Injury prevention in Brazilian women's football: Perceptions of physiotherapists and practices within elite clubs.

OBJECTIVES: To describe the perceptions of physiotherapists and the injury prevention practices implemented within elite women's football clubs in Brazil. DESIGN: Cross-sectional study. SETTING: Online survey. PARTICIPANTS: Head physiotherapists from 32 Brazilian elite clubs. MAIN OUTCOME MEASURES: Structured questionnaire. RESULTS: Physiotherapists identified ACL rupture as the primary target for prevention. The top-five perceived injury risk factors included 'early return to sport after injury', 'workload too high', 'previous injury', 'poor sleep/rest', and 'muscle strength/power deficit'. 'Adoption of return to sport criteria' was almost unanimously recognized as a very important preventive strategy. 'Poor infrastructure' was elected as the main barrier to implementing prevention programs. From a practical standpoint, at least two-third of clubs implemented multi-component exercise interventions for injury prevention. These interventions typically encompassed flexibility/mobility, balance/proprioception, lumbo-pelvic stability, and agility exercises, alongside exposure to sprinting. Strength training routines typically included traditional, functional, and eccentric exercises. Most teams also employed other prevention strategies, including adoption of return to sport criteria, internal workload monitoring, post-exercise recovery modalities, preseason risk factor screening, and application of rigid strapping tapes. CONCLUSIONS: This study provided unprecedented insights into the physiotherapists' perceptions and injury prevention practices implemented within elite women's football clubs.

Uncovering injuries in Brazilian elite women's football: A prospective cohort study.

OBJECTIVES: To elucidate the injury profile in Brazilian elite women's football. DESIGN: Prospective cohort study. METHODS: Time-loss injuries, along with match and training exposure, were monitored throughout a full season in four Brazilian elite clubs. RESULTS: Sixty-three out of 133 players (47 %) sustained 112 time-loss injuries along the season, leading to 0.8 injuries per player on average. The overall injury incidence rate was 5.0 injuries per 1000 h of exposure. Sudden onset injuries occurred at a rate of 4.2/1000 h of overall exposure, with rates of 15.9/1000 h during matches and 2.9/1000 h during training sessions. Forty-eight percent of the time-loss injuries were attributed to non-contact events. Gradual onset injuries accounted for 16 % of the injuries, resulting in a rate of 0.8/1000 h of overall exposure. The most affected locations were knee and thigh (29 % of all injuries for each), followed by ankle (17 %) and hip/groin (13 %). Muscle/tendon was the most affected tissue (47 % of all injuries), followed by ligament/joint capsule (33 %), bone (10 %), and cartilage/synovium/bursa (7 %). Ankle sprains, hamstring strains, and anterior cruciate ligament injuries accounted for over one-third of the injuries. Mild, moderate, and severe injuries account for 40 %, 43 %, and 17 % of cases, respectively. Overall, 18 % of cases were categorized as re-injuries, and 40 % of those occurred within 2 months of the index injury. CONCLUSIONS: This study provides the initial understanding into the injury profile of Brazilian elite women's football. This information should serve as a guiding resource for injury prevention programs.

Propriocepção e reforço muscular na estabilidade do tornozelo em atletas de futsal feminino / Proprioception and muscle strengthening in the stability of the ankle in female indoor soccer athletes / Propiocepción y refuerzo muscular en la estabilidad del tobillo en atletas de futsal femenino

RESUMO Introdução: O futsal é um esporte coletivo caracterizado por movimentos rápidos e de alta intensidade, com frequentes trocas de direção dos atletas, o que predispõe os membros inferiores a lesões principalmente na articulação do tornozelo. Objetivo: Comparar os efeitos de um treinamento proprioceptivo e um treinamento de reforço muscular sobre a estabilidade articular do tornozelo, em atletas de futsal feminino, por meio do Star Excursion Balance Test (SEBT). Métodos: Foram avaliadas 20 atletas de futsal feminino, com idade entre 18 e 30 anos (média 22,45 ± 3,30), sem histórico de lesões nos membros inferiores nos últimos seis meses, divididas randomicamente em dois grupos. Um grupo realizou um treinamento proprioceptivo e o outro um protocolo de reforço muscular, durante quatro semanas. Foi utilizado o SEBT para avaliar as fases pré e pós-intervenção. Para a comparação de médias de ambos os tornozelos, em cada grupo isolado, utilizou-se o teste t para medidas repetidas. Para a comparação de médias entre os grupos, aplicou-se o teste t para amostras independentes. Adotou-se 5% (p ≤ 0,05) como nível de significância e as análises foram realizadas no programa SPSS (Statistical Package for the Social Sciences) versão 18. Resultados: Tanto o treinamento proprioceptivo quanto o de reforço muscular obtiveram resultados estatisticamente significativos nas direções lateral, posterolateral, posterior, posteromedial e medial, demonstrando boa estabilidade da articulação do tornozelo para qualquer um dos protocolos. Na comparação do pré e pós-intervenção entre os grupos, não foram encontradas diferenças estatisticamente significativas em nenhuma das direções do teste. Conclusão: Treinamentos proprioceptivos e treinamentos de reforço muscular com duração de quatro semanas parecem ser alternativas viáveis e eficazes no incremento da estabilidade articular do tornozelo em atletas de futsal feminino.

ABSTRACT Introduction: Indoor soccer is a team sport characterized by fast and high intensity movements, with frequent change of direction of the athletes, which predisposes the lower limb to injuries mainly in the ankle joint. Objective: To compare the effects of a proprioceptive training and muscle strengthening training on ankle joint stability in female indoor soccer athletes through the Star Excursion Balance Test (SEBT). Methods: Twenty female indoor soccer athletes, aged between 18 and 30 years (mean 22.45 ± 3.30) with no history of lower limb injuries in the last six months were divided randomly into two groups. One group underwent proprioceptive training and the other a muscle strengthening protocol for four weeks. SEBT was used to evaluate the pre and post-intervention phases. For the comparison of means of both ankles in each isolated groups the t test was used for repeated measures. For the comparison of means between groups, the t test was applied for independent samples. The level of significance was set at 5 % (p≤0.05) and statistical analyzes were performed using SPSS (Statistical Package for the Social Sciences) version 18. Results: Both proprioceptive training and muscle strengthening training obtained statistically significant results in lateral, posterior-lateral, posterior, posterior-medial and medial directions, demonstrating a good stability of the ankle joint for any of the protocols. When comparing the pre- and post-intervention between groups there were no statistically significant differences in any of test directions. Conclusion: Proprioceptive training and muscle strengthening training during four weeks seem to be viable and effective alternatives to increase ankle joint stability in female indoor soccer players.

RESUMEN Introducción: El futsal es un deporte colectivo caracterizado por movimientos rápidos y de alta intensidad, con frecuentes cambios de direcciones de los atletas, lo que predispone a los miembros inferiores a lesiones, principalmente en la articulación del tobillo. Objetivo: Comparar los efectos de un entrenamiento propioceptivo y un entrenamiento de refuerzo muscular sobre la estabilidad articular del tobillo en atletas de futsal femenino, a través del Star Excursion Balance Test (SEBT). Métodos: Se evaluaron 20 atletas de futsal femenino, con edad entre 18 y 30 años (promedio 22,45 ± 3,30), sin antecedentes de lesiones en los miembros inferiores, en los últimos seis meses, divididas aleatoriamente en dos grupos. Un grupo realizó un entrenamiento propioceptivo y el otro un protocolo de refuerzo muscular durante cuatro semanas. Se utilizó el SEBT para evaluar las fases pre y post-intervención. Para la comparación de promedios de ambos tobillos en cada grupo aislado se utilizó la prueba t para medidas repetidas. Para la comparación de promedios entre los grupos, se aplicó la prueba t para muestras independientes. Se adoptó el 5% (p ≤ 0,05) como nivel de significación y los análisis se realizaron en el programa SPSS (Statistical Package for the Social Sciences) versión 18. Resultados: Tanto el entrenamiento propioceptivo, como el de refuerzo muscular obtuvieron resultados estadísticamente significativos en las direcciones lateral, posterolateral, posterior, posteromedial y medial, demostrando buena estabilidad de la articulación del tobillo para cualquiera de los protocolos. En la comparación del pre y post-intervención entre los grupos no se encontraron diferencias estadísticamente significativas en ninguna de las direcciones de la prueba. Conclusión: Entrenamientos propioceptivos y entrenamientos de refuerzo muscular con duración de cuatro semanas parecen ser alternativas viables y eficaces, en el incremento de la estabilidad articular del tobillo en atletas de futsal femenino.