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Background Neuromuscular training (NMT) has been shown to reduce anterior cruciate ligament injury rates in highly structured clinical trials. However, there is a paucity of studies that evaluate implementation of NMT programmes in sports. Aim To evaluate the implementation of an NMT programme in female adolescent football 3 years after a randomised controlled trial (RCT). Methods Cross-sectional follow-up after an RCT using the Reach, Effectiveness, Adoption, Implementation, and Maintenance Sports Setting Matrix (RE-AIM SSM) framework. Questionnaires were sent to the Swedish Football Association (FA), to eight district FAs and coaches (n=303) that participated in the RCT in 2009, and coaches who did not participate in the RCT but were coaching female adolescent football teams during the 2012 season (n=496). Results Response rates were 100% among the FAs, 57% among trial coaches and 36% among currently active coaches. The reach of the intervention was high, 99% of trial coaches (control group) and 91% of current coaches were familiar with the programme. The adoption rate was 74% among current coaches, but programme modifications were common among coaches. No district FA had formal policies regarding implementation, and 87% of current coaches reported no club routines for programme use. Maintenance was fairly high; 82% of trial coaches from the intervention group and 68% from the control group still used the programme. Conclusions Reach and adoption of the programme was high among coaches. However, this study identified low programme fidelity and lack of formal policies for its implementation and use in clubs and district FAs. [ABSTRACT FROM AUTHOR]

Objective To analyse the incidence, characteristics and circumstances of injuries during a female youth amateur football tournament in Kenya. Design 14 injury recorders prospectively registered and classified all injuries during all matches. Four physiotherapists and two doctors supported the injury recorders. Setting A 2-day Mathare Youth Sports Association (MYSA) inter-provincial football tournament for female players in Nairobi, Kenya. The tournament is organised by a non-governmental organisation (NGO). Participants 938 females divided into three age groups (under 13 years (U13), under 16 years (U16) and over 16 years (O16)). Main outcome measurements Overall injury incidence. Results 123 injuries occurred in 106 matches. The incidence of all injuries was 93.3 injuries/1000 h. Players in the U13 (relative risk (RR)=2.16, 95% CI 1.3 to 3.5; p=0.002) and U16 (RR=2.17, 95% CI 1.3 to 3.5; p=0.002) age groups had an increased risk of injury compared to the O16 group. Most injuries allowed the players to continue to play (n=98 of 121; 81%). For 15 (12%) of the injuries the player did not continue to play but was expected to fully participate in the following match, and eight of the injuries (6.1 injuries/1000 h) were expected to result in the player's absence from play for 1-7 days. The injuries most commonly affected the lower limb (n=100; 82%); contusions to the ankle (n=15; 12%) and foot/toe (n=15; 12%) were the most common specific injury types. Most acute injuries (89 of 113, 79%) were caused by player contact. Conclusions The incidence of injuries among female youth football players in a national tournament in Kenya was high, but time-loss injuries were rare. Playing football in a tournament organised by an NGO at the inter-provincial level was safe. [ABSTRACT FROM AUTHOR]

Background Injury prevention programme delivery on adherence and injury risk, specifically involving regular supervisions with coaches and players on programme execution on field, has not been examined. Aim The objective of this cluster-randomised study was to evaluate different delivery methods of an effective injury prevention programme (FIFA 11+) on adherence and injury risk among female youth football teams. Method During the 4-month 2011 football season, coaches and 13-year-old to 18-year-old players from 31 tier 1-3 level teams were introduced to the 11+ through either an unsupervised website ('control') or a coachfocused workshop with ('comprehensive') and without ('regular') additional supervisions by a physiotherapist. Team and player adherence to the 11+, playing exposure, history and injuries were recorded. Results Teams in the comprehensive and regular intervention groups demonstrated adherence to the 11+ programme of 85.6% and 81.3% completion of total possible sessions, compared to 73.5% for teams in the control group. These differences were not statistically significant, after adjustment for cluster by team, age, level and injury history. Compared to players with low adherence, players with high adherence to the 11+ had a 57% lower injury risk (IRR 0.43, 95% CI 0.19 to 1.00). However, adjusting for covariates, this betweengroup difference was not statistically significant (IRR=0.44, 95% CI 0.18 to 1.06). Conclusion Following a coach workshop, coach-led delivery of the FIFA 11+ was equally successful with or without the additional field involvement of a physiotherapist. Proper education of coaches during an extensive preseason workshop was more effective in terms of team adherence than an unsupervised delivery of the 11+ programme to the team. [ABSTRACT FROM AUTHOR]

Objective: To establish injury profile of collegiate rugby union in the USA Design/setting: 31 men's and 38 women's collegiate rugby union teams prospectively recorded injuries during games and practice during the 2005-06 season. Three teams withdrew before data collection. An injury was defined as one: (1) occurring in an organised inter- collegiate game or practice; and (2) requiring medical attention during or after the game or practice, or (3) resulting in any restriction of the athletes' participation for ⩾day(s) beyond the day of injury, or in a dental injury. Main outcome measures: In total, 847 injuries (447 in men; 400 in women) during 48 026 practice (24 280 in men; 23746 in women) and 25 808 game (13 943 in men; 11 865 in women) exposures were recorded. Results: During games, injury rates of 22.5 (95% Cl 20.2 to 25.0) and 22.7 (20.2 to 25.5) per 1000 game athletic exposures or 16.9 (15.1 to 18.9) and 17.1 (15.1 to 19.1) per 1000 player game hours were recorded for men and women, respectively. Over half of all match injuries were of major severity (>7 days' absence) (men 56%; women 51%) and the tackle was the game event most often associated with injury (men 48%; women 53%). Conclusions: Collegiate game injury rates for rugby were lower than rates recorded previously in men's professional club and international rugby and lower than reported by the National Collegiate Athletic Association Injury Surveillance System for American football, but similar to rates reported for men's and women's soccer in 2005-06. [ABSTRACT FROM AUTHOR]

There is little information on the nutritional habits of female football players at any level of the game. There is also a shortage of information on the nutrition and hydration strategies that players should adopt. In general, differences in nutritional needs between males and females are smaller than differences between individuals, so that principles developed for male players also apply to women. There is a need to address energy balance and body composition: prolonged energy deficits cannot be sustained without harm to health and performance. Published reports show mean carbohydrate intakes for female players of about 5 g/kg/day, and this seems to be too low to sustain consistent intensive training. The timing of protein intake may be as important as the amounts consumed, provided that the total intake is adequate. Dehydration adversely affects skill and stamina in women as it does in men, so an individualised hydration strategy should be developed. The prevalence of iron deficiency in women generally is high, but it seems to be alarmingly high in female players. All players should adopt dietary habits that ensure adequate iron intake. Football training seems to increase bone mass in the weight-bearing limbs, with positive implications for bone health in later life, but some players may be at risk from inadequate calcium dietary intake. [ABSTRACT FROM AUTHOR]

On the surface, the women's game appears to be similar to the men's game. On closer examination, there are subtle differences in the nature of how each gender plays the game, which are evident in the disparity between skills, tactics and fitness. The technical weaknesses of women include the first touch, dribbling, long passing and goal keeping. These skill limitations have dictated specific tactical approaches towards both attack and defence. Specific biological limitations inherent in the female player affect the pace and total work output in the women's game. Although it is unrealistic to expect the women's game to approach the work output of the men's game, specific training of skills and fitness will influence the tactical approach to the game. [ABSTRACT FROM AUTHOR]

Objective: To compare the incidence, nature, severity and cause of match injuries sustained on grass and new generation artificial turf by male and female footballers. Methods: The National Collegiate Athletic Association Injury Surveillance System was used for a two-season (August to December) prospective study of American college and university football teams (2005 season: men 52 teams, women 64 teams; 2006 season: men 54 teams, women 72 teams). Injury definitions and recording procedures were compliant with the international consensus statement for epidemiological studies of injuries in football. Athletic trainers recorded details of the playing surface and the location, diagnosis, severity and cause of all match injuries. The number of days lost from training and match play was used to define the severity of an injury. Match exposures (player hours) were recorded on a team basis. Results: The overall incidence of match injuries for men was 25.43 injuries/1000 player hours on artificial turf and 23.92 on grass (incidence ratio 1.06; p=0.46) and for women was 19.15 injuries/1000 player hours on artificial turf and 21.79 on grass (incidence ratio=0.88; p=0.16). For men, the mean severity of non-season ending injuries was 7.1 days (median 5) on artificial turf and 8.4 days (median 5) on grass and, for women, 11 .2 days (median 5) on artificial turf and 8.9 days (median 5) on grass. Joint (non-bone)! ligament/cartilage and contusion injuries to the lower limbs were the most common general categories of match injury on artificial turf and grass for both male and female players. Most injuries were acute (men: of artificial turf 24.60, grass 22.91; p=0.40; women: artificial turf 18.29, grass 20.64; p=0.21) and resulted from player-to-player contact (men: artificial turf 14.73, grass 13.34; p=0.37 women: artificial turf 10.72; grass 11.68; p=0.50). Conclusions: There were no major differences in the incidence, severity, nature or cause of match injuries sustained on new generation artificial turf and grass by either male or female players. [ABSTRACT FROM AUTHOR]

Although all injuries in sports are a concern for participants, head injuries are particularly troublesome because of the potential for long-term cognitive deficits. To prevent any specific injury, it is important to understand the basic frequency and incidence of injury and then the mechanism of injury. Once these are established, prevention programmes can be tested to see if the rate of injury changes. A primary problem with head injuries is recognising that the injury has occurred. Many athletes are not aware of the seriousness of concussive injury, thus this type of injury is probably under-reported. Once the diagnosis of a concussion is made, the next difficult decision is when to return a player to the game. These two management issues dominate the continuing development of understanding of concussive head injury. This paper explores the known gender differences between head injuries and highlights the areas that need to be considered in future research. [ABSTRACT FROM AUTHOR]

A stress fracture represents the inability of the skeleton to withstand repetitive bouts of mechanical loading, which results in structural fatigue, and resultant signs and symptoms of localised pain and tenderness. Reports of stress fractures in female football players are not prevalent; however, they are probably under-reported and their importance lies in the morbidity that they cause in terms of time lost from participation. By considering risk factors for stress fractures in female football players it may be possible to reduce the impact of these troublesome injuries. Risk factors for stress fractures in female football players include intrinsic risk factors such as gender, endocrine, nutritional, physical fitness and neuromusculoskeletal factors, as well as extrinsic risk factors such as training programme, equipment and environmental factors. This paper discusses these risk factors and their implications in terms of developing prevention and management strategies for stress fractures in female football players. [ABSTRACT FROM AUTHOR]

Objective: To compare the incidence, nature, severity and cause of training injuries sustained on new generation artificial turf and grass by male and female footballers. Methods: The National Collegiate Athletic Association Injury Surveillance System was used for a two-season (August to December) prospective study involving American college and university football teams (2005 season: men 52 teams, women 64 teams; 2006 season: men 54 teams, women 72 teams). Injury definitions and recording procedures were compliant with the international consensus statement for epidemiological studies of injuries in football. Athletic trainers recorded details of the playing surface and the location, diagnosis, severity and cause of all training injuries. The number of days lost from training and match play was used to define the severity of an injury. Training exposures (player hours) were recorded on a team basis. Results: The overall incidence of training injuries for men was 3.34 injuries/1000 player hours on artificial turf and 3.01 on grass (incidence ratio 1.11; p=0.21) and for women it was 2.60 injuries/1000 player hours on artificial turf and 2.79 on grass (incidence ratio 0.93; p=0.46). For men, the mean severity of injuries that were not season ending injuries was 9.4 days (median 5) on artificial turf and 7.8 days (median 4) on grass and, for women, 10.5 days (median 4) on artificial turf and 10.0 days (median 5) on grass. Joint (non-bone)/ligament/cartilage and muscle/tendon injuries to the lower limbs were the most common general categories of injury on artificial turf and grass for both male and female players. Most training injuries were f acute (men: artificial turf 2.92, grass 2.63, p=0.24; women: artificial turf 1.94, grass 2.23, p=0.21) and resulted from player-to-player contact (men: artificial turf 1.08, grass 0.85, p=0.10 women: artificial turf 0.47, grass 0.56; p=0.45). Conclusions: There were no major differences between the incidence, severity, nature or cause of training injuries sustained on new generation artificial turf and on grass by either men or women. [ABSTRACT FROM AUTHOR]

Background: Artificial turf is becoming increasingly popular, although the risk of injury on newer generations of turf is unknown. Aim: To investigate the risk of injury on artificial turf compared with natural grass among young female football players. Study design: Prospective cohort study. Methods: 2020 players from 109 teams (mean (SD) 15.4 (0.8) years) participated in the study during the 2005 football season. Time-loss injuries and exposure data on different types of turf were recorded over an eight-month period. Results: 421 (21%) players sustained 526 injuries, leading to an injury incidence of 3.7/1000 playing hours (95% CI 3.4 to 4.0). The incidence of acute injuries on artificial turf and grass did not differ significantly with respect to match injuries (rate ratio (RR) 1.0, 95% CI 0.8 to 1.3; p=0.72) or training injuries (RR 1.0, 95% CI 0.6 to 1.5, p=0.93). In matches, the incidence of serious injuries was significantly higher on artificial turf (RR 2.0, 95% CI 1.3 to 3.2; p=0.03). Ankle sprain was the most common type of injury (34% of all acute injuries), and there was a trend towards more ankle sprains on artificial turf than on grass (RR 1 .5, 95% CI 1.0 to 2.2; p=0.06). Conclusion: In the present study among young female football players, the overall risk of acute injuries was similar between artificial turf and natural grass. [ABSTRACT FROM AUTHOR]

Background: Several tools have been used for assessing risk situations and for gathering tackle information from international football matches for men but not for women. Purpose: To analyse activities in women's football and to identify the characteristics and risk potentials of tackles. Study design: Retrospective video analysis. Method: Video recordings of 24 representative matches from six women's top-level tournaments were analysed for tackle parameters and their risk potential. Results: 3531 tackles were recorded. Tackles in which the tackling player came from the side and stayed on her feet accounted for nearly half of all challenges for the ball in which body contact occurred. 2.7% of all tackles were classified as risk situations, with sliding-in tackles from behind and the side having the highest risk potential. Match referees sanctioned sliding-in tackles more often than other tackles (20% v 1 7%, respectively). Tackle parameters did not change in the duration of a match; however, there was an increase in the number of injury risk situations and foul plays towards the end of each half. Conclusions: Match properties provide valuable information for a better understanding of injury situations in football. Staying on feet and lumping vertically tackle actions leading to injury were sanctioned significantly more times by the referee than those not leading to injury (p<0.00), but no such difference was seen for sliding-in tackles (previously reported to have the highest injury potential in women's football). Therefore, either the laws of the game are not adequate or match referees in women's football are not able to distinguish between sliding-in tackles leading to and those not leading to injury. [ABSTRACT FROM AUTHOR]