1. |
- Clos, E., et al.
(author)
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ACTN3 single nucleotide polymorphism is associated with non-contact musculoskeletal soft-tissue injury incidence in elite professional football players
- 2019
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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 27, s. 4055-4061
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Journal article (peer-reviewed)abstract
- Purpose: Muscle injuries are common in professional football, even though prevention protocols are being implemented. Genetics constitutes a novel field for studying intrinsic injury risks and performance. Since previous studies involving single nucleotide polymorphisms (SNPs) have shown that SNPs influence muscle injury rate, injury severity and recovery time, the aim was to study the association the SNP of ACTN3 has with those parameters in professional football players. Methods: The medical staff team recorded non-contact musculoskeletal soft-tissue injuries in 43 professional football players in 7 different seasons (2007–2012 and 2015–2016). Injury rate, injury severity and injury recovery times were established. Players were genotyped by extracting DNA from a blood sample and using a polymerase chain reaction. Results: Injury rate was associated with the SNP of ACTN3 (p = 0.003). The 577R allele was more frequent in subjects than in a normal population by showing presence in 93% of the subjects and suggesting that it could influence football performance. No statistically significant differences in injury severity and recovery time were associated with the SNP of ACTN3. Conclusions: Genetics is gaining in importance when assessing injury risk and performance in professional football. ACTN3 can be regarded as a biomarker of injury susceptibility in this discipline. Identifying those players with the highest injury susceptibility through genetics could lead football teams to individualise workloads and prevention protocols. Level of evidence: III. © 2019, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).
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2. |
- Clos, E., et al.
(author)
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ACTN3's R577X Single Nucleotide Polymorphism Allele Distribution Differs Significantly in Professional Football Players according to Their Field Position
- 2021
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In: Medical Principles and Practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 30:1, s. 92-97
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Journal article (peer-reviewed)abstract
- Introduction: Football is characterised by intermittent high-intensity efforts varying according to the field position of a player. We aimed to ascertain whether polymorphisms in the ACTN3 gene are associated with different playing positions in elite professional football players. Subjects and Methods: Genotyping of the ACTN3 gene was conducted in 43 elite professional football players of a single team. Playing position was recorded based on the player's most frequent position. Results: The genotype distribution was not significant between positions (p = 0.057), while the allele distribution differed significantly (p = 0.035). Goalkeepers (p = 0.04, p = 0.03), central defenders (p = 0.03, p = 0.01), and central midfielders (p = 0.01, p = 0.00) had a significantly different allele distribution compared with wide midfielders and forward players. Conclusions: Genetic biomarkers may be important when analysing performance capability in elite professional football. Identifying the genetic characteristics of a player to adapt his playing position may lead to orientation of positions based on physical capabilities and tissue quality in young football players, and also to performance enhancement in those who are already playing in professional teams.
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3. |
- Gudelis, M., et al.
(author)
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Epidemiology of hamstring injuries in 538 cases from an FC Barcelona multi sports club
- 2024
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In: Physician and Sportsmedicine. - : Informa UK Limited. - 0091-3847 .- 2326-3660. ; 52:1, s. 57-64
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Journal article (peer-reviewed)abstract
- ObjectivesHamstring injuries are the most common muscle injuries in team sports. The aims of this study were to describe the epidemiology of hamstring muscle injuries in the professional and amateur sport sections of a multi-sport club Football Club Barcelona (FCB) and to determine any potential correlation between return-to-play (RTP) and injury location, severity of connective tissue damage, age, sex, and athlete's level of competition.MethodsThis descriptive epidemiological study with data collected from September 2007 to September 2017 stored in the FCB database. The study included non-contact hamstring injuries sustained during training or competition.ResultsA total of 538 hamstring injuries were reported in the club's database, of which 240 were structurally verified by imaging as hamstring injuries. The overall incidence for the 17 sports studied was 1.29 structurally verified hamstring injuries per 100 athletes per year. The muscle most commonly involved in hamstring injuries was the biceps femoris, and the connective tissue most frequently involved was the myofascial. There was no evidence of a statistically significant association between age and RTP after injury, and no statistically significant difference between sex and RTP. However, the time loss by professionals was shorter than for amateurs, and proximal hamstring injuries took longer RTP than distal ones.ConclusionIn the 17 sports practiced at multi-sport club, the incidence of hamstring injury was 1.29 per 100 athletes per year. Players from sports in which high-speed sprinting and kicking are necessary, and amateurs, were at higher risk of suffering a hamstring injury. In addition, proximally located hamstring injuries involving tendinous connective tissue showed the longest RTP time. Age did not seem to have any influence on RTP. Documenting location and the exact tissue involved in hamstring injuries may be beneficial for determining the prognosis and RTP.
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4. |
- Lundblad, Matilda, 1982, et al.
(author)
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Epidemiological Data on LCL and PCL Injuries Over 17 Seasons in Men's Professional Soccer: The UEFA Elite Club Injury Study
- 2020
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In: Open Access Journal of Sports Medicine. - 1179-1543. ; 11, s. 105-112
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Journal article (peer-reviewed)abstract
- Background: There is limited epidemiological information on injury rates and injury mechanisms for lateral collateral ligament (LCL) and posterior cruciate ligament (PCL) injuries in male professional soccer. In addition, time trends and lay-off times for these injuries have not yet been determined. Aim: To determine injury rates and circumstances of LCL and PCL injuries over 17 seasons in men's professional soccer. Methods: A prospective cohort study, in which 68 professional European soccer teams were followed over 17 consecutive seasons (2001/2002 to 2017/2018). The teams' medical staff recorded player exposure and time-loss injuries. Lay-off time was reported as the median and the first and third quartile. Injury rate was defined as the number of injuries per 1000 playerhours. Results: One hundred and twenty-eight LCL and 28 PCL injuries occurred during 2,554,686 h of exposure (rate 0.05 and 0.01/1000 h, respectively). The median lay-off time for LCL injuries was 15 (Q(1)=7, Q(3)=32) days, while it was 31 days for PCL injuries (Q(1)=15, Q(3)=74). The match injury rate for LCL injuries was 11 times higher than the training injury rate (0.21 vs 0.02/1000 h, rate ratio [RR] 10.5, 95% CI 7.3 to 15.1 p<0.001) and the match injury rate for PCL injuries was 20 times higher than the training injury rate (0.056 vs 0.003/1000 h, RR 20.1, 95% CI 8.2 to 49.6, p<0.001). LCL injuries saw a significant annual decrease of approximately 3.5% (p=0.006). In total, 58% (63/108) of all LCL injuries and 54% (14/26) of all PCL injuries were related to contact mechanism. Conclusion: This study with prospectively registered data on LCL and PCL injuries in men's professional soccer shows that the median lay-off from soccer for LCL and PCL injuries is approximately 2 and 4 weeks respectively. These rare knee ligament injuries typically occur during matches and are associated with a contact injury mechanism.
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5. |
- Lundblad, Matilda, 1982
(author)
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Knee ligament injuries in male professional football players
- 2019
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Doctoral thesis (other academic/artistic)abstract
- ABSTRACT Knee ligament injuries are common in professional football and entail a significant time loss from football, but studies of knee ligament injuries other than anterior cruciate ligament (ACL) injuries are scarce. The aim of this thesis was prospectively to study the epidemiology and characteristics of medial collateral ligament (MCL), lateral collateral ligament (LCL) and posterior cruciate ligament (PCL) injuries in male professional football players with the main emphasis on MCL injuries. A further aim was to analyse whether professional football players are more susceptible to ACL injury after returning to play from any previous injury. The main sample in this thesis is from the UEFA Elite Club Injury Study (Studies I-IV) that has been ongoing since 2001. In addition, data from the English Premier League (Studies II-IV) and the Nordic Football Injury Audit (Study III) were used during 2011 and 2014 and 2010 and 2011 respectively. All four studies followed a prospective design using standardised methodology, which documents training and match exposure and time loss injuries on an individual basis. Injury severity was evaluated according to length of time loss. Injury rate and the rate ratio (RR) for injury between training and matches were calculat- ed. In Study II, further details on clinical grading, imaging findings and specific treatments were collected between 2013 and 2016 for all injuries, with MCL injury as the main diagnosis. In Study III, first-time complete ACL injuries were matched 1:1 according to team, age and playing position with control players who did not have a current injury and the 90-day period prior to the ACL injury was analysed for injuries and compared by using the odds ratio (OR) and a 95% confidence interval (CI). The match injury rates were significantly higher than the training injury rates for MCL injury (1.31 vs 0.14/1,000 h, RR 9.3, 95% CI 7.5 to 11.6, p<0.001), LCL injury (0.21 vs 0.02/1,000 h, RR 10.5, 95% CI 7.3 to 15.1 p<0.001) and PCL injury (0.056 vs 0.003/1,000 h, RR 20.1, 95% CI 8.2 to 49.6, p<0.001). There was a significant average annual decrease for MCL injuries of 6.9% (p=0.023) between 2001 and 2012 in Study I and for LCL injuries of 3.5% (p=0.006) be- tween 2001 and 2018 in Study IV respectively. For MCL and LCL injuries, the majority were mild to moderate injuries, i.e. the lay-off time was less than four weeks (71.7%, and 72.7%, respectively). On the other hand, most PCL injuries (57.1%) were severe injuries causing more than four weeks’ lay-off. In total, 75% (98/130) of all MCL injuries in Study II and 58% (63/108) of all LCL injuries and 54% (14/26) of all PCL injuries in Study IV were related to contact injury mechanisms. For MCL injuries, the agreement between clinical examination and magnetic resonance imaging (MRI) for grading was 92% in Study II. Using a brace in the treatment of grade II MCL injuries was associated with a longer lay-off compared with not using a brace (41.5 (SD 13.2) vs. 31.5 (SD 20.3) days, p = 0.010) in Study II. The odds of a player with an ACL injury sustaining an injury in the previous 90-day period did not differ significantly from that of controls (OR 1.20, 95% CI, 0.66-2.17, p = 0.65). A men’s professional team, typically with 25 players in the squad, can expect ap- proximately two MCL injuries a season and one LCL injury every third season, while a PCL injury can only be expected every 17th season. These knee liga- ment injuries typically occur during matches and are associated with a contact injury mechanism. Moreover, the collateral ligament injury rates have decreased significantly since 2001. For players sustaining a grade II MCL injury, using a stabilising knee brace was associated with a longer lay-off period compared with players who did not use a brace, indicating that routine bracing may not be an optimal therapeutic option and is better determined individually.
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6. |
- Lundblad, Matilda, 1982, et al.
(author)
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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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In: Knee Surgery, Sports Traumatology, Arthroscopy. - : Springer Science and Business Media LLC. - 0942-2056 .- 1433-7347. ; 27:11, s. 3692-3698
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Journal article (peer-reviewed)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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7. |
- Lundblad, Matilda, 1982, et al.
(author)
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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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In: Orthopaedic Journal of Sports Medicine. - : SAGE Publications. - 2325-9671. ; 4:10
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Journal article (peer-reviewed)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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8. |
- Nilsson, Tania, et al.
(author)
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Injury incidence in male elite youth football players is associated with preceding levels and changes in training load
- 2023
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In: BMJ Open Sport and Exercise Medicine. - London : BMJ Publishing Group Ltd. - 2055-7647. ; 9:4, s. 1-7
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Journal article (peer-reviewed)abstract
- Objectives Elite youth football players miss out on a large part of seasonal training due to injury. Limited research suggests an association between external and internal training load (TL) and injury incidence in elite youth football. This study analysed external and internal TL variables and their association with injury incidence in a group of male elite youth football players over four seasons. Methods Measures of external and internal TL and injury incidence of 56 male elite youth football players (age 17-19 years) were collected throughout four seasons. Heart rate, session rating of perceived exertion andGlobal Positioning System (GPS) variables were analysed. Individual players' TL during the 30 days leading up to injury was compared with 30-day injury-free control periods. Change in TL through the periods was also analysed. Results Eighty-five injuries were included for analysis, showing that for most TL variables, the average levels were significantly lower during the period leading up to injury. Significant increases for the majority of TL variables were also found during the periods leading up to injury, while the control periods did not show any significant change. Conclusion A lower and/or increasing average TL volume over 30 days might increase the risk of injury in male elite youth football players. Avoiding long-term drops in TL and balance increases in TL might be beneficial to reduce injury risk. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
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