Background Groin injuries represent a considerable problem in male football. Previous groin-specific prevention programmes have not shown a significant reduction in groin injury rates. An exercise programme using the Copenhagen Adduction exercise increases hip adduction strength, a key risk factor for groin injuries. However, its preventive effect is yet to be tested. Aim To evaluate the effect of a single-exercise approach, based on the Copenhagen Adduction exercise, on the prevalence of groin problems in male football players. Methods 35 semiprofessional Norwegian football teams were cluster-randomised into an intervention group (18 teams, 339 players) and a control group (17 teams, 313 players). The intervention group performed an Adductor Strengthening Programme using one exercise, with three progression levels, three times per week during the preseason (6–8 weeks), and once per week during the competitive season (28 weeks). The control group were instructed to train as normal. The prevalence of groin problems was measured weekly in both groups during the competitive season using the Oslo Sports Trauma Research Center Overuse Injury Questionnaire. Results The average prevalence of groin problems during the season was 13.5% (95% CI 12.3% to 14.7%) in the intervention group and 21.3% (95% CI 20.0% to 22.6%) in the control group. The risk of reporting groin problems was 41% lower in the intervention group (OR 0.59, 95% CI 0.40 to 0.86, p=0.008). Conclusion The simple Adductor Strengthening Programme substantially reduced the self-reported prevalence and risk of groin problems in male football players. Trial registration number ISRCTN98514933.

https://bjsm.bmj.com/content/bjsports/53/3/150.full.pdf

The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial

Objectives To describe age group patterns for injury incidence, severity and burden in elite male youth football. Methods Prospective cohort study capturing data on individual exposure and time-loss injuries from training and matches over four seasons (2016/2017 through 2019/2020) at a national football academy (U13–U18; age range: 11–18 years). Injury incidence was calculated as the number of injuries per 1000 hours, injury severity as the median number of days lost and injury burden as the number of days lost per 1000 hours. Results We included 301 players (591 player-seasons) and recorded 1111 time-loss injuries. Overall incidence was 12.0 per 1000 hours (95% CI 11.3 to 12.7) and burden was 255 days lost per 1000 hours (252 to 259). The mean incidence for overall injuries was higher in the older age groups (7.8 to 18.6 injuries per 1000 hours), while the greatest burden was observed in the U16 age group (425 days; 415 to 435). In older age groups, incidence and burden were higher for muscle injuries and lower for physis injuries. Incidence of joint sprains and bone stress injuries was greatest for players in the U16, U17 and U18 age groups, with the largest burden observed for U16 players. No clear age group trend was observed for fractures. Conclusion Injury patterns differed with age; tailoring prevention programmes may be possible.

https://bjsm.bmj.com/content/bjsports/55/14/794.full.pdf

Injury patterns differ with age in male youth football: a four-season prospective study of 1111 time-loss injuries in an elite national academy

Injury prevention of knee injuries by means of training and warm-up exercises has been investigated in several studies in amateur football. However, the number of investigations in elite football is limited despite the currently higher injury incidence of severe knee injuries. Therefore, the purpose of this study was to investigate whether specifically adapted preventive training modules may reduce severe knee injuries in elite football. In a prospective controlled cohort study of elite football players in Germany, an injury prevention programme with 5 modules was implemented in the season of 2015–2016. The training modules were specifically adapted to this skill level and based on scientific evidence, team coach preferences, and the specific environment of this playing level. Of the 62 teams taking part in this study, 26 used the new trainings modules and 36 continued their standard programme as a control group. Success of the programme was documented by means of an injury report over one season. The primary outcome was reduction in severe knee injuries. A pre-seasonal investigation had identified five modules to be implemented in the training routine. Postural stability, mobilisation of lower extremity joints, leg and trunk stabilisation, jumping, and landing exercises as well as agility movements were incorporated into the programme to prevent severe knee injuries in elite football. Over the season, the study group (529 players) with the adapted training modules had sustained 52 severe knee injuries (incidence: 0.38 per 1000 h football exposure; prevalence: 9.8%) compared to 108 severe knee injuries in the control group (601 players) using the standard programme (incidence: 0.68 per 1000 h football exposure; prevalence: 18.0%; p < 0.05). The overall injury incidence for any other type of injury was comparable between the two groups (3.3 vs. 3.4 in h 1000 football, n.s.). Appropriate preventive training modules reduce severe knee injuries in elite football significantly. The key for the sustainability of preventive training measures are programmes specifically adapted to the demands of the playing level and to the preferences of the coaches II.

Prevention of severe knee injuries in men’s elite football by implementing specific training modules

Sport is a domain that is rife with loss, failures, and disappointment. Self-compassion – the recognition of one’s own suffering and a desire to alleviate it – offers protection against maladaptive psychological experiences in sport. The purpose of this scoping review was to update and expand the results of the review by Röthlin and colleagues ([2019]. Go soft or go home? A scoping review of empirical studies on the role of self-compassion in the competitive sport setting. Current Issues in Sport Science, 4, Article 013. https://doi.org/10.15203/CISS_2019.013), and to identify new themes to help guide future research. Sixty-nine publications were identified using a variety of search strategies. Quantitative research (62.3%) and cross-sectional designs (83.3%) were most common, and most research was conducted by researchers residing in Westernized countries (81.2%). The majority of study participants (n = 10,025) were collegiate athletes (42.1%), and female/women sport participants were sampled slightly more frequently (52.4%). Researchers often investigated sex- or gender-based and competition level differences in self-compassion scores. Other common areas of research focus included well-being, mindfulness, striving for excellence, overcoming setbacks, negative thoughts and emotions, and self-criticism. New research areas that were identified included a need for theory, additional efforts towards conceptualization and measurement, acknowledgement of participant selection bias, integrating intersectionality, the relationship between self-compassion and performance, the distinctiveness between self-compassion and mindfulness, and future directions for interventions. 

Self-compassion in sport: a scoping review

For a successful return to sport (RTS) after an anterior cruciate ligament reconstruction (ACLR), patients are recommended to attend a comprehensive rehabilitation program, followed by an RTS assessment, that is a combination of tests. The purpose of this study was to predict a successful return to sport using the results of the RTS assessment and self-reported questionnaires at minimum 2 years after ACLR. A total of 123 consecutive ACLR patients undertook an intensive rehabilitation program followed by a comprehensive RTS assessment that included an established combination of balance and strength tests, the ACL-return to sport after Injury scale (ACL-RSI) questionnaire and a KT1000 laximetry test. Preinjury and expected Tegner and Lysholm were collected at baseline, at RTS and prospectively collected at minimum 2-year follow-up. The patients were asked if they returned to their previous sport and at which level. All variables were included in a regression analysis predicting a successful return to previous sport, return to the same level of sport as well as the Tegner level at 2 years. Sixty-two patients (50%) returned to their previous sport by the 2-year follow-up, without a difference in preinjury Tegner between these two groups (n.s.). Expected preoperative Tegner was the only significant predictor of a successful return to previous sport (p = 0.042; OR 1.300, 95% CI 1.010–1.672). Out of the 62 patients returning to their previous sport, 38 (61%) reported to be on the same or higher level. The only predictive variable for returning to the same level was the higher preinjury Tegner level (p = 0.048; OR 1.522). Multivariate regression analysis of Tegner level at 2 years found younger age to be the only predictive value. From the RTS assessment tests, the ACL-RSI questionnaire and the posterolateral balance test were predictive variables for Tegner at 2-year follow-up, albeit in the univariate regression analysis. Preoperative Tegner and expected Tegner level collected prior to an ACL reconstruction can aid in the objective prediction of patients’ return to sport after 2 years. High-level athletes are more likely to return to their previous sport and to the previous level. Younger patients achieve a higher Tegner level at 2 years. Level III study.

/pdf/tegner-level-is-predictive-for-successful-return-to-sport-2-42a3c1wici.pdf

Tegner level is predictive for successful return to sport 2 years after anterior cruciate ligament reconstruction

Injuries are a common occurrence in football. Sufficient epidemiological data are available in professional football but not in salaried semi-professional football. This study investigates the injury incidence at different levels of semi-professional football with focus on junior football. The data were based on injury reports provided by players and medical staff over the 2015–2016 season, which corresponded to the consensus statement for data samples in football. This study investigated the injury incidence and prevalence of five skill levels of semi-professional football (the fourth to the seventh league and elite junior football). 1130 players had sustained 2630 injuries over the 2015–2016 season. The overall injury incidence was 9.7 per 1000 h football exposure; prevalence with at least one injury was 79%. The highest overall injury incidence in elite junior football was 10.4 in 1000 h football exposure. The fifth league had the lowest incidence with 9.0 in 1000 h football (p < 0.05). Traumatic injuries most often occurred in the fourth league (3.9 in 1000 h football). The body areas most affected by traumatic injury were knees, ankles and thighs. Elite junior players had a significantly higher incidence of overuse complaints (7.4 in 1000 h football) than the fourth league (5.4, p = 0.005). The body areas most affected by overuse complaints were the lower back, thigh and groin. No differences were found between the different positions on field. Salaried semi-professional football involves a high overall injury incidence. The highest incidence, particularly of overuse injuries, was seen in elite junior football. These findings should be incorporated in specific injury prevention training or screenings beginning in junior football. Level of evidence II.

Injury incidence in semi-professional football claims for increased need of injury prevention in elite junior football

Injuries are a common problem in football. To improve prevention strategies, the players’ (p) and coaches’ (c) views need to be disclosed as they have a strong impact on return to play decisions. The aim of this study is to reveal current opinions with regard to injury prevention and return to play strategies to introduce new strategies in elite football. In a retrospective data analysis of elite salaried football players (n = 486) and team coaches (n = 88), a detailed investigation by means of a standardized questionnaire was carried out. In a preseason period of the 2015/16 season and as part of a large interventional research project in elite salaried German football, a request about players’ and team coaches’ knowledge and opinions was performed. Topics such as injury prevention, return to play after injuries, the importance of screening tests, general problems of injuries in football, or the decision-making in terms of prevention and return to play in elite football were investigated. The study revealed a high interest in injury prevention and screening tests among players and coaches (p 82.5%; c 99.1%). The participants of the study reported warm-up exercises (p 76.4%; c 74.7%), regeneration training (p 54.1%; c 56.3%), and core stability (p 53.8; c 70.1%) as the most important prevention methods, but the additional investigation of the teams’ current daily training routine showed that the transfer is incomplete. Coaches are more familiar with scientific published warm-up programs like FIFA 11 + than players (42.5 vs. 12.6; p < 0.001). Knee injuries (p 90.7%; c 93.1%) and ACL injuries in particular were reported as the most severe and common problem in elite football. Players and coaches expressed different attitudes concerning return to play decisions. While players want to decide themselves (81.4%), team coaches consult medical advice ahead of the decision of return to play after injuries (83.5%; p < 0.001). Decisions against the doctor’s recommendation are often made by both groups (p 64.4% vs. c 87.1%; p < 0.001). The basic knowledge of prevention and injuries is sufficient in elite football, but the transfer from theoretical knowledge to practical routine is suboptimal. The study also shows possibilities to improve the prevention process and communication between players, coaches, doctors, and physiotherapists, while there is no consent between players and coaches regarding return to play decision.

Injury prevention and return to play strategies in elite football: no consent between players and team coaches.

Objectives The first main goal of this study was to investigate the prevalence of depression and anxiety as well as self-compassion in a heterogeneous sample of male amateur soccer players. The second main goal of this study was the examination of the relationship between injuries and psychological factors in amateur soccer players. Methods Players were recruited from German amateur soccer clubs of the fourth to seventh league. 419 soccer players with the mean age of 22.88 years participated in the psychological and the injury assessment at the beginning of the season and at the end, 9 months later. For the psychological assessment, depression and anxiety rate as well as self-compassion was analysed. Furthermore, the frequencies of injuries were registered. Results The results showed that players of the highest amateur league, the fourth league in German soccer, showed significantly higher anxiety values than players from a lower league (p=0.013). There were no differences in depression values dependent on the league. Furthermore, players who suffered from an injury before the start of the season demonstrated higher anxiety values (p=0.027). This result was independent of the respective league. Conclusion The results of this study demonstrate that even in higher amateur soccer the anxiety level of the players varies between soccer players of different leagues. Because an injury before the start of the season influenced the anxiety level, a psychological treatment during injury should be considered.

https://bmjopensem.bmj.com/content/bmjosem/5/1/e000522.full.pdf

Relation of injuries and psychological symptoms in amateur soccer players.

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Prevention of severe knee injuries in men’s elite football by implementing specific training modules

Injury incidence in semi-professional football claims for increased need of injury prevention in elite junior football

Injury prevention and return to play strategies in elite football: no consent between players and team coaches.

Relation of injuries and psychological symptoms in amateur soccer players.