Professional Football Athletes Research Articles

Lower extremity movement quality in professional team sport athletes: Inter-rater agreement and relationships with quantitative results from the corresponding pattern

BackgroundAdequate movement control and quality can be prerequisite functions for performance of the lower extremity. The purposes of our work were 1) to explore the agreement of an efficient test battery assessing qualitative movement execution and 2) to determine its consistency with quantitative performance tests from the corresponding movement pattern.MethodsThe participants were professional male association football players competing in the first German Bundesliga. They performed four movement quality tests (Single-limb balance squat, Balance forward hop, Balance side hop, Balance 90° rotation hop) and the corresponding performance tests (Y-balance test, Forward hop for distance, Side hop test, Square hop test). Qualitative tests were judged by two experienced raters; the ratings were compared to determine inter-rater agreement using Kappa statistics. The relationship with the quantitative tests was determined using Spearman’s rank correlations.ResultsThirty participants (19 to 33 years old) were included in this study. We found an at least substantial level of agreement (Cohen’s Kappa, 0.64-0.84) with an excellent percentage of exact (83-93%) agreement between the two raters for the movement quality tests. Our findings revealed that the quantitative test results are only slightly related to the movement quality outcomes (ρ(27) <|0.3| and P > 0.2).ConclusionsConsequently, the qualitative test results provide unique information and complement corresponding quantitative performance tests in professional football athletes. Their observational judgement of foot position, lower limb alignment and upper body control in sagittal, frontal, and transverse planes is agreeable.

Positional Movement Demands during NFL Football Games: A 3-Year Review

Understanding the in-game demands placed on athletes may allow practitioners to design improved training protocols to prepare athletes for competitive demands. This study aimed to quantify the competitive movement demands of professional American football athletes and to determine any inter-positional differences that may exist. Player tracking data were collected from 2018 to 2020 regular season games of the National Football League. Distance, maximum velocity, high-velocity efforts and distance, and acceleration and deceleration efforts and distance were used to evaluate competitive movement demands. To determine position-specific demands, each player was classified by their designated position, and velocity data from competitive games were used to develop position-specific velocity thresholds. One-way ANOVA and post hoc Bonferroni statistical analysis were used to determine inter-positional difference. Significant (p &lt; 0.05) positional differences were found for all load metrics with respect to competitive game demands. Generally, wide receivers and defensive backs had faster maximum velocities, higher distances, and more acceleration and deceleration efforts and distance than other positions. Linebackers accumulated the most high-velocity efforts and distance. Lineman had the lowest values for all assessed metrics. These findings may assist the performance staff in developing improved training and return-to-play protocols with the aim of improving player performance and mitigating injury.

Comparative Risk Analysis of Low Back Pain among Professional Football, Ice Hockey, and Floorball Athletes.

BACKGROUND Low back pain (LBP) is a common concern among professional athletes, potentially hindering performance and career longevity. However, comparative assessments of LBP prevalence and severity across various sports remain scarce. This study aimed to evaluate the factors associated with LBP in 388 professional athletes, including football, ice hockey, and floorball players. MATERIAL AND METHODS Conducted from June 2021 to September 2022, this cross-sectional study incorporated 388 athletes from national elite clubs, including football (n=148), ice hockey (n=179), and floorball (n=61). The Oswestry Disability Index (ODI), comprising sections like pain intensity, self-care, lifting, walking, sitting, standing, sleeping, sexual life, social life, and traveling, was employed to evaluate spinal pain and disability. RESULTS The study found no significant disparities in the LBP assessment among the groups. The relative risk (OR) of LBP and disability varied among the sports: football players displayed a lower risk (OR=0.49; 95% CI 0.32-0.74, P≤0.001), while ice hockey players had a higher risk (OR=2.18; 95% CI 1.45-3.29, P≤0.001) compared to the others. In contrast, the risk for floorball players (OR=0.82; 95% CI 0.47-1.41) did not significantly deviate from that of the other two sports. CONCLUSIONS LBP prevalence stood at 42.6% for football players, 60.1% for ice hockey players, and 49.2% for floorball players. Among these, ice hockey players exhibited a 2.18-fold increased risk of developing LBP and associated disability when compared to their football and floorball counterparts.

Longitudinal Aortic Root Dilatation in Collegiate American-Style Football Athletes.

Background Clinically relevant aortic dilatation (>40 mm) and increased cardiovascular risk are common among retired professional American-style football athletes. Among younger athletes, the effect of American-style football participation on aortic size is incompletely understood. We sought to determine changes in aortic root (AR) size and associated cardiovascular phenotypes across the collegiate career. Methods and Results This was a multicenter, longitudinal repeated-measures observational cohort study of athletes across 3 years of elite collegiate American-style football participation. A total of 247 athletes (119 [48%] Black, 126 [51%] White, 2 [1%] Latino; 91 [37%] linemen, 156 [63%] non-linemen) were enrolled as freshmen and studied at pre- and postseason year 1, postseason year2 (N=140 athletes), and postseason year 3 (N=82 athletes). AR size was measured with transthoracic echocardiography. AR diameter increased over the study period from 31.7 (95% CI, 31.4-32.0) to 33.5 mm (95% CI, 33.1-33.8; P<0.001). No athlete developed an AR ≥40 mm. Athletes also demonstrated increased weight (cumulative mean Δ, 5.0 [95% CI, 4.1-6.0] kg, P<0.001), systolic blood pressure (cumulative mean Δ, 10.6 [95% CI, 8.0-13.2] mm Hg, P<0.001), pulse wave velocity (cumulative mean Δ, 0.43 [95% CI, 0.31-0.56] m/s, P<0.001), and left ventricular mass index (cumulative mean Δ, 21.2 [95% CI, 19.2-23.3] g/m2, P<0.001), and decreased E' velocity (cumulative mean Δ, -2.4 [95%CI, -2.9 to -1.9] cm/s, P<0.001). Adjusting for height, player position, systolic blood pressure, and diastolic blood pressure, higher weight (β=0.030, P=0.003), pulse wave velocity (β=0.215, P=0.02), and left ventricular mass index (β=0.032, P<0.001) and lower E' (β=-0.082, P=0.001) were associated with increased AR diameter. Conclusions Over the collegiate American-style footballcareer, athletes demonstrate progressive AR dilatation associated with cardiac and vascular functional impairment. Future studies delineating aortic outcomes are necessary to determine whether AR dilation is indicative of maladaptive vascular remodeling in this population.

The correlation of centre of mass evaluation utilising accelerometry-based measurement and the clinical dynamic balance test in professional football athletes with chronic ankle instability

BackgroundSimilar to a modified star excursion balance test, the Y-balance test is recommended for use in clinical settings to evaluate dynamic balance, particularly in athletes with chronic ankle instability. However, due to the testing errors, there are certain restrictions. As a result, the modification of the centre of mass tracking system was developed in order to aid in the detection of the ability to control the dynamic balance. Therefore, the purpose of this study was to correlate the usage of an accelerometer for the shifting of the centre of mass during a dynamic balance test with a Y-balance test reach distance score. MethodologyForty professional football athletes with CAI participated in this study by performing the Y-balance test three times while wearing an accelerometer. The jerk, RMS sway amplitude, mean velocity from the time domain, and the normalised reach distance scores of the Y-balance test in the anterior, posteromedial, and posterolateral directions were all collected. ResultsThere was a strong positive correlation of jerk and RMS sway amplitude with the normalised reach distance scores in the posteromedial direction (r = 0.706 and 0.777, respectively), a moderate positive correlation of jerk and RMS sway amplitude with the normalised reach distance scores in the posterolateral direction (r = 0.609 and 0.606, respectively), a moderate positive correlation of jerk and RMS sway amplitude with the composite reach distance scores (r = 0.531 and 0.573, respectively) and significant differences in the posteromedial, posterolateral and overall directions (p-value < 0.001). ConclusionThese findings indicate that the area of the centre of mass shifting as represented by the accelerometer can disclose the body’s ability to control the centre of mass over the base of support when the body is moving. Furthermore, in this study, the RMS sway variable in the posteromedial direction appears to be the most prominent.

MRI Findings Associated With Anterior Cruciate Ligament Tears in National Football League Athletes.

Anterior cruciate ligament (ACL) tears are a high-frequency injury requiring a lengthy recovery in professional American football players. Concomitant pathology associated with ACL tears as identified on magnetic resonance imaging (MRI) is not well understood in these athletes. To describe the MRI findings of concomitant injuries associated with ACL tears among athletes in the National Football League (NFL). Cross-sectional study; Level of evidence, 3. Of 314 ACL injuries in NFL athletes from 2015 through 2019, 191 complete MRI scans from the time of primary ACL injury were identified and reviewed by 2 fellowship-trained musculoskeletal radiologists. Data were collected on ACL tear type and location, as well as presence and location of bone bruises, meniscal tears, articular cartilage pathology, and concomitant ligament pathology. Mechanism data from video review were linked with imaging data to assess association between injury mechanism (contact vs noncontact) and presence of concomitant pathology. Bone bruises were evident in 94.8% of ACL tears in this cohort, most often in the lateral tibial plateau (81%). Meniscal, additional ligamentous, and/or cartilage injury was present in 89% of these knees. Meniscal tears were present in 70% of knees, lateral (59%) more than medial (41%). Additional ligamentous injury was present in 71% of all MRI scans, more often a grade 1/2 sprain (67%) rather than a grade 3 tear (33%), and most often involving the medial collateral ligament (MCL) (57%) and least often the posterior cruciate ligament (10%). Chondral damage was evident in 49% of all MRI scans, with ≥1 full-thickness defect in 25% of all MRI scans, most often lateral. Most (79%) ACL tears did not involve direct contact to the injured lower extremity. Direct contact injuries (21%) were more likely to have a concomitant MCL tear and/or medial patellofemoral ligament injury and less likely to have a medial meniscal tear. ACL tears were rarely isolated injuries in this cohort of professional American football athletes. Bone bruises were almost always present, and additional meniscal, ligamentous, and chondral injuries were also common. MRI findings varied by injury mechanism.

Dietary Intake, Body Composition and Performance of Professional Football Athletes in Slovenia

This is the first study to examine the nutritional status of professional Slovenian football players. This study aimed to analyze the dietary intake of elite football players during their preparation phase of the season and to investigate whether there is a relationship between energy and macronutrient intake with body composition and physical performance. Twenty-three footballers completed a three-day dietary and physical activity diary and underwent body composition measurements via bioelectrical impedance vector analysis (BIVA). Fifteen participants also took part in the Cooper treadmill test to assess their physical performance in correlation with their nutritional intake. Football players had an energy intake that was significantly too low for their needs, reflecting low energy availability. The average carbohydrate (CHO) intake was below the Union of European Football Associations (UEFA) recommendations, i.e., <4 g CHO/kg body weight (BW). Additionally, players had adequate intakes of protein and fat, and inadequate intakes of saturated fat, fiber, calcium and vitamin D. There was a positive correlation between protein intake and lean body mass. Additionally, a negative correlation was observed between body fat mass and carbohydrate intake as well as between performance with the percentage of energy intake from fat. Results of this study highlight what aspects of nutrition might be improved upon in professional football players to maximize performance, longevity and body composition of athletes, as well as the necessity of a nutritionist role in this process.

The association of player wellness data and running performance in professional Australian football athletes

Introduction: Wellness questionnaires are frequently used by professional Australian football teams to monitor stress and biopsychosocial states. They have been shown to be sensitive to changes in training load and, in some sports, to influence total running volume. The purpose of this study was to compare player wellness data with external running load, with the aim of determining if there was any association between wellness questionnaires and high-speed running or acceleration density during games.

Anthropometry and Physical Condition Profile of Bhayangkara FC Professional Football Athletes

The purpose of this study was to investigate the anthropometry and physical condition profile of Bhayangkara FC professional football athletes. The research was conducted by survey. The research sample amounted to 19 athletes. Data were collected through anthropometric measurements including weight, height, and leg length as well as physical condition tests including 30 meter sprint, illinois, sit and reach, vertical jump, Yo Yo Fitness test. The data were analyzed by T-score and then categorized on a scale of very good to very poor. The results showed that the anthropometric profile of Bhayangkara FC professional football athletes were mostly in the moderate category (8 athletes/42.11%), while the others were in the poor category (5 athletes/26.32%), good (3 athletes/15.79%), good once (2 athletes/10.53 %), and less than once (1 athlete 5.26 %). The study also showed that the physical condition profile of Bhayangkara FC professional football athletes were mostly in the moderate category (10 athletes/52.63%), while the others were in the good category (4 athletes/21.05%), less (3 athletes/15.79%), very good (1 athlete/5.26 %), and very poor (1 athlete/5.26 %). In conclusion, the mean anthropometric profile of Bhayangkara FC professional football athletes showed a moderate category and the mean physical condition profile of Bhayangkara FC professional football athletes showed a moderate category.

The Impact of COVID-19 on Physical Performance and Mental Health-A Retrospective Case Series of Belgian Male Professional Football Players.

Rationale: As every season, physical performance of players of Royal Antwerp FC's first team was regularly tested and mental well-being and mood were assessed during football season 2020–2021. Just like in the general population, several professional athletes were infected by SARS-CoV-2 during that season. COVID-19 is a complex disorder affecting multiple body systems, potentially damaging lungs, affecting the cardiovascular system or causing muscle weakness. Therefore, the impact of COVID-19 on performance was a major concern for the affected football players and their entourage.Objectives: To retrospectively examine the influence of COVID-19 on physical performance and mental health in professional football athletes during the season 2020–2021.Methods: Thirty-three professional athletes (age: 25.37 ± 4.11 years; height: 182.75 ± 7.62 cm; weight: 78.90 ± 8.97 kg) of a Belgian first division football club were assessed weekly during the 2020-2021 season. Weekly assessments comprised strength values of the hamstrings, hip abductors and hip adductors, jump performance, a modified Hooper questionnaire to assess mental status and nose swab PCR tests for COVID-19. Data analysis was performed from 2 weeks prior to COVID-19 contamination up to 8 weeks after the first positive test. Post-hoc Bonferroni correction was applied when performing statistical analysis.Results: Eleven players tested positive for COVID-19. Duration of contamination was 13 ± 7 days. There was no statistically significant difference before and after COVID-19 infection for jump performance, and adductor and abductor muscle strength (p > 0.05). Functional hamstring strength improved significantly 2 weeks (MD: 41.48; 95%CI: −3.79 to 86.75; p = 0.009) and 4 weeks (MD: 34.76; 95%CI: −8.91 to 78.42; p = 0.019) after COVID-19, whereas mood (MD: −0.60; 95%CI: −1.46 to 0.26; p = 0.041), stress levels (MD: −0.83; 95%CI: −1.85 to 0.20; p = 0.020) and total wellness (MD: −2.41; 95%CI: −5.25 to 0.43; p = 0.015) showed a significant reduction 8 weeks after confirmed COVID-19.Conclusion: Physical performance varied considerably across outcomes before and 8 weeks after COVID-19 contamination in a sample of first division football players. However, affected football players' overall well-being, stress levels and mood diminished after a positive COVID-19 test.

Epidemiology of Tibial Fractures in Professional American Football Athletes From 2013 to 2019.

Background:Lower extremity injuries occur with high frequency in National Football League (NFL) athletes and cause high burden to players and teams. Tibial fractures are among the most severe lower extremity injuries sustained in athletes and are associated with prolonged time loss from sport.Purpose:To determine the number of tibial fractures in NFL athletes from the 2013 to 2019 NFL seasons and describe athlete demographics, fracture characteristics, and details of injury onset.Study Design:Case series; Level of evidence, 4.Methods:A retrospective review of the NFL injury database was performed to identify all NFL athletes sustaining tibial fractures over the 2013 to 2019 NFL seasons. Athlete characteristics, injury characteristics, days missed, and treatment (operative vs nonoperative) were examined. Descriptive statistics were used to calculate means, standard deviations, ranges, and percentages.Results:A total of 64 tibial fractures were identified in 60 athletes, resulting in a median loss of 74 days. Defensive secondary athletes had the highest number of injuries (n = 10; 16%), followed by running backs (n = 9; 14%), while 61% of these injuries occurred during NFL regular-season games, primarily between weeks 13 and 17. The most commonly reported activity during injury was athletes being tackled, with a direct impact to the tibia being the most common mechanism of injury. Lateral tibial plateau fractures were the most frequently reported, while distal tibial fractures resulted in the greatest number of days lost. The median time lost for injuries requiring surgery was 232 days compared with 56 days for injuries treated using conservative management.Conclusion:The highest proportion of tibial fractures were injuries to defensive secondary athletes and athletes being tackled while sustaining a direct impact to the leg, primarily to the lateral tibial plateau. Tibial fracture injuries were commonly sustained during NFL regular-season games, primarily during the final 4 weeks of the NFL regular season. Further investigations examining performance and career longevity in athletes sustaining tibial fractures are warranted to help improve the health and safety of NFL athletes.

Increased carbohydrate availability effects energy and nutrient periodisation of professional male athletes from the Australian Football League.

This research aimed to explore the effect of increased carbohydrate availability intervention on energy intake and distribution in professional Australian Football athletes. Six 24-h energy and macronutrient intakes were quantified (n= 19 males; age 24± 4y, stature 187± 8cm, mass 87± 9kg) using photographic food diaries and Foodworks analyses. Energy expenditure was estimated for the same period using GeneActiv accelerometers. During 3 control days, athletes had ad libitum access to food, while the 3 intervention days increased carbohydrate availability, through greater prompting and access to carbohydrate foods. Daily energy intake was higher during intervention (185± 40kJ/kg/d) compared with control (172± 31kJ/kg/d; p< 0.05) but remained below estimated expenditure, and carbohydrate intake was also greater with intervention (5.0± 0.2g/kg/d) than control (4.0± 0.2g/kg/d; p< 0.05). Expenditure was highest during the morning, which coincided with lowest intake on all days, while the intervention was associated with greater carbohydrate intake in the morning (0.6g/kg, p< 0.05) compared with control. Increasing availability of carbohydrate during high-load training generated a modest increase in carbohydrate and energy intake, and the intervention was most effective in improving carbohydrate intake during mornings. Novelty: Increased access and provision of carbohydrate foods increased carbohydrate consumption and energy intake on high training load days. Daily distribution of energy intake can be modified through actively promoting carbohydrate consumption.

Comparisons of Daily Energy Intake vs. Expenditure Using the GeneActiv Accelerometer in Elite Australian Football Athletes.

Salagaras, BS, Mackenzie-Shalders, KL, Nelson, MJ, Fraysse, F, Wycherley, TP, Slater, GJ, McLellan, C, Kumar, K, and Coffey, VG. Comparisons of daily energy intake vs. expenditure using the GeneActiv accelerometer in elite Australian Football athletes. J Strength Cond Res 35(5): 1273-1278, 2021-To assess validity of the GeneActiv accelerometer for use within an athlete population and compare energy expenditure (EE) with energy and macronutrient intake of elite Australian Football athletes during a competition week. The GeneActiv was first assessed for utility during high-intensity exercise with indirect calorimetry. Thereafter, 14 professional Australian Football athletes (age, 24 ± 4 [SD] y; height, 1.87 ± 0.08 m; body mass, 86 ± 10 kg) wore the accelerometer and had dietary intake assessed via dietitian-led 24-hour recalls throughout a continuous 7 days of competition period (including match day). There was a significant relationship between metabolic equivalents and GeneActiv g·min-1 (SEE 1.77 METs; r2 = 0.64; p < 0.0001). Across the in-season week a significant difference only occurred on days 3 and 4 (day 3: energy intake [EI] EI 137 ± 31 kJ·kg-1·d-1; 11,763 ± 2,646 kJ·d-1 and EE: 186 ± 14 kJ·kg-1·d-1; 16,018 ± 1973 kJ·d-1; p < 0.05; d = -1.4; day 4: EI: 179 ± 44 kJ·kg-1·d-1, 15,413 ± 3,960 kJ·d-1 and EE: 225 ± 42 kJ·kg-1·d-1; 19,313 ± 3,072 kJ·d-1; d = -0.7). Carbohydrate intake (CI) was substantially below current sports nutrition recommendations on 6 of 7 days with deficits ranging from -1 to -7.2 g·kg-1·d-1 (p < 0.05), whereas daily protein and fat intake was adequate. In conclusion, the GeneActiv provides effective estimation of EE during weekly preparation for a professional team sport competition. Australian Footballers attempt to periodize dietary EI to varying daily training loads but fail to match expenditure on higher-training load days. Specific dietary strategies to increase CI may be beneficial to achieve appropriate energy balance and macronutrient distribution, particularly on days where athletes undertake multiple training sessions.

Evaluation of Musculoskeletal Re-Injury Occurrence in Previously Concussed National Football League Athletes.

IntroductionIncreased risk of musculoskeletal (MSK) injury post-concussion has been reported in collegiate athletes, yet it is unknown if professional football athletes are at the same risk of secondary injury. The objective of this study was to determine if the risk of MSK injury in National Football League (NFL) athletes increases after concussion.MethodsNFL injury reports from 2013 to 2017 were collected from public websites. Concussed athletes (n=91) were equally matched to a non-injured control and an athlete with an incident of musculoskeletal (MSK) injury.ResultsFollowing their return to sport, concussed athletes were 2.35 times more likely to have a subsequent MSK injury relative to non-injured controls (95% CI: 2.35 [1.25, 4.44], P = 0.01), but were no more likely than athletes with an incident MSK injury (P = 0.55). Likewise, athletes with an incident MSK injury were no more likely to have a subsequent MSK injury than controls (P = 0.08).DiscussionIncreased odds of MSK injury in the 12-week period following a concussion in professional football athletes warrants future research on the acute effects of concussion and the relationship to MSK injury risk.

Professional Athletes Have Poorer Sleep Quality and Sleep Hygiene Compared With an Age-Matched Cohort.

To study sleep quality and sleep hygiene in professional athletes and an age-matched cohort. Cross-sectional study. Professional athletes and a sport medicine center. Professional rugby, netball and football athletes (n = 184) and attendees to a sport medicine center (n = 101). Participants completed an online survey. Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI). Forty-five percent (n = 128) of respondents were aged between 18 and 24 years, 54% (n = 154) were men and 65% (n = 184) were professional athletes. The sleep duration of the professional athletes (mean rank 134.3, n = 181) was greater than the age-matched cohort (mean rank = 154.4, n = 101), U = 7835.0, z = -2.3, P = 0.02; however, they reported more sleep disturbance (mean ranking = 148.0, n = 181) than the age-matched cohort (mean rank = 129.8, n = 101), U = 7960.5 z = -2.5, P = 0.01, 2-tailed. Professional athletes had worse sleep regularity (mean rank = 152.3, n = 183) compared with the age-matched cohort (mean rank = 124.6, n = 101), U = 7448.5, z = -2.7, P = 0.006, 2-tailed, had an inferior sleep environment (mean rank = 149.5, n = 183) compared with the age-matched cohort (mean rank = 129.8, n = 101), U = 7959.5, z = -2.0, P = 0.047, and had more naps (mean rank = 156.2, n = 183) compared with the age-matched cohort (mean rank = 117.6, n = 101), U = 6729.0, z = -4.2, P = 0.00 0, 2-tailed. Professional athletes reported poorer sleep quality and sleep hygiene compared with an age-matched cohort, and difficulty falling asleep following competition. It is likely this is due to the stress of competition, training, and traveling. Because sleep plays an important role in postexercise recovery and has an impact on injury and athletic performance, it is important to have strategies to support better sleep quality and sleep hygiene in athletes.

Saliva microRNA Biomarkers of Cumulative Concussion.

Recurrent concussions increase risk for persistent post-concussion symptoms, and may lead to chronic neurocognitive deficits. Little is known about the molecular pathways that contribute to persistent concussion symptoms. We hypothesized that salivary measurement of microribonucleic acids (miRNAs), a class of epitranscriptional molecules implicated in concussion pathophysiology, would provide insights about the molecular cascade resulting from recurrent concussions. This hypothesis was tested in a case-control study involving 13 former professional football athletes with a history of recurrent concussion, and 18 age/sex-matched peers. Molecules of interest were further validated in a cross-sectional study of 310 younger individuals with a history of no concussion (n = 230), a single concussion (n = 56), or recurrent concussions (n = 24). There was no difference in neurocognitive performance between the former professional athletes and their peers, or among younger individuals with varying concussion exposures. However, younger individuals without prior concussion outperformed peers with prior concussion on three balance assessments. Twenty salivary miRNAs differed (adj. p < 0.05) between former professional athletes and their peers. Two of these (miR-28-3p and miR-339-3p) demonstrated relationships (p < 0.05) with the number of prior concussions reported by younger individuals. miR-28-3p and miR-339-5p may play a role in the pathophysiologic mechanism involved in cumulative concussion effects.

Diversifying sport-related concussion measures with baseline balance and ocular-motor scores in professional Zambian football athletes

ABSTRACT Purpose Normative values of common sport-related concussion assessment tools may assist clinical diagnosis and management. However, current baseline normative values are not representative of athletic participants across international domains. This study develops healthy baseline norms on the Balance Error Scoring System (BESS), and King-Devick (K-D), providing baseline reference values for professional Zambian football athletes. Methods Of the 125 male participants (aged 24.48 ± 5.41 years) screened for this study, 9 (7.2%) reported a previous history of concussion, 98 (78.4%) completed the Balance Error Scoring System and 88 (70.4%) completed the King-Devick. Descriptive statistics calculated for the BESS and the K-D test included mean, standard deviation, median, interquartile range (IQR), and percentiles ranks. Main findings Participants scored a mean ± standard deviation of 10.15 ± 5.6 and a median [IQR] of 9 [6–12.25] errors on the total BESS and completed the K-D test in a mean ± standard deviation 56.85 ± 10.55 seconds and a median [IQR] 55.28 [48.7–64.8] seconds. Conclusions Cross-cultural awareness and management of sport-related concussion are continuously improving the safety and well-being of athletic participants around the world. The diverse representation in these data may aid in interpretation of post-injury performance during sport-related concussion management in Zambia. This study develops baseline reference values currently lacking within African cultures and demonstrates the feasibility and global clinical utility of two sport-related concussion assessment resources.

Assessing the nutrition knowledge of professional female Australian football (AFLW) athletes

ABSTRACT Nutrition education in professional sport may improve athletes’ nutrition knowledge (NK), self-efficacy and food choices. Understanding athletes’ NK can inform development of tailored nutrition education programs. To enhance health and performance, athletes’ dietary intakes must meet their energy and nutritional needs and NK has been identified as a modifiable determinant of dietary intake. This study aimed to assess the NK of Australian football league women’s (AFLW) athletes to provide recommendations for possible dietetic intervention. AFLW athletes (n = 26) were recruited from one Victorian football club. NK was assessed using the validated online Nutrition for Sport Knowledge Questionnaire. AFLW athletes scored ‘average’ overall NK (score: 45.1 ± 12.5, mean accuracy: 50.6 ± 14%). Athletes demonstrated better knowledge in alcohol (5.6 ± 1.9, mean accuracy: 70 ± 23%), macronutrients (18.2 ± 5.0, mean accuracy: 60 ± 17%) and weight management subsections (7.3 ± 2.2, mean accuracy: 57 ± 17%). Athletes performed poorly in the supplements subsection (3.2 ± 2.0, mean accuracy: 23 ± 14%). This study assessed the NK of AFLW athletes and found athletes had average NK, with room for improvement particularly regarding supplement knowledge. Future research should assess the efficacy of online and group education to improve athletes’ NK and dietary intake.

Performance-based outcomes following patellar tendon repair in professional athletes

ABSTRACTObjectives: There are limited data on the impact of a patellar tendon repair to a professional athlete’s career. The purpose of this study was to determine differences return to play (RTP) rate, career length, and performance-based outcomes after a patellar tendon repair in professional athletes of four different sports.Methods: Participants met inclusion criteria if initial reports of the date and type of surgery were corroborated by at least two independent sources of information through a well-established protocol of public newspaper archives, team injury reports, and player profiles. Players with other concomitant injuries of the knee or treated nonoperatively were excluded. One hundred and three athletes across professional baseball, basketball, American football, and soccer athletes were identified and met inclusion criteria. RTP rate, career length, and sports-specific performance statistics (i.e. player efficiency rating (PER) for professional basketball players) before and after surgery were collected for each athlete.Results: Seventy-nine (76.7%) professional athletes successfully RTP. American football athletes had the lowest RTP rate and the largest drop in performance in post-operative season 1 (P < 0.001). These athletes also experienced the shortest adjusted career lengths (P = 0.003) compared to players in the other sports. Basketball athletes played significantly less games through post-operative seasons 1 to 3 (P < 0.05). Soccer athletes had less goals and assists per game and played fewer games (P < 0.05) in post-operative season 1 that recovered to baseline by seasons 2 and 3.Conclusion: A patellar tendon rupture is a potentially devastating injury for the professional athlete. American football players appeared to have the worst postoperative outcome with the lowest RTP rate and a most significant decrease in performance in the first postoperative season. This procedure also had a significant short-term impact on soccer athletes who sustained decreases in short-term game performance. These findings are likely explained by the unique physical demands imposed by each sport.

Athletes With Musculoskeletal Injuries Identified at the NFL Scouting Combine and Prediction of Outcomes in the NFL: A Systematic Review.

Background:Prior to the annual National Football League (NFL) Draft, the top college football prospects are evaluated by medical personnel from each team at the NFL Scouting Combine. On the basis of these evaluations, each athlete is assigned an orthopaedic grade from the medical staff of each club, which aims to predict the impact of an athlete’s injury history on his ability to participate in the NFL.Purpose:(1) To identify clinical predictors of signs, symptoms, and subsequent professional participation associated with football-related injuries identified at the NFL Combine and (2) to assess the methodological quality of the evidence currently published.Study Design:Systematic review; Level of evidence, 3.Methods:A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We reviewed all studies that examined musculoskeletal injuries identified among athletes at the NFL Combine and associated outcomes. Data on signs, symptoms, and subsequent NFL participation were collected, and the methodological quality of the studies was assessed.Results:Overall, 32 studies, including 30 injury-specific studies, met the inclusion criteria. Twenty studies analyzed data collected at the NFL Combine from 2009 and later. When compared with matched controls, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, superior labrum anterior-posterior repair, anterior cruciate ligament reconstruction, full-thickness chondral lesions of the knee, or Lisfranc injury played in significantly fewer games early in their NFL careers. Additionally, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, and navicular injury had decreased career lengths versus controls. Defensive players and linemen were found to have decreased participation in the NFL for several injuries, including prior meniscectomy, anterior cruciate ligament reconstruction, and shoulder instability. Career length follow-up, measures of athletic participation, and matching criteria were highly variable among studies.Conclusion:For medical professionals caring for professional football athletes, this information can help guide orthopaedic grading of prospects at the NFL Combine and counseling of athletes on the potential impact of prior injuries on their professional careers. For future studies, improvements in study methodology will provide greater insight into the efficacy of current treatments and areas that require further understanding.