Latest research in football - week 22 - 2018

#1 Prevention of Ankle Sprain Injuries in Youth Soccer and Basketball: Effectiveness of a Neuromuscular Training Program and Examining Risk Factors
Reference: Clin J Sport Med. 2017 Jun 29. doi: 10.1097/JSM.0000000000000462. [Epub ahead of print]
Authors: Owoeye OBA, Palacios-Derflingher LM, Emery CA
Summary: The primary objective of this study was to examine the effectiveness of a neuromuscular training (NMT) warm-up program in reducing the risk of ankle sprain injury (ASI) in youth soccer and basketball. The secondary objective included the evaluation of risk factors for ASI. Male and female youth (11-18 years) soccer and basketball players (n = 2265) in Alberta, Canada participated in this study. Ankle sprain injury was the primary outcome and was recorded using a validated prospective injury surveillance system consistent in all studies. The primary exposure of interest was NMT warm-up, which included aerobic, strength, agility, and balance components. Multivariable Poisson regression, controlling for clustering by team and offset for exposure hours, was used to estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs), with considerations for confounding and effect modification and evaluating all covariates as potential risk factors. A total of 188 ASIs were reported in 171 players. Neuromuscular training significantly reduced the risk of ASI [IRR = 0.68 (95% CI; 0.46-0.99)]. Independent risk factors for ASI included previous ASI [IRR = 1.98 (95% CI; 1.38-2.81)] and participation in basketball versus soccer [IRR = 1.83 (95% CI; 1.18-2.85)]. Sex, age, body mass index, and previous lower extremity injury (without previous ASI) did not predict ASI (P > 0.05). Exposure to an NMT program is significantly protective for ASI in youth soccer and basketball. Risk of ASI in youth basketball is greater than soccer, and players with a history of ASI are at greater risk


#2 Patellar tendon properties distinguish elite from non-elite soccer players and are related to peak horizontal but not vertical power
Reference: Eur J Appl Physiol. 2018 Jun 2. doi: 10.1007/s00421-018-3905-0. [Epub ahead of print]
Authors: Murtagh CF, Stubbs M, Vanrenterghem J, O'Boyle A, Morgans R, Drust B, Erskine RM
Download link: https://link.springer.com/content/pdf/10.1007%2Fs00421-018-3905-0.pdf
Summary: The purpose was to investigate potential differences in patellar tendon properties between elite and non-elite soccer players, and to establish whether tendon properties were related to power assessed during unilateral jumps performed in different directions. Elite (n = 16; age 18.1 ± 1.0 years) and non-elite (n = 13; age 22.3 ± 2.7 years) soccer players performed vertical, horizontal-forward and medial unilateral countermovement jumps (CMJs) on a force plate. Patellar tendon (PT) cross-sectional area, elongation, strain, stiffness, and Young's modulus (measured at the highest common force interval) were assessed with ultrasonography and isokinetic dynamometry. Elite demonstrated greater PT elongation (6.83 ± 1.87 vs. 4.92 ± 1.88 mm, P = 0.011) and strain (11.73 ± 3.25 vs. 8.38 ± 3.06%, P = 0.009) than non-elite soccer players. Projectile range and peak horizontal power during horizontal-forward CMJ correlated positively with tendon elongation (r = 0.657 and 0.693, P < 0.001) but inversely with Young's modulus (r = - 0.376 and - 0.402; P = 0.044 and 0.031). Peak medial power during medial CMJ correlated positively with tendon elongation (r = 0.658, P < 0.001) but inversely with tendon stiffness (r = - 0.368, P = 0.050). Not only does a more compliant patellar tendon appear to be an indicator of elite soccer playing status but it may also facilitate unilateral horizontal-forward and medial, but not vertical CMJ performance. These findings should be considered when prescribing talent selection and development protocols related to direction-specific power in elite soccer players.


#3 Workload and non-contact injury incidence in elite football players competing in European leagues
Reference: Eur J Sport Sci. 2018 Jun 2:1-8. doi: 10.1080/17461391.2018.1477994. [Epub ahead of print]
Authors: Delecroix B, McCall A, Dawson B, Berthoin S, Dupont G
Summary: The aim of this study was to analyse the relationship between absolute and acute:chronic workload ratios and non-contact injury incidence in professional football players and to assess their predictive ability. Elite football players (n = 130) from five teams competing in European domestic and confederation level competitions were followed during one full competitive season. Non-contact injuries were recorded and using session rate of perceived exertion (s-RPE) internal absolute workload and acute:chronic (A:C) workload ratios (4-weeks, 3-weeks, 2-weeks and week-to-week) were calculated using a rolling days method. The relative risk (RR) of non-contact injury was increased (RR = 1.59, CI95%: 1.18-2.15) when a cumulative 4-week absolute workload was greater than 10629 arbitrary units (AU) in comparison with a workload between 3745 and 10628 AU. When the 3-week absolute workload was more than 8319 AU versus between 2822 and 8318 AU injury risk was also increased (RR= 1.46, CI95% 1.08-1.98). Injury incidence was higher when the 4-week A:C ratio was <0.85 versus >0.85 (RR = 1.31, CI95%: 1.02-1.70) and with a 3-week A:C ratio >1.30 versus <1.30 (RR = 1.37, CI95%: 1.05-1.77). Importantly, none of the A:C workload combinations showed high sensitivity or specificity. In elite European footballers, using internal workload (sRPE) revealed that cumulative workloads over 3 and 4 weeks were associated with injury incidence. Additionally, A:C workloads, using combinations of 2, 3 and 4 weeks as the C workloads were also associated with increased injury risk. No A:C workload combination was appropriate to predict injury.


#4 Hip and groin injury is the most common non-time-loss injury in female amateur football
Reference: Knee Surg Sports Traumatol Arthrosc. 2018 Jun 2. doi: 10.1007/s00167-018-4996-1. [Epub ahead of print]
Authors: Langhout R, Weir A, Litjes W, Gozeling M, Stubbe JH1, Kerkhoffs G, Tak I
Download link: https://link.springer.com/content/pdf/10.1007%2Fs00167-018-4996-1.pdf
Summary: Hip and groin injuries in football are problematic due to their high incidence and risk of chronicity and recurrence. The use of only time-loss injury definitions may underestimate the burden of hip and groin injuries. Little is known about hip and groin injury epidemiology in female football. The first aim of this study was to examine the within-season (2014-2015) prevalence of total injury with and without time-loss in female amateur football players. The second aim was to study the within-season and preseason (2015-2016) prevalence of hip/groin injuries with and without time-loss. The third aim was to study the association between the duration of hip and groin injury in the 2014-2015 season and the severity of hip/groin problems during the 2015-2016 preseason. During the preseason, 434 Dutch female amateur football players completed an online questionnaire based on the previous season and current preseason. The hip and groin outcome score (HAGOS) was used to assess the severity of hip and groin injuries. The hip/groin (17%), knee (14%), and ankle (12%) were the most frequent non-time-loss injury locations. The ankle (22%), knee (18%), hamstring (11%), thigh (10%), and hip/groin (9%) were the most common time-loss injury locations. The previous season prevalence of total injury was 93%, of which non-time-loss injury was 63% and time-loss injury was 37%. The prevalence of hip/groin injury was 40%, non-time-loss hip/groin injury was 36% and time-loss hip/groin injury was 11%. The preseason prevalence of hip/groin injury was 27%, non-time-loss hip/groin injury was 25%, and time-loss hip/groin injury was 4%. Players with longstanding hip/groin injury (> 28 days) in the previous season had lower HAGOS scores at the next preseason than players with short-term (1-7 days) or no hip/groin injury (p < 0.001). From all players with hip/groin injury from the previous season, 52% also sustained hip/groin injury in the following preseason, of which 73% were recurrent and 27% were chronic hip/groin injuries. Injury risk, and especially non-time-loss hip and groin injury risk, is high in female amateur football. Three-quarters of the players with longstanding hip and groin injuries in the previous season have residual problems at the start of the following season.


#5 Distribution of Arsenic and Risk Assessment of Activities on Soccer Pitches Irrigated with Arsenic-Contaminated Water
Reference: Int J Environ Res Public Health. 2018 May 24;15(6). pii: E1060. doi: 10.3390/ijerph15061060.
Authors: Martinez-Villegas N, Hernandez A, Meza-Figueroa D, Sen Gupta B
Download link: www.mdpi.com/1660-4601/15/6/1060/pdf
Summary: The aim of this research was to estimate the risk of human exposure to arsenic due to sporting activities in a private soccer club in Mexico, where arsenic-contaminated water was regularly used for irrigation. For this purpose, the total concentration in the topsoil was considered for risk assessment. This was accomplished through three main objectives: (1) measuring arsenic concentrations in irrigation water and irrigated soils, (2) determining arsenic spatial distribution in shallow soils with Geographical Information Systems (GIS) using geostatistical analysis, and (3) collecting field and survey data to develop a risk assessment calculation for soccer activities in the soccer club. The results showed that the average arsenic concentrations in shallow soils (138.1 mg/kg) were 6.2 times higher than the Mexican threshold for domestic soils (22 mg/kg). Furthermore, dermal contact between exposed users and contaminated soils accounted for a maximum carcinogenic risk value of 1.8 &times; 10&minus;5, which is one order of magnitude higher than the recommended risk value, while arsenic concentrations in the irrigation water were higher (6 mg/L) than the WHO&rsquo;s permissible threshold in drinking water, explaining the contamination of soils after irrigation. To the best of our knowledge, this is the first risk study regarding dermal contact with arsenic following regular grass irrigation with contaminated water in soccer pitches.


#6 Modeling of relationships between physical and technical activities and match outcome in elite German soccer players
Reference: J Sports Med Phys Fitness. 2018 Jun 7. doi: 10.23736/S0022-4707.18.08506-7. [Epub ahead of print]
Authors: Konefal M, Chmura P, Kowalczuk E, Figueiredo AJ, Sarmento H, Rokita A, Chmura J, Andrzejewski M
Summary: The aim of this study was to determine what physical and technical activities of soccer players in different pitch positions affect significantly the match outcome of professional German soccer players; as well as to examine whether differences in physical and technical activities increase or reduce the probability of a match being won. The study sample comprised 4393 individual match observations of 350 soccer players competing in the Bundesliga during the 2014/2015 domestic season. Analysis was confined to outfield players (other than goalkeepers) who completed entire matches, and was carried out using the Impire AG motion analysis system. The selection of physical and technical activities to be used in predictive models was achieved using the lasso method. The odds ratio revealed that an mean running speed in the second half that was greater by 0.1 km/h was associated with a 27.0% improvement in the odds of a match being won (OR=1.27; 95% CI: 1.17 to 1.38) (forwards), 15.7% (OR=1.16; 95% CI: 1.09 to 1.23) (wide midfielders), and 10.0% (OR=1.10; 95% CI: 1.04 to 1.17) (central midfielders). Furthermore, in the case of wide midfielders, a significant variable was the distance covered at > 24 km/h, with an increase of 0.1 km associated with odds of winning the game improved by 31.7% (OR=1.32; 95% CI: 1.05 to 1.66). Match outcome is affected significantly where peak and mean running speeds in the second half of the match are greater, and where longer distances are covered at speeds in excess of 24 km/h.


#7 Professional soccer is associated with radiographic cam and pincer hip morphology
Reference: Knee Surg Sports Traumatol Arthrosc. 2018 Jun 6. doi: 10.1007/s00167-018-5008-1. [Epub ahead of print]
Authors: Falotico GG, Arliani GG, Yamada AF, Fernandes ADRC, Ejnisman B, Cohen M
Summary: Femoroacetabular impingement (FAI) syndrome is characterized by a triad: symptoms, clinical signs and imaging findings. Some individuals, especially athletes, have only imaging alterations. The objective of this study was to evaluate the prevalence of cam and pincer morphology in professional soccer players compared with a control group of non-athletes and to investigate the association between the age at which players start playing competitive soccer more than three times per week and duration of the soccer career with the prevalence of these radiographic findings. The prevalence of cam and pincer morphology in sixty professional adult male soccer players and thirty-two male controls was determined using pelvic anteroposterior radiography. Data were recorded for all hips and correlated with the age at which the players started competitive soccer practice and with the duration of their soccer career. The prevalence of morphological FAI in the soccer players was 92.5% versus 28.1% in the controls (p < 0.001). The duration of the soccer career was positively correlated with the alpha angle (p = 0.033) and negatively correlated with the retroversion index (p = 0.009). The age at which competitive play began was inversely correlated with the alpha angle (p < 0.001). The study showed a high prevalence of cam and pincer morphology in Brazilian professional soccer players compared with controls. The duration of the soccer career was associated with an increased alpha angle and a decreased retroversion index, and the age at which competitive soccer participation began was negatively associated with alpha angle values. Finally, this manuscript provides data about the association between greater exposure to soccer and cam and pincer morphological changes in the hip; specifically, cam morphology was more common in patients who began participating in sports at earlier ages. This information serves as an alert for coaches of youth teams to manage the training load in youth athletes.


#8 Injury rate and prevention in elite football: let us first search within our own hearts
Reference: Br J Sports Med. 2018 Jun 2. pii: bjsports-2018-099267. doi: 10.1136/bjsports-2018-099267. [Epub ahead of print]
Authors: Buchheit M, Eirale C, Simpson BM, Lacome M


#9 How the Experimental Setting Influences Representativeness: A Review of Gaze Behavior in Football Penalty Takers
Reference: Front Psychol. 2018 May 8;9:682. doi: 10.3389/fpsyg.2018.00682. eCollection 2018.
Authors: Kurz J, Munzert J
Download link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5952262/pdf/fpsyg-09-00682.pdf
Summary: This article reviews research on the gaze behavior of penalty takers in football. It focuses on how artificial versus representative experimental conditions affect gaze behavior in this far-aiming task. Findings reveal that-irrespective of the representativeness of the experimental conditions-different instructions regarding the aiming strategy and different threat conditions lead to different gaze patterns. Results also reveal that the goal size and the distance to the goal did not affect the gaze behavior. Moreover, it is particularly run-up conditions that lead to differences. These can be either artificial or more natural. During a natural run-up, penalty takers direct their gaze mainly toward the ball. When there is no run-up, they do not direct their gaze toward the ball. Hence, in order to deliver generalizable results with which to interpret gaze strategies, it seems important to use a run-up with a minimum length that is comparable to that in a real-life situation.


#10 Creatine kinase, neuromuscular fatigue, and the contact codes of football: A systematic review and meta-analysis of pre- and post-match differences
Reference: Eur J Sport Sci. 2018 Jun 5:1-11. doi: 10.1080/17461391.2018.1480661. [Epub ahead of print]
Authors: Hagstrom AD, Shorter KA
Summary: Physiological or performance tests are routinely utilised to assess athletes' recovery. At present, the ideal tool to assess recovery remains unknown. Therefore, the aim of this systematic review was to examine the change in creatine kinase (CK) and neuromuscular function as measured via a countermovement jump (CMJ) following a match in the contact codes of football. A comprehensive search of databases was undertaken with RevMan (V 5.3) used for statistical analysis. Our results demonstrated that CK pre- versus post-match (standardised mean difference (SMD) = 0.90, 95% CI = 0.50 to 1.31, p < .0001), CK pre- versus 24 h post-match (SMD = 1.50, 95% CI = 1.12 to 1.88, p < .00001), and CK pre- versus 48 h post-match all increased significantly (SMD = 0.90, 95% CI = 0.50 to 1.31, p < .0001), while CMJ peak power (PP) pre- versus post-match (SMD = -0.59, 95% CI = -1.12 to -0.06, p = .03), and pre- versus 24 h post-match (SMD = -0.80, 95% CI = -1.31 to -0.28, p = .002) decreased significantly. There was a significant relationship between the change in CK and the change in CMJ PP from immediately pre to immediately post (r = -0.924, p = .025), and between CMJ immediately following a match and 24 h CK change (r = -0.983, p = .017). In conclusion, CK levels increase and performance in the CMJ decreases following a match of a contact code of football. The identification of this relationship may allow coaching staff to implement a standalone measure of recovery.


#11 Lunacy revisited - the myth of the full moon: are football injuries related to the lunar cycle?
Reference: Chronobiol Int. 2018 Jun 6:1-6. doi: 10.1080/07420528.2018.1483943. [Epub ahead of print]
Authors: Yousfi N, Rekik RN, Eirale C, Whiteley R, Farooq A, Tabben M, Gillogly S, Bahr R, Chamari K
Summary: Previous literature suggests that human behaviour and physiology are somehow altered by the moon-cycle, with particular emphasis on poorer sleep quality and increased aggressive behaviour during full moon. The latter variables can negatively impact athletes' recovery and increase the likelihood of injury resulting from collision with another athlete. Therefore, the current study aimed to investigate the association between the lunar cycle and injury risk in professional football players (soccer). We monitored injuries and player exposure in the premier professional league in Qatar during four consecutive seasons (2013-2014 through 2016-2017). Acute (sudden-onset traumatic) injuries (n = 1184; 587 from contact with another player and 597 without player contact) recorded during matches and training were classified according to the lunar cycle characteristics on the date of injury: (i) moon illumination, (ii) lunar distance from earth and (iii) tidal coefficient, acquired from the lunar calendar and tide tables. We used a Poisson regression model to examine the relationship between injury risk and lunar cycle characteristics. We did not detect any association between injury risk and moon illumination, earth-to-moon distance or tidal coefficient, not for all acute injuries, nor for contact and non-contact injuries when examined separately. The findings suggest that the full moon or new moon or the gravitational pull have no effect on football injuries. Thus, organisers need not consult moon or tide tables when planning future event schedules.