Osteocartilaginous lesions of the talus in soccer players

Objective  

The objective of this study is to describe the results of arthroscopic debridement for talar lesions in a population of soccer players.     

Total and regional bone mass in female soccer players

This cross-sectional study investigated bone mass in female athletes participating in an impact-loading sport (soccer), and evaluated whether any changes in bone mass could be related to the type of weight-bearing loading and muscle strength. The group of soccer players consisted of 16 second-division female players (age 20.9±2.2 years) training for about 6 hours/week. The reference group consisted of 13 nonactive females (age 25.0±2.4 years) not participating in any kind of regular or organized sport activity. The groups were matched according to weight and height. Areal bone mineral density (BMD) was measured in total body, head, lumbar spine, femoral neck, Ward's triangle, trochanter, the whole femur and humerus, and in specific sites in femur diaphysis, distal femur, proximal tibia, and tibia diaphysis using dual X-ray absorptiometry. Isokinetic concentric peak torque of the quadriceps and hamstring muscles was measured using an isokinetic dynamometer. The soccer players had significantly (P<0.05-0.01) higher BMD in the lumbar spine (10.7%), femoral neck (13.7%), Ward's triangle (19.6%), nondominant femur and humerus (8.2 and 8.0%, respectively), distal femur (12.6%), and proximal tibia (12.0%) compared with the nonactive women. There was no significant difference in muscle strength of the thigh between the two groups. In the nonactive group, muscle strength in the quadriceps and especially hamstrings, was correlated to BMD of the adjacent bones (whole femur, hip sites) and also to distant sites (humerus). In the soccer group, there were no correlations between muscle strength and BMD of the adjacent and distant bones. Soccer playing and training appears to have a beneficial effect on bone mass in young females, and it seems that there is a site-specific skeletal response to the type of loading subjected to each BMD site. Muscle strength in the thigh is not related to bone mass in female soccer players.     

Psychophysiological responses in the pre-competition period in elite soccer players

This study investigated pre-competition physiological and psychological states of eighteen elite soccer players. Salivary cortisol was assessed during a non- training day and before three league games. Affective states (unpleasant and pleasant, somatic and transactional emotions) were evaluated using the Tension and Effort-Stress Inventory before the three league games. Participants formed 2 groups, 11 starters and 7 non-starters, depending on the starting list established by the coach. All players reported more intense pleasant transactional and somatic emotions than unpleasant ones prior to all games (p < 0.05), and relatively stable profiles of these psychological responses were observed across the three league games. However, salivary cortisol levels increased during pre-game for all players in comparison with the non- training day (p < 0.001). This anticipatory rise was only related to unpleasant somatic emotions (p < 0.001). This demonstrates that cortisol can be used as an index of emotional response to competition.

Key points

• Elite athletes perceive the participation to competition as a challenging situation as they experience more pleasant emotions than unpleasant ones in the pre-competition period. This profile is relatively stable across three league games, which is possibly due to the athletes'' experience at this level.
• Participation to competition lead to anticipatory acute response of cortisol in the pre-competition period, which potentially prepares the athlete to perform.
• These responses are not related to status player (e.g., starter versus non-starter)
• Physiological stress (e.g. anticipatory rise in cortisol concentrations) is related to negative somatic emotions.
• Cortisol may constitute a measure of emotional response in pre-competition period.

Key words: Emotions, affect, salivary cortisol     

Isokinetic maximal torque power of greek elite soccer players

Eighteen elite Greek soccer players (age, 27.8 +/- 3.4 years; height, 176.6 +/- 5.2 cm; weight, 75.5 +/- 5.2 kg) were tested on the Cybex(R) II apparatus in order to determine 1) the maximal muscle power for the lower extremity dominant side at angular velocities of 30 degrees /sec, 90 degrees /sec, and 180 degrees /sec; 2) the total muscular output and the relative power at 30 degrees /sec; 3) the relationship between the muscle power of the agonist and antagonist musculature. The absolute maximal muscle power (Nm) at 30 degrees /sec for the different joint movements was as follows: Hip Ext = 269 +/- 39; Hip Flex = 179 +/- 29; Hip Add = 160 +/- 17; Hip Abd = 119 +/- 24; Knee Ext = 247 +/- 29; Knee Flex = 146 +/- 12; PI. Flex = 120 +/- 22; and Do. Flex = 32 +/- 6. The muscle agonist-antagonist percent relationship at 30 degrees /sec was found to be: (hip flex)/(hip ext) = 66%(hip abd)/(hip add) = 74%(knee flex)/(knee ext) = 60%(dor. fle)/(pl. fle) = 28%These findings have significant implications for preseason conditioning programs as well as for minimizing the rate of muscle injuries by restoring the correct relationship between agonist-antagonist musculature.J Orthop Sports Phys Ther 1985;6(5):293-295.     

Treatment of fractures of the tibial tuberosity in adolescent soccer players

Fractures of the tibial tuberosity are uncommon injuries that mainly occur in 14 to 16 year-old adolescents involved in sports activities. The mechanism of injury is related to jumping while practicing sports. This retrospective study presents the outcome of fractures of the tibial tuberosity in a series of 18 adolescent soccer players treated with the same surgical technique in one center. The hypothesis was that our surgical technique with two parallel screws, one proximal and one distal to the physis, avoids physis injury and has no repercussions on growth. The average age was 14.7 years. All patients were male. The fractures included 4 type IIA, 3 type IIB, 6 type IIIA, and 5 type IIIB (Ogden classification). All patients underwent open reduction and internal fixation consisting of screw placement parallel to the joint surface, sparing the tibial physis. There were no complications in any case, and all patients were able to resume their previous sports activities. The technique used appeared to be safe. Screws were removed in 8 patients owing to local discomfort. All patients achieved the same competition level as before the injury.     

Clinical and radiological surveys of lumbar spondylolysis in young soccer players

Four thousand eighty one young boy soccer players ranging from age 7 to 12 were surveyed with a hope to establish the specific causative factors and the preventive measures for spondylolysis. Four hundred ninety six (12%) out of these players were found to have lumbago. Two hundred forty seven out of these boys with lumbago received X-ray examinations on which 122 were found to have lumbar lesions. These lesions included spondylolysis, concave vertebral endplates and narrowed disc, the incidence of which were 30.8%, 21.1%, and 8.1%, respectively. Spondylolysis occurred most commonly at L5 and was classified into fissure type (56 cases) and pseudoarthrosis type (20 cases). The occurrence of spondylolysis was related well to the duration of the training time per week. On X-ray examinations, spondylolysis was found to be correlated closely with trapezoid deformity at L5 and increased lumbar lordosis. Thirty patients (71%) out of 42 with fissure type showed solid healing of their pars defect as a result of conservative therapy. The results of the present study indicated that young soccer players should limit their training time to 1.5 hours per day and to 3 days per week in order to prevent spondylolysis.     

Effects of trunk muscle activation on trunk stability,arm power,blood pressure and performance in wheelchair rugby players with a spinal cord injury

Objective: In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.Design: Cross-sectional study.Setting: Rehabilitation research laboratory and WR court.Participants: Eleven WR athletes with tetraplegia.Interventions: ES was applied to the rectus abdominis, obliquus externus abdominis and erector spinae muscles. For every test, the ES condition was compared to the non-ES condition.Outcome measures: Stability was assessed with reaching tasks, arm force/power with an isokinetic test on a dynamometer, BP during an ES protocol and WR skill performance with the USA Wheelchair Rugby Skill Assessment.Results: Overall reaching distance (ES 14.6 ± 7.5 cm, non-ES 13.4 ± 8.2 cm), and BP showed a significant increase with ES. Arm force (ES 154 ± 106 N, non-ES 148 ± 102 N) and power (ES 37 ± 26 W, non-ES 36 ± 25 W), and WR skills were not significantly improved.Conclusion: ES-induced trunk muscle activation positively affects trunk stability and BP, but not arm force/power. No effects were found in WR skill performance, probably due to abdominal strapping. More research is needed to assess different ES (training) protocols and longitudinal effects.     

Bone mineral density of young boy soccer players at different pubertal stages: relationships with hormonal concentration

ObjectivesTo examine the effects of soccer in relation with the hormonal concentration, on the bone mass of young Tunisian players at different pubertal stages.MethodsTwo groups of 152 young boys (age: 13.3 ± 0.9 years) participated in this study: (1) 91 soccer players, and (2) 61 non-athletic boys used as control subjects. The bone mineral density (BMD) and the bone mineral content (BMC) were measured by dual-energy X-ray absorptiometry (DXA). Pubertal stages were assessed, and serum concentrations of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), growth hormone (GH) and the total testosterone were measured.ResultsThe BMD and BMC for whole body, lumbar spine, femoral neck, pelvis and lower limbs were higher in soccer players than in controls (p < 0.001). In early puberty, the soccer players also exhibited significantly greater BMD and BMC in the whole body and in weight-bearing bones compared with the controls (p < 0.001). However, there was no intersubject variability due to puberty in either BMD or BMC. The pubescent soccer players had significantly higher hormonal concentrations of IGF-1 and IGFBP-3 than their counterpart controls (p < 0.05). Moreover, the whole body BMD was significantly (p < 0.001) correlated with GH, IGF-1 and IGFBP-3 but not with the testosterone concentrations.ConclusionThe soccer participation of boys is generally associated with the improvement of their bone mass which is mainly marked at early and late puberty. The relationships between somatotropic axis hormones and BMD of the players may be linked to the parallel development of these two parameters during puberty.     

Osteoarthritis of the ankle and foot complex in former Greek soccer players

Sports activities cause increased loads in elite athletes' joints. Current scientific knowledge highlights the importance of applied mechanical loads on the physiology and pathophysiology of the articular cartilage. Thus, it is possible that sporting activity has a role in the development of osteoarthritis (OA), a painful and damaging joint disease. The aim of the present study was to investigate and record osteoarthritic alterations in the ankle and foot complex in former Greek soccer players and also compare them with those in the general population. The study sample consisted of 170 male, former elite soccer players, aged between 42 and 55 years (mean = 49.8 years, standard deviation [SD] = 7.4). A control group of 132 men, aged between 42 and 55 years (mean, 50.7 years, SD = 9.9), with no regular athletic activity were examined. The development of osteoarthritic alterations was recorded through a questionnaire and clinical and radiological examination. Radiographic analysis of the images in former athletes group showed not only more signs of cartilage degeneration in comparison with the control group (P < .05) but also similar clinical manifestations (pain and impaired mobility; P > .05). Osteophyte formation is a frequent disease among former soccer players--with variations on radiographic images--but it does not appear in their clinical picture. However, it is likely that both spurs and subchondral sclerosis (main findings) are preclinical manifestations of OA. Levels of Evidence: Prognostic, Level II.     

The influence of playing level on functional ankle stability in soccer players

Objective  

The aim of this study was to compare the functional ankle stability between professional and amateur soccer players as well as controls.     

Incidence and risk factors of lower leg fractures in Belgian soccer players

Introduction

Soccer is the world's most popular sport and one that is physically demanding and highly competitive. Consequently, the rate of injuries resulting from this sport is only increasing. It is estimated that 2–20% of all such injuries are fractures, one-third of which are located in the lower extremities. The aim of this epidemiological study was to investigate the incidence of lower-leg fractures (LLFs) in Belgian soccer players and determine the possible risk factors that lead to them.

Methods

All injuries of players associated with the Royal Belgium Football Association (RBFA) were reported and collected in a nationwide registry. We retrospectively compared the incidence rate of and risk factors for LLFs in Belgian soccer players during two seasons, 1999–2000 and 2009–2010.

Results

In total, 1600 fractures (3%) were located in the lower leg. After a decade, the number of LLFs remained unchanged. Ankle fractures were the most common (37%), followed by foot and tibia fractures (33% and 22%, respectively). The least common were fibula fractures, which accounted for just 9%. A higher incidence of every type of LLF was observed in older and amateur-level soccer players, when compared with their younger and professional counterparts. Male players experienced more tibia and foot fractures, whereas the incidences of ankle and fibula fractures were comparable with those in female soccer players. The vast majority of fractures occurred during soccer games.

Conclusion

Ankle fractures and foot fractures represented two-thirds of all fractures noted in this analysis. Male gender, recreational level and adult age were important risk factors for LLFs. After 10 years, the incidence of LLFs did not decrease. Given the socioeconomic impact of these injuries, improved prevention techniques are required to reduce their incidence, particularly with regard to the frequently occurring ankle and foot fractures in this population.     

Adductor strain and hip range of movement in male professional soccer players

PURPOSE: To determine whether hip range of movement (ROM) can predict the occurrence of adductor strain among male professional soccer players. METHODS: 120 subjects were prospectively selected from 6 professional soccer clubs in Australia. Internal rotation, external rotation, and ROM of the hip were measured using a goniometer before and during the course of a soccer season (2003-2004). When adductor strain occurred, further assessments of the hip were performed. Injured subjects' hip ROMs were measured again at the end of the season. RESULTS: Eight of the 120 subjects had 9 adductor strains (one bilateral). There was a correlation between preseason decreased hip ROM and occurrence of adductor strain. The mean preseason hip ROM was 44.7 degrees in the injured group and 53.7 degrees in the uninjured group. Once the subjects were able to resume playing soccer, their hip ROM increased to near pre-injury levels. CONCLUSION: Decreased hip ROM may be considered an aetiological factor in the occurrence of adductor strain in male professional soccer players.     

Epidemiology of acute head injuries in Canadian children and youth soccer players

Background

Limited studies have been done to assess head injury characteristics for children and youth soccer players in Canada.

Objectives

To describe acute head injury characteristics in children and youth soccer players and identify the characteristics of patients who required hospital admission.

Methods

Analysis was based on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP). Soccer-related head injuries amongst 5-19 year old children presenting at 16 hospital emergency departments during 1994-2004 were selected in the study. All head injury-related variables (nature of injury, mechanism of injury, location of play, soccer type and season of play) were stratified by age and sex. A logistic regression model, consisting of the injury-related variables, sex and age as the independent variables, was performed to examine the characteristics of those head-injured patients who required hospital admission.

Results

Overall, there were 4720 head injury cases identified (15% of all soccer-related emergency department visits). The highest proportion of head injuries was amongst males (70%) and children aged 10-14 years (50%). Of head injury cases, 35% were superficial and/or open wounds, 28% minor head injuries, 11% concussions, 9% eye injuries and 5% fractures. The total number of cases that required hospital admission was 164 (3.5%). Based on logistic regression analysis, head-injured youth aged 15-19 years were almost two times more likely to be admitted to hospital than their younger counterparts (OR = 2.2, 95% CI: 1.3-3.6). Compared to ball contact injuries, contact with structures/surfaces, other players/persons and other unspecified objects increased the odds of hospital admission at least by two-folds. Moreover, those who played unorganised soccer were significantly more likely to be admitted to the hospital as compared to those who played organised soccer (OR = 1.7, 95% CI: 1.2-2.6). Finally, playing in the non-winter seasons had increased likelihood of hospital admissions.

Conclusions

Head injuries constituted a significant proportion of soccer-related injuries presenting to emergency departments. Future studies need to evaluate the nature and safety of the playing surfaces/turf and other structures on or around the field of play.     

Surgical treatment of proximal ruptures of the rectus femoris in professional soccer players

Introduction  

Muscle injuries are very common in athletes. Depending on the type of sport, muscle injuries represent approximately 9–54% of total injuries. The rectus femoris muscle is very important in specific sports, such as soccer and American football, because it is the muscle involved in movements, such as sprinting and kicking the ball. Therefore, we believe that these disabling injuries need special and prompt treatment to enable athletes to return to their sporting activities.     

Acute inguinal pain associated with iliopectineal bursitis in four professional soccer players

Four professional soccer players were investigated for acute or subacute pain in the inguinal region. Clinical tests were negative for an inguinal hernia or adductor tendinitis. Resisted hip flexion caused pain. MRI in these four patients showed the onset of iliopectineal bursitis, with signal abnormalities predominantly at the periphery of the psoas tendon in contact with the iliopectineal eminence. Ultrasound-guided steroid injection allowed the two players injected to continue their sporting activity. The two other players were treated by 3 and 7 days rest and oral anti-inflammatory treatment.     

Prediction of knee extensor and flexor isokinetic strength in young male soccer players

STUDY DESIGN: Single group, cross-sectional study. OBJECTIVES: To measure various anthropometric and demographic variables in young male soccer players and to use these measurements to develop equations with which to predict the isokinetic, concentric, and eccentric moment of force. BACKGROUND: The development of equations that can predict isokinetic muscle strength from commonly measured subject characteristics can assist in the effective design of training and rehabilitation programs for athletic children. METHODS AND MEASURES: One hundred thirteen male soccer players (13.50 +/- 2.21 years of age) performed eccentric and concentric maximum efforts of the knee extensors and flexors at 60, 120, and 180 degrees/second. Stepwise regression tests were used to develop predictive equations using combinations of age, height, body mass, sexual maturation (Tanner) stage, percentage of body fat, and hours spent training per week. RESULTS: The results indicated a significant relationship of concentric and eccentric isokinetic strength for both knee extensors and flexors with 73-93% of the variance explained by using combinations of age, body mass, percentage of body fat, and hours training per week. Body mass and age were the main predictor variables under concentric conditions, whereas chronological age was not included in the models under eccentric conditions. CONCLUSIONS: The relation between isokinetic moment and multiple anthropometric and demographic variables depends on the type of muscle action examined. The results suggest that the equations we developed can be used to predict the isokinetic moment in trained, young soccer players. A cross-validation analysis is required to confirm the accuracy and the suitability of the equations developed in our study.