Return to play following muscle injuries in professional footballers

Abstract

This prospective cohort study described return-to-play (RTP) data for different types of muscle injuries in male elite-level football players in Europe. Eighty-nine European professional teams were followed between 2001 and 2013. Team medical staff recorded individual player exposure and time-loss injuries. A total of 17,371 injuries occurred, including 5603 (32%) muscle injuries. From 2007, we received results from 386 magnetic resonance imaging (MRI) examinations, and radiological grading was performed. A negative MRI was associated with shorter recovery time (6 ± 7 days). Lay-off days were correlated with MRI grading of thigh muscle injuries (P < 0.001). Among hamstring injuries, 83% occurred to the biceps femoris, 12% affected the semimembranosus and 5% the semitendinosus. Recurrence rate was higher among biceps femoris injuries (18%) compared with semitendinosus and semimembranosus injuries (2% together). Groin muscle injuries caused shorter median absence (9 days) than hamstring (13 days; P < 0.001), quadriceps (12 days; P < 0.001) and calf muscle (13 days; P < 0.001) injuries. Overall, we found that MRI was valuable for prognosticating RTP, with radiological grading associated with lay-off times after injury. Re-injuries were common in biceps femoris injuries but rare in semitendinosus and semimembranosus injuries.     

Return to play management after concussion in football: recommendations for team physicians

Abstract

A concussion is a rare but potentially serious injury of football players. Thus, an immediate and valid diagnosis, estimate of severity and therapeutic management is required. To summarise the published information on management of concussion with respect to a safe return to play (RTP), a literature search was conducted. Current guidelines on concussion in sports and significant studies on concussion in football were analysed. After concussion, management and RTP decision should remain in the area of clinical judgement on an individualised basis according to the current international guidelines. If a concussion is suspected, the player should not be allowed to RTP the same day. The RTP programme should follow a gradual step-wise procedure. A concussed player should not RTP unless he/she is asymptomatic and the neurological and neuropsychological examinations are normal. Untimely RTP bears an increased risk of sustaining another more severe brain injury and repetitive brain injury of long-term sequelae. In football, the management of concussion should primarily follow the recommendations proposed by the Concussion in Sports Group. Information and education of players and their medical and coaching team help to protect the players’ health. Future studies on concussion should include validated and detailed information on RTP protocols.     

Strategies to maintain skeletal muscle mass in the injured athlete: Nutritional considerations and exercise mimetics

Abstract

The recovery from many injuries sustained in athletic training or competition often requires an extensive period of limb immobilisation (muscle disuse). Such periods induce skeletal muscle loss and consequent declines in metabolic health and functional capacity, particularly during the early stages (1–2 weeks) of muscle disuse. The extent of muscle loss during injury strongly influences the level and duration of rehabilitation required. Currently, however, efforts to intervene and attenuate muscle loss during the initial two weeks of injury are minimal. Mechanistically, muscle disuse atrophy is primarily attributed to a decline in basal muscle protein synthesis rate and the development of anabolic resistance to food intake. Dietary protein consumption is of critical importance for stimulating muscle protein synthesis rates throughout the day. Given that the injured athlete greatly reduces physical activity levels, maintaining muscle mass whilst simultaneously avoiding gains in fat mass can become challenging. Nevertheless, evidence suggests that maintaining or increasing daily protein intake by focusing upon the amount, type and timing of dietary protein ingestion throughout the day can restrict the loss of muscle mass and strength during recovery from injury. Moreover, neuromuscular electrical stimulation may be applied to evoke involuntary muscle contractions and support muscle mass maintenance in the injured athlete. Although more applied work is required to translate laboratory findings directly to the injured athlete, current recommendations for practitioners aiming to limit the loss of muscle mass and/or strength following injury in their athletes are outlined herein.     

我国儿童足球训练运动损伤初探:基于992名6~9岁球员的横断面研究

目的：调查我国6~9岁儿童在足球训练中运动损伤的患病率、患病特点、影响因素。方法：本横断面研究纳入2017—2019年中国足球小将相关赛事报名参赛球员，收集人口基本信息、足球训练情况、足球训练相关损伤情况。结果：研究纳入992例球员，来自全国16个省和直辖市。其中男性儿童953人、女性儿童39人，平均年龄(8.1±0.8)岁，平均身高(135.3±6.8) cm，平均体重(29.0±4.7) kg，平均BMI(15.8±1.8) kg/m2，平均球龄(28.7±10.5)月。足球训练中运动损伤的患病率为15.0%。损伤最常见的部位为踝关节；最常见受伤类型是关节扭伤或韧带损伤。受伤球员与未受伤球员间最大训练强度有统计学差异(P<0.05)，性别、年龄、场上位置、每次训练时间、每周训练频率无统计学差异。结论：我国6~9岁参与足球运动的儿童在训练中出现运动损伤的患病率为15%。其中踝关节扭伤最常见。训练强度过高很可能是导致发生训练损伤的风险因素。     

对广西交通职业技术学院学生运动损伤的调查

我院学生在体育活动过程中 ,运动损伤的发生率较高 ,而且多发生在课外活动和课中 ,其中以足球和篮球运动项目发生的损伤最多。损伤部位也较集中在手腕、踝关节和脚及小腿 ,造成损伤的原因是多方面的。     

Relationship between leg stiffness and lower body injuries in professional Australian football

Abstract

Leg stiffness is a modifiable mechanical property that may be related to soft tissue injury risk. The purpose of this study was to examine mean leg stiffness and bilateral differences in leg stiffness across an entire professional Australian Football League (AFL) season, and determine whether this parameter was related to the incidence of lower body soft tissue injury. The stiffness of the left and right legs of 39 professional AFL players (age 24.4 ± 4.4 years, body mass 87.4 ± 8.1 kg, stature 1.87 ± 0.07 m) was measured using a unilateral hopping test at least once per month throughout the season. Injury data were obtained directly from the head medical officer at the football club. Mean leg stiffness and bilateral differences in leg stiffness were compared between the injured and non-injured players. There was no difference between the season mean leg stiffness values for the injured (219.3 ± 16.1 N · m^?1 · kg^?1) and non-injured (217.4 ± 14.9 N · m^?1 · kg^?1; P = 0.721) groups. The injured group (7.5 ± 3.0%) recorded a significantly higher season mean bilateral difference in leg stiffness than the non-injured group (5.5 ± 1.3%; P = 0.05). A relatively high bilateral difference in leg stiffness appears to be related to the incidence of soft tissue injury in Australian football players. This information is of particular importance to medical and conditioning staff across a variety of sports.     

Relationship between leg stiffness and lower body injuries in professional Australian football

Leg stiffness is a modifiable mechanical property that may be related to soft tissue injury risk. The purpose of this study was to examine mean leg stiffness and bilateral differences in leg stiffness across an entire professional Australian Football League (AFL) season, and determine whether this parameter was related to the incidence of lower body soft tissue injury. The stiffness of the left and right legs of 39 professional AFL players (age 24.4 ± 4.4 years, body mass 87.4 ± 8.1 kg, stature 1.87 ± 0.07 m) was measured using a unilateral hopping test at least once per month throughout the season. Injury data were obtained directly from the head medical officer at the football club. Mean leg stiffness and bilateral differences in leg stiffness were compared between the injured and non-injured players. There was no difference between the season mean leg stiffness values for the injured (219.3 ± 16.1 N x m(-1) x kg(-1)) and non-injured (217.4 ± 14.9 N x m(-1) x kg(-1); P = 0.721) groups. The injured group (7.5 ± 3.0%) recorded a significantly higher season mean bilateral difference in leg stiffness than the non-injured group (5.5 ± 1.3%; P = 0.05). A relatively high bilateral difference in leg stiffness appears to be related to the incidence of soft tissue injury in Australian football players. This information is of particular importance to medical and conditioning staff across a variety of sports.     

Relationship between vertical stiffness and soft-tissue injuries in professional Australian football

ABSTRACT

Soft-tissue injuries are common in Australian football. Recently, literature has identified non-modifiable and modifiable risk factors, including vertical stiffness (K_vert). However, limitations regarding measurement frequency and duration exist; thus, further information is required about the role of K_vert as a modifiable risk factor for injury. This study examined the seasonal variation in K_vert and its relationship to soft-tissue injuries in professional Australian football. The mean K_vert and bilateral asymmetry were assessed and compared between injured and non-injured players. For the seasonal analysis, 56 players were tested across two seasons with no variation in bilateral asymmetry evident (p= 0.33). While there were generally no changes in K_vert, the value from the end of the second pre-season revealed 5% lower values than the mean of two seasons (p= 0.02). Considering the injury analysis, 21 lower-body soft-tissue injuries were recorded from 18 participants. No differences were recorded for mean K_vert between the injured and non-injured groups (p= 0.16–0.76). When assessing K_vert asymmetry, the injured group displayed a 4.5% higher value than the non-injured group at the end of the pre-season test (p= 0.03) but not at other time-points (p= 0.16–0.99). Higher K_vert bilateral asymmetry measures after the pre-season appear to be related to lower-body soft-tissue injury in professional Australian footballers. Medical and conditioning staff should consider this measure when trying to mitigate the onset of injury or identify at-risk players.     

业余足球运动员踝关节损伤的原因及治疗

通过查阅相关资料,并参与山西省太原市业余足球比赛若干场次,对在比赛中踝关节急性损伤的运动员进行各期治疗并进行对比,观察疗效。结果显示：业余足球运动员踝关节损伤后未处理的,痊愈率为17％;只进行前期处理的,痊愈率为50％;进行前期、中期、后期治疗的,痊愈率为100％。     

江苏省部分优秀投掷运动员运动损伤调查

对国家女子投掷人才基地南通组16名现役优秀运动员进行了运动损伤调查。结果表明,优秀投掷运动员的受伤多发部位依次为膝、肩、手和腹。多发伤种与项目有关:推铅球易致肩袖伤、掌指关节扭伤、膝创伤筋膜炎;掷铁饼易致髌骨软骨病;投标枪易致肩袖伤、半月板损伤;掷链球易致腹外斜肌拉伤。局部运动负荷过大、技术动作不正确和身体疲劳是造成运动损伤的主要原因。科学安排训练和竞赛,注重对运动员的技术训练和技术诊断,加强对膝、肩等受伤多发部位的保护,提高对急性损伤的诊治水平,建立、健全运动员医疗制度和康复制度,对于预防投掷运动损伤和提高治疗效果具有积极作用。     

优秀田径运动员腘绳肌拉伤后的肌力特征分析

运用CYBEX-Norm型等速肌力测试与康复系统,以上海市优秀田径运动员为研究对象,探讨腘绳肌拉伤后的等速参数变化,分析伤后的恢复情况.结果显示：受伤运动员伤侧腘绳肌峰力矩角度明显增大,表明拉伤腘绳肌达到最大力量的时间明显延长,最大收缩长度发生了改变.建议：在运动实践中,合理运用等速测试的峰力矩角指标作为腘绳肌拉伤后恢复效果的监控指标,并结合适当比例的离心训练,将有助于减少运动中腘绳肌的拉伤.     

基于FMS训练对现役人员半月板损伤康复影响的个案研究

目的:探索基于FMS训练的运动干预对半月板损伤康复的影响,以期发现针对半月板损伤康复的重要变项及有用范畴,得到推导性的理论与实验发现。方法:对1名病程2个月,经MRI检查诊断为左膝内侧半月板后角损伤Ⅱ度青年男性军校大学生,制动一周后,进行8周线性单周期训练,训练内容基于FMS训练的运动康复计划。在运动康复前后分别进行受伤部位疼痛测试、基本形态测试、运动能力测试、基本生理指标测试及下肢步态分析。结果:与训练前相比,8周训练后,疼痛程度由中重度疼痛逐渐降至轻中度疼痛;基本身体形态和运动能力指标方面,在身体形态方面体重和体指数呈下降趋势;心肺耐力方面经改良版Bruce方案检测最大摄氧量显著提高;骨骼肌耐力(引体向上、双杠臂屈伸、俯卧撑)和最大力量(卧推、下肢等速测试)方面均显著提高;协调能力(平板支撑+变向滑步)方面显著提高;动摇角度、最大动摇径、重心偏移均显著下降,平衡能力提高;无氧能力方面有所改善;下肢爆发力方面呈现出机能节省化的趋势;认知能力方面选择注意力和抑制控制能力提高。结论:对于半月板损伤患者而言,运用8周基于FMS训练的运动康复计划可在一定程度上提高患者的基础运动能力,基本的生理指标也发生一定程度的改善。     

等速康复训练在集体小球项目中的应用研究

对2007-2012年间广东省集体小球类项目(手球、曲棍球、垒球)运动损伤后等速肌力康复效果进行归纳总结。应用等速肌力测试系统为广东集体小球项目运动员提供了419人次5 872关节次等速康复训练,康复前后进行角速度为60°/s的膝、肩关节等速肌力测试,以及角速度为30°/s的踝关节等速肌力测试,结果发现:(1)膝关节损伤发生率最高,达到60.88%,踝、肩也是损伤多发部位,整体看来,下肢损伤发生率高于上肢。(2)各项目运动员经过一段时间的等速康复训练后,关节等速肌力得到显著提高。结论:(1)在集体小球项目中,运动损伤发生部位与运动专项特点密切相关,损伤发生率从高到低依次为膝、踝、肩、腰背、髋。(2)等速肌力康复作为一种康复手段,在集体小球项目运动员运动损伤过程中效果明显,提供了客观可靠的量化指标。     

Medical interventions in the management of hamstring muscle injury

Abstract

Acute muscle belly injuries to the semitendinosus, semimembranosus and biceps femoris (the ‘hamstring’ muscles) remain a common problem in the sporting population. Physiotherapy-led rehabilitation remains the mainstay of treatment, and the physician's input is often minimal. Anecdotally, many different topical, oral and injectable therapies are used around the world in an effort to accelerate the healing of these injuries and to prevent their recurrence. This article reviews the evidence available to support some of the most commonly used medical therapies and the pathophysiological basis for their use. It also presents the evidence behind some of the more promising future treatments for muscle injury, including stem cell therapy, growth factor delivery and potential novel uses of current medication not traditionally used in the musculoskeletal setting.     

肌电生物反馈训练对消除运动员疲劳的功效

将18名男性足球运动员随机分为肌电反馈训练、渐进性肌肉放松和对照等3组,采用实验对比法进行研究。结果显示,采用肌电生物反馈训练、渐进性肌肉放松训练,均能促进运动员疲劳的消除,其中以肌电生物反馈训练法效果为优。     

Physical exercises for preventing injuries among adult male football players: A systematic review

Background:Football is the most practised sport in the world and is associated with the risk of injuries in the players.Some studies have been published that identify injury prevention programs,but there is no review of the full body of evidence on injury prevention programs for use by football coaches.The aim of this article was to carry out a systematic review of published studies on injury prevention programs for adult male footballers,identify points of common understanding and establish recommendations that should be considered in the design of injury prevention strategies.Methods:PubMed and EMBASE databases were used to identify relevant published articles using the following keywords:"soccer"AND"injury"AND"prevention".Results:A total of 2512 studies were identified initially,but only 11 studies met the inclusion criteria,and their outcomes are presented.Results revealed that injury prevention programs in football have focused on strength training,proprioceptive training,multicomponent programs(balance,core stability,and functional strength and mobility),and warm-up programs.Conclusion:Based on results from the studies analyzed,football players can lower the incidence of match and training injuries by participating in dynamic warm-up programs that include preventive exercises before games or during training sessions,and by adding strength,balance,and mobility training to the training sessions.     

散打后鞭腿训练导致腰方肌损伤的康复对策

文章旨在针对散打后鞭腿训练中出现的队员腰方肌损伤,探讨有效的康复对策。研究方法：采用中频调制电流配合护具等措施,对受伤队员进行2周的康复治疗。研究结果：受伤队员的局部痛感基本消失,恢复了正常的训练。研究结论：对于散打后鞭腿训练中出现的腰方肌损伤,中频调制电流配合护具是有效的康复措施。     

高校足球运动常见损伤的调查与预防

通过对本校参加足球活动的学生损伤调查统计分析,在总发病率、伤痛的种类、损伤的部位、损伤原因等方面进行了分析。除损伤的部位外,大学生足球运动员发生运动损伤的种类、损伤的原因与同龄的职业足球运动员有明显的不同。建议在以后的教学、训练、课外活动中采取针对性的预防措施。     

功能康复中不可或缺的环节——离心力量训练

康复训练的核心是功能恢复。渐进性功能训练不仅应用于体能训练,在伤后运动康复实践中也是一项非常重要的康复手段,能够循序渐进地帮助运动员或受伤者逐渐恢复体能及重塑肌肉功能,并在较低一级基础动作正确完成的前提下,推动其向更高水平的功能目标迈进,从而改善运动功能,为受伤运动员安全地重返赛场提供了必不可少的手段。离心力量训练能够有效预防损伤、提高快速力量,是功能康复不可或缺的重要环节,对运动员功能康复的效率和质量起到显著的作用。