine and compared to peers at the same workout. Results: During the eight years analyzed 51 separate NFL players suffered a total of 55 pectoralis major ruptures. Defensive players accounted for 82% (42 of 51) of the injured players. The ruptures happened at the average age of 26±1 years, and 76.4% (42 of 55) of them occurred during games. After the rupture, 87.3% (48 of 55) required surgery, while definitive treatment could not be determined for the remaining seven injuries. For athletes that received playing time before injury and had their rupture occur prior to the most recent 2017 season, 85.4% (41 of 48) returned to play in a game. When comparing athletes at the combine who later ruptured their pectoralis major to peers at their position, those who tore their pectoralis major tendon on-average ranked in the 63 rd percentile for bench press (N=40), 50th percentile for arm length (N=14), and 52nd percentile for 20-yard shuttle (N=20). When the NFL suspension records were examined, only 5.9% (3 of 51) of players with a pectoralis major rupture had been suspended for (performance-enhancing drug) PED use before or after the injury. Conclusion: The total number of pectoralis major ruptures has drastically risen from 10 cases between 2000-2010 to 55 cases from 2010-2017. The reason behind this increase remain uncertain but appears to be independent of relative strength, agility, and arm length, and suspension for PED use.

ACTN3 R577X Polymorphism Is Associated With the Incidence and Severity of Injuries in Professional Football Players.

The ACTN3 R577X gene variant results in the absence of the α-actinin-3 protein in ∼18% of humans worldwide and has been associated with athletic performance and increased susceptibility to eccentric muscle damage. The aim of this study was to investigate the association between ACTN3 R577X variant and indirect muscle disorders/injuries in professional football players. A case-control, genotype-phenotype association study. Two hundred fifty-seven male professional Italian football players (from Serie A, Primavera, Allievi, and Giovanissimi; age = 21.2 ± 5.3 years) and 265 nonathletic controls were recruited for the study. Genomic DNA was extracted using a buccal swab, and the ACTN3 R577X genotype was performed using a PCR method. Structural-mechanical injuries and functional muscle disorders were collected from a subgroup of 169 football players during the period of 2009 to 2014. We hypothesized that the 577XX genotype would be associated with higher predisposition to muscle injuries (compared with the other genotypes). ACTN3 XX (α-actinin-3 deficiency) players had 2.66 higher odds for an injury incidence than their ACTN3 RR counterparts (95% confidence interval [CI]: 1.09-6.63, P = 0.02), whereas RX and RR players had similar injury incidence. Furthermore, ACTN3 XX players had 2.13 higher odds for having a severe injury compared with their RR counterparts (95% CI: 1.25-3.74, P = 0.0054), whereas RX individuals had 1.63 higher odds for having a severe injury compared with the RR players (95% CI: 1.10-2.40, P = 0.015). The ACTN3 R577X polymorphism is associated with the incidence and severity of muscle injuries in professional football players; players with the ACTN3 577XX genotype have higher odds of having muscle injuries than their RR counterparts. Discovering the complex relationship between gene variants and muscle injuries may assist coaches, physiologists, and the medical community to development tailored injury prevention program for football players, which could provide a new edge for successful competition.

Creatine Phosphokinase and Urea as Biochemical Markers of Muscle Injuries in Professional Football Players

Background: Although biochemical markers have been used to monitor training loads (TL), it is unknown if they can be used to predict muscle injuries (MI) in professional football (soccer) players (PFP). Objectives: To evaluate the relationship between the incidence of MI, serum concentration of creatine phosphokinase (CPK) and urea, as well as TL in PFP. Methods: Twenty-three PFP from a Colombian first-division team were enrolled in a retrospective cohort study. CPK, urea, TL and new MI were measured during 19 weeks. CPK and urea serum levels within 4 weeks before a diagnosed MI were compared to those measured preseason. CPK and urea relationship with TL were analyzed using a mixed-effects model. Results: The subjects had an age of 25.3 ± 4.2 years. Nine subjects presented with MI during follow-up, 66.6% of which were localized to hamstrings. Serum CPK and urea profiles were constructed for each player along the season. Injured players had a significant elevation of these markers within 4 weeks before the injury was clinically evident when compared to their own preseason values. Expected individual increases in CPK and urea according to TL during the season were estimated. Conclusions: Since CPK and urea values rose several weeks before the MI became overt, constructing CPK and urea profiles for each player during the whole preseason and season may help identify peaks in their concentration as early markers of MI. A tight biochemical control of training may become a preventive strategy for MI, but the use of published reference values is discouraged.

No association between rate of torque development and onset of muscle activity with increased risk of hamstring injury in elite football.

Hamstring injuries remain a significant burden in sports that involve high-speed running. In elite male football, hamstring injury has repeatedly been identified as the most common non-contact injury, representing 12% of all injuries. As the incidence remains high, investigations are aimed at better understanding how to improve prevention efforts. Intrinsic risk factors such as strength have been investigated extensively in a cohort of professional football players; however, other intrinsic measures of neuromuscular function have not been studied in this cohort. This study aims to investigate the association between timing of hamstring muscle activity onset and the rate of torque development during the early phase of isokinetic strength testing with risk of hamstring injury in professional football players in a prospective cohort study. All teams (n=18) eligible to compete in the premier football league in Qatar underwent a comprehensive strength assessment during their annual periodic health evaluation at Aspetar Orthopaedic and Sports Medicine Hospital in Doha, Qatar. Variables included rate of torque development and timing of muscle activity onset. A total of 367 unique players (60.6% of all QSL players) competed for 514 player seasons (103 players competed both seasons) and sustained 65 hamstring injuries. There was no difference in the onset of muscle activity between the biceps femoris and medial hamstrings comparing the injured to uninjured players. For both onset of muscle activity and rate of torque development, there were no significant differences between any of the variables (P>.05), with small effect sizes detected across all the different variables (d<0.3). Rate of torque development and onset of muscle activity were not associated with a risk of future hamstring injury. The use of these measures as part of a periodic health evaluation to identify risk of hamstring injury is unsupported.

Characteristics and Outcomes of Arthroscopic Femoroacetabular Impingement Surgery in the National Football League

Background: Previous studies have reported that hip abnormalities may account for 10% of injuries in professional football players. The effect of femoroacetabular impingement (FAI) and arthroscopic FAI surgery in National Football League (NFL) athletes has not been well studied. Purpose: To investigate the effect of arthroscopic FAI surgery on return to play (RTP) and RTP performance in NFL players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL athletes undergoing arthroscopic FAI surgery at a single institution between 2006 and 2014 were identified. Medical records were reviewed for demographic, clinical, and operative variables. RTP and RTP performance were assessed based on a review of publicly available NFL player statistics. RTP and RTP performance data included time to RTP; games played before and after the injury; yearly total yards and touchdowns for offensive players; and yearly total tackles, sacks, and interceptions for defensive players. The offensive power rating (OPR = [total yards/10] + [total touchdowns × 6]) and defensive power rating (DPR = total tackles + [total sacks × 2] + [total interceptions × 2]) were calculated. Paired t tests comparing preinjury and postinjury seasons were performed. A matched cohort of NFL players was created to compare trends for OPR, DPR, and career longevity. Results: Forty-eight hips in 40 NFL players (mean age, 25.6 years) with symptomatic FAI were included; 8 players underwent staged bilateral hip arthroscopic procedures. The majority of players were offensive (n = 24; 60.0%), with offensive lineman (n = 11; 27.5%) being the most common of all positions. Of the 48 included hips, all had labral tears, and 41 (85.4%) underwent labral repair. Forty-two of the 48 hips (87.5%) underwent cam decompression, and 10 (20.8%) underwent rim decompression. Of the 40 included players, 37 (92.5%) achieved RTP to professional competition after their hip arthroscopic surgery at a mean of 6.0 months. Before the injury, included patients played in a mean of 11.0 games compared with 9.5 games in their postoperative season (P = .26). The mean OPR and DPR demonstrated a nonsignificant decline in the postoperative season (preinjury OPR, 40.2; postinjury OPR, 32.3; P = .34) (preinjury DPR, 49.6; postinjury DPR, 36.4; P = .10). A similar decline in the OPR and DPR across seasons was observed in the control group. NFL athletes played, on average, 3.3 ± 1.5 seasons after undergoing hip arthroscopic surgery; this was not significantly different from the controls (2.5 ± 1.5 seasons; P = .47). There was no significant difference in mean annual salaries based on contracts negotiated before the injury and the first negotiated contract after surgery ($3.3 million vs $3.6 million, respectively; P = .58). Conclusion: There was a very high rate of RTP in the NFL after arthroscopic FAI surgery; this rate is higher than what has been previously reported for other orthopaedic procedures in NFL athletes. Additionally, these NFL athletes achieved RTP at a faster time frame (6 months) than previously reported for other procedures. These findings have important implications for counseling elite football players about the expected outcome of arthroscopic FAI surgery.