| 1. |
- Asker, Martin, et al.
(författare)
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A prospective cohort study identifying risk factors for shoulder injuries in adolescent elite handball players: the Karolinska Handball Study (KHAST) study protocol
- 2017
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Ingår i: BMC Musculoskeletal Disorders. - : BIOMED CENTRAL LTD. - 1471-2474. ; 18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Handball is a physical contact sport that includes frequent overhead throwing, and this combination leads to a high rate of shoulder injuries. Several factors have been associated with shoulder injuries in overhead athletes, but strong scientific evidence is lacking for most suggested risk factors. We therefore designed the Karolinska Handball Study (KHAST) with the aim to identify risk factors for shoulder injuries in adolescent male and female elite handball players studying at handball-profiled secondary schools in Sweden. Secondary objectives are to investigate whether shoulder function changes during the competition season and whether the physical profile of the players changes during their time in secondary school. Methods: Players aged 15 to 19 years were included during the pre-season period of the 2014-2015 and the 2015-2016 seasons. At inclusion, players signed informed consent and filled in a questionnaire regarding playing position, playing level, previous handball experience, history of shoulder problems and athletic identity. Players also completed a detailed test battery at baseline evaluating the shoulder, neck and trunk. Players were then prospectively monitored weekly during the 2014-2015 and/or 2015-2016 competitive seasons regarding injuries and training/match workload. Results from the annual routine physical tests in the secondary school curriculum including bench press, deep squat, hand grip strength, clean lifts, squat jumps, counter movement jumps, amp;lt;30 m sprints, chins, dips and Coopers test will be collected until the end of the competitive season 2017-2018. The primary outcome is the incidence of shoulder injuries and shoulder problems. The secondary outcome is the prevalence of shoulder injuries and shoulder problems. Discussion: Shoulder problems are frequent among handball players and a reduction of these injuries is therefore warranted. However, in order to introduce appropriate preventive measures, a detailed understanding of the underlying risk factors is needed. Our study has a high potential to identify important risk factors for shoulder injuries in adolescent elite handball players owing to a large study sample, a high response rate, data collection during consecutive seasons, and recording of potential confounding factors.
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| 2. |
- Asker, Martin, et al.
(författare)
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Female adolescent elite handball players are more susceptible to shoulder problems than their male counterparts
- 2018
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 26:7, s. 1892-1900
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Tidskriftsartikel (refereegranskat)abstract
- Shoulder problems are frequent among senior elite handball players. The objective of this study was to assess the prevalence of shoulder problems among adolescent elite handball players and to investigate potential differences in gender, school grade, playing position and playing level. During the 2014 and 2015 pre-season periods, 471 players (age 15-18 years, 54% female) completed a comprehensive baseline questionnaire regarding history of any shoulder pain and shoulder problems experienced during the past season. The players were monitored weekly for one competition season (September-April) regarding shoulder problems and the amount of match and training. Generalised linear models with a binomial link function were used to calculate a prevalence ratio (PR) with 95% confidence interval (CI) to compare the subgroups of players. In total, 110 players (23%) reported having substantial shoulder problems (defined as moderate/severe reduction in training volume, or moderate/severe reduction in performance, or complete inability to participate) at some point during the follow-up season, of which almost half reported complete inability to participate. Of those players reporting substantial problems, 43% (95% CI 39-48) did so for at least 3 consecutive weeks during the season. The prevalence was significantly higher in female players (PR 1.46, 95% 1.04-2.06) and in backcourt players (PR 1.58, 95% CI 1.08-2.32), but no differences were found for school grade (PR 1.21 95% CI 0.88-1.67) or playing level (PR 1.09 95% CI 0.76-1.56). The prevalence of substantial shoulder problems in adolescent elite handball players is high, especially among females, and this warrants further studies on risk factors for shoulder injury and the development of prevention strategies in handball players already before the age of 15. These findings also highlight the importance of introducing a clinical monitoring programme on a routine basis and improving the medical support, taking gender-related aspects into consideration, at handball-profiled secondary schools. II.
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| 3. |
- Asker, Martin, et al.
(författare)
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Risk factors for, and prevention of, shoulder injuries in overhead sports : a systematic review with best-evidence synthesis.
- 2018
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 52:20, s. 312-1319
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.DESIGN: Systematic review with best-evidence synthesis.DATA SOURCES: Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.RESULTS: Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.CONCLUSIONS: All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.PROSPERO TRIAL REGISTRATION NUMBER: CRD42015026850.
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| 4. |
- Atroshi, Isam, et al.
(författare)
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Collagenase treatment of Dupuytrens contracture using a modified injection method
- 2015
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Ingår i: Acta Orthopaedica. - : Informa Healthcare: Creative Commons Attribution Non-Commercial / Informa Healthcare. - 1745-3674 .- 1745-3682. ; 86:3, s. 310-315
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose - Treatment of Dupuytrens contracture (DC) with collagenase Clostridium histolyticum (CCH) consists of injection followed by finger manipulation. We used a modified method, injecting a higher dose than recommended on the label into several parts of the cord, which allows treatment of multiple joint contractures in 1 session and may increase efficacy. We studied the occurrence of skin tears and short-term outcome with this procedure. Patients and methods - We studied 164 consecutive hands with DC, palpable cord, and extension deficit of greater than= 20 degrees in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint (mean patient age 70 years, 82% men). A hand surgeon injected all the content of 1 CCH vial (approximately 0.80 mg) into multiple spots in the cord and performed finger extension under local anesthesia after 1 or 2 days. A nurse recorded skin tears on a diagram and conducted a standard telephone follow-up within 4 weeks. A hand therapist measured joint contracture before injection and at a median of 23 (IQR: 7-34) days after finger extension. Results - A skin tear occurred in 66 hands (40%). The largest diameter of the tear was less than= 5 mm in 30 hands and greater than 10 mm in 14 hands. Hands with skin tear had greater mean pretreatment MCP extension deficit than those without tear: 59 degrees (SD 26) as opposed to 32 degrees (SD 23). Skin tear occurred in 21 of 24 hands with MCP contracture of greater than= 75 degrees. All tears healed with open-wound treatment. No infections occurred. Mean improvement in total (MCP + PIP) extension deficit was 55 degrees (SD 28). Interpretation - Skin tears occurred in 40% of hands treated with collagenase injections, but only a fifth of them were larger than 1 cm. Tears were more likely in hands with severe MCP joint contracture. All tears healed without complications. Short-term contracture reduction was good.
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| 5. |
- Bengtsson, Håkan, 1985-
(författare)
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Match-related risk factors for injury in male professional football
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Injuries are common in professional football, especially during matches, and they cause suffering for players, in both the short and the long term. It is therefore important to try to prevent these injuries. One of the most important steps in injury prevention is to fully understand the different risk factors that contribute to these injuries. Aim: The aim of this thesis was therefore to investigate several match-related factors that have been suggested to be important for the risk of sustaining injuries during professional football matches. Methods: The thesis consists of four papers, and all analyses are based on data gathered during a large-scale prospective cohort study that has been running since 2001: the UEFA Elite Club Injury Study. Medical teams from 61 clubs have been involved in this study, and they have prospectively gathered data about football exposure and injuries for their first team players.Associations between the following factors and injuries have been analysed: • Match characteristics in terms of match venue, match result, and competition • Match congestion, both short and long term, and at team and individual player level • Number of completed training sessions between return to sport after an injury and the first match exposure Results: All match characteristics studied were shown to be associated with injury rates, with higher injury rates during home matches compared with away matches, in matches that were lost or drawn compared with matches won, and in domestic league and Champions League matches compared with Europa League and other cup matches. It was also shown that injury rates, muscle injury rates in particular, were higher if the recovery time between matches was short. This association between match congestion and injury rates was shown when match congestion was considered at both team and individual player level. Finally, the odds of injury during the first match exposure after a period of absence due to injury was found to be higher if players had completed few training sessions between return to sport and their first match. Conclusion: There are several match-related risk factors that contribute to the injury rate during professional football matches. A better understanding of these risk factors will help teams to make better estimations of the injury risks to which players are exposed in different situations (e.g. during periods of match congestion and when players return to sport after an injury). Knowledge about risk factors will also offer the possibility of reducing the number of injuries for football teams by addressing them with appropriate measures.
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| 6. |
- Bengtsson, Håkan, et al.
(författare)
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Muscle injury rate in professional football is higher in matches played within 5 days since the previous match: a 14-year prospective study with more than 130 000 match observations
- 2018
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 52:17, s. 1116-1122
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Tidskriftsartikel (refereegranskat)abstract
- Background The association between match congestion and injury rates in professional football has yielded conflicting results. Aim To analyse associations between match congestion on an individual player level and injury rates during professional football matches. Methods Data from a prospective cohort study of professional football with 133 170 match observations were analysed with Poisson regressions. Associations between short-term match congestion, defined as number of days between two match exposures (3, 4, 5, 6 and 7-10 days) and injury rates were analysed. To analyse the influence of long-term match congestion, defined as individual match exposure hours in the 30 days preceding a match, observations were categorised into three groups (low, 4.5; medium, amp;gt;4.5to 7.5; and high, amp;gt;7.5hours). Results No differences in total match injury rates were found between the reference category (3 days) and the other categories of short-term congestion. Muscle injury rates were significantly lower in matches preceded by 6 (rate ratio (RR) 0.79; 95%CI 0.65 to 0.95) or 7-10 days (RR 0.81; 95%CI 0.71 to 0.93) compared with 3 days since the last match exposure. No differences in total and muscle injury rates between the three long-term match congestion groups were found. Conclusions In this study of male professional football players, there were no match congestion-related differences in total match injury rates, but muscle injury rates during matches were lower when players were given at least 6days between their match exposures.
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| 7. |
- Bjorneboe, John, et al.
(författare)
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Role of illness in male professional football: not a major contributor to time loss
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:11, s. 699-702
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Tidskriftsartikel (refereegranskat)abstract
- Background There are limited data on the nature, type and incidence of illness in football. Previous studies indicate that gastrointestinal and respiratory tract illnesses are most common. Aim To describe the incidence and burden of illness in male professional football. Methods Over the 4-year study period, 2011-2014, 73 professional football teams in Europe participated, with a total of 1 261 367 player-days recorded. All time-loss illnesses were recorded by the medical staff of each club. A recordable illness episode was any physical or psychological symptom (not related to injury) that resulted in the player being unable to participate fully in training or match play. Results A total of 1914 illness episodes were recorded. The illness incidence was 1.5 per 1000 player-days, meaning that, on average, a player experienced an illness episode every second season, with a median of 3 days absence per illness episode. Severe illness (absence amp;gt;4 weeks) constituted 2% of all illnesses. Respiratory tract illness was the most common (58%), followed by gastrointestinal illness (38%). Respiratory tract illness, gastrointestinal illness and cardiovascular illness caused the highest illness burden. Conclusions The illness incidence among male professional football players is low compared with the injury incidence. We found that the highest illness burden was caused by illness to the respiratory tract, gastrointestinal tract and cardiovascular system.
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| 8. |
- Ekstrand, Jan, et al.
(författare)
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Hamstring injuries have increased by 4% annually in mens professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:12, s. 731-737
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Tidskriftsartikel (refereegranskat)abstract
- Background There are limited data on hamstring injury rates over time in football. Aim To analyse time trends in hamstring injury rates in male professional footballers over 13 consecutive seasons and to distinguish the relative contribution of training and match injuries. Methods 36 clubs from 12 European countries were followed between 2001 and 2014. Team medical staff recorded individual player exposure and time-loss injuries. Injuries per 1000 h were compared as a rate ratio (RR) with 95% CI. Injury burden was the number of lay off days per 1000 h. Seasonal trend for injury was analysed using linear regression. Results A total of 1614 hamstring injuries were recorded; 22% of players sustained at least one hamstring injury during a season. The overall hamstring injury rate over the 13-year period was 1.20 injuries per 1000 h; the match injury rate (4.77) being 9 times higher than the training injury rate (0.51; RR 9.4; 95% CI 8.5 to 10.4). The time-trend analysis showed an annual average 2.3% year on year increase in the total hamstring injury rate over the 13-year period (R-2=0.431, b=0.023, 95% CI 0.006 to 0.041, p=0.015). This increase over time was most pronounced for training injuries-these increased by 4.0% per year (R-2=0.450, b=0.040, 95% CI 0.011 to 0.070, p=0.012). The average hamstring injury burden was 19.7 days per 1000 h (annual average increase 4.1%) (R-2=0.437, b=0.041, 95% CI 0.010 to 0.072, p=0.014). Conclusions Training-related hamstring injury rates have increased substantially since 2001 but match-related injury rates have remained stable. The challenge is for clubs to reduce training-related hamstring injury rates without impairing match performance.
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| 9. |
- Gomez-Piqueras, Pedro, et al.
(författare)
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Are we making SMART decisions regarding return to training of injured football players? Preliminary results from a pilot study
- 2018
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Ingår i: Isokinetics and exercise science. - : IOS PRESS. - 0959-3020 .- 1878-5913. ; 26:2, s. 115-123
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: "When will I be able to play again?" is the most frequent question asked by injured athletes. Due to the complex nature of sports injury, deciding when an injured athlete may safely return to training is a critical and difficult decision. OBJECTIVE: To study if the Safe Multidimensional Algorithm for Return to Training (SMART) scores, applied before the release to full return to training after injury differs between football players who suffer a subsequent re-injury and football players who do not. METHOD: Seventy one male professional football players were prospectively monitored for injuries during two seasons. The SMART tool was applied in injured players with an absence amp;gt; 10 days. The injured player had to carry out 17 multidimensional tests included in the algorithm in his final days of the planned rehabilitation. The results of the SMART were compared between players who sustained re-injuries and those who did not. RESULTS: Fifty-five injuries with absence amp;gt; 10 days were recorded and re-injuries occurred in 12 of these cases (22%). There was a lower re-injury rate in players who presented a better recovery in pain (p amp;lt; 0.001), agility (RR 21.0, 95% CI: 2.0 to 213.2), advanced agility (RR 26.7, 95% CI: 4.9 to 142.8), anxiety (RR 8.6, 95% CI: 2.0 to 36.2), depression (RR 10.3, 95% CI: 1.5 to 65.7), self-perception (p amp;lt; 0.001), advanced skills mode (RR 20.5, 95% CI: 3.3 to 125.9) and group skills mode (p amp;lt; 0.001). CONCLUSIONS: A multidimensional approach of Return to Training that includes objective measures may indicate potential deficiencies in the recovery of injured players.
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| 10. |
- Hägglund, Martin, et al.
(författare)
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Injury recurrence is lower at the highest professional football level than at national and amateur levels: does sports medicine and sports physiotherapy deliver?
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:12, s. 751-758
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous injury is a well-documented risk factor for football injury. The time trends and patterns of recurrent injuries at different playing levels are not clear. Aim To compare recurrent injury proportions, incidences and patterns between different football playing levels, and to study time trends in recurrent injury incidence. Methods Time-loss injuries were collected from injury surveillance of 43 top-level European professional teams (240 team-seasons), 19 Swedish premier division teams (82 team-seasons) and 10 Swedish amateur teams (10 team-seasons). Recurrent injury was defined as an injury of the same type and at the same site as an index injury within the preceding year, with injury amp;lt;2 months defined as an early recurrence, and amp;gt;2 months as a delayed recurrence. Seasonal trend for recurrent injury incidence, expressed as the average annual percentage of change, was analysed using linear regression. Results 13 050 injuries were included, 2449 (18.8%) being recurrent injuries, with 1944 early (14.9%) and 505 delayed recurrences (3.9%). Recurrence proportions were highest in the second half of the competitive season for all cohorts. Recurrence proportions differed between playing levels, with 35.1% in the amateur cohort, 25.0% in the Swedish elite cohort and 16.6% in the European cohort (chi(2) overall effect, pamp;lt;0.001). A decreasing trend was observed in recurrent injury incidence in the European cohort, a -2.9% average annual change over the 14-year study period (95% CI -5.4% to -0.4%, p=0.026). Similarly, a decreasing tendency was also seen in the Swedish premier division. Conclusions Recurrence proportions showed an inverse relationship with playing level, and recurrent injury incidence has decreased over the past decade.
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| 11. |
- Hägglund, Martin, et al.
(författare)
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Risk factors for acute knee injury in female youth football.
- 2016
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer. - 0942-2056 .- 1433-7347. ; 24:3, s. 737-746
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To prospectively evaluate risk factors for acute time-loss knee injury, in particular ACL injury, in female youth football players.andlt;br /andgt;Methods: Risk factors were studied in 4556 players aged 12-17 years from a randomised controlled trial during the 2009 season. Covariates were both intrinsic (body mass index, age, relative age effect, onset of menarche, previous acute knee injury or ACL injury, current knee complaints, and familial disposition of ACL injury) and extrinsic (no. of training sessions/week, no. of matches/week, match exposure ratio, match play with other teams, and artificial turf exposure). Hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated from individual variable and multiple Cox regression analyses.andlt;br /andgt;Results: Ninety-six acute knee injuries were recorded, 21 of them ACL injuries. Multiple Cox regression showed a fourfold higher ACL injury rate for players with familial disposition of ACL injury (HR 3.57; 95 % CI 1.48-8.62). Significant predictor variables for acute knee injury were age andgt;14 years (HR 1.97; 95 % CI 1.30-2.97), knee complaints at the start of the season (HR 1.98; 95 % CI 1.30-3.02), and familial disposition of ACL injury (HR 1.96; 95 % CI 1.22-3.16). No differences in injury rates were seen when playing on artificial turf compared with natural grass.andlt;br /andgt;Conclusion: Female youth football players with a familial disposition of ACL injury had an increased risk of ACL injury and acute knee injury. Older players and those with knee complaints at pre-season were more at risk of acute knee injury. Although the predictive values were low, these factors could be used in athlete screening to target preventive interventions.andlt;br /andgt;Level Of Evidence: II.
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| 12. |
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| 13. |
- Ivarsson, Andreas, 1984-, et al.
(författare)
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Elite female footballers’ stories of sociocultural factors, emotions, and behaviours prior to anterior cruciate ligament injury
- 2019
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Ingår i: International Journal of Sport and Exercise Psychology. - New York, NY : Taylor & Francis. - 1612-197X .- 1557-251X. ; 17:6, s. 630-646
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to examine how players’ perceptions of sociocultural factors and intra- and interpersonal aspects of sporting experiences may have influenced the emotions, cognitions, and behaviours of elite female soccer players prior to the occurrence of ACL injuries. The research questions guiding the study were: (a) how did female elite soccer players perceive that their psychosocial experiences were related to their cognitive, physiological, and emotional states prior to their ACL injuries, and (b) how did the players feel their perceived states influenced their behaviours prior to injury occurrence. The participants consisted of the total population of female players (N = 18) competing in the Swedish women’s elite league, who incurred a total ACL tear during the 2012 season. Using a semi-structured interview guide, all players were interviewed post-season. We represented the data using a storytelling approach of aggregated creative nonfiction. The aggregated stories showed sociocultural rules and expectations of overtraining and placing pressure on athletes to play even if they were not physically or psychologically fit. Responding to pressures with potentially risk-increasing behaviours might raise the probability of becoming injured through a number of pathways. Team managers, coaches, and members of the medical team are recommended to develop environments that stimulate the players to engage in adaptive stress-recovery and risk-decreasing behaviours. © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 14. |
- Johnson, Urban, 1961-, et al.
(författare)
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Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors
- 2016
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Ingår i: Bmc Sports Science Medicine and Rehabilitation. - London : Springer Science and Business Media LLC. - 2052-1847. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction. Methods: A qualitative method was used based on individual in-person interviews and video communication of players who incurred a first-time ACL tear during the 2012 season of the Swedish Women's Elite Football League. In total, 13 players had a first-time ACL and were interviewed post-season. The interviews were followed by a thematic content analysis. Based on this, eight players were identified as showing resilient behaviors during their rehabilitation and were included in the final analysis. Results: Three core themes representing psychosocial factors that help players cope successfully with rehabilitation were identified: (I) constructive communication and rich interaction with significant others; (II) strong belief in the importance and efficacy of one's own actions; and (III) the ability to set reasonable goals. Conclusions: The findings suggest three core themes of psychosocial factors that characterize first-time ACL-injured elite female football players showing resilience during rehabilitation after ACL reconstruction. Suggestions for medical teams about ways to support communication, self-efficacy, and goal-setting during the rehabilitation process, are provided.
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| 15. |
- Kilic, O., et al.
(författare)
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Severe musculoskeletal time-loss injuries and symptoms of common mental disorders in professional soccer: a longitudinal analysis of 12-month follow-up data
- 2018
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : SPRINGER. - 0942-2056 .- 1433-7347. ; 26:3, s. 946-954
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Tidskriftsartikel (refereegranskat)abstract
- Psychological factors have shown to be predictors of injury in professional football. However, it seems that this is a two-way relationship, as severe musculoskeletal time-loss injuries have shown to be associated with the onset of symptoms of common mental disorders (CMD). There is no longitudinal study performed exploring this interaction between symptoms of CMD and injuries. The purpose of this study was to explore the interaction between severe musculoskeletal time-loss injuries and symptoms of CMD in professional football players over a 12-month period. Players were recruited by their national players unions in five European countries. Symptoms of CMD included in the study were related to distress, anxiety/depression, sleep disturbance and adverse alcohol use. A total of 384 professional football players were enrolled in the study, of whom 262 (68%) completed the 12-month follow-up period. The mean age of the participants at baseline was 27 +/- 5 years, and they had played professional football for 8 +/- 5 years on average. Symptoms of CMD at baseline were not associated with the onset of severe musculoskeletal time-loss injuries during the follow-up period with relative risks (and 95% CI) ranging from 0.6 (0.3-1.0) to 1.0 (0.5-2.2). In contrast, severe musculoskeletal time-loss injuries reported at baseline were associated with the onset of symptoms of CMD during the follow-up period with relative risks ranging from 1.8 (0.8-3.7) to 6.9 (4.0-11.9). No relationship was found between symptoms of CMD and the onset of severe musculoskeletal time-loss injuries. However, professional football players who suffered from severe musculoskeletal time-loss injuries are likely to develop subsequent symptoms of CMD. This study emphasizes the need for an interdisciplinary medical approach, which not only focuses on the physical but also on the mental health of professional football players. An early identification of players at risk of symptoms of CMD, such as those suffering from severe musculoskeletal injuries, creates the opportunity for an interdisciplinary clinical medical team to treat the players timely and adequately. Prospective cohort study, Level II.
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| 16. |
- Kristenson, Karolina, et al.
(författare)
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Injuries in male professional football : a prospective comparison between individual and team-based exposure registration
- 2016
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 26:10, s. 1225-1232
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Tidskriftsartikel (refereegranskat)abstract
- Methodological considerations of football injury epidemiology have only scarcely been described. The aim of this study was to evaluate the inter-rater agreement in injury capture rate and injury categorisation for data registered in two different prospective injury surveillance audits studying the same two Norwegian male professional football clubs for two consecutive seasons, 2008-2009. One audit used team-based exposure (TBE) recording and the other individual-based exposure (IBE). The number of injuries recorded and corresponding injury rates (injuries/1000 h exposure) were compared between audits. Cohen’s Kappa and Prevalence Adjusted Bias Adjusted Kappa (PABAK) coefficients were calculated for injury variables. Of 323 injuries included, the IBE audit captured 318 (overall capture rate 98.5%, training 98.9%, match 97.8%) and the TBE audit 303 injuries (overall capture rate 93.8%, training 91.4%, match 97.1%). Agreement analysis showed Kappa and PABAK coefficients regarded as almost perfect (> 0.81) for 8 of 9 injury variables, and substantial (ƙ 0.75) for the variable injury severity. In conclusion, the capture rate for training injuries was slightly higher with individual-based exposure recording, and inter-agreement in injury categorisation was very high.
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| 17. |
- Kristenson, Karolina, et al.
(författare)
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No association between surface shifts and time-loss overuse injury risk in male professional football : a prospective cohort study
- 2016
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Ingår i: Journal of Science and Medicine in Sport. - : Elsevier BV. - 1440-2440 .- 1878-1861. ; 19:3, s. 218-221
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate frequent surface shifts, match play on an unaccustomed surface, and climate type as potential risk factors for injury in Scandinavian male professional football.Design: Prospective cohort study.Methods: 32 clubs from two climate zones, warm temperate (n=19) and snow climates (n=13), were followed during seasons 2010 and 2011. The association between number of surface shifts during fivematch sequences and subsequent overuse injury risk was evaluated with generalized estimating equations. Injury rate was expressed as time loss injuries/1000 hours, and compared between groups with a rate ratio and 95% confidence interval (CI).Results: No association was found between the number of surface shifts and subsequent overuse injury risk (risk ratio 1.01, 95% CI 0.91-1.12). Grass clubs (grass installed at home venue) had a lower match injury rate when playing away matches on artificial turf vs. away matches on grass (rate ratio 0.66, 95% CI 0.40-0.89). Analyses on the total cohort showed no difference in injury rates between clubs in the two climate zones, but sub-analyses revealed that grass clubs from the snow climate zone had lower training and match injury rates than grass clubs from the warm temperate zone (rate ratio 0.69, 95% CI 0.55-0.87).Conclusions: No influence on injury risk was seen from frequent surface shifts or from playing matches on an unaccustomed surface. Climate type at club home venue had minimal influence on injury rates.
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| 18. |
- Kristenson, Karolina, 1984-
(författare)
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Risk factors for injury in men´s professional football
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis includes four papers based on three different prospective cohort studies on injury characteristics in men’s professional football. The same general methodology was used in all papers. Time-loss injuries and player individual exposure was registered for match and training separately. The general aim was to investigate potential internal and external risk factors for injury, with a focus on age, playing position, time in professional football, playing surface (artificial turf and natural grass), changes between surfaces and climate; and to evaluate the study methodology.Paper I was based on data collected between 2001 and 2010 from 26 top professional clubs in Europe; the UCL injury study. In total, 6140 injuries and 797 389 hours of exposure were registered. A decreased general injury rate was observed for newcomers compared with established players (hazard ratio (HR), 0.77; 95% CI 0.61-0.99). Using goalkeepers as a reference, all outfield playing positions had significantly higher age-adjusted injury rates. Using players aged ≤ 21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30 years (HR, 1.44; 95% CI, 1.24-1.68).Paper II and Paper III are based on data collected during two consecutive seasons, 2010 and 2011, in the Swedish and Norwegian male first leagues. In total, 2186 injuries and 367 490 hours of football exposure were recorded. No statistically significant differences were found in acute injury rates on artificial turf (AT) compared with natural grass (NG) during match play (rate ratio, 0.98, 99% CI 0.79-1.22) or training (rate ratio 1.14, 99% CI 0.86-1.50) when analysing at the individual player level. However, when analysing at the club level, clubs with AT installed at their home arena had a significantly higher acute training injury rate (rate ratio 1.31, 99% CI 1.04-1.63) and overuse injury rate (rate ratio 1.38, 99% CI 1.14-1.65) compared to clubs with NG installed at their home venue. No association was found between frequent surface shifts and subsequent overuse injury risk (risk ratio 1.01, 95% CI 0.91-1.12). Analyses on the total cohort showed no difference in injury rates between clubs in the two climate zones (total rate ratio 1.01, 95% CI 0.92-1.10).Data included in Paper IV were collected during two consecutive seasons 2008 and 2009. During this period, two Norwegian elite football clubs were concurrently included in two research groups’ surveillance systems. The capture rate for match injuries was similar between the two audits, while the capture rate for training injuries was slightly higher with individual-based exposure recording. The inter-rater agreement in injury variable categorisations was in most aspects very high.
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| 19. |
- Lindblom, Hanna, 1984-
(författare)
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Injury Prevention in Youth Football Players : Training Effects and Programme Implementation
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background With 17–35% of all 14-year-olds in Sweden being active in football, injuries do occur, most frequently during match play. Based on knowledge of injury mechanisms and risk factors, different injury prevention exercise programmes (IPEPs) have been developed. In this thesis, the Swedish IPEP Knee Control was used as a model for injury preventive training.Aim The overall aim of this thesis was to improve our understanding of the effects of the Knee Control injury prevention exercise programme on sports performance and jump-landing technique, as well as exploring programme implementation and coach experiences of using the programme in youth football.Methods Studies I and IV were cluster-randomised trials focusing on the performance effects of Knee Control. Study I included four teams with 41 female youth football players (mean age 14). The intervention group used Knee Control twice weekly for 11 weeks, whereas the control group teams did their usual training. Knee Control includes six different exercises at four levels of difficulty and with partner exercises and is meant to be used during warm-up at every training session. Performance was tested using a battery of balance, agility, jump and sprint tests at baseline and follow-up at an indoor venue. Study IV had a similar set-up but included two different interventions: Knee Control and a new, further-developed version of the programme, Knee Control+, which were studied during an eight-week intervention involving eight youth football teams, four male, four female (mean age 14), with 77 players. Similar, but not identical, performance tests were used in Study IV, along with drop vertical jumps and tuck jump assessment to assess jump-landing technique.Studies II and III focused on the implementation context. Study II was questionnaire based, using the RE-AIM framework covering the reach, effectiveness, adoption, implementation and maintenance of Knee Control. Coaches for female youth teams (n=352), one representative of the national football association and representatives of eight district football associations responded to web-based questionnaires. Data collection was performed two years after the nation-wide implementation of Knee Control started. Study III was a qualitative study that followed up on the results of Study II. Interviews were conducted with 20 coaches for female football teams and analysed using qualitative content analysis. The interviews focused on factors that affected the adoption and use of Knee Control. All 20 coaches had experience of Knee Control.Results Limited positive effects were seen on jump-landing technique in girls, with the total tuck jump assessment score improving, as well as two separate criteria, the number of jumps accomplished during the 10-second test and additionally an increased knee-flexion angle upon landing from a drop vertical jump. No improvements on the performance tests were found in either Study I or Study IV. Both studies, however, suffered from low player compliance with the IPEPs and as a result low training dosage. No major differences in results were seen between Knee Control and Knee Control+ in Study IV.Study II showed that 91% of the responding coaches were familiar with Knee Control, they perceived the programme to be effective, 74% had started to use it, and it was fairly well maintained over time. However, only one third of the coaches used the programme every week and few used the whole programme. There were no formal policies for programme implementation and use in the district football associations and clubs. Study III showed that the coach was vital for programme use but needed social support, buy-in from players, resources and a feasible programme to facilitate programme adoption and use. When facing challenges with Knee Control implementation and use, the coaches did their best to work around these obstacles; for example, by modifying the programme content or dosage.Conclusions In conclusion, limited positive effects on jump-landing technique were seen in girls, potentially affecting risk factors for injury positively. No clinically meaningful effects from Knee Control or Knee Control+ were seen on performance tests as measured in the studies in either boys or girls. This may be related to the low training dosage. The high programme reach, perceived effectiveness, adoption and fairly high maintenance of Knee Control were positive. The modifications of programme content and/or dosage were concerning but will hopefully decrease with a more user-friendly programme.
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| 20. |
- Lindblom, Hanna, et al.
(författare)
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The knee control prevention programme
- 2018
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Ingår i: Return to Play in Football : An Evidence-based Approach - An Evidence-based Approach. - Berlin, Heidelberg : Springer Berlin Heidelberg. - 9783662557129 - 9783662557136 ; , s. 919-928
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Bokkapitel (refereegranskat)abstract
- In 2008, the Swedish Football Association and the insurance company Folksam, where all licensed players are insured, initiated a project aiming to reduce the burden of severe knee injuries in Swedish football. As a first step, the efficacy of an injury prevention exercise programme (IPEP) was evaluated in girls’ adolescent football (12–17 years). In a large-scale cluster randomised controlled trial including more than 4500 players, the Knee Control programme, a simple low-cost IPEP that takes no more than 10–15 min to complete, was found to reduce the rate of anterior cruciate ligament injury by 64%. Compliance with the IPEP is key, with large injury rate reductions seen in the most diligent players, whereas in players who only used the programme sporadically, it had no preventive effect. In this chapter some of the experiences from the Knee Control injury prevention initiative are summarised, including the evaluation of the programme’s preventive efficacy, performance effects and the implementation efforts made in Swedish football.
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| 21. |
- Lundblad, Matilda, 1982, et al.
(författare)
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Medial collateral ligament injuries of the knee in male professional football players: a prospective three-season study of 130 cases from the UEFA Elite Club Injury Study
- 2019
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Ingår i: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 27:11, s. 3692-3698
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Medial collateral ligament (MCL) injury is the single most common traumatic knee injury in football. The purpose of this study was to study the epidemiology and mechanisms of MCL injury in men’s professional football and to evaluate the diagnostic and treatment methods used. Methods: Fifty-one teams were followed prospectively between one and three full seasons (2013/2014–2015/2016). Individual player exposure and time-loss injuries were recorded by the teams’ medical staffs. Moreover, details on clinical grading, imaging findings and specific treatments were recorded for all injuries with MCL injury of the knee as the main diagnosis. Agreement between magnetic resonance imaging (MRI) and clinical grading (grades I–III) was described by weighted kappa. Results: One hundred and thirty of 4364 registered injuries (3%) were MCL injuries. Most MCL injuries (98 injuries, 75%) occurred with a contact mechanism, where the two most common playing situations were being tackled (38 injuries, 29%) and tackling (15 injuries, 12%). MRI was used in 88 (68%) of the injuries, while 33 (25%) were diagnosed by clinical examination alone. In the 88 cases in which both MRI and clinical examination were used to evaluate the grading of MCL injury, 80 (92% agreement) were equally evaluated with a weighted kappa of 0.87 (95% CI 0.77–0.96). Using a stabilising knee brace in players who sustained a grade II MCL injury was associated with a longer lay-off period compared with players who did not use a brace (41.5 (SD 13.2) vs. 31.5 (SD 20.3) days, p = 0.010). Conclusion: Three-quarter of the MCL injuries occurred with a contact mechanism. The clinical grading of MCL injuries showed almost perfect agreement with MRI grading, in cases where the MCL injury is the primary diagnosis. Not all grade II MCL injuries were treated with a brace and may thus indicate that routine bracing should not be necessary in milder cases. Level of evidence: Prospective cohort study, II. © 2019, The Author(s).
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| 22. |
- Lundblad, Matilda, 1982, et al.
(författare)
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No Association Between Return to Play After Injury and Increased Rate of Anterior Cruciate Ligament Injury in Men’s Professional Soccer
- 2016
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Ingår i: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 4:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies have shown that previous injury, not necessarily anatomically related, is an important injury risk factor. However, it is not known whether a player runs an increased risk of anterior cruciate ligament (ACL) injury after returning to play from other injury types. Purpose: To analyze whether professional soccer players are more susceptible to ACL injury after returning to play from any previous injury. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 101 elite male soccer players suffering a first-time complete ACL injury between 2001 and 2014 were included and matched according to team, age, and playing position with control players who did not have a current injury (1:1 match). For each injured player, the 90-day period prior to the ACL injury was analyzed for injuries and compared with that of control players by using odds ratios (ORs) and 95% CIs. Results: The odds of a player with an ACL injury sustaining a previous injury in the 90-day period did not differ significantly from that of controls (OR, 1.20; 95% CI, 0.66-2.17; P =.65). Testing the frequency of absence periods due to injury between the groups revealed that the odds of a player with an ACL injury having a previous period of absence due to injury did not differ compared with controls (OR, 1.14; 95% CI, 0.64-2.01; P =.77). Conclusion: Players with ACL injury did not have a greater occurrence of absence due to injury in the 3 months preceding their ACL injury compared with matched controls. This indicates that previous injury of any type does not increase the risk of suffering an ACL injury. © 2016, © The Author(s) 2016.
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| 23. |
- Nordenskjöld, Jesper, et al.
(författare)
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Benefit of Local Anesthesia in Reducing Pain during Collagenase Injection for Dupuytrens Contracture
- 2017
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Ingår i: Plastic and reconstructive surgery (1963). - : Lippincott Williams & Wilkins. - 0032-1052 .- 1529-4242. ; 140:3, s. 565-569
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Tidskriftsartikel (refereegranskat)abstract
- Collagenase injection for Dupuytrens contracture is commonly administered without anesthesia. The authors studied the benefit of injecting local anesthesia before collagenase in reducing treatment-related pain. This prospective cohort study included 187 patients (mean age, 69 years; 80 percent men) at two orthopedic departments in Sweden. At one center, 161 consecutive patients scheduled for collagenase injection were assigned to two groups by alternating outpatient clinics; 78 received collagenase without local anesthesia using a modified method (injecting 0.80 mg in multiple spots in the cord) and 83 received local anesthesia injected in the proximal palm before collagenase. At the other center, 26 consecutive patients received collagenase using the standard method (0.58 mg injected in one spot) without local anesthesia. Immediately after the first injection (collagenase or local anesthesia), the patients rated the severity of injection-related pain on a visual analogue scale from 0 (no pain) to 10 (worst pain). Before finger manipulation 1 or 2 days after injection, the patients rated the pain experienced since injection. Mean score +/- SD for pain experienced during modified collagenase injection was 4.3 +/- 2.5 without local anesthesia and 2.3 +/- 1.7 during injection of local anesthesia (before collagenase) (age-and sex-adjusted mean difference, 2.1; 95 percent CI, 1.5 to 2.7; p amp;lt; 0.001). Mean pain score +/- SD during standard collagenase injection without local anesthesia was 4.8 +/- 1.8. Mean pain score +/- SD during the injection-manipulation interval was 2.9 +/- 1.9 in the group without local anesthesia and 2.9 +/- 2.3 in the local anesthesia group (p = 0.79). This study shows that local anesthesia significantly reduces the patients overall pain experience during collagenase treatment for Dupuytrens contracture.
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| 24. |
- Nordenskjöld, Jesper, et al.
(författare)
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Surgical fasciectomy versus collagenase injection in treating recurrent Dupuytren disease : Study protocol of a randomised controlled trial
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:2
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: There is no definitive cure for Dupuytren disease (DD), and recurrence of finger contractures after treatment is common. Surgical fasciectomy is considered the standard treatment method for recurrence, although associated with a high incidence of complications. Collagenase injection, a non-surgical treatment option, has been shown to be a safe and effective method; however, most studies regarding collagenase have involved first-time treatment. Collagenase efficacy in patients with recurrent DD beyond the immediate effect has not yet been determined. The aim of our study is to compare surgical fasciectomy and collagenase injection in treating recurrent DD. Methods and analysis: The study is a single-centre randomised controlled trial. Inclusion criteria are recurrence of DD in one or more fingers after previous treatment with fasciectomy or collagenase injection, a passive extension deficit ≥30° in the metacarpophalangeal (MCP) and/or proximal interphalangeal (PIP) joint, and a palpable cord causing the recurrent contracture. A total of 56 patients will be randomised to either surgical fasciectomy or collagenase injection. A hand therapist blinded to patients' group allocation will measure range of motion at baseline, 3 months, 12 months, 24 months and 60 months. The primary outcomes are the total active extension deficit (MCP plus PIP) at 3 months and the proportion of patients with contracture worsening ≥20° in the treated finger joint at 2 years compared with 3 months. The secondary outcomes include changes in total active motion, active and passive extension deficit from baseline up to 5 years, scores on patient-reported outcome measures, adverse events and costs of treatment. Ethics and dissemination: Ethical approval has been obtained from the Regional Ethical Review Board, Lund University, Sweden(2017/623). The trial will be conducted according to the Helsinki Declaration of 1975, revised in 2000. The results of the trial will be disseminated as published articles in peer-reviewed journals.
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| 25. |
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| 26. |
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| 27. |
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| 28. |
- Waldén, Markus, et al.
(författare)
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ACL injuries in mens professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture
- 2016
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 50:12, s. 744-750
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Tidskriftsartikel (refereegranskat)abstract
- Background Studies investigating the development of ACL injuries over time in football are scarce and more data on what happens before and after return to play (RTP) are needed. Aim To investigate (1) time trends in ACL injury rates, (2) complication rates before return to match play following ACL reconstruction, and (3) the influence of ACL injury on the subsequent playing career in male professional football players. Methods 78 clubs were followed between 2001 and 2015. Time trend in ACL injury rate was analysed using linear regression. ACL-injured players were monitored until RTP and tracked for 3 years after RTP. Results We recorded 157 ACL injuries, 140 total and 17 partial ruptures, with a non-significant average annual increase in the ACL injury rate by 6% (R-2=0.13, b=0.059, 95% CI -0.04 to 0.15, p=0.20). The match ACL injury rate was 20-fold higher than the training injury rate (0.340 vs 0.017 per 1000 h). 138 players (98.6%) with a total rupture underwent ACL reconstruction; all 134 players with RTP data (4 players still under rehabilitation) were able to return to training, but 9 of them (6.7%) suffered complications before their first match appearance (5 reruptures and 4 other knee surgeries). The median layoff after ACL reconstruction was 6.6 months to training and 7.4 months to match play. We report 3-year follow-up data for 106 players in total; 91 players (85.8%) were still playing football and 60 of 93 players (65%) with ACL reconstruction for a total rupture played at the same level. Conclusions The ACL injury rate has not declined during the 2000s and the rerupture rate before return to match play was 4%. The RTP rate within a year after ACL reconstruction was very high, but only two-thirds competed at the highest level 3 years later.
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| 29. |
- Waldén, Markus, 1975-, et al.
(författare)
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Perspectives in football medicine
- 2018
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Ingår i: Der Unfallchirurg (Berlin. Print). - : Springer. - 0177-5537 .- 1433-044X. ; 121:6, s. 470-474
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Tidskriftsartikel (refereegranskat)abstract
- The high injury rate among mens professional football players is well-known. Therefore, the Union of European Football Associations (UEFA) launched an injury study already in 2001. This study, the UEFA Elite Club Injury Study (ECIS), currently includes data from a total of 51 clubs from 18 European countries with more than 14,000 registered injuries. With the 21(st) World Cup (WC) in Russia just around the corner, we have from our study identified a higher match injury rate and a higher proportion of severe injuries in the European Championships compared to the preceding club competitive seasons. Moreover, we have also recently showed that the muscle injury rate is higher when players are given a recovery window of five days or less between two matches. Considering the congested match schedule of the upcoming WC, it is therefore likely that injuries and fatigue once again will be a topic of discussion this summer.
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| 30. |
- Waldén, Markus, et al.
(författare)
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The epidemiology of groin injury in senior football: a systematic review of prospective studies
- 2015
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group. - 0306-3674 .- 1473-0480. ; 49:12
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Forskningsöversikt (refereegranskat)abstract
- Background Groin injuries are troublesome in mens and womens football. Aim To review the literature on the epidemiology of groin injury in senior football and compare injury occurrence between sexes. Methods Studies were identified through a search of PubMed, EMBASE, CINAHL and Web of Science, in the reference lists of the selected articles and the authors bibliographies. The number of injuries, percentage of groin injury from all injuries and rate of groin injury per 1000 h were extracted. Exposure and injury data were aggregated across included studies and the absolute differences in groin injury proportion and rate of groin injury were compared between sexes. Risk of bias was assessed using a 5-item checklist. Results 34 articles met the study criteria and were included. The proportion of groin injury in club-seasonal football was 4-19% in men and 2-14% in women. Aggregated data analysis (29 studies) showed a higher relative proportion of groin injury in men than in women (12.8% vs 6.9%, absolute difference 5.9%, 95% CI 4.6% to 7.1%). The rate of groin injury varied from 0.2 to 2.1/1000 h in men and 0.1 to 0.6/1000 h in womens club football, and aggregated analysis (23 studies) showed a more than two-fold higher rate in men (0.83/1000 h vs 0.35/1000 h, rate ratio 2.4, 95% CI 2.0 to 2.9). High risk of bias was identified for participant selection (18 studies), exposure (17 studies) and precision estimate (16 studies). Conclusions Groin injuries are frequent in senior football and are more common in men than women. Future research needs to be of higher quality.
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| 31. |
- Waldén, Markus, et al.
(författare)
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Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases
- 2015
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Ingår i: British Journal of Sports Medicine. - : BMJ PUBLISHING GROUP. - 0306-3674 .- 1473-0480. ; 49:22
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Tidskriftsartikel (refereegranskat)abstract
- Background Current knowledge on anterior cruciate ligament (ACL) injury mechanisms in male football players is limited. Aim To describe ACL injury mechanisms in male professional football players using systematic video analysis. Methods We assessed videos from 39 complete ACL tears recorded via prospective professional football injury surveillance between 2001 and 2011. Five analysts independently reviewed all videos to estimate the time of initial foot contact with the ground and the time of ACL tear. We then analysed all videos according to a structured format describing the injury circumstances and lower limb joint biomechanics. Results Twenty-five injuries were non-contact, eight indirect contact and six direct contact injuries. We identified three main categories of non-contact and indirect contact injury situations: (1) pressing (n=11), (2) re-gaining balance after kicking (n=5) and (3) landing after heading (n=5). The fourth main injury situation was direct contact with the injured leg or knee (n=6). Knee valgus was frequently seen in the main categories of non-contact and indirect contact playing situations (n=11), but a dynamic valgus collapse was infrequent (n=3). This was in contrast to the tackling-induced direct contact situations where a knee valgus collapse occurred in all cases (n=3). Conclusions Eighty-five per cent of the ACL injuries in male professional football players resulted from non-contact or indirect contact mechanisms. The most common playing situation leading to injury was pressing followed by kicking and heading. Knee valgus was frequently seen regardless of the playing situation, but a dynamic valgus collapse was rare.
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| 32. |
- Werner, Jonas, et al.
(författare)
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Hip and groin time-loss injuries decreased slightly but injury burden remained constant in mens professional football : the 15-year prospective UEFA Elite Club Injury Study
- 2019
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Ingår i: British Journal of Sports Medicine. - : BMJ Publishing Group Ltd. - 0306-3674 .- 1473-0480. ; 53:9, s. 539-546
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Tidskriftsartikel (refereegranskat)abstract
- Background Hip and groin injuries are common in men’s professional football, but the time-trend of these injuries is not known.Aim To investigate hip and groin injury rates, especially time-trends, in men’s professional football over 15 consecutive seasons.Study design Prospective cohort study.Setting Men’s professional football.Methods 47 European teams were followed prospectively for a varying number of seasons between 2001/2002 and 2015/2016, totalling 268 team seasons. Time-loss injuries and individual player exposure during training and matches were recorded. Injury rate was defined as the number of injuries/1000 hours and injury burden as the number of lay-off days/1000 hours. Time-trends for total hip and groin injuries and adductor-related injury rates were analysed using Poisson regression, and injury burden was analysed using a negative binomial regression model.Results Hip and groin injuries contributed 1812 out of 12 736 injuries (14%), with adductor-related injury as the most common of hip and groin injuries (n=1139, 63%). The rates of hip and groin injury and adductor-related injury were 1.0/1000 hours and 0.6/1000 hours, and these rates decreased significantly with on average 2% (Exp(b)=0.98, 95% CI 0.97 to 0.99, P=0.003) and 3% (Exp(b)=0.97, 95% CI 0.95 to 0.99, P<0.001) per season (year on year), respectively. The seasonal trend of hip and groin injury burden did not improve (Exp(b)=0.99, 95% CI 0.97 to 1.01, P=0.40).Conclusions Hip and groin injuries constitute a considerable part of all time-loss injuries in men’s professional football. Although there was a promising slight decreasing trend in the rates of hip and groin injury (as a category) and adductor-related injury (as a specific diagnosis), the injury burden remained at a consistent level over the study period.
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| 33. |
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| 34. |
- Åman, Malin, et al.
(författare)
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A Nationwide Follow-up Survey on the Effectiveness of an Implemented Neuromuscular Training Program to Reduce Acute Knee Injuries in Soccer Players
- 2018
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Ingår i: The Orthopaedic Journal of Sports Medicine. - : Sage Publications. - 2325-9671. ; 6:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: A cruciate ligament (CL) injury is a severe injury in soccer. Neuromuscular training programs have a well-documented preventive effect, but there are few studies on the effectiveness of such a program at a national level. The Swedish Knee Control Program (KCP) was found to be effective in preventing CL injuries in youth female soccer players. The KCP was implemented nationwide in Sweden in 2010.Purpose: To evaluate the effectiveness of the Swedish KCP in reducing acute knee injuries in soccer players at a nationwide level.Study Design: Descriptive epidemiology study.Methods: All licensed soccer players in Sweden are covered by the same insurance company. Using this insurance database, around 17,500 acute knee injuries that were reported to the insurance company between 2006 and 2015 were included in the study. By matching the number of licensed soccer players with the number of reported injuries each year, the annual incidence of knee and CL injuries was able to be calculated. To evaluate the spread of the KCP nationally, a questionnaire was sent to all 24 Swedish district football associations (FAs) with questions regarding KCP education. The number of downloads of the KCP mobile application (app) was obtained.Results: The incidence of CL injuries decreased during the study period for both male (from 2.9 to 2.4 per 1000 player-years) and female players (from 4.9 to 3.9 per 1000 player-years). The overall incidence of knee injuries decreased in both male (from 5.6 to 4.6 per 1000 player-years) and female players (from 8.7 to 6.4 per 1000 player-years). Comparing before and after the nationwide implementation of the KCP, there was a decrease in the incidence of CL injuries by 6% (rate ratio [RR], 0.94 [95% CI, 0.89-0.98]) in male players and 13% (RR, 0.87 [95% CI, 0.81-0.92]) in female players and a decrease in the incidence of knee injuries by 8% (RR, 0.92 [95% CI, 0.89-0.96]) and 21% (RR, 0.79 [95% CI, 0.75-0.83]), respectively (P < .01 for all). This trend corresponded to a reduction of approximately 100 CL injuries each year in Sweden. A total of 21 of 24 district FAs held organized KCP educational courses during the study period. The percentage of district FAs holding KCP courses was between 46% and 79% each year. There were 101,236 downloads of the KCP app.Conclusion: The KCP can be considered partially implemented nationwide, and the incidence of knee and CL injuries has decreased in both sexes at a nationwide level.
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