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Context: We designed this study to investigate the effects of 2 myofascial release techniques, Instrument-Assisted Soft Tissue Mobilization (IASTM) and Foam Roller (FR), on pain, joint range of motion, and muscle strength in athletes suffering from iliotibial band (ITB) tightness. Design: A total of 39 male soccer players were enrolled in this randomized controlled trial, aged between 18 and 23 years who were divided into 3 groups: Only Exercise, IASTM, and FR. Methods: All participants performed daily strengthening and stretching exercises, while 1 group added IASTM, and the other added FR to the exercise program. We evaluated ITB tightness with the Ober test and an inclinometer, pressure pain threshold, using an algometer, and we evaluated muscle strength with the Cybex Norm Isokinetic device. Results: We found that all 3 groups exhibited an increase in the Ober inclination angle after the interventions (P =.001), but the increase was greater for participants in the IASTM and FR groups, compared with exercise alone. Additionally, both the IASTM and FR groups displayed an increased pressure pain threshold (P =.001), whereas there was no change in the control group. Moreover, while all 3 groups experienced an increase in hip muscle strength (P =.001), the IASTM and FR groups exhibited a greater increase compared with exercise alone (P =.001). Conclusions: Based on these findings, exercise improves pain, range of motion, and muscle strength in athletes with ITB tightness, and IASTM, and FR techniques enhanced exercise effects but did not differ from one another. While our study demonstrated that both IASTM and FR techniques significantly enhance the benefits of exercise for athletes with ITB tightness, further research could delve into the long-term effects of these interventions. [ABSTRACT FROM AUTHOR]

Prior studies have explored the relationship between knee valgus and musculoskeletal variables to formulate injury prevention programs, primarily for females. Nonetheless, there is insufficient evidence pertaining to professional male soccer players. Here, the aim was to test the correlation of lateral trunk inclination, hip adduction, hip internal rotation, ankle dorsiflexion range of motion, and hip isometric strength with knee valgus during the single-leg vertical jump test. Twenty-four professional male soccer players performed a single-leg vertical hop test, hip strength assessments, and an ankle dorsiflexion range of motion test. A motion analysis system was employed for kinematic analysis. Maximal isometric hip strength and ankle dorsiflexion range of motion were tested using a handheld dynamometer and a digital inclinometer, respectively. The correlation of peak knee valgus with peak lateral trunk inclination was.43 during the landing phase (P =.04) and with peak hip internal rotation was −.68 (P <.001). For knee valgus angular displacement, only peak lateral trunk inclination presented a moderate positive correlation (r =.40, P =.05). This study showed that trunk and hip kinematics are associated with knee valgus, which could consequently lead to increased knee overload in male professional soccer players following a unilateral vertical landing test. [ABSTRACT FROM AUTHOR]

Background: Strength training (ST) primarily enhances physical fitness (e.g., muscle strength, power, speed) and bone density in female soccer players. Less information is available on the injury preventive effects of ST in female athletes. Accordingly, this study aimed to investigate the effects of a 12-week in-season ST on measures of physical fitness and injury occurrence in young elite female soccer players. Methods: Thirty elite female soccer players (15.4 ± 1.9 years; maturity offset + 2.3 ± 1.1 years) participated in this study, and were randomly assigned to a strength training group (STG, n = 14) or an active control (CG, n = 16) group. ST lasted twelve weeks and included full body muscle strengthening exercises using primarily weight machines at progressive intensities ranging between 40 and 85% of the one-repetition-maximum (1-RM). The CG practiced a traditional soccer training program. Overall, training volumes of the two groups were similar with a training load (rating of perceived exertion × time) of 1158.4 ± 67.7 arbitrary unity (AU) for the STG and 1188.8 ± 44.1 AU for the CG. Pre and post training, the following physical fitness tests were applied: dynamic muscle strength (relative [to body mass] and absolute 1-RM bench/leg press, lat-pull down), jump performance (countermovement jump [CMJ], squat jump [SJ], five-jump-test [5JT]), linear-sprint speed (5-m, 10-m, 30-m), change-of-direction speed (T-test with and without ball), sport-specific performance (Yo-Yo Intermittent Level1 [YYIRTL1], and repeated shuttle sprint ability [RSSA]). The injury rate per 1000-h exposure was monitored throughout the soccer season. Results: No significant baseline differences were observed between groups. Statistically significant group-by-time interactions were found for absolute (p < 0.001, d = 2.59) and relative 1-RM bench press (p < 0.001, d = 2.39), absolute 1-RM lat-pull down (p < 0.001, d = 1.68), and relative 1-RM leg press (p < 0.001, d = 1.72). Significant group-by-time interactions were observed for CMJ (p = 0.005, d = 1.27), RSSAmean (p = 0.007, d = 0.81), and RSSAtotal (p < 0.001, d = 1.90). Post-hoc tests indicated that the STG group demonstrated greater improvements in all tested variables compared to CG (1.2 < d < 2.5). However, no significant interaction effects were noted for measures of linear sprint speed and YYIRTL1 performance. Additionally, non-contact injuries during the season were significantly lower (p = 0.003, d = 1.31) in the STG (0.48/1000 h of exposure) than the CG (2.62/1000 h of exposure). Conclusions: Twelve weeks of an in-season ST resulted in larger physical fitness improvements and fewer injuries compared with an active control in elite young female soccer players. Accordingly, ST should be systematically applied in female soccer to enhance performance and prevent injuries. Key Finding: This study showed that the incorporation of 12 weeks of strength training with two weekly sessions during the soccer season improves anthropometric and body composition characteristics as well as measures of physical fitness in adolescent elite female soccer players. Strength training reduces the incidence of non-contact injuries in young female soccer players. The usage of strength training machines is safe in elite young female soccer players with no previous experience in weightlifting. [ABSTRACT FROM AUTHOR]

The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green – yellow–red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers. [ABSTRACT FROM AUTHOR]

Implicit learning has the potential to improve movement execution and reduce injury risk. Previous research showed beneficial effects of short-term interventions with implicit learning in male athletes. However, research on long-term interventions in female athletes is lacking. The aim of this study was to examine the effects of a 4-week intervention with video instruction on movement execution of SSC, a task that is highly related with anterior cruciate ligament (ACL) injury risk, in female athletes. Twenty talented adolescent female soccer players were part of the control (CTRL, n = 10) or video instruction (VIDEO, n = 10) group. All subjects practiced 4 weeks and received general task instructions. In addition, the VIDEO group received expert video instruction during practice. Lower extremity kinematics and kinetics and vertical ground reaction force of SSC were examined during baseline, immediate post, and 1-week retention tests. After nonlinear registration, differences between each subject and the expert she had seen were determined. These differences were analyzed with SPM1D 2-way ANOVA. No interaction effects between time and group were found (p > 0.05). Main effects of time were found in the frontal plane. In particular, smaller deviations of subjects compared with the seen expert of the knee adduction (p = 0.005, 97.9-100% stance phase [SP]) and hip abduction (p = 0.005,11.5-13.8% SP) and adduction (p < 0.001, 33.4-87.7% SP) moments were found in immediate post compared with baseline. These frontal plane short-term improvements, replicating earlier findings in both sexes, may lower ACL injury risk. The large observed interindividual differences overtime may have concealed the long-term effects of video instruction at the group level. [ABSTRACT FROM AUTHOR]

A reliable, versatile means of assessing visuo-motor reaction time (V-MRT) is important to football (soccer) players for many reasons, including the fact that faster V-MRT is a critical sport skill that may even play a role in reducing common sports injuries to the lower muscle extremities that can be associated with lost time on the field. We aimed to determine the test-retest reliability and minimum detectable change (MDC) of the Brain Pro System for assessing lower-extremity V-MRT in young male football players. We had 68 participants (M age = 16.35, SD = 1.71 years) perform two assessment sessions one-week apart. For test-retest reliability, we calculated a one-way intra-class correlation coefficient (ICC) at the 95% confidence interval and provided the standard error of measurement (SEM) and minimum detectable change (MDC) (MDC = SEM × 1.96 × √2) for V-MRTs. We obtained excellent V-MRT test-retest reliability for dominant lower-extremity, non-dominant lower-extremity, and dominant and non-dominant lower-extremities (ICC2,1 =.93, 95%CI =.89–.96; ICC2,1 =.94, 95%CI =.91–.96; ICC2,1 =.96, 95%CI =.94–.97; respectively). The calculated MDC for the dominant lower-extremity V-MRT, the non-dominant lower-extremity V-MRT, and dominant and non-dominant lower-extremities (random) V-MRT were 1.21 seconds, 1.13 seconds, and 1.21 seconds, respectively. Brain Pro System had excellent reliability for assessing lower-extremity V-MRT in young male football players. The MDC values at the 95% confidence level (MDC95) we obtained were reliable for assessing clinically meaningful V-MRT changes. [ABSTRACT FROM AUTHOR]

Background: The "FIFA 11+" is an injury prevention program conceived for soccer athletes aged over 14. The use of FIFA 11+ Kids in soccer was associated with a reduction of the overall risk of injuries in children by 48%, and of 74% for serious injuries. However, to the best of our knowledge, a systematic review of the literature on the effects of FIFA 11+ Kids is still missing. Therefore, a systematic review was conducted to ascertain the benefits of the "FIFA 11+ KIDS" program in children who practice soccer. Methods: This systematic review was conducted according to the PRISMA recommendations and prospectively registered in PROSPERO. The electronic search was conducted in the following databases: Web of Science, PubMed, Medline via Ovid, EMBASE and SportDiscuss via EBSCO. Database searches were performed in January 2024. This review included studies that evaluated the effects of the "FIFA 11+ KIDS" program. Eligible studies had to describe program implementation and the mean age of the children. Results: A total of 11 articles were included in this systematic review from a pool of 8513 articles screened across various databases. These articles involved over 10,000 young participants from 8 countries, primarily aged 7–14 years, with the majority being soccer athletes. Study quality varied, with four categorized as high, four as good, and three as fair quality. Objectives varied across studies, with four focusing on FIFA 11+ Kids' efficacy in injury prevention, five examining its impact on performance and physical abilities, and two assessing its effects on children's focus and attention skills. Notably, injury prevention studies reported around a 50% reduction in overall injuries and nearly 60% in severe injuries, with a dose–response relationship observed with increased weekly sessions. Significant improvements were noted in physical and functional tests such as the Y balance, jump tests, and various soccer skills, along with positive effects on children's focus and attention, as indicated by 13–18% improvements in Attention Scale for Elementary School Children (ASESC) scores. Conclusion: The FIFA 11+ KIDS injury prevention program appears to be effective in reducing injuries in young football players. This can positively influence player and team overall performance and might support the long-term athlete development of these young athletes. These findings highlight the importance and necessity of injury prevention in young athletes. [ABSTRACT FROM AUTHOR]

Futsal carries a high risk of injury for players. This systematic review aimed to assess the existing literature on injury prevention strategies for futsal players. The literature was searched using PubMed, Web of Science, and Scopus databases from inception to 20 March 2024. Relevant articles were searched using the terms "futsal" AND "injury" AND "prevention". Fourteen studies were included in the review. The review identified several injury prevention strategies with potential benefits for futsal players. Structured warm-up routines were shown to improve balance and eccentric strength and to reduce total, acute, and lower limb injuries. Proprioceptive training methods were suggested to improve joint stability and landing mechanics, which may reduce the risk of injury. Furthermore, multicomponent methods that include components such as core stability and flexibility have shown potential for reducing injury rates in futsal players. Finally, by reducing fatigue and improving movement control, strength training procedures designed to correct muscular imbalances may improve performance, which may ultimately minimize the risk of injury. This systematic review demonstrates the potential benefits of different injury prevention strategies for futsal players. The combination of several strategies, such as proprioceptive training, multicomponent programs, warm-up routines, and strength training specifically designed to address muscular imbalances, appears promising. [ABSTRACT FROM AUTHOR]

The authors reflect on a teamwork modeling method to achieve good performance management in elite football (soccer) and ensure the health and availability of players during games. The model focuses on key performance indicators (KPI) to improve the performance of players and the pillars of the model like creating a systematic monitoring system and establishing an appropriate training process.

Purpose: To examine the association between the programming of days off (ie, no pitch training, days off feet) within turnarounds of varying length and injury rate in elite soccer. Methods: Retrospective data from 56 team seasons of players belonging to 18 elite teams performing in top leagues including the English Premier League, Italian Serie A, Bundesliga, Scottish Premiership, Major League Soccer, and the Dutch Eredivisie from January 2018 to December 2021 were analyzed (total of 1578 players, 2865 injuries, 2859 noninternational matches, and 12,939 training-session days). The turnarounds examined lasted from 3 to 8 days. Only injuries with ≥3-day time loss were retained for analysis. The authors then looked at the injury rate within each microcycle in relation to the presence of a day off or not and its programming sequences in relation to the previous match (ie, day off at D + 1 vs D + 2 for the day after the match or the following, respectively). Results: During 3- and 7-day turnarounds, the sequences including the day off feet at D + 2 were associated with 2 to 3 times lower overall noncontact injury rates than the other programming sequences (Cohen d: 0.9–2.7). For the other turnarounds, the differences between the sequences were unclear. Conclusion: The programming of a day off (or at least "off feet") at D + 2 may be associated with moderately to largely lower incidence of noncontact injuries, especially during 3- and 7-day turnarounds. [ABSTRACT FROM AUTHOR]

Background: The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players. Methods: Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45–60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season. Results: No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014). Conclusions: The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players. Key points: • Our results indicate that the integration of 45 to 60 min of preseason neuromuscular training, three times per week, for 6 weeks, can improve physical fitness and prevent injuries in young female soccer players. • The present study demonstrated that the neuromuscular training program can reduce the incidence injury rate by more than 50% and the burden by more than 65% compared to the endurance-dominated training. • Neuromuscular training is an effective approach during the preseason period to improve diverse measures of physical fitness and to reduce injury occurrence. • Preseason neuromuscular training appears to improve the fitness level of female soccer players and as such could allow them to compete at the high level. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the relationships between the recovery kinetics experienced by professional football players and noncontact injury. Methods: A cohort of 46 professional football players (age 24.2 [4.7] y) from the same team (French Ligue 1) was monitored each day between matches when the team played twice a week. The recovery monitoring procedure was implemented after 38 matches and included some questionnaires: duration of sleep, Hooper scale (quality of sleep, level of stress, fatigue, and muscle soreness), perceived recovery status scale, creatine kinase concentrations, a countermovement jump, and an isometric force test. Noncontact injuries were collected during these periods. Results: Noncontact injuries were associated with perceived fatigue and muscle soreness 2 days (relative risk [RR] = 1.89 and 1.48, respectively) and 3 days following the matches (RR = 2.08 and 2.08, respectively). An increase of sleep quantity during the 2 nights following a match was significantly associated with a lower RR (RR = 0.65), as well as a lower decrement score on the isometric force test on each of the 3 days after the matches (RR = 0.97, RR = 0.99, and RR = 0.97, respectively). No other association was reported for the variables sleep quality, stress, perceived recovery, creatine kinase concentrations, countermovement jump, and noncontact injuries. Conclusion: During a congested schedule, implementing a recovery monitoring protocol including questionnaires about fatigue, muscle soreness, quantity of sleep, and a physical test of isometric force could help practitioners prevent injuries. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the differences in hip adductor and abductor muscle strength in elite male footballers from youth to senior level. Methods: We tested 125 players from the under-13-years (U'13) to senior squads of a Danish male professional football club in this cross-sectional design study. Hip adductor and abductor force (in newtons), torque (in newton meters), normalized torque (in newton meters per body mass), and adduction-to-abduction ratio were measured using handheld dynamometry. Results: Between U'13 and senior level, adductor force increased by 104%, torque by 127%, and normalized torque by 21%. Abductor force increased by 78%, torque by 126%, and normalized torque by 17%. For incremental differences between age groups, significant increases were observed between the ages of U'13 to U'14 (18%–39%) and U'14 to U'15 (19%–33%) for all strength measures (P ≤.021). No incremental difference was observed for adductor-to-abductor ratio. Conclusions: The large increases in hip adductor and abductor strength occurring between the ages of U'13 and U'15 offer insight into the strength capabilities and stress demands in these players, which may relate to injury vulnerability, and facilitate clinicians in selecting best-suited exercise interventions. [ABSTRACT FROM AUTHOR]

Context: It is well demonstrated that Nordic hamstring (NH) program has poor compliance across European soccer clubs, but little is known about its implementation in Major League Soccer (MLS). The authors aimed to investigate MLS hamstring prevention practices and compliance with the NH program and understand the reasons for its inclusion or exclusion. Design: A cross-sectional electronic survey was completed by 24 of the 26 (92%) MLS top-division soccer clubs. Methods: The survey, based on the Reach, Efficacy, Adoption, Implementation, and Maintenance framework, was sent to team medical staff. Medical staff were also asked for opinions on barriers to implementation. Results: Eighteen clubs (75%) reported a formal hamstring injury prevention program, with eccentric exercises (94%; 95% CI [confidence interval], 74%-99%), high-speed running (94%; 95% CI, 74%-99%), and NH exercises (89%; 95% CI, 67%-97%) the most common strategies adopted. Fifteen clubs partially implemented the NH program, but only 5 (21 %; 95% CI, 9%-40%) completed the full program and were classed as compliant. A total of 20 respondents reported that player perception and muscle soreness (83%; 95% CI, 64%-93%) were barriers to the implementation of the NH program. On a 5-point Likert scale, respondents "partially agreed" (4.13 [0.80]) that the NH exercise could substantially reduce injuries and would be "effective" at their own club (3.88 [0.61]). Conclusions: The NH exercise was valued, but negative player perception and muscular soreness were identified as barriers to implementing the full program. Manipulation of volume and frequency should inform future "effectiveness" research to prospectively assess such modifications in the context of MLS. [ABSTRACT FROM AUTHOR]

Evidence is emerging that core neurocognitive functions such as working memory and inhibitory control (ie, motor-response and attentional inhibition) are linked to the anterior cruciate ligament (ACL) injury risk. Research has been conducted in laboratory settings, but the contribution of neurocognition to actual ACL injuries under real-world conditions is unknown. To describe the possible neurocognitive errors involved in noncontact ACL injury mechanisms. Case series. Soccer matches. A total of 47 professional male soccer players. Three independent reviewers evaluated 47 videos of players sustaining noncontact ACL injuries. Neurocognitive errors in inhibitory control were operationalized as follows: (1) motor-response inhibition was scored when a player demonstrated poor decision-making and approached the opponent with high speed that reduced the ability to stop or change the intended action and (2) an attentional error was scored when a player shifted his selective attention away from the relevant task to irrelevant stimuli. Of 47 noncontact ACL injuries, 26 (55%) were related to a pressing-type injury, 19 (73%) of which involved a deceiving action made by the opponent, suggesting poor inhibitory control of the defender. Of the remaining 21 noncontact ACL injuries (45%), 16 (76%) could be attributed to attentional errors. Agreement among the 3 raters was very good for all items except poor decision-making, which showed fair to good agreement (Fleiss κ = 0.71). Interrater reliability was excellent (intraclass correlation coefficient = 0.99–1.00). Errors in motor-response inhibitory control and attentional inhibition were common during noncontact ACL injury events in professional male soccer players. The interrater agreement in detecting neurocognitive errors in general was very good. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research was to compare the effect of video games, training with catalogs, and face-to-face training of the FIFA +11 warm-up program on the level of acceptance and belief of football players. Methods: The current semi-experimental research was done on 240 male players and coaches present in the premier soccer league of Khorasan Province who were randomly divided into four groups: 11+ face-to-face exercises, catalog, video games, and control (60 people in each group). Electronic questionnaires on acceptance and knowledge were filled by players and coaches. Then, the subjects of the training groups performed the exercises in three 15-minute sessions per week for eight weeks. Kruskal-Wallis test and marginal mean were used to check differences between the groups. Results: After eight weeks of training, there was a significant difference in the knowledge and awareness of the players between the four groups (P<0.05). Also, the marginal average test results showed that the effect of these exercises on the level of knowledge and awareness of the players was greater in the face-to-face group than in other groups. Also, 33.3% of the players considered these exercises to be boring and 23.7% of the players considered the limitation of time to do other exercises and soccer skills as one of the factors that prevent them from doing the exercise. Conclusion: Football players had low levels of knowledge and awareness of 11+ exercises, which increased after eight weeks of 11+ exercises using face-to-face exercises, catalogs, and videos. [ABSTRACT FROM AUTHOR]

Background: Football is the most common sport played around the world with 300 million registered players. To decrease injury rates and promote fair play in football, the FIFA-Medical and Assessment Research Centre designed the FIFA 11+ training program. Purpose: The aim of this study was to investigate the effect of FIFA 11+ training program on functional performance and functional movement in collegiate football players. Materials and Methods: A total of thirty subjects were chosen. Fifteen adult male football players were randomly assigned into one of two groups: Group A (traditional training) or Group B (FIFA 11+ training). Both the groups received the training for six weeks. And to check the performance speed was calculated using a 20m sprint test and aerobic capacity was measured using treadmill test. To check the functional movement FMS score was measured. Results:A Pearson correlation test shows a positive correlation (r = 0.208) but the weaker relationship between the variables. Paired t test analysis shows a significant improvement after the treatment in terms of Gluteus Maximus muscle activity, Hamstring muscle length and pain reduction with a P value < 0.001. Conclusion: This study concluded that FIFA 11+ training programs were better than the conventional training program in terms of functional performance, functional movement, and injury prevention. This was attributed to the effect of the program on stability, muscle strength, proprioception, and postural alignment, which makes it a better training program for preventing injuries. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effects of a multicomponent training program (ProSAS) on selected measures of physical fitness and joint injuries in Spanish male professional soccer players. Twenty-six professional soccer players (age: 25.2 ± 3.1 years) were randomly assigned to either the experimental (EG; n = 16) or control group (CG; n = 10). Y-balance test (YBT), Single leg countermovement jump (SLCMJ), Single leg hop for distance test (SLH), Side-hop test (SH), Speedy jump test (SpJ), Agility T-test (TT) and Lower extremity functional test (LEFT) were performed before and after an 8-weeks training period. Additionally, any joint injury occurring during the intervention period were recorded. Significant improvements in the EG in all tests (p = 0.001 to p = 0.014), except for SLCMJ (p = 0.632) with the dominant leg were observed. CG displayed decreases in SLCMJ with the non-dominant leg (p = 0.014), SH for both legs (p = 0.001 to p = 0.050), TT (p = 0.005), and LEFT (p = 0.001). Inter-groups differences revealed better results for the EG in all variables (p = 0.001 to p = 0.008) except from SLCMJd (p = 0.555). Moreover, the EG exhibited lower joint injury incidence and burden compared to the CG (p < 0.05). These findings suggest that the ProSAS is an effective multicomponent program to improve variables related to risk of joint injuries, and consequently, to reduce the incidence and burden of these injuries in professional soccer players. [ABSTRACT FROM AUTHOR]

This review aimed, as part of a larger FIFA project aiming to steer women's football research, to scope literature on any level of competitive football for women, to understand the current quantity of research on women's football injuries. The study reviewed all injury-related papers scoped by a recent scoping review mapping all published women's football research with an updated search performed on 23 February 2021. Eligibility criteria assessment followed the recent scoping review with injury-specific research focus. A total of 497 studies were scoped. Most studies contained an epidemiological (N = 226; 45%) or risk factors assessment (N = 105; 21%). Less assessed areas included financial burden (N = 1; <1%) and injury awareness (N = 5; 1%). 159 studies (32%) assessed injuries of the whole body. The most common single location assessed in the literature was the knee (N = 134, 27%), followed by head/face (N =108, 22%). These numbers were, however, substantially lowered, when subdivided by playing level and age-group. The volume of research focuses especially on descriptive research and specific body locations (head/face and knee). Although information can be taken from studies in other sports, more football-specific studies to support management and prevention of injuries are warranted. [ABSTRACT FROM AUTHOR]

The present study was intended to i) investigate the relationship between metabolic power average (MPA), acceleration (AcZ) and deceleration (DcZ) zones, and their differences (Δ) on 3 load levels with noncontact injuries in professional players throughout a full soccer season and ii) to analyze the injury risk associated between high-load versus low-load levels for each of the aforementioned parameters with odds ratios (OR) and relative risk (RR), respectively. Twenty-one professional soccer players (age = 28.3 ± 3.9 years) were monitored during a full season (48 weeks) through global positioning system (GPS). A relationship between MPA and accelerometer-based GPS, mainly in explosive actions (i.e., AcZs and DcZs), was found. A higher incidence of injuries in the high-load weeks compared with the low-load weeks were reported (mainly in MPA, AcZ1, AcZ2, and DcZ3 variables). Moreover, significant means of OR (mean = 4.3) and RR (mean = 2.6) of noncontact injuries were established in intense periods with higher metabolic load (i.e., power accelerations, AcZ1, x² = 0.022). Our results may be useful for coaches, sports scientists, and researchers regarding the optimization of the athletes' performance, as well as providing insights about the impact of intense exercise. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the preventive effects of the FIFA 11+ for one‐season and over three consecutive seasons on the injury incidence rates in collegiate female football players in terms of duration of intervention. A total of 763 collegiate female football players from seven teams belonging to Kanto University Women Football Association Division 1 in 2013–2015 seasons were included in the study. At the start of the study, 235 players were assigned to a FIFA 11+ intervention group (four teams, 115 players) and a control group (three teams, 120 players). The intervention period was set to three seasons, and the players were followed up during this period. The one‐season effect of the FIFA 11+ was investigated after each season. The effect of continuous intervention was verified in 66 and 62 players from the intervention and control groups who continued the study for all three seasons, respectively. The one‐season intervention showed significantly lower total, ankle, knee, sprain, ligament injury, noncontact, moderate and severe injury incidence rates in the intervention group in each season. Regarding the continuous intervention, compared with the first season, the injury incidence rates in lower extremity, ankle, and sprain, decreased in the intervention group by 66.0%, 79.8%, and 82.2%, respectively, in the second season, and by 82.6%, 94.6%, and 93.4%, respectively, in the third season, indicating the persistent effect of the FIFA 11+. In conclusion, the FIFA 11+ is an effective program for lower extremity injury prevention in collegiate female football players, and preventive effects persist with continuation of the program. [ABSTRACT FROM AUTHOR]

Background: To manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understanding the injury context, whereby specific personal, environmental, and societal factors can influence the implementation of injury prevention initiatives and injury management strategies is critical to player welfare. To date, no qualitative research investigating the context of injuries, has been undertaken in elite-level women's football. The aim of our study was to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish Women's National League (WNL) to injury prevention and injury management. Methods: We used qualitative research methods to explore the knowledge, attitudes, and behaviours of players, head coaches, and medical personnel in the Irish WNL to injury prevention and injury management. Semi-structured interviews were undertaken with 17 players, 8 medical personnel, and 7 head coaches in the Irish WNL. The data were analysed using thematic analysis. Our study is located within an interpretivist, constructivist research paradigm. Results: The participants had incomplete knowledge of common injuries in elite-level football, and many held beliefs about risk factors for injuries, such as menstrual cycle stage, which lacked evidence to support them. Jumping and landing exercises were commonly used to reduce the risk of injuries but evidence-based injury prevention exercises and programmes such as the Nordic hamstring curl, Copenhagen adduction exercise, and the FIFA 11+ were rarely mentioned. Overall, there was dissatisfaction amongst players with their medical care and strength and conditioning (S & C) support, with resultant inadequate communication between players, head coaches, and medical personnel. Conclusion: Poor quality and availability of medical care and S & C support were considered to be a major obstacle in the effective implementation of injury risk reduction strategies and successful return-to-sport practices. More original research is required in elite-level women's football to explore injury risk factors, injury prevention initiatives, and contextual return-to-sport strategies, so that players, head coaches, and medical personnel can use evidence that is both up-to-date and specific to their environment. [ABSTRACT FROM AUTHOR]

Background: Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use of programme material, and overall preventive strategies. Methods: This is a sub-study analysing data from a three-armed randomised trial with teams randomised to use either a comprehensive IPEP (extended Knee Control) or an adductor strength programme, and non-randomised teams that already used a self-chosen IPEP regularly at study start (comparison group). Teams were instructed to use their respective intervention across the 2020 football season. Male and female, adolescent (≥ 14 years of age), and adult amateur players took part. Coaches and players responded to weekly and end-of-season questionnaires. Data were presented descriptively. Results: Weekly player data were reported by 502 players (weekly response rate 65%), 289 (58%) responded to end-of-season questionnaires. Teams in the extended Knee Control and comparison group used their respective IPEP in 483/529 (91%) and 585/641 (91%) of training sessions, and teams in the adductor group in in 199/315 (63%) sessions. Regarding utilisation fidelity, 42–52% of players in each group used 1–10 repetitions per exercise. Seven out of 17 teams in the adductor group had progressed as recommended in terms of number of repetitions. Two teams (10%) in the extended Knee Control group, and 7/24 of comparison teams used the same exercises across the season. Coaches accessed the IPEPs by different means (printed material, films, workshops, etc.), but half did not use the provided digital material. The players appreciated that the IPEPs could reduce injury risk and that they improved their exercise performance, but disliked that they had less time for football and that the exercises were boring. Forty-nine players had experienced pain during IPEP performance. Conclusions: Adherence with the IPEPs was generally high. To meet different coach needs, programme material should be available via different digital and printed resources. The number of players reporting pain during IPEP performance is a noteworthy finding. Trial registration: Clinical Trials gov identifier: NCT04272047. Registered February 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04272047. [ABSTRACT FROM AUTHOR]

Given the scientific and public concern regarding the short-, medium- and long-term consequences of heading on brain health, being proactive about developing and implementing guidelines that help reduce the burden (volume, impact magnitude and injury risk) of heading in young and beginner players appears justified. This narrative review explores the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria for inclusion were: (1) original data, (2) study population included football players, (3) outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head/brain injury incidence, and (4) published in English or English translation available. In total, 58 papers were included that outlined strategies based on (1) game or team development, (2) player skill development and (3) equipment. In particular, greater emphasis existed for small-sided games (particularly in young players) where fewer headers are observed when compared with the conventional 11 versus 11 game, as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focusses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. To mitigate potential risks of heading on brain health, a number of pragmatic strategies have been examined in scientific studies and may be considered as part of future heading guidelines. [ABSTRACT FROM AUTHOR]

In this report, we discuss the case of a now 23-year-old athlete who was diagnosed with mild hemophilia, successfully played varsity soccer throughout high school, and continued to play intramural and club soccer while in college. A prophylactic protocol was developed by the athlete's hematologist to allow his safe participation in contact sports. Similar prophylactic protocols have been discussed by Maffet et al that successfully allowed an athlete to participate in high-level basketball. However, significant barriers still exist for an athlete with hemophilia who wants to engage in contact sports. We discussed how athletes with adequate support networks can participate in contact sports. Decisions need to be made on a case-by-case basis and involve the athlete, family, team, and medical personnel. [ABSTRACT FROM AUTHOR]

Purpose: Overuse injury risk increases during periods of accelerated growth, which can subsequently impact development in academy soccer, suggesting a need to quantify training exposure. Nonprescriptive development scheme legislation could lead to inconsistent approaches to monitoring maturity and training load. Therefore, this study aimed to communicate current practices of UK soccer academies toward biological maturity and training load. Methods: Forty-nine respondents completed an online survey representing support staff from male Premier League academies (n = 38) and female Regional Talent Clubs (n = 11). The survey included 16 questions covering maturity and training-load monitoring. Questions were multiple-choice or unipolar scaled (agreement 0-100) with a magnitude-based decision approach used for interpretation. Results: Injury prevention was deemed highest importance for maturity (83.0 [5.3], mean [SD]) and training-load monitoring (80.0 [2.8]). There were large differences in methods adopted for maturity estimation and moderate differences for training-loadmonitoring between academies. Predictions of maturity were deemed comparatively low in importance for bio-banded (biological classification) training (61.0 [3.3]) and low for bio-banded competition (56.0 [1.8]) across academies. Few respondents reported maturity (42%) and training load (16%) to parent/guardians, and only 9% of medical staff were routinely provided this data. Conclusions: Although consistencies between academies exist, disparities in monitoring approaches are likely reflective of environment-specific resource and logistical constraints. Designating consistent and qualified responsibility to staff will help promote fidelity, feedback, and transparency to advise stakeholders of maturity--load relationships. Practitioners should consider biological categorization to manage load prescription to promote maturity-appropriate dose--responses and to help reduce the risk of noncontact injury. [ABSTRACT FROM AUTHOR]

Context: Infrared thermography has been used to detect skeletal muscle overload and fatigue in athletes, but its use in injury prevention in professional soccer has not been studied to date. Objectives: To establish a novel injury prevention program based on infrared thermography and to determine its influence on the injury incidence in professional soccer players in the preseason. Design: A cross-sectional, prospective study design was used to compare a conventional injury prevention program (CPP) applied over the first preseason and an infrared thermography injury prevention program (IRTPP) carried out in the following preseason. Setting: Soccer training ground. Participants: Twenty-four players belonging to a first division soccer team from Spain. Main Outcome Measures: Injury incidences of each player were recorded according to the Orchard Sports Injury Classification System (version 10.0) convention to determine the injury classification, location, and type. Results: The incidence of injuries decreased from 15 injuries in the CPP preseason (0.63 [0.77] injuries per player) to 6 injuries in the second preseason when the IRTPP was applied (0.25 [0.53] injuries per player). The days of absence due to injuries also decreased from the CPP preseason (156 d, 10.4 [11.0] d per injury) to the IRTPP preseason (14 d, 2.3 [2.8] d per injury). The injury severity also decreased from the first preseason to the second preseason, and fewer musculoskeletal injuries in the thigh, hip, and groin were reported. Conclusions: The implementation of an IRTPP can reduce the presence of injuries by identifying players potentially at risk and as a result, reducing the injury severity and days lost as a consequence. [ABSTRACT FROM AUTHOR]

Purpose: To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. Methods: In this randomized trial, 32 football players (18–23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week; n = 15) and group 2 (twice a week; n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. Results: Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155–164 vs 149–158 N·m; P =.043; ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212–234 vs 198–221 N·m; P =.098; ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56–0.59 vs 0.54–0.57; P =.089; ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76–0.84 vs 0.71–0.79; P =.076; ES = 0.50). No between-groups differences were found for muscle thickness (P =.864; ES = 0.12), pennation angle (P =.289; ES = 0.18), fascicle length (P =.406; ES = 0.03), and quadriceps concentric peak torque (P =.340; ES = 0.02). Conclusion: Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions. [ABSTRACT FROM AUTHOR]

Purpose: The "11+ Kids" injury-prevention program has been shown to reduce injuries and related costs in youth football players less than 14 y of age. A major argument to convince coaches to use this exercise-based injury-prevention program is a potential performance enhancement of the players. Therefore, this study investigated the effects of the "11 + Kids" program on isokinetic strength. Methods: Two teams were randomly assigned to the intervention and control groups. The intervention group replaced their warm-up by the "11+ Kids" and the control group warmed up as usual. Two days before and after the 10-wk intervention, isokinetic strength of the hip adductors and abductors, knee flexors and extensors, and ankle invertors and evertors was tested. Results: Thirty-one players (mean age 11.5 [0.8] y) completed the study. The intervention group showed large improvements in all isokinetic strength measures (P < .001 for all measures; Cohen d = 0.8-1.4), whereas the control group only showed negligible to medium positive effects (P values ranging from .006 to .718; Cohen d = -0.1 to 0.7). The intervention was beneficial compared with the control group regarding isokinetic strength of the hip adductors (P < .001), knee flexors (P = .002), and ankle evertors (P < .001) and invertors (P = .005). Conclusions: Given the relatively short intervention period of 10 wk, the observed improvements relate to a practically meaningful effect of the intervention. The gain in strength may improve players' performance and may contribute to a reduction of injury risk in the long-term application. [ABSTRACT FROM AUTHOR]

Background: Playing football is associated with a high risk of injury. Injury prevention is a priority as injuries not only negatively impact health but also potentially performance. Various multi-component exercise-based injury prevention programs for football players have been examined in studies. Objective: We aimed to investigate the efficacy of multi-component exercise-based injury prevention programs among footballers of all age groups in comparison to a control group. Methods: We conducted a systematic review and meta-analysis of randomized and cluster-randomized controlled trials. CINAHL, Cochrane, PubMed, Scopus, and Web of Science databases were searched from inception to June 2022. The following inclusion criteria were used for studies to determine their eligibility: they (1) include football (soccer) players; (2) investigate the preventive effect of multi-component exercise-based injury prevention programs in football; (3) contain original data from a randomized or cluster-randomized trial; and (4) investigate football injuries as the outcome. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The outcome measures were the risk ratio (RR) between the intervention and the control group for the overall number of injuries and body region-specific, contact, and non-contact injuries sustained during the study period in training and match play. Results: Fifteen randomized and cluster-randomized controlled trials with 22,177 players, 5080 injuries, and 1,587,327 exposure hours fulfilled the inclusion criteria and reported the required outcome measures. The point estimate (RR) for the overall number of injuries was 0.71 (95% confidence interval [CI] 0.59–0.85; 95% prediction interval [PI] 0.38–1.32) with very low-quality evidence. The point estimate (RR) for lower limb injuries was 0.82 (95% CI 0.71–0.94; 95% PI 0.58–1.15) with moderate-quality evidence; for hip/groin injuries, the RR was 0.56 (95% CI 0.30–1.05; 95% PI 0.00–102.92) with low-quality evidence; for knee injuries, the RR was 0.69 (95% CI 0.52–0.90; 95% PI 0.31–1.50) with low-quality evidence; for ankle injuries, the RR was 0.73 (95% CI 0.55–0.96; 95% PI 0.36–1.46) with moderate-quality evidence; and for hamstring injuries, the RR was 0.83 (95% CI 0.50–1.37) with low-quality evidence. The point estimate (RR) for contact injuries was 0.70 (95% CI 0.56–0.88; 95% PI 0.40–1.24) with moderate-quality evidence, while for non-contact injuries, the RR was 0.78 (95% CI 0.55–1.10; 95% PI 0.25–2.47) with low-quality evidence. Conclusions: This systematic review and meta-analysis indicated that the treatment effect associated with the use of multi-component exercise-based injury prevention programs in football is uncertain and inconclusive. In addition, the majority of the results are based on low-quality evidence. Therefore, future high-quality trials are needed to provide more reliable evidence. Clinical Trial Registration: PROSPERO CRD42020221772. [ABSTRACT FROM AUTHOR]

Different eccentric strength assessments are used to identifying the risk of hamstring injury in athletes. However, there is scarce information to determine the association between Nordic-based measurements and the gold standard measurement of eccentric hamstring strength in an isokinetic dynamometer. To investigate the relationship of different measures of eccentric hamstring strength (break-point angle and eccentric strength during Nordic exercise) with eccentric hamstring peak torque measured with an isokinetic dynamometer. Forty-six participants volunteered to participate in this study. Eccentric peak force in the Smart-Nordic System and break-point angle measured as trunk lowering at >20°/s and >150°/s2 during the Nordic exercise via high-frequency video-analysis were compared to eccentric hamstring peak torque in an isokinetic dynamometer set to produce knee extension at 30°/s. There was a moderate association between peak eccentric strength with the Smart-Nordic and isokinetic eccentric hamstring peak torque (r = −0.65, p < 0.001, 95%CI = [−0.76-(−0.50)]). The association between Nordic break-point angle measured at 20°/s (r = 0.49, p < 0.001, 95%CI = [0.30–0.64]) and at 150°/s2 (r = 0.52, p < 0.001, 95%CI = [0.33–0.66]) presented statistically significant but lower associations with isokinetic eccentric hamstring peak torque. All Nordic-based measurements presented acceptable associations with the gold standard isokinetic eccentric hamstring peak torque. However, peak eccentric force measured on the Smart-Nordic device had a better agreement with eccentric peak torque measured with an isokinetic dynamometer than the video-based measurements. Highlights Peak eccentric force measured on the isometric strain-gauges device had a better agreement with eccentric hamstring peak torque measured with an isokinetic dynamometer than the break-point angle. The Nordic-based measurements are an alternative cost-effective method to assess eccentric muscle strength and weakness when the access to isokinetic dynamometry is not feasible. Caution should be taken with certain variables such as participants body mass, hip position and movement speed when interpreting the results of Nordic-based measurements. [ABSTRACT FROM AUTHOR]

Futsal promotes stress by handling the ball, physical contact, and exhaustive muscle contractions, elevating the risks for injury, oxidative stress, and inflammation after a training session or a match. In this review, we critically evaluate the more recent advances in the performance and health of futsal players. We searched the effects of futsal on performance, physiological parameters, muscle injury, inflammation, and oxidative stress. Although the stressful factors apply to all futsal players, goalkeepers require special attention during the competition and the recovery phase. We also show that the FIFA injury prevention programme, called The 11+, is effective in improving athletic performance and avoiding injury in futsal players. Research with different training durations and intensities and a wider range of studies involving oxidative stress, inflammation, and physiological mechanisms are of interest to design a more precise map of the biochemical regulation of training load and competition season in futsal. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Objective: To determine whether slow processing speed is associated with risk of sport-related concussion. Design: We conducted a retrospective cohort study using computerized neurocognitive assessments (Immediate Post-concussion Assessment and Cognitive Testing [ImPACT]) from the Massachusetts Concussion Management Coalition. Slow processing speed was defined as 2 SD below the sample mean (n = 131) and fast processing speed as 2 SD above the sample mean (n = 259). We used a binary logistic regression model to determine the odds of sustaining a concussion with our main predictor being processing speed (high or low) adjusted for the effects of age, sex, and prior number of concussions. Setting: Massachusetts Concussion Management Coalition, Institutional care. Participants: Three hundred ninety junior high soccer players ages 10 to 15 with a baseline score for ImPACT. Independent Variables: Processing Speed. Main Outcome Measures: Risk of sustaining a concussion. Results: Those with slow processing speed had a visual motor composite score of ≤19.92, those with fast-processing speed had a score of ≥46.20. Athletes with slow processing speed were younger (13 vs 14 years; P < 0.001) and more likely to be male (57% vs 49%; P = 0.014). After adjusting for the effects of age, sex, and prior concussions, there was no significant difference in the odds of sustaining a concussion between groups (aOR 1.01; 95% CI, 0.99-1.04). Conclusions: Despite previous research showing that slow processing speed is a risk factor for musculoskeletal injuries during sports, our study suggests that processing speed is not associated with the risk of sustaining a concussion among junior high school soccer players. [ABSTRACT FROM AUTHOR]

In football, unpredictable events (e.g. unexpected landings) seem to play a crucial role in the mechanism of non-contact knee injuries. This study investigated the effects of a single bout of an injury preventive warmup protocol on biomechanical landing stability and decision-making quality during preplanned and unanticipated jump-landings. A crossover study on 18 male amateur football players was performed. The participants completed a standard (ergometer) and an injury-preventive warmup protocol (Prevent injury and Enhance Performance (PEP)) on two different test days. After each protocol, participants performed countermovement jumps with preplanned (landing side displayed before takeoff) and unanticipated (landing side shown after takeoff) single-leg landings on a force plate. Outcomes were landing stability (height and time of the maximum vertical ground reaction force (pGRF), centre of pressure (CoP), the number of standing errors (ground contact with free leg)) and decision-making quality (landing error (wrong foot) count). Carry-over and crossover-tests were performed to find potential between-condition-differences. No carry-over effects occurred (p >.05). The PEP led to a reduced CoP trace length (−18.4 ± 32.2%, p =.021) and earlier occurrence of pGRF (−4.72 ± 6.78%, p =.017) in the preplanned condition. No significant between-treatment-differences occurred within the unanticipated landings and decision-making quality (p >.05). The primarily neuromuscular warmup protocol affects landing stability in the preplanned condition. However, it does not seem to better prepare football players for unpredictable events than a standard warmup. Trial registration: German Clinical Trials Register identifier: DRKS00016942. Adapting movements rapidly to unanticipated external stimuli (e.g. unexpected landings) is crutial to prevent injuries in football It is unclear wether popular neuromuscular injury preventive warmup programmes (e.g. Prevent injury and Enhance Performance (PEP)) adaquatly prepare athletes for these situations Our study shows that the PEP warm up programme has acute effects on anticipated landing stability, but no influence on unanticipated landings or decision making quality Classic neuromuscular warm up programmes may not be the optimal choice to prepare athletes properly for the upcoming motor-cognitive demands in a football match [ABSTRACT FROM AUTHOR]

Soccer is a very popular sport with a high incidence of injuries. Clinical screening tools are an important component of injury prevention. The aim of this study was to investigate the relationship between two screening tools, the Functional Movement Screen (FMS) and Star Excursion Balance Test (SEBT), and whether there are differences regarding SEBT scores, injuries, and painful symptoms in participants below and above the FMS cutoff score of ≤14. The research was performed as a secondary analysis of a longitudinal cohort study and included 42 non-professional soccer players from Eastern Croatia (age 25.5±6 years, training experience 15.8±6.6 years). Participants were surveyed regarding their sociodemographic data, soccer playing, and FMS and SEBT tests were performed. They were followed for 3.5 months when an additional set of data regarding injuries and painful symptoms was obtained. Moderate to good correlation was found between FMS total score and posterolateral reach of dominant and non-dominant legs (r=0.503, p=0.001; r=0.525, p<0.001). Significant correlations were found between FMS total score and SEBT composite scores for dominant and non-dominant legs (r=0.486, p=0.001; r=0.453, p=0.003). Numerous significant correlations were found between individual items of FMS and SEBT. Participants with FMS score ≤14 had a higher occurrence of injuries and painful symptoms (p=0.018; p=0.034) and lower results of SEBT composite scores for dominant and non-dominant legs (p=0.010; p=0.001). There is a significant relationship between FMS and SEBT scores. Players with FMS scores ≤14 are more prone to injuries and painful symptoms and they have lower SEBT scores. [ABSTRACT FROM AUTHOR]

Context: A limiting factor for reducing anterior cruciate ligament injury risk is ensuring that the movement adaptions made during the prevention program transfer to sport-specific activity. Virtual reality provides a mechanism to assess transferability, and neuroimaging provides a means to assay the neural processes allowing for such skill transfer. Objective: To determine the neural mechanisms for injury risk–reducing biomechanics transfer to sport after anterior cruciate ligament injury prevention training. Design: Cohort study. Setting: Research laboratory. Participants: Four healthy high school soccer athletes. Interventions: Participants completed augmented neuromuscular training utilizing real-time visual feedback. An unloaded knee extension task and a loaded leg press task were completed with neuroimaging before and after training. A virtual reality soccer-specific landing task was also competed following training to assess transfer of movement mechanics. Main Outcome Measures: Landing mechanics during the virtual reality soccer task and blood oxygen level–dependent signal change during neuroimaging. Results: Increased motor planning, sensory and visual region activity during unloaded knee extension and decreased motor cortex activity during loaded leg press were highly correlated with improvements in landing mechanics (decreased hip adduction and knee rotation). Conclusion: Changes in brain activity may underlie adaptation and transfer of injury risk–reducing movement mechanics to sport activity. Clinicians may be able to target these specific brain processes with adjunctive therapy to facilitate intervention improvements transferring to sport. [ABSTRACT FROM AUTHOR]

Background: One of the most frequently injured muscle groups in soccer is the hamstring group. Soccer players have high rates of hamstring injury (HSI) due to frequent sprinting, changes in direction and similar high-risk activities. Such movements put immense stress on the hamstrings which can lead to injury. Over the last decade, at least four different HSI prevention programs and techniques have been explored in research. The purpose of this review is to assess the effectiveness of these methods. Methods: Studies in this review were collected using multiple database searches of PubMed. A total of six studies were selected, all either randomized controlled trials (RCTs) or cluster-RCTs. The selected trials were from various soccer leagues in Denmark, Japan, the Netherlands, and the United States. Results: The most prevalently studied method is the Nordic hamstring exercise (NHE). Studies that utilized the NHE, either as a standalone or within a program, reduced the risk of HSI by 15-71%. In addition, effective programs were characterized by progressively increasing the difficulty of exercises and high compliance rates. Conclusion: Studies that utilized the NHE showed effectiveness in the prevention of hamstring injuries in male soccer athletes. Based on the limited research available, it is unclear whether adding other exercises to prevention programs further reduces injury risk. More research is needed to explore new and existing prevention methods in a variety of populations and regions. [ABSTRACT FROM AUTHOR]

BACKGROUND: The knee is one of the most common sites of injuries among soccer players. The incidence of knee injuries can be reduced by improving the neuromuscular control and core stability. OBJECTIVE: This study aimed to evaluate the effectiveness of injury prevention programs that include core stability exercises in reducing the incidence of knee injuries among soccer players. METHODS: Data were obtained from different databases (1985–2021). Only randomized controlled trials that used injury prevention programs that include core stability exercise to prevent knee injuries were included. The keywords used during the search were 'knee injuries', 'core stability exercises', 'FIFA 11 + ', 'prevention of knee injuries', 'anterior cruciate ligament injury' and variations of these search terms. RESULTS: The pooled results of 7828 soccer players and 863700 exposure h showed an overall injury reduction of 56% per 1000 h of exposure in the intervention group compared to the control group with an injury risk ratio of 0.44 (95% CI 0.321–0.619; P = 0.001). CONCLUSIONS: Injury prevention programs that include core stability exercises reduce knee injury rates among soccer players by 56% (46% in male and 65% in female soccer players). [ABSTRACT FROM AUTHOR]

Background The single leg bridge test (SLBT) has been introduced in the sports context as a way of estimating hamstring muscle capacity for prevention and rehabilitation of hamstring strain injuries. Purpose The primary aim was to examine the association between SLBT scores with concentric and eccentric knee flexor peak torques. Secondarily, this study aimed examine the association of between-limb asymmetries provided by SLBT and isokinetic tests. Study design Cross-sectional study. Methods One hundred male soccer players (20±3 years) performed the SLBT and the knee flexion-extension isokinetic dynamometry evaluation (60°/s) billaterally during a single visit. SLBT score (i.e., number of repetitions until failure) and concentric and eccentric knee flexor peak torques (normalized per body mass) were considered for analysis. For both SLBT and isokinetic dynamometry, between-limb asymmetry was calculated as the percentage difference between the left limb and the right limb. Associations were assessed through Pearson's correlation coefficient. Results The mean SLBT score was 33.6±9.6 repetitions, concentric peak torque was 2.00±0.22 Nm/kg, and eccentric peak torque was 2.79±0.44 Nm/kg. Between-limb asymmetry was 0.4±9.6%, 1.08±8.5%, and 1.64±14.61% in SLBT, concentric, and eccentric tests, respectively. There was a poor association of SLBT score with concentric (p<0.001, r=0.275) and eccentric (p=0.002, r=0.215) peak torques. The SLBT between-limb asymmetry was poorly associated with asymmetry found in concentric peak torque asymmetry (p=0.033, r=0.213) and was not associated with eccentric peak torque asymmetry (p=0.539, r=0.062). Conclusion The SLBT should not be used as a clinical tool to assess the maximum strength of hamstring muscles. [ABSTRACT FROM AUTHOR]

What is the effect of injury prevention programs that include balance training exercises on the incidence of ankle injuries among soccer players? Systematic review of randomised trials with meta-analysis. Soccer players of any age, sex or competition level. The experimental intervention was an injury prevention program that included balance training exercises. The control intervention was the soccer team's usual warm-up program. Exposure-based ankle injury rates. Nine articles met the inclusion criteria. The pooled results of injury prevention programs that included balance training exercises among 4,959 soccer players showed a 36% reduction in ankle injury per 1,000 hours of exposure compared to the control group with an injury risk ratio (IRR) of 0.64 (95% CI 0.54 to 0.77). The pooled results of the Fédération Internationale de Football Association (FIFA) injury prevention programs caused a 37% reduction in ankle injury (IRR 0.63, 95% CI 0.48 to 0.84) and balance-training exercises alone cause a 42% reduction in ankle injury (IRR 0.58, 95% CI 0.41 to 0.84). This meta-analysis demonstrates that balance exercises alone or as part of an injury prevention program decrease the risk of ankle injuries. PROSPERO CRD42017054450. [ABSTRACT FROM AUTHOR]

Purpose: Dynamic knee valgus and poor technique during landing are not only key risk factors for lower extremity injuries especially knee injury, but also can reduce the performance of athletes in the field. Sportsmetrics soccer training is one of the successful knee injury prevention and enhancement performance protocols for female soccer players. Because the effect of sportsmetrics soccer training has not been investigated on the performance and knee valgus during landing in female soccer players, we aimed to investigate this subject. Methods: The current field-trial study was conducted on 24 female soccer players with dynamic knee valgus that were randomly divided into two groups: the training group (TG) and the control group (CG). The assessment tests were the agility t-test, 40-yard test, vertical jump test, double leg squat test, and valgus landing error scoring system test (LESS). The TG group participated in sportsmetrics soccer training regularly for 6 weeks, three 90-min sessions a week. Analysis of covariance was used to analyze the obtained data (P<0.05). Results: Six weeks of sportsmetrics soccer training in the TG group not only reduced dynamic knee valgus during landing (51% reduction, F=171.8, P=0.01) but also improved performance factors significantly: agility (0.50 s reduction, F=23.29, P=0.01), power (2.50 cm increase, F=13.20, P=0.01) and speed (0.30 s reduction, F=23.66, P=0.01). Conclusion: Sportsmetrics soccer training is strongly suggested for soccer players exposed to knee injuries due to dynamic knee valgus during landing. [ABSTRACT FROM AUTHOR]

Clinical Scenario: Hamstring strains are a common sport-related injury, which may limit athletic performance for an extended period of time. These injuries are common in the soccer setting. As such, it is important to determine an appropriate prevention program to minimize the risk of such an injury for these athletes. Eccentric hamstring training may be an effective and practical hamstring strain prevention strategy. Clinical Question: What is the effect of eccentric exercises on hamstring strain prevention in adult male soccer players? Summary of Key Findings: Current literature was searched for studies of level 2 evidence or higher that investigated the effect of eccentric exercises in preventing hamstring strains in adult male soccer players. Three articles returned from the literature search met the inclusion criteria. A fourth article looked at differences in strength gains between eccentric and concentric hamstring strengthening exercises, but did not record hamstring strain incidence. A fifth article, a systematic review, met all the criteria except for the correct population. Of the 3 studies, 2 were randomized control trails and 1 was a cohort study. Clinical Bottom Line: There is robust supportive evidence that eccentric hamstring exercises can prevent a hamstring injury to an elite adult male soccer player. Therefore, it is recommended that athletic trainers and other sports medicine providers evaluate current practices relating to reducing hamstring strains and consider implementing eccentric exercise based prevention programs. Strength of Recommendation: All evidence was attained from articles with a level of evidence 2b or higher, based on the Center for Evidence-Based Medicine (CEBM) criteria, stating that eccentric exercises can decrease hamstring strains. [ABSTRACT FROM AUTHOR]

The creation of risk profiles using the model of stress and athletic injury (J Appl Sport Psychol. 1998;10(1):5) represents a proposed shift from the reductionism paradigm to the complex sport approach in an attempt to formulate prevention strategies to combat the increasing number of injuries being reported in sporting populations. As a result, the primary purpose of this study was to: (a) identify different risk profiles based on psychosocial factors associated with the Williams and Andersen's model of stress and athletic injury model; and (b) examine potential differences in the frequency of injuries across these risk profiles. A prospective research design was utilized with a sample of 117 competitive soccer players (81 males and 36 females) from Sweden and the United States of America. Data was collected at two time points over the course of three months. At time 1 (beginning of the season) -a demographic information sheet, the Life Event Survey for Collegiate Athletes (LESCA), Sport Competitive Anxiety Test (SCAT), and Brief Cope were administered. At time two (T2), three months after the initial data collection, participants’ traumatic injuries were recorded. Latent profile analysis (LPA) showed that 3 profiles solution showed best fit to data. Players in profile 1 and 2 reported fewer injuries compared to players in profile 3. However, whereas individuals in profile 1 had a lower predictive risk of sustaining an injury when compared to those in profile 3, both profiles had similar anxiety levels and use of coping strategies with differing stress levels. These findings suggest that the interaction between different proposed risk factors might influence injury risk. [ABSTRACT FROM AUTHOR]

Taping is a method to prevent serious injuries or support the athletes to feel less pain around injured limbs during their performance. Sometimes football players use it as a protective mechanism in the presence of an existing injury. This review has tried to collect the available data regarding the role of taping as a practical way of prevention from serious injuries. For this purpose, Science Direct, Web of Science, PubMed, and Scopus were used. Among inserted titles in Mendeley, finally, six papers were analyzed. The findings of this research confirmed the important role of taping in the prevention of serious injuries among football players. [ABSTRACT FROM AUTHOR]

Introduction: Bio-banding (BB) is a strategy used in sports to level out the differences in growth, maturation and development in children and youth during training and non-official competition. Instead of grouping athletes based on chronological age, they are grouped based on their biological maturity status. Objectives: Bio-banding in soccer has been proposed to assist in the process of identifying, selecting and developing talents and reduce the risk of injury. The aim of this study was therefore to identify primary research on bio-banding in soccer relating to the; technical/tactical-; physical-; psychological-, social-; and medical-dimension of performance. Study design: A scoping review following the PRISMA-ScR guidelines was used to identify research from the databases of Sport- Discus, Medline and ORIA NORD from its origin to October 2022 using bio-banding as the primary search term. Primary research on BB in soccer, written in English or a Scandinavian language with full text, was included. An additional search was performed in referencelists, Google Scholar and grey literature. Results: The study identified 20 studies from 2018 to 2022 on the use of BB among 9- to 18-year-old soccer players (N=1951), coaches/stakeholders (N=8) and parents (N=80). In terms of outcome measures there were 10 studies related to the technical- and/or tactical dimension; 15 to the physical-, 9 to the psychological-; 5 to the social-; and 4 to the medicaldimension. Conclusion: Players, coaches/stakeholders and parents identified both advantages and disadvantages with the use of BB. The outcome measures support the potential use of BB in soccer through identification, selection, player development and risk of injury. However, the evidence is limited, so further studies are warranted, especially among female soccer players. To facilitate a more holistic and integrated approach to banding in soccer, the study proposes a biopsychosocial model for further development. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study is to research how the decision-making on RTP from the medical staff impact on the perceived short- and long-term performance of the player and the team, from a coach, medical staff, and player perspective. Methods: Two professional football players, one physical coach, one physiotherapist and one assistant coach were interviewed in-depth and recruited because of their insight, experience, and expertise from one Norwegian premiere league club. Results: The decision-making process on RTP in the club were partly based on the hierarchy in the club, where the coach was on the top among these actors. Despite that the actor´s describes the process as a natural dynamic, and felt a shared responsibility in the process, their different roles impact on the decisions. The RTP decision was affected by aspects such as the period in the season, earlier injury experience of the player and the medical staff and coach collaboration. Conclusions: Even though the medical staff and the injury prevention could mean that the player could have a longer career, the choices made in the process of RTP is often based on short term player and team performance. Applications in sport: Professional football players have competition as a living and are expected to enjoy and embrace competing against both other teams related to winning trophies and teammates related to a place on the team in matches. This degree of competition was also seen as a part of the RTP process since the competition with teammates gave the players motivation to overcome their injury situation and get back to compete for their "spot" on the team. Even though this study only includes experiences from one professional football club, it gives insight into how the RTP process is done in a professional football context. Future studies should consider recruiting representatives from the club management, which also could give insight on how the macro aspects of a club impact on the RTP decisions in the coaching team of a professional football club. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate yellow card policies' (YCPs) effectiveness in reducing competition contact injuries (CCIs). Design: Retrospective cohort. Setting: High schools. Participants: Soccer players from High School (HS) Reporting Information Online participating schools, 2005/06 to 2017/18. Independent Variables: Athlete exposure (AE), CCIs from HS competitions collected from states with/without YCPs. Main Outcome Measures: Rate and rate ratio (RR) of athlete-athlete CCIs recorded by athletic trainers were compared between states with/without YCPs and pre-YCPs/post-YCPs among the states with YCPs using Poisson regressions. Proportions of severe athlete-athlete CCIs were also described in states with/without YCPs. Results: Fifteen states implemented YCPs between 2005/06 and 2017/18; 901 athlete-athlete CCIs occurred during 352 775 competition AEs in states with YCPs, and 3525 injuries during 1 459 708 competition AEs in states without YCPs. There was no significant difference in injury rates between schools in states with/without YCPs (RR 1.07; 95% confidence interval [CI]: 0.97-1.17). Among state with YCPs, injury rates were not significantly different between pre-YCP and post-YCP implementation (RR 1.15; 95% CI: 0.98-1.34). Although a significantly lower proportion of injuries resulting in >3 weeks' time loss (TL) occurred in states with YCPs (injury proportion ratio 0.81; 95% CI: 0.66-0.997), no significant differences were observed in proportions of other severe athlete-athlete CCIs between states with/without YCPs. Conclusions: Yellow card policies were ineffective in lowering HS soccer athlete-athlete CCI rates, although injuries resulting in >3 weeks' TL were less prevalent in states with YCPs. Implementation of YCPs alone, without proper enforcement, may not be a sufficient injury prevention strategy. [ABSTRACT FROM AUTHOR]