The Football Association Medical Research Programme: an audit of injuries in professional football--analysis of hamstring injuries

OBJECTIVE: To conduct a detailed analysis of hamstring injuries sustained in English professional football over two competitive seasons. METHODS: Club medical staff at 91 professional football clubs annotated player injuries over two seasons. A specific injury audit questionnaire was used together with a weekly form that documented each clubs' current injury status. RESULTS: Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs respectively. Hamstring strains accounted for 12% of the total injuries over the two seasons with nearly half (53%) involving the biceps femoris. An average of five hamstring strains per club per season was observed. A total of 13 116 days and 2029 matches were missed because of hamstring strains, giving an average of 90 days and 15 matches missed per club per season. In 57% of cases, the injury occurred during running. Hamstring strains were most often observed during matches (62%) with an increase at the end of each half (p<0.01). Groups of players sustaining higher than expected rates of hamstring injury were Premiership (p<0.01) and outfield players (p<0.01), players of black ethnic origin (p<0.05), and players in the older age groups (p<0.01). Only 5% of hamstring strains underwent some form of diagnostic investigation. The reinjury rate for hamstring injury was 12%. CONCLUSION: Hamstring strains are common in football. In trying to reduce the number of initial and recurrent hamstring strains in football, prevention of initial injury is paramount. If injury does occur, the importance of differential diagnosis followed by the management of all causes of posterior thigh pain is emphasised. Clinical reasoning with treatment based on best available evidence is recommended.     

A prospective epidemiological study of injuries in four English professional football clubs

OBJECTIVE: To define the causes of injuries to players in English professional football during competition and training. METHOD: Lost time injuries to professional and youth players were prospectively recorded by physiotherapists at four English League clubs over the period 1994 to 1997. Data recorded included information related to the injury, date and place of occurrence, type of activity, and extrinsic Playing factors. RESULTS: In all, 67% of all injuries occurred during competition. The overall injury frequency rate (IFR) was 8.5 injuries/1000 hours, with the IFR during competitions (27.7) being significantly (p < 0.01) higher than that during training (3.5). The IFRs for youth players were found to increase over the second half of the season, whereas they decreased for professional players. There were no significant differences in IFRs for professional and youth players during training. There were significantly (p < 0.01) injuries in competition in the 15 minute periods at the end of each half. Strains (41%), sprains (20%), and contusions (20%) represented the major types of injury. The thigh (23%), the ankle (17%), knee (14%), and lower leg (13%) represented the major locations of injury, with significantly (p < 0.01) more injuries to the dominant body side. Reinjury counted for 22% of all injuries. Only 12% of all injuries were caused by a breach of the rules of football, although player to player contact was involved in 41% of all injuries. CONCLUSIONS: The overall level of injury to professional footballers has been showed to be around 1000 times higher times higher than for industrial occupations generally regarded as high risk. The high level of muscle strains, in particular, indicates possible weakness in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players' levels of fitness and performance. Increasing levels of injury to youth players as a season progresses emphasizes the importance of controlling the exposure of young players to high levels of competition.     

Older elite football players have reduced cardiac and osteoporosis risk factors

INTRODUCTION/PURPOSE: Aging with a sedentary lifestyle is associated with increased risk for developing cardiovascular disease (CVD), osteoporosis, and sarcopenia. The purpose of this study was to determine whether former professional football athleticism would be associated with reduced risk factors for CVD and osteoporosis, and higher muscle mass in later life. METHODS: Maximal aerobic capacity (VO2max), body composition, and lipid and glucose risk factors for CVD were compared between 16 older former professional football players and never-athletic men matched for age, body mass index, current physical activity, and race. Regional bone mineral density of the football players was compared with age-matched reference norms. RESULTS: Despite greater physical activity into middle age, the former football players had similar VO2max as the controls. Former football players had 26% lower total-body fat mass, 26% lower visceral adipose tissue area, and 13% higher muscle mass compared with the controls (P < 0.05). High-density lipoprotein cholesterol (HDL-C) levels were 37% higher (P < 0.001), HDL2-C levels were fourfold higher (P < 0.001), and triglycerides were 31% lower (P < 0.05) in the former football players than the controls. The former football players also had 20% and 6% higher total-body bone mineral content and density than the controls (P < 0.05) and higher lumbar spine, femoral neck, and greater trochanter bone mineral density than similar age-referenced norms (P < 0.05). CONCLUSION: Elite athlete physical activity status in young adulthood, and remaining physically active in middle age, may confer body composition changes that are sustained in older adulthood. In this small sample of older men, former successful professional athletes who remained physically active in middle age have a favorable body composition and reduced risk factors for CVD and osteoporosis compared with healthy age- and BMI-matched older men.     

Body cell mass measured by bioelectrical impedance spectroscopy in professional football (soccer) players

AIM: The aim of this study was to measure body cell mass (BCM) in two football (soccer) teams and assess if there are differences in body composition among players of different field positions. METHODS: Two professional Italian (male) football teams, representing two different divisions (A and C), have been recruited. There were 14 players (4 forwards, 4 defenders, 6 midfielders) in A and 18 players (4 forwards, 4 defenders, 8 midfielders, 2 goalkeepers) in C. Fat free mass (FFM), fat mass (FM), percent body fat (%BF), and BCM have been assessed using bioelectrical impedance spectroscopy (BIS). RESULTS: There were no significant differences in age, body weight, height or body mass index between teams. Team A's BCM was approximately 4 kg greater than C (P=0.001). FFM was significantly greater in midfielders and defenders in A vs C (P=0.02). FFM was significantly lower in forwards compared to defenders within A (P=0.02). Within A, FM and %BF were significantly lower for defenders compared to forwards and midfielders (P=0.01), and BCM was significantly greater in forwards vs defenders (P=0.01), with no significant differences among other field positions. BCM was significantly greater in forwards vs midfielders and defenders within C (P=0.02), with no significant differences between midfielders and defenders. CONCLUSIONS: BCM, measured using BIS, represents an innovative, simple approach to assess body composition. The present study demonstrates that it is very important to analyze body composition in football players, not only with the aim to evaluate the variation of weight in a quantitative and qualitative way, but also with the purpose of selecting players for specific roles. Although these results must be considered not yet conclusive, they could be an important information for coaches, especially during the selection of young football players.     

The association football medical research programme: an audit of injuries in professional football

OBJECTIVES: To undertake a prospective epidemiological study of the injuries sustained in English professional football over two competitive seasons. METHODS: Player injuries were annotated by club medical staff at 91 professional football clubs. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status. RESULTS: A total of 6,030 injuries were reported over the two seasons with an average of 1.3 injuries per player per season. The mean (SD) number of days absent for each injury was 24.2 (40.2), with 78% of the injuries leading to a minimum of one competitive match being missed. The injury incidence varied throughout the season, with training injuries peaking during July (p<0.05) and match injuries peaking during August (p<0.05). Competition injuries represented 63% of those reported, significantly (p<0.01) more of these injuries occurring towards the end of both halves. Strains (37%) and sprains (19%) were the major injury types, the lower extremity being the site of 87% of the injuries reported. Most injury mechanisms were classified as being non-contact (58%). Re-injuries accounted for 7% of all injuries, 66% of these being classified as either a strain or a sprain. The severity of re-injuries was greater than the initial injury (p<0.01). CONCLUSIONS: Professional football players are exposed to a high risk of injury and there is a need to investigate ways of reducing this risk. Areas that warrant attention include the training programmes implemented by clubs during various stages of the season, the factors contributing to the pattern of injuries during matches with respect to time, and the rehabilitation protocols employed by clubs.     

Lower-limb work during high- and low-impact activities in hip-related pain: Associations with sex and symptom severity

Background:Hip-related pain (HRP) is described as a movement-related disorder. However, little attention is given to the way people with HRP move, especially in populations still participating in sport. Thus, limiting our understanding of movementbased impairments in HRP and their potential relationships with pain/symptoms.Research Question: (1) What are the differences in absolute and relative amounts of positive and negative lower-limb joint work during walking and the single-leg drop jump (SLDJ) in football players with and without HRP? (2) What are the relationships between lower-limb joint work and HRP burden?Methods:88 football players with HRP and 30 control football players were recruited. Positive and negative work done by the hip, knee, and ankle (and each joint’s relative contribution to total work done) were calculated. The effect of sex on the relationship between HRP and work done, as well as the association between work done and International Hip Outcome Tool (iHOT33) scores, were assessed using linear and beta regressions models.Results:Walking: No joint work variables were significantly different between groups, nor were any relationships with iHOT33 scores evident. SLDJ: The knee’s relative contribution to total lower-limb negative work done was 37.7 % and 42.4 % for women with and without HRP, respectively (P = 0.04). The iHOT33 was significantly associated with positive (P = 0.03 to <0.01) and negative (P = 0.02 to <0.01) work done by the hip as well as negative work done by the ankle (P = 0.03 to 0.01), independent of sex.Significance:Only one significant between-group comparison was revealed, involving the knee in female football players. In addition, football players with a greater selfreported burden of HRP tended to display lower hip joint work during the SLDJ. Rehabilitation programs could be targeted to address these impairments and normalize work done during high impact tasks in the management of HRP.     

Performance-based outcomes following patellar tendon repair in professional athletes

ABSTRACT

Objectives: There are limited data on the impact of a patellar tendon repair to a professional athlete’s career. The purpose of this study was to determine differences return to play (RTP) rate, career length, and performance-based outcomes after a patellar tendon repair in professional athletes of four different sports.

Methods: Participants met inclusion criteria if initial reports of the date and type of surgery were corroborated by at least two independent sources of information through a well-established protocol of public newspaper archives, team injury reports, and player profiles. Players with other concomitant injuries of the knee or treated nonoperatively were excluded. One hundred and three athletes across professional baseball, basketball, American football, and soccer athletes were identified and met inclusion criteria. RTP rate, career length, and sports-specific performance statistics (i.e. player efficiency rating (PER) for professional basketball players) before and after surgery were collected for each athlete.

Results: Seventy-nine (76.7%) professional athletes successfully RTP. American football athletes had the lowest RTP rate and the largest drop in performance in post-operative season 1 (P < 0.001). These athletes also experienced the shortest adjusted career lengths (P = 0.003) compared to players in the other sports. Basketball athletes played significantly less games through post-operative seasons 1 to 3 (P < 0.05). Soccer athletes had less goals and assists per game and played fewer games (P < 0.05) in post-operative season 1 that recovered to baseline by seasons 2 and 3.

Conclusion: A patellar tendon rupture is a potentially devastating injury for the professional athlete. American football players appeared to have the worst postoperative outcome with the lowest RTP rate and a most significant decrease in performance in the first postoperative season. This procedure also had a significant short-term impact on soccer athletes who sustained decreases in short-term game performance. These findings are likely explained by the unique physical demands imposed by each sport.     

The Football Association Medical Research Programme: an audit of injuries in professional football-analysis of preseason injuries

OBJECTIVES: To conduct a detailed analysis of preseason football injuries sustained in English professional football over two competitive seasons. METHODS: Club medical staff at 91 professional football clubs annotated player injuries. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status. RESULTS: 17% (1025) of the total number of injuries over the two seasons were sustained during the preseason, the mean number of days absent per injury was 22.3 days. Younger age groups (17-25 yrs) were more likely to sustain a preseason injury than more experienced players (26-35+) (p<0.01). There were relatively more "slight" and "minor" injuries (as defined in the methodology), overuse, and tendon related injuries sustained during preseason compared to the in season (p<0.01). The thigh (23%), knee (17%), and ankle (17%) were the most common locations for injuries during the preseason, there was a relatively greater number of lower leg injuries (15%) during the preseason (p<0.05). Achilles tendonitis was most prevalent in the preseason, with 33% of all Achilles related injuries sustained during this period (p<0.01). Muscle strains were the most common injury during preseason (37%). Rectus femoris muscle strains were observed twice as frequently during the preseason relative to the in season (p<0.01). Ligament sprains were the second most common injury during preseason (19%). Non-contact mechanisms were the cause of significantly more injuries during the preseason (p<0.01), with relatively more preseason injuries sustained while running or shooting (p<0.01). For 70% of the injuries reported during the preseason, the ground condition was described as dry. CONCLUSIONS: Players are at a greater risk of slight and minor injuries, overuse injuries, lower leg injuries (especially the Achilles tendon) and rectus femoris strains during the preseason period. Prevention of preseason injury is important to ensure availability of players for the commencement of the season and to decrease the risk of injury later in the season, we recommend the implementation of a risk management policy for this purpose. Areas requiring further investigation include methods of prevention for the common preseason injuries that have been identified, a detailed analysis of preseason and closed season training programmes, and a smaller study involving exposure data.     

Biological maturity and injury in elite youth football

The purpose of the present study was to investigate injury according to biological maturity in elite under-14 youth football players based at the National Football Institute, France. Over 10 seasons, injury incidence, severity and distribution were compared in 233 players classed according to individual biological maturity determined by skeletal age into three cohorts as early, normal and late maturers.A non-significant higher injury incidence was found in early and normal maturers compared with late maturers. In contrast, the latter group sustained a significantly higher incidence of major injuries compared with early maturers (0.3 vs 0.6 vs 0.9, P=0.039). A significantly higher incidence of osteochrondoses was reported in normal and late maturers (0.3 vs 0.7 vs 0.9, P=0.014), whereas tendinopathy incidence was greater in early and normal maturers (0.06 vs 0.08 vs 0.02, P=0.033). Early maturers incurred the highest incidence of groin strains and re-injuries (P<0.05). There was no significant difference between groups in the seasonal disposition of injury.Biological maturity status did not significantly affect overall injury incidence in elite French youth football players, although there were differences between maturity groups when patterns of injury location, type, severity and re-injury were analyzed.     

A comparison between clinical assessment and magnetic resonance imaging of acute hamstring injuries

BACKGROUND: Physicians evaluating hamstring strains in professional football players are increasingly turning to magnetic resonance imaging to support the clinical diagnosis and management of the injury. However, little information is available to assess how magnetic resonance imaging compares with the clinical evaluation in establishing the duration of rehabilitation required. HYPOTHESIS: Magnetic resonance imaging of hamstring strains can be useful in determining duration of rehabilitation. STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 1. METHODS: Fifty-eight professional football players with a diagnosis of hamstring injury made by the team physician were enrolled in the study. All players underwent magnetic resonance imaging and a clinical evaluation by an independent physical therapist within 3 days of the injury. Presence, type, and location of injury were recorded in each examination. The physical therapist estimated the time required until return to competition, and the radiologist used the length of the injury (coronal view) to establish rehabilitation duration. Both clinicians were blinded to the other modality. RESULTS: Clinical and magnetic resonance imaging assessments were in agreement in 38 of 58 cases (65.5%). In 18 cases (31.0%), a clinically positive diagnosis was made, but no abnormalities were evident on magnetic resonance imaging. In 2 cases (3.4%), magnetic resonance imaging detected an injury, whereas the clinical examination had negative or equivocal findings. Both clinical examination and magnetic resonance imaging findings were strongly correlated with the actual time required to return to competition (r = .69, P < .001 and r = .58, P < .001, respectively). The correlation coefficient between clinical predictions and magnetic resonance imaging findings was moderate (r = .36, P = .006). CONCLUSION: This study shows that magnetic resonance imaging is not required for estimating the duration of rehabilitation of an acute minor or moderate hamstring injury in professional football players.     

UEFA Champions League study: a prospective study of injuries in professional football during the 2001-2002 season

Background: No previous study on adult football involving several different countries has investigated the incidence and pattern of injuries at the highest club competitive level. Objective: To investigate the risk exposure, risk of injury, and injury pattern of footballers involved in UEFA Champions League and international matches during a full football season. Method: Eleven top clubs (266 players) in five European countries were followed prospectively throughout the season of 2001–2002. Time-lost injuries and individual exposure times were recorded during all club and national team training sessions and matches. Results: A total of 658 injuries were recorded. The mean (SD) injury incidence was 9.4 (3.2) injuries per 1000 hours (30.5 (11.0) injuries per 1000 match hours and 5.8 (2.1) injuries per 1000 training hours). The risk of match injury was significantly higher in the English and Dutch teams than in the teams from France, Italy, and Spain (41.8 (3.3) v 24.0 (7.9) injuries per 1000 hours; p = 0.008). Major injuries (absence >4 weeks) constituted 15% of all injuries, and the risk of major injury was also significantly higher among the English and Dutch teams (p = 0.04). National team players had a higher match exposure, with a tendency towards a lower training injury incidence than the rest of the players (p = 0.051). Thigh strain was the most common injury (16%), with posterior strains being significantly more common than anterior ones (67 v 36; p<0.0001). Conclusions: The risk of injury in European professional football is high. The most common injury is the thigh strain typically involving the hamstrings. The results suggest that regional differences may influence injury epidemiology and traumatology, but the factors involved are unclear. National team players have a higher match exposure, but no higher risk of injury than other top level players.     

Glenohumeral joint total rotation range of motion in elite tennis players and baseball pitchers

The amount of glenohumeral joint internal and external rotation used during overhead sport activities has been measured experimentally by sports scientists. Clinical measurement of glenohumeral joint internal and external rotation using goniometry is an integral part of a shoulder evaluation after injury or surgery or during preseason or preventative musculoskeletal screenings. PURPOSE: This study measured glenohumeral joint internal and external rotation in two groups of unilaterally dominant upper extremity athletes to compare the total arc of rotational range of motion between the dominant and nondominant extremities. METHODS: A total of 163 elite athletes (117 male junior tennis players and 46 male baseball pitchers) were measured for glenohumeral joint internal and external rotation at 90 degrees of abduction. Total rotation range of motion was calculated by summing internal and external rotation measures in each extremity. RESULTS: An ANOVA with post hoc testing revealed no significant difference (P > 0.05) between extremities in baseball pitchers for total rotation range of motion (145.7 vs 146.9), whereas significantly less (P < 0.001) dominant arm total rotation range of motion was identified in the elite junior tennis players (149.1 vs 158.2).CONCLUSION: This study has identified unique glenohumeral joint rotational patterning in unilaterally dominant upper extremity athletes that has ramifications for rehabilitation after injury and for both injury prevention and performance enhancement.     

High femoral bone mineral content and density in male football (soccer) players

PURPOSE: This investigation examined the effect that long-term football (soccer) participation may have on areal bone mineral density (BMD) and bone mineral content (BMC) in male football players. METHODS: Dual energy x-ray absorptiometry (DXA) scans were obtained in 33 recreational male football players active in football for the last 12 yr and 19 nonactive subjects from the same population. Both groups had comparable age (23 +/- 4 yr vs 24 +/- 3 yr), body mass (73 +/- 7 kg vs 72 +/- 11 kg), height (176 +/- 5 cm vs 176 +/- 8 cm), and calcium intake (23 +/- 10 mg.kg(-1).d(-1) vs 20 +/- 11 mg.kg(-1).d(-1) (mean +/- SD). RESULTS: The football players showed 8% greater total lean mass (P < 0.001), 13% greater whole-body BMC (P < 0.001), and 5 units lower percentage body fat (P < 0.001) than control subjects. Lumbar spine (L2-L4) BMC and BMD were 13% and 10% higher, respectively, in the football players than in the control subjects (P < 0.05). Furthermore, football players displayed higher femoral neck BMC (24%, 18%, 23%, and 24% for the femoral neck, intertrochanteric, greater trochanter, and Ward's triangle subregions, respectively, P < 0.05) and BMD (21%, 19%, 21%, and 27%, respectively, P < 0.05) than controls. BMC in the whole leg was 16-17% greater in the football players, mainly because of enhanced BMD (9-10%) but also because of bone hypertrophy, since the area occupied by the osseous pixels was 7% higher (867 +/- 63 cm2 vs 814 +/- 26 cm2, P < 0.05). Leg muscle mass was 11% higher in the football players than in the control subjects (20,635 +/- 2,073 g vs 18,331 +/- 2,301 g, P < 0.001). No differences were found between the legs in either groups for BMC, BMD, and muscle mass. Left leg muscle mass was correlated with femoral neck BMC and BMD (P < 0.001), as well as with lumbar spine (L2-L4) BMC and BMD (P < 0.001). CONCLUSION: Long-term football participation, starting at prepubertal age, is associated with markedly increased BMC and BMD at the femoral neck and lumbar spine regions.     

Injury incidence and distribution in elite football--a prospective study of the Danish and the Swedish top divisions

The Danish and Swedish male top football divisions were studied prospectively from January to June 2001. Exposure to football and injury incidence, severity and distribution were compared between the countries. Swedish players had greater exposure to training (171 vs. 123 h per season, P<0.001), whereas exposure to matches did not differ between the countries. There was a higher risk for injury during training in Denmark than in Sweden (11.8 vs. 6.0 per 1000 h, P<0.01), whereas for match play there was no difference (28.2 vs. 26.2 per 1000 h). The risk for incurring a major injury (absence from football more than 4 weeks) was greater in Denmark (1.8 vs. 0.7 per 1000 h, P = 0.002). The distribution of injuries according to type and location was similar in both countries. Of all injuries in Denmark and Sweden, overuse injury accounted for 39% and 38% (NS), and re-injury for 30% and 24% (P = 0.032), respectively. The greater training exposure and the long pre-season period in Sweden may explain some of the reported differences.     

Glenohumeral range of motion and stiffness in professional baseball pitchers

PURPOSE: This study was conducted to perform kinematic measures in a group of asymptomatic professional baseball pitchers to determine side-to-side differences in passive glenohumeral range of motion (ROM) and stiffness. We hypothesized that the throwing shoulder in asymptomatic pitchers would display greater passive glenohumeral stiffness than the contralateral nonthrowing shoulder. METHODS: Thirty-four professional baseball pitchers had bilateral assessments for passive glenohumeral ROM and stiffness during a single test session. ROM and stiffness measures were obtained objectively using standard goniometry and instrumented stress arthrometry, respectively. RESULTS: The throwing shoulder had significantly less (-8.5 degrees) internal rotation and significantly more external rotation (5.1 degrees) than the nonthrowing shoulder (P < 0.01). Passive joint stiffness was not significantly different between the throwing and nonthrowing shoulder, and anterior joint stiffness was significantly greater than posterior joint stiffness for both shoulders (P < 0.05). CONCLUSIONS: The repetitive stress of long-term throwing creates altered glenohumeral rotational patterns in the throwing shoulder of the professional baseball pitcher without compromising the joint's passive restraining quality.     

Comparative echocardiographic study of junior and senior basketball players

The echocardiographic data on 14 junior and 15 senior players in a first-division basketball club were compared. No difference was found between the senior and junior players as regards the thickness of the interventricular septum (11.47 vs 11.21 mm) or the thickness of the posterior wall of the left ventricle (9.8 vs 9.86 mm). The adults displayed a larger left ventricular end-diastolic diameter (56.8 vs 53.6 mm, P less than 0.05), end-diastolic volume (194 vs 164 ml, P less than 0.05), stroke volume (142 vs 116 ml, P less than 0.05), right ventricular diameter (27.9 vs 23.2, P less than 0.01), aortic root diameter (35.0 vs 32.0, P less than 0.05), and left atrial diameter (42.7 vs 37.2, P less than 0.01). However, among these, only the stroke volume and right ventricular diameter remained significantly different after normalization to body surface area. A significant difference could not be demonstrated in the linear ejection fraction, the ejection fraction, or the fractionated interventricular septum and posterior wall thicknesses. The examinations indicated that left ventricular hypertrophy had fully developed by the age of 18 years in the basketball players and that there was no further enhancement in adults. However, the left ventricular, right ventricular, and left atrial volume were larger in the adults than in the junior players.     

The healthy worker effect in professional football

We investigated the "healthy athlete effect" (HAE) in American professional football. Ages of death of professional football players who debuted prior to 1940 were obtained and differences between those ages and age-adjusted life expectancies were examined to determine if longevity increased with career length, controlling for birth year, body mass index (BMI), position, and type. Professional football players (N=1,512) lived an average of 6.1 (+/- 11.9 SD) years longer than age-matched controls from the general public. Career length significantly and incrementally increased longevity of players from an average of 5.5 years for players playing one season to 6.7 years for players playing 4 or more seasons. Both birth year and BMI had a statistically significant association with longevity, but position type did not. These data provide strong support for the healthy worker effect (HWE) in professional football.     

Anthropometric and fitness profiles of elite players in two football codes

BACKGROUND: The aims were to describe anthropometric and performance characteristics of elite players in two football codes and explore the differences between them. METHODS: Data were compared by means of "t"-tests. Subjects: subjects were 19 professional soccer players and 33 inter-county Gaelic football players. Settings: measurements were made on members of a Premier League soccer team throughout their regular season, whilst the Gaelic footballers were members of the Mayo squad preparing for the 1999 All-Ireland championship. RESULTS: The variability in stature was significantly greater in the soccer players compared to the Gaelic footballers (p<0.01). Performances in the 10-m and 30-m sprints, and in vertical jump were superior in the soccer group compared to the Gaelic footballers (p<0.01). CONCLUSIONS: The intra-group variability on the anthropometric and performance measures of the soccer players is likely to be due to the specificity of positional roles. The combined groups could be described as lean and muscular with a reasonably high level of capacity in all areas of physical performance. Anaerobic characteristics of the professional soccer players were superior to those of Gaelic football players. It is concluded that anthropometric and performance assessment of elite footballers using mean values masks the heterogeneity evident within the football codes.     

Is it safe to use local anaesthetic painkilling injections in professional football?

The use of local anaesthetic painkilling injections in professional football can counter the performance-reducing impact of injury and lower the rate of players missing matches through injury. In the majority of cases, these injections are probably safe, although scientific evidence in this area is scant, particularly regarding long-term follow-up. The known long-term injury sequelae of professional football, such as increased rates of osteoarthritis of the knee (in particular), hip, ankle and lumbar spine, do not generally relate to the injuries for which local anaesthetic is commonly used. The most commonly injected injuries (acromioclavicular joint sprains, finger and rib injuries and iliac crest haematomas) are probably the safest to inject. There are risks of worsening injuries and known specific complications when local anaesthetic is used, and players requesting injections should be made aware of these. Local anaesthetic injections as painkillers should only be used when both the doctor and player consider that the benefits clearly outweigh the anticipated possible risks. Intra-articular injections to the knee, ankle, wrist, joints of the foot, and to the pubic symphysis and major tendons of the lower limb are best avoided in most circumstances. To enable the benefit and risk profile of local anaesthetic injections to be better understood, it is recommended that professional football competitions make local anaesthetics legal only with compulsory notification.