Football-specific extension of the IOC consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020.

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.

Examination of the validity of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale in male professional football players: A worldwide study of 29 professional teams.

Perceived confidence is an important dimension of an athlete's psychological readiness to return-to-play. However, there is no established and validated tool to evaluate confidence in professional football. This study aimed to provide preliminary evaluation of the internal structure of the Injury-Psychological Readiness to Return-to-Sport scale (I-PRRS) in a cohort of injured male professional footballers. Over an 18-month period, 29 teams from 17 leagues participated. Players sustaining injuries eliciting ≥ 3 weeks' time-loss were recruited. Cross culturally adapted to 4 further languages, the I-PRRS was administered on two occasions: 1) day before returning-to-training and 2) day before returning-to-match-play. In total, 113 injuries were recorded with 96 completed I-PRRS data sets collected. Confirmatory factor analysis indicated the I-PRRS was a unidimensional scale, with all items measuring the same construct. The scale demonstrated good internal consistency (ω = .88). When examining longitudinal invariance of the I-PRRS across administration time-points, indices of model fit supported scalar invariance. There was preliminary evidence of good internal structure for the I-PRRS in professional male footballers. However, before further research involving the I-PRRS can be endorsed, efforts to confirm or refute empirical developments pertaining to psychological readiness are necessary.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research.

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Active Versus Passive Recovery in High-Intensity Intermittent Exercises in Children: An Exploratory Study.

This study aimed to compare the effect of active recovery (AR) versus passive recovery (PR) on time to exhaustion and time spent at high percentages of peak oxygen uptake ( peakV˙O2 ) during short, high-intensity intermittent exercises in children. Twelve children (9.5 [0.7] y) underwent a graded test and 2 short, high-intensity intermittent exercises (15 s at 120% of maximal aerobic speed) interspersed with either 15 seconds of AR (50% of maximal aerobic speed) or 15-second PR until exhaustion. A very large effect (effect size = 2.42; 95% confidence interval, 1.32 to 3.52) was observed for time to exhaustion in favor of longer time to exhaustion with PR compared with AR. Trivial or small effect sizes were found for peakV˙O2 , peakHR, and peak ventilation between PR and AR, while a moderate effect in favor of higher average V˙O2 values (effect size = -0.87; 95% confidence interval, -1.76 to -0.01) was found using AR. The difference between PR and AR for the time spent above 80% (t80%) and 90% (t90%) of peakV˙O2 was trivial. Despite the shorter running duration in AR, similar t80% and t90% were spent with AR and PR. Time spent at a high percentage of peakV˙O2 may be attained by running 3-fold shorter using AR compared with using PR.

Workload and injury incidence in elite football academy players.

The aim of this study was to prospectively analyse the relationship between workloads and injury in elite football academy players. Elite football academy players (n = 122) from under-19 (U19) and under-21 (U21) of a professional football team competing in UEFA European Cups were followed during 5 seasons. Injuries were collected and absolute workload and workload ratios (4-weeks, 3-weeks, 2-weeks and week-to-week) calculated using a rolling days method with the help of the session Rate of Perceived Exertion. There was no association between absolute workload or workload ratio with the injury incidence in the U19. In the U21, the level of cumulative absolute workloads during 3-weeks (RR = 1.39, p = 0.026) and during 4-weeks (RR = 1.40, p = 0.019) were associated with an increase in injury. There was no association between workload ratio and injury in U21. The significant link between high cumulated 3-weeks and 4 weeks workloads and injury in U21 confirmed the requirement to monitor the internal subjective workload in U21 in order to prevent injury. Further studies exploring the relationships between workload and injury are required in football academy.

Influence of Night Soccer Matches on Sleep in Elite Players.

Nédélec, M, Dawson, B, and Dupont, G. Influence of night soccer matches on sleep in elite players. J Strength Cond Res 33(1): 174-179, 2019-This study examined the impact of night matches on the sleep/wake behavior of elite soccer players participating in the UEFA Champions League and French Ligue 1. A mixed method approach was used, combining objective sleep assessment with wrist activity monitors, and a survey to ascertain the sleep complaints after night matches (kick off after 18:00 hours). Most players (90%) indicated worse sleep in the nights after evening matches than after training days. Objective time in bed (-01:39 hours; effect size [ES] = 1.7; p < 0.001) and total sleep time (-01:32 hours; ES = 1.4; p < 0.001) were both lower after night matches than after training days. Night matches had a marked influence on sleep quantity later that night, both objectively and subjectively. The survey revealed that players may not have appropriate methods for better managing their sleep after night matches. It is yet to be determined whether players may benefit from individualized sleep interventions in these circumstances.

Case Study: Sleep and Injury in Elite Soccer-A Mixed Method Approach.

Nédélec, M, Leduc, C, Dawson, B, Guilhem, G, and Dupont, G. Case study: sleep and injury in elite soccer. A mixed method approach. J Strength Cond Res 33(11): 3085-3091, 2019-This case study allowed an examination of the link between sleep and injury occurrence in an elite male soccer player competing in French League 1 and Union of European Football Associations matches. During 4 months, a mixed method approach was used, combining actigraphic sleep assessment with qualitative interviews on a daily basis. Three injuries were reported over the study period. Sleep onset latency (SOL), both in the single night (117 ± 43 minutes) and in the week (78 ± 50 minutes) before injury occurrence, was longer than preseason baseline values (18 ± 13 minutes; effect size (ES): 3.1 and 1.6, respectively). Similarly, sleep efficiency in the single night (73 ± 7%) and the week (75 ± 7%) before injury occurrence was lower than baseline (90 ± 3%; ES: 3.2 and 2.8, respectively). In this case study, SOL and efficiency were altered on the night and in the week before injury occurrence. Individualized assessment of sleep during congested playing schedules may be useful to aid in preventing injury occurrence.

Internal workload and non-contact injury: a one-season study of five teams from the UEFA Elite Club Injury Study.

BACKGROUND: Internal workload (ie, from training and matches) is considered one of the most important injury risk factors for elite European football teams, however there is little published evidence to support this belief. OBJECTIVE: We examined the association and predictive power of internal workload and non-contact injuries. METHODS: Five elite European teams, 171 players (age: 25.1±4.9 years; height: 181.6±6.7 cm; body mass: 77.5±7.2 kg) participated over one full competitive season. Using the session-rating of perceived exertion (s-RPE) method player's internal workloads were calculated for acute week, week-to-week changes, cumulated weeks, chronic weeks and acute:chronic ratios and analysed for association with non-contact injury (using generalised estimating equations (GEE)). Associated variables from GEE analysis were categorised into very low to very high workload zones and checked for increased relative risks (RRs). Associated workload variables were also analysed for predictive power (receiver operating characteristics). RESULTS: Acute:chronic workload ratios at 1:3 and 1:4 weeks were associated with non-contact injury (P<0.05). Specifically, a greater risk of injury was found for players with an acute:chronic workload at 1:4 weeks of 0.97 to 1.38 (RR 1.68; 95% CI 1.02 to 2.78, likely harmful) and >1.38 (RR 2.13; 95% CI 1.21 to 3.77, very likely harmful) compared with players whose acute:chronic workload was 0.60 to 0.97. An acute:chronic workload 1:3 of >1.42 compared with 0.59 to 0.97 displayed a 1.94 times higher risk of injury (RR 1.90; 95% CI 1.08 to 3.36, very likely harmful). Importantly, acute:chronic workload at both 1:4 and 1:3 showed poor predictive power (area under the curve 0.53 to 0.58) despite previous reports and beliefs that it can predict injury. CONCLUSIONS: This study provides evidence for the acute:chronic internal workload (measured using s-RPE) as a risk factor for non-contact injury in elite European footballers. However the acute:chronic workload, in isolation, should not be used to predict non-contact injury.

Cognitive performance and self-reported sleepiness are modulated by time-of-day during a mountain ultramarathon.

Ninety-two runners completed the study during a 168 km mountain ultramarathon (MUM). Sleepiness, self-reported sleep duration, and cognitive performance were assessed the day before the race and up to eight checkpoints during the race. Sleepiness was assessed using the Karolinska Sleepiness Scale. Cognitive performance was also assessed using the Digital Symbol Substitution Task (DSST). Runner reported 23.40 ± 22.20 minutes of sleep (mean ± SD) during the race (race time: 29.38 to 46.20 hours). Sleepiness and cognitive performance decrements increased across this race, and this was modulated by time-of-day with higher sleepiness and greater performance decrements occurring during the early morning hours. Runners who slept on the course prior to testing had poorer cognitive performance, which may suggest that naps on the course were taken due to extreme exertion. This study provides evidence that cognitive performance deficits and sleepiness in MUM are sensitive to time into race and time-of-day.

Allergies and Exercise-Induced Bronchoconstriction in a Youth Academy and Reserve Professional Soccer Team.

OBJECTIVES: A high prevalence of respiratory allergies and exercise-induced bronchoconstriction (EIB) has been reported among endurance athletes. This study was designed to analyze the frequency of sensitization to respiratory allergens and EIB in young soccer players. DESIGN: Prospective cohort design. SETTING: Youth academy and reserve professional soccer team during the seasons 2012 to 2013 and 2013 to 2014. PARTICIPANTS: Eighty-five soccer players (mean age: 20 ± 4 years) participated. INTERVENTION: Players underwent skin prick tests (SPTs) during the seasons 2012 to 2013 and 2013 to 2014. Spirometry and a eucapnic voluntary hyperpnea test were performed on soccer players during the first season 2012 to 2013 (n = 51) to detect EIB. Two self-administered questionnaires on respiratory history and allergic symptoms (European Community Respiratory Health Survey and Allergy Questionnaire for Athletes) were also distributed during both seasons (n = 59). MAIN OUTCOME MEASURES: The number of positive SPTs, exercise-induced respiratory symptoms, presence of asthma, airway obstruction, and EIB. RESULTS: Forty-nine percent of players were sensitized to at least one respiratory allergen, 33% reported an allergic disease, 1 player presented airway obstruction at rest, and 16% presented EIB. Factors predictive of EIB were self-reported exercise-induced symptoms and sensitization to at least 5 allergens. CONCLUSIONS: Questioning players about exercise-induced respiratory symptoms and allergies as well as spirometry at the time of the inclusion medical checkup would improve management of respiratory health of soccer players and would constitute inexpensive preliminary screening to select players requiring indirect bronchial provocation test or SPTs. CLINICAL RELEVANCE: This study showed that despite low frequencies, EIB and allergies are underdiagnosed and undertreated in young soccer players.

Effects of a Strength Training Session After an Exercise Inducing Muscle Damage on Recovery Kinetics.

Abaïdia, A-E, Delecroix, B, Leduc, C, Lamblin, J, McCall, A, Baquet, G, and Dupont, G. Effects of a strength training session after an exercise inducing muscle damage on recovery kinetics. J Strength Cond Res 31(1): 115-125, 2017-The purpose of this study was to investigate the effects of an upper-limb strength training session the day after an exercise inducing muscle damage on recovery of performance. In a randomized crossover design, subjects performed the day after the exercise, on 2 separate occasions (passive vs. active recovery conditions) a single-leg exercise (dominant in one condition and nondominant in the other condition) consisting of 5 sets of 15 eccentric contractions of the knee flexors. Active recovery consisted of performing an upper-body strength training session the day after the exercise. Creatine kinase, hamstring strength, and muscle soreness were assessed immediately and 20, 24, and 48 hours after exercise-induced muscle damage. The upper-body strength session, after muscle-damaging exercise accelerated the recovery of slow concentric force (effect size = 0.65; 90% confidence interval = -0.06 to 1.32), but did not affect the recovery kinetics for the other outcomes. The addition of an upper-body strength training session the day after muscle-damaging activity does not negatively affect the recovery kinetics. Upper-body strength training may be programmed the day after a competition.

Curcumin and Piperine Supplementation and Recovery Following Exercise Induced Muscle Damage: A Randomized Controlled Trial.

The aim of this study was to analyze the effects of oral consumption of curcumin and piperine in combination on the recovery kinetics after exercise-induced muscle damage. Forty-eight hours before and following exercise-induced muscle damage, ten elite rugby players consumed curcumin and piperine (experimental condition) or placebo. A randomized cross-over design was performed. Concentric and isometric peak torque for the knee extensors, one leg 6 seconds sprint performance on a non-motorized treadmill, counter movement jump performance, blood creatine kinase concentration and muscle soreness were assessed immediately after exercise, then at 24h, 48h and 72h post-exercise. There were moderate to large effects of the exercise on the concentric peak torque for the knee extensors (Effect size (ES) = -1.12; Confidence interval at 90% (CI90%): -2.17 to -0.06), the one leg 6 seconds sprint performance (ES=-1.65; CI90% = -2.51to -0.80) and the counter movement jump performance (ES = -0.56; CI90% = -0.81 to -0.32) in the 48h following the exercise. There was also a large effect of the exercise on the creatine kinase level 72h after the exercise in the control group (ES = 3.61; CI90%: 0.24 to 6.98). This decrease in muscle function and this elevation in creatine kinase indicate that the exercise implemented was efficient to induce muscle damage. Twenty four hours post-exercise, the reduction (from baseline) in sprint mean power output was moderately lower in the experimental condition (-1.77 ± 7.25%; 1277 ± 153W) in comparison with the placebo condition (-13.6 ± 13.0%; 1130 ± 241W) (Effect Size = -1.12; Confidence Interval 90%=-1.86 to -0.86). However, no other effect was found between the two conditions. Curcumin and piperine supplementation before and after exercise can attenuate some, but not all, aspects of muscle damage.

Injury prevention strategies, coach compliance and player adherence of 33 of the UEFA Elite Club Injury Study teams: a survey of teams' head medical officers.

PURPOSE: (1) To quantify current practice at the most elite level of professional club football in Europe with regard to injury prevention strategy; (2) to describe player adherence and coach compliance to the overall injury prevention programme. METHODS: A structured online survey was administered to the Head medical officers of 34 elite European teams currently participating in the UEFA Elite Club Injury Study. The survey had 4 sections; (1) risk factors for injury, (2) assessment and monitoring of injury risk, (3) prevention strategies and (4) coach compliance and player adherence to the injury prevention process. RESULTS: 33 (97%) Medical officers of the teams responded. The most important perceived injury risk factor was previous injury. Four of the top 6 risk factors-physical fitness, accumulated fatigue, reduced recovery time between matches and training load-were related to player workload. The top 3 preventative exercises were eccentric, balance/proprioception and core training. Regarding monitoring, the top 3 tools implemented were measurement of workload, subjective wellness and a general medical screen. The subjectively rated level of coach compliance in UEFA teams was perceived as 'high', while the player adherence varied from none at all to perfect. SUMMARY AND CONCLUSION: Medical officers place importance on workload-related variables as risk factors for injury in elite European football players. A lack of consistently high player adherence may limit the effects of contemporary injury prevention programmes in elite European footballers.

The impact of short periods of match congestion on injury risk and patterns in an elite football club.

BACKGROUND: The effect of fixture congestion on injury rates and patterns has received scarce attention in elite football and existing investigations have not accounted for player rotation or examined the temporal distribution and potential cause of injuries. AIM: To prospectively investigate the epidemiology of injury during short periods of fixture congestion in a professional football club. METHODS: Over a six-season period, exposure time and injury data were compared in the same players (n=25 (14 individuals)) when participating in two frequently occurring short congested fixture cycles in comparison to match-play outside these cycles. (1) two successive matches separated by an interval totalling ≤3 days calculated immediately from the end of play in match 1 to the beginning of play in match 2; (2) three successive matches separated by ≤4-day intervals starting the day immediately after each match. RESULTS: In two-match congestion cycles, incidence rate ratios (IRR) showed that there was a higher risk of injury in the final 15 min of play in the second match in comparison to match-play outside the cycles (IRR: 3.1 (95% CI 1.1 to 9.3), p=0.0400). A greater risk of injury overall (IRR: 2.0 (95% CI 1.1 to 3.8), p=0.0345) and in the first-half of play (2.6 (1.1 to 6,5), p=0.0386), and risk of ankle sprains (10.4 (95% CI 1.9 to 57.9), p=0.0068) and non-contact injuries due to a 'change in direction' (IRR: 7.8 (1.3 to 46.8), p=0.0243) were observed in the final match of three-match congestion cycles in comparison to match-play outside the cycles. CONCLUSIONS: Injury rates and patterns were affected in the same elite football players when competing in short congested fixture cycles in comparison to match-play outside the cycles.

Match-to-match variability in high-speed running activity in a professional soccer team.

This study investigated variability in competitive high-speed running performance in an elite soccer team. A semi-automated tracking system quantified running performance in 12 players over a season (median 17 matches per player, 207 observations). Variability [coefficient of variation (CV)] was compared for total sprint distance (TSD, >25.2 km/h), high-speed running (HSR, 19.8-25.2 km/h), total high-speed running (THSR, ≥19.8 km/h); THSR when the team was in and out of ball possession, in individual ball possession, in the peak 5 min activity period; and distance run according to individual maximal aerobic speed (MAS). Variability for % declines in THSR and distance covered at ≥80% MAS across halves, at the end of play (final 15 min vs. mean for all 15 min periods) and transiently (5 min period following peak 5 min activity period), was analysed. Collectively, variability was higher for TSD versus HSR and THSR and lowest for distance run at ≥80% MAS (CVs: 37.1%, 18.1%, 19.8% and 11.8%). THSR CVs when the team was in/out of ball possession, in individual ball possession and during the peak 5 min period were 31.5%, 26.1%, 60.1% and 23.9%. Variability in THSR declines across halves, at the end of play and transiently, ranged from 37.1% to 142.6%, while lower CVs were observed in these metrics for running at ≥80% MAS (20.9-53.3%).These results cast doubt on the appropriateness of general measures of high-speed activity for determining variability in an elite soccer team, although individualisation of HSR thresholds according to fitness characteristics might provide more stable indicators of running performance and fatigue occurrence.

Strength Training Reduces Injury Rate in Elite Young Soccer Players During One Season.

The purpose of this study was to examine the effect of strength training on physical fitness parameters and injuries occurrence in young elite soccer players. Fifty-two elite young soccer players (13-14 years) were divided on a randomized order into experimental group (EG, n = 26) and control group (CG, n = 26). For EG, 2 to 3 sessions of strength training (90 minutes) were introduced weekly in their training program for 12 weeks (4 × 3 weeks separated by 1-week recovery). Sprint tests (10-20-30 m), T-test time, and jumping tests were measured at the start (T0), at the middle (T1), and at the end of the experiment period (T2). The injury rate was recorded by the medical and fitness training staff throughout the soccer season. Compared to CG, EG performed significantly better in sprint running and T-test time at T2 (p < 0.01). Similarly, the improvement amount for jumping tests was significantly greater (p ≤ 0.05) in EG than in CG. A total of 17 injuries were recorded over the soccer season. The rate was higher in CG (13 injuries) than in training group (4 injuries). This study showed that strength training accurately and efficiently scheduled in youth soccer players, induced performance improvement, and reduced the rate of injuries.

Relationship between daily training load and psychometric status of professional soccer players.

We studied the relationship between daily training load (TL) experienced by professional soccer players and the Hooper questionnaire reflecting their perceived quality of sleep, fatigue, stress and delayed onset muscle soreness. During a 16-week training period, the rating of perceived exertion and duration were collected after each training session, and daily TL was calculated from 14 professional soccer players. The Hooper questionnaire was completed every day before the first training session and the Hooper's score (HS) was then calculated. The daily TL and HS were 379.9 ± 198.3 AU and 16.2 ± 5.1, respectively. Pearson correlation showed significant relationships (p < 0.01) between TL and perceived fatigue, muscle soreness, sleep and stress. Our findings revealed that the perceived sleep, stress, fatigue and muscle soreness are moderately related to the daily TL in professional soccer players. The Hooper questionnaire is both a simple and useful tool for monitoring perceived wellness and psychometric players' status of professional soccer players.

Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues.

PURPOSE: To systematically review the scientific level of evidence for the 'Top 3' risk factors, screening tests and preventative exercises identified by a previously published survey of 44 premier league football (soccer) teams. Also, to provide an overall scientific level of evidence and graded recommendation based on the current research literature. METHODS: A systematic literature search (Pubmed [MEDLINE], SportDiscus, PEDRO and Cochrane databases). The quality of the articles was assessed and a level of evidence (1++ to 4) was assigned. Level 1++ corresponded to the highest level of evidence available and 4, the lowest. A graded recommendation (A: strong, B: moderate, C: weak, D: insufficient evidence to assign a specific recommendation) for use in the practical setting was given. RESULTS: Fourteen studies were analysed. The overall level of evidence for the risk factors previous injury, fatigue and muscle imbalance were 2++, 4 and 'inconclusive', respectively. The graded recommendation for functional movement screen, psychological questionnaire and isokinetic muscle testing were all 'D'. Hamstring eccentric had a weak graded 'C' recommendation, and eccentric exercise for other body parts was 'D'. Balance/proprioception exercise to reduce ankle and knee sprain injury was assigned a graded recommendation 'D'. CONCLUSIONS: The majority of perceptions and practices of premier league teams have a low level of evidence and low graded recommendation. This does not imply that these perceptions and practices are not important or not valid, as it may simply be that they are yet to be sufficiently validated or refuted by research.

Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams.

PURPOSE: The available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams. METHODS: A survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup. RESULTS: Following responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric. CONCLUSIONS: The present study showed that many of the National football (soccer) teams' injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices.