Awareness of fifth metatarsal stress fractures among soccer coaches in Japan: A cross-sectional study.

Although a fifth metatarsal stress fracture is the most frequent stress fracture in soccer players, awareness of fifth metatarsal stress fractures among soccer coaches is unclear. Therefore, we performed an online survey of soccer coaches affiliated with the Japan Football Association to assess their awareness of fifth metatarsal stress fractures. A total of 150 soccer coaches were invited for an original online survey. Data on participants' age, sex, types of coaching licence, coaching category, types of training surface, awareness of fifth metatarsal stress fractures, and measures employed to prevent fifth metatarsal stress fractures were collected using the survey. Data from 117 coaches were analysed. Eighty-seven of the 117 coaches were aware of fifth metatarsal stress fractures; however, only 30% reported awareness of preventive and treatment measures for fifth metatarsal stress fractures. Licensed coaches (i.e., licensed higher than level C) were also more likely to be aware of fifth metatarsal stress fractures than unlicensed coaches were. Furthermore, although playing on artificial turf is an established risk factor for numerous sports injuries, soccer coaches who usually trained on artificial turf were more likely to be unaware of the risks associated with fifth metatarsal stress fractures than coaches who trained on other surfaces were (e.g., clay fields). Soccer coaches in the study population were generally aware of fifth metatarsal stress fractures; however, most were unaware of specific treatment or preventive training strategies for fifth metatarsal stress fractures. Additionally, coaches who practised on artificial turf were not well educated on fifth metatarsal stress fractures. Our findings suggest the need for increased awareness of fifth metatarsal stress fractures and improved education of soccer coaches regarding injury prevention strategies.　.

Efficacy of a new injury prevention programme (FUNBALL) in young male football (soccer) players: a cluster-randomised controlled trial.

OBJECTIVES: To evaluate the efficacy of a new multicomponent, exercise-based injury prevention programme in football players 13-19 years old. METHODS: Two-arm cluster-randomised controlled trial with clubs as the unit of randomisation. 55 football teams from Kosovo of the under 15, under 17 and under 19 age groups were randomly assigned to the intervention (INT; 28 teams) or the control group (CON; 27 teams) and were followed for one football season (August 2021-May 2022). The INT group performed the 'FUNBALL' programme after their usual warm-up at least twice per week, while the CON group followed their usual training routine. The primary outcome measure was the overall number of football-related injuries. Secondary outcomes were region-specific injuries of the lower limbs (hip/groin, thigh, knee, lower leg, ankle and foot) and injury severity. RESULTS: 319 injuries occurred, 132 in the INT and 187 in the CON group. The INT group used the 'FUNBALL' programme in 72.2% of all training sessions, on average 2.2 times per week. There was a significantly lower incidence in the INT group regarding the overall number of injuries (incidence rate ratio (IRR) 0.69, 95% CI 0.55 to 0.87), the number of thigh injuries (IRR 0.62, 95% CI 0.39 to 0.98), of moderate (time loss between 7 and 28 days) (IRR 0.65, 95% CI 0.44 to 0.97) and of severe injuries (time loss >28 days) (IRR 0.51, 95% CI 0.28 to 0.91). CONCLUSION: The 'FUNBALL' programme reduced the incidence of football-related injuries among male adolescent football players, and its regular use for injury prevention in this population is recommended. TRIAL REGISTRATION NUMBER: NCT05137015.

What exercise programme is the most appropriate to mitigate anterior cruciate ligament injury risk in football (soccer) players? A systematic review and network meta-analysis.

OBJECTIVES: To examine the effectiveness of different exercise-based interventions to mitigate the risk of anterior cruciate ligament injury in football players, and to determine which is the most appropriate for them, specifically for female football players. DESIGN: Four databases were accessed in July 2023 using the keywords football, soccer, athletic injuries, anterior cruciate ligament, knee injuries, injury prevention, exercise-based programme, and risk factor. METHODS: Randomised controlled trials that evaluated any exercise-based injury prevention intervention compared with a control group on the prevention of anterior cruciate ligament injury in football players were included. RESULTS: Eleven studies were included. Data were presented as logarithm hazard ratio, credible intervals and standard deviation. FIFA 11+ was the most effective in reducing anterior cruciate ligament injury risk in football players (logarithm hazard ratio = -1.23 [95% credible intervals: -2.20, -0.35]; SD = 0.47), followed by the Knäkontroll programme (logarithm hazard ratio = -0.76 [95% credible intervals: -1.60, -0.03]; standard deviation = 0.42). For females, only Knäkontroll had a significant impact on reducing the risk of anterior cruciate ligament injury (logarithm hazard ratio = -0.62 [95% credible intervals: -1.71, 0.62]; standard deviation = 0.58). CONCLUSIONS: Our results support the use of FIFA 11+ and Knäkontroll to mitigate injury incidence at overall level. However, the effectiveness of these interventions changed when adjusting for females. Knäkontroll is postulated as the programme with the greatest preventive nature, although these results should be interpreted with caution due to the lack of the sample.

Role of the Menstrual Cycle on Performance and Injury Risk: A Survey of Female Professional Rugby Players in the United Kingdom.

BACKGROUND: Female athletic performance and injury risk is impacted by variations in the menstrual cycle (MC), but the understanding of the impacts and mechanisms influenced by the menstrual cycle on exercise performance are not fully delineated. AIMS AND OBJECTIVES: Evaluate associations between the menstrual cycle, perceived performance, and injury risk of elite female rugby players using an online survey. METHODS: An anonymous online questionnaire was completed by 150 elite female rugby players from two English rugby leagues, the Betfred Women's Super League (BWSL) and the Allianz Premier 15s (AP15s). The collected data were analysed thematically. RESULTS: The Chi-square test was used to assess associations between age groups and contraception usage, weight change, and training and playing performance; none of the associations were statistically significant (all p values > 0.05). Thematic analysis of 11,660 words of data revealed four themes: (a) MC impact on training and competition, (b) education and period management plans, (c) openness of conversations and comfort taking time off, and (d) injury risk. The impacted performance areas were physical (83.7%), psychological (85.7%), and nutritional (80.3%); players experienced decreased appetite, nausea, fatigue, strength declines, heighted emotions, and worsened focus. In total, 87.8% of athletes perceived the MC to negatively impact performance, 85.7% of players desired to be educated further to prevent injuries, improve nutrition, and training adaptions, 51.7% of participants perceived risk of injury to be higher during MC, and 86.4% of participants did not feel comfortable taking time off due to the MC, worrying that selection would be affected and about opinions from others. CONCLUSION: A clear negative impact on perceived performance and injury risk was reported by survey participants. The interaction of physical, psychological, and nutritional factors, and a lack of awareness and education emphasise the need for further comprehensive studies and interventions, with measures such as MC monitoring and profiling, education, and training adaptions to develop openness, knowledge, and understanding.

Differences in training load, jump performance and injury occurrence in elite youth volleyball players.

BACKGROUND: External and internal training load are used to monitor training effects in volleyball. Occurrence of injuries in volleyball is dependent of training loads and state of fitness but also playing positions and gender. This study aims to investigate the impact of gender and playing positions on injury occurrence among young volleyball players, considering both training loads and fitness levels. METHODS: Conducted from September 2021 to May 2022, this study involved 37 elite young volleyball players, comprising 16 female (176.8±3.6 cm; 65.3±5.7 kg; 13.9±1.1 years old) and 21 males (189.6±7.3 cm; 77.4±9.5 kg; 14.7±1.2 years old). G-Vert accelerometer was used to quantify training load. During these sessions, RPE, state of fitness and occurrence of injuries, were collected using a daily questionnaire. RESULTS: The primary findings indicate that males demonstrated a higher number of jumps, mean intensity, mean training load per session, and reported higher fitness levels compared to females (P<0.001). However, females were more injured than males (P<0.001). Setters were identified as the players with the highest jump frequency, albeit at lower heights and intensities than their counterparts (P<0.001). Among males, middle blockers exhibited the highest mean intensity and training load per session (P<0.01). CONCLUSIONS: The elevated frequency of injuries and a worse reported fitness levels among females, despite lower training loads, suggests a potential deficiency in physical preparation among young women, particularly in terms of their ability to perform repeated high-intensity jumps.

Coaches of youth field sports as delivery agents of injury prevention programmes: how are we training the trainers? A scoping review.

OBJECTIVE: To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. DESIGN: Scoping review. DATA SOURCES: PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus and Google Scholar electronic databases were searched using keywords related to IPPs and youth field sports. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies of IPPs in youth field sports, that provided 'train-the-trainer' education to coaches as designated delivery agents. RESULTS: 20 studies from two field sports (soccer/football; n=17, Rugby Union; n=3) fulfilled the eligibility criteria. Eleven CE interventions occurred in the preseason and 18 occurred at one time-point (single day). Five studies cited use of a behavioural change theory or model in the design of their CE, most frequently the Health Action Process Approach model (n=5); and use of behavioural change techniques varied. Twelve of twenty studies (60%) reported some form of ongoing support to coaches following the CE primary intervention concurrent with IPP implementation. CONCLUSION: CE that occurs on 1 day (one time-point) is most popular for preparing coaches as delivery agents of IPPs in youth field sports. While recognising pragmatic barriers, more expansive in-service training, support and feedback may enhance the effective implementation of IPPs. TRIAL REGISTRATION NUMBER: https://doi.org/10.17605/OSF.IO/FMHGD.

Medical imaging-based physiological characterization and performance prediction in athletes

The application of medical imaging in the physiological characterization of athletes covers multiple aspects such as injury diagnosis and monitoring, physiological structure assessment, preventive examination, and body change monitoring, which is of great significance in safeguarding athletes' health and improving their competitive performance. Field hockey is a high-intensity sport with intense confrontation, and the high incidence of knee injuries is a characteristic of athletic injuries in field hockey players. Early detection and treatment of articular cartilage injuries are of great significance to the performance of athletes' level of play and the extension of athletic injurie life. T2 mapping is a widely used cartilage MR imaging technique with high sensitivity to cartilage biochemical changes. In this paper, the T2 mapping technique was used to image the kneecap cartilage of field hockey athletes and healthy youths, to investigate the effect of field hockey on athletic injurie and the physiological characteristics of kneecap cartilage injury and to predict the development of the injury (AU)

A sports-related injury prevention program for Dutch youth volleyball players: Process evaluation alongside a quasi-randomized controlled trial.

OBJECTIVE: This process evaluation aimed to gain insight into the implementation of the VolleyVeilig Youth program by Dutch volleyball clubs within the context of an effectiveness trial. METHODS: We applied the UK Medical Research Council framework for process evaluations and assessed the context, implementation and mechanisms of impact. Trainers participating in the effectiveness trial were asked to complete a questionnaire at the end of the study. A subsample of the trainers based on the self-reported adherence score was invited to participate in an interview accordingly. We used a thematic analysis to present the data. RESULTS: Thirty-one trainers (100%) completed the questionnaire, and seven agreed to participate in an interview. Although adherence gradually decreased over the volleyball season, most trainers reported partially adhere with the program until the end of the study. The main themes included factors associated with the (1) VolleyVeilig Youth program, (2) trainer, (3) players, and (4) volleyball club. CONCLUSION: Although (partial) adherence to the VolleyVeilig Youth program was high in this study, implementation strategies must be developed to target the barriers reported by the trainers before the program can be successfully implemented nationwide in the Netherlands.

If we build it together, will they use it? A mixed-methods study evaluating the implementation of Prep-to-Play PRO: an injury prevention programme for women's elite Australian Football.

OBJECTIVES: We evaluated the implementation of Prep-to-Play PRO, an injury prevention programme for women's elite Australian Football League (AFLW). METHODS: The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of Prep-to-Play PRO were assessed based on the proportion of AFLW players and/or staff who: were aware of the programme (R), believed it may reduce anterior cruciate ligament injury (E), attempted to implement any/all programme components (A), implemented all intended components as practically as possible (I) and intended future programme implementation (M). Quantitative and qualitative data were triangulated to assess 58 RE-AIM items (evidence of yes/no/unsure/no evidence) and the 5 RE-AIM dimensions (fully achieved=evidence of yes on >50% dimension items, partially achieved=50% of items evidence of yes and 50% unsure or 50% mix of unsure and unanswered, or not met=evidence of yes on <50% dimension items). RESULTS: Multiple sources including AFLW training observations (n=7 total), post-implementation surveys (141 players, 25 staff), semistructured interviews (19 players, 13 staff) and internal programme records (9 staff) contributed to the RE-AIM assessment. After the 2019 season, 8 of 10 (80%) AFLW clubs fully met all five RE-AIM dimensions. All 10 clubs participating in the AFLW fully achieved the reach (R) dimension. One club partially achieved the implementation (I) dimension, and one club partially achieved the effectiveness (E) and adoption (A) dimensions. CONCLUSION: The Prep-to-Play PRO injury prevention programme for the AFLW achieved high implementation, possibly due to the programme's deliberately flexible approach coupled with our pragmatic definition of implementation. Engaging key stakeholders at multiple ecological levels (organisation, coaches, athletes) throughout programme development and implementation likely enhanced programme implementation.

Overuse Injuries, Overtraining, and Burnout in Young Athletes.

Sports participation can have tremendous physical and mental health benefits for children. Properly implemented progressive training programs can yield a broad range of beneficial physiologic adaptations, but imbalances of training load and recovery can have important negative consequences. Overuse injuries, for example, can result from repetitive stress without sufficient recovery that leads to accumulated musculoskeletal damage. In addition, extended periods of increased training loads that exceed the intervening recovery can have systemic consequences such as overtraining syndrome, which results in decreased performance, increased injury and illness risk, and derangement of endocrine, neurologic, cardiovascular, and psychological systems. Burnout represents one of the primary reasons for attrition in youth sports. Broadly defined as physical or mental exhaustion and a reduced sense of accomplishment that leads to devaluation of sport, burnout represents a direct threat to the goal of lifelong physical activity and the wide-ranging health benefits that it provides. This clinical report is intended to provide pediatricians with information regarding the risk factors, diagnosis, management, and prevention of these conditions to assist in the identification of at-risk children, the treatment of young athletes, and the guidance of families in the promotion of safe and healthy sport participation.

Perceptions and beliefs on sports injury prediction as an injury risk reduction strategy: An online survey on elite athletics (track and field) athletes, coaches, and health professionals.

OBJECTIVES: To explore perceptions and beliefs of elite athletics (track and field) athletes, coaches, and health professionals, towards the use of injury prediction as an injury risk reduction strategy. DESIGN: Cross-sectional study. METHOD: During the 2022 European Athletics Championships in Munich, registered athletes, coaches, and health professionals were asked to complete an online questionnaire on their perceptions and beliefs of injury prediction use as an injury risk reduction strategy. The perceived level of interest, intent to use, help, potential stress (psychological impact) and dissemination were assessed by a score from 0 to 100. RESULTS: We collected 54 responses from 17 countries. Elite athletics stakeholders expressed a perceived level of interest, intent to use, and help of injury prediction of (mean ± SD) 85 ± 16, 84 ± 16, and 85 ± 15, respectively. The perceived level of potential stress was 41 ± 33 (range from 0 to 100), with an important inter-individual variability in each elite athletics stakeholder's category. CONCLUSIONS: This was the first study investigating the perceptions and beliefs of elite athletics stakeholders regarding the use of injury prediction as an injury risk reduction strategy. Regardless of the stakeholders, there was a high perceived level of interest, intent to use and help reported in this potential strategy.

Reduced Match Exposure in the Previous 2 Matches Accounts for Hamstring Muscle Injury Incidence in Professional Football Players.

BACKGROUND: Hamstring strain injuries are one of the most prevalent injuries in football (soccer). We examined the influence of accumulated match-play exposure on the occurrence of hamstring strain injury in professional football from 2 teams (Spanish 1st Division, LaLiga) over 3 seasons, and determined specific cut-off points as indicators of injury risk. HYPOTHESIS: Overloaded players would be more likely to sustain a hamstring injury. STUDY DESIGN: Prospective, controlled, observational study. LEVEL OF EVIDENCE: Level 2b. METHODS: Playing time, total running distance, and high-speed running (>24 km/h) distance during official matches of players that sustained a hamstring injury were compared with uninjured, paired controls. Cumulative playing time and running performance of 4 matches before the injury was computed. Relative risk (RR) of injury occurrence was estimated by generalized estimating equations. Diagnostic accuracy was determined by receiver operating characteristics and the area under the curve. RESULTS: Thirty-seven hamstring strain injuries occurred, representing 23 ± 18 absence days per injury. Thirty-seven controls (uninjured players) were used as comparators. Low match-play exposures during 1 and 2 matches before injury were likely to explain injury occurrence (RR: 14-53%; P < 0.01). Metrics from the match before the hamstring muscle strain demonstrated the best accuracy to predict injury occurrence: high-speed running distance ≤328 m (sensitivity, 64%; specificity, 84%), playing time ≤64 min (sensitivity, 36%; specificity, 97%), and running distance ≤5.8 km (sensitivity, 39%; specificity, 97%). CONCLUSION: Relatively reduced competitive exposure in the previous 2 matches was associated with higher hamstring injury risk in professional football players. CLINICAL RELEVANCE: Screening simple metrics such as the accumulated match exposure during official matches and considering specific cut-off points for some running variables may be good indicators of injury risk and may assist in better individual injury management in professional soccer players.

A Systematic Review on the Effectiveness of Eyewear in Reducing the Incidence and Severity of Eye Injuries in Racket Sports.

PURPOSE: To assess what eyewear (if any) reduces eye injury incidence and severity in squash, racketball, tennis and badminton. DESIGN: Systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) and the 'implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science' (PERSiST) guidelines. METHODS: PubMed, SportDiscus and Web of Science were searched on 22nd February 2023. All study types except reviews were eligible. Studies had to report the type of eyewear worn (if any) with a form of eye injury incidence and severity. RESULTS: 364 papers were initially retrieved and after the screening process 29 remained. A subgroup analysis was carried out on studies that had a sample size of five or above, were not only looking at a particular type of eye injury and that had sufficient data to allow the percentage of eye injuries that occurred when no eyewear was worn to be calculated. From this analysis, the median percentage of eye injuries that occurred when no eyewear was worn was found to be 93%. Some of these injuries were serious and required complex treatment. Prescription lenses, contact lenses and industrial eyewear made some injuries more severe. In squash and racketball, lensless eye guards were ineffective as the ball could deform on impact, still making contact with the eye. Only eyewear compliant with updated ASTM (or similar) standards was associated with no eye injuries and so provided adequate protection in all four sports. CONCLUSIONS: Although this systematic review only summarizes evidence on injuries requiring hospital treatment, it is recommended that national governing bodies and key decision makers within squash, racketball, tennis and badminton examine the evidence presented and consider extending existing rules or implementing new recommendations and policies on protective eyewear use to reduce eye injury incidence and severity in their sport.

Effectiveness of warm-up and dynamic balance training in preventing anterior cruciate ligament injuries in college gymnasts: a 3-year prospective study for one team.

BACKGROUND: The effect of trunk stability and dynamic balance warm-up exercises on physical functional improvement remains unelucidated. This study examined whether exercises could prevent anterior cruciate ligament (ACL) injury and improve trunk muscle activation and dynamic balance in gymnasts. METHODS: This comparison study, involving gymnastics practice sessions, included 31 university gymnasts and was conducted in two periods: 1 year of observation followed by 2 years of intervention. Participants performed a trunk and dynamic balance warm-up exercise program during the intervention. The effect of exercise on the incidence of ACL injury was evaluated. In addition, the paired t-test was used to compare the Y-balance distance and the changes in muscle thickness associated with trunk muscle activation at rest and during plank. RESULTS: ACL injury risk during the intervention was significantly lower, with a relative risk of 0.23 (P=0.02, 95% CI: 0.06-0.88). Changes in muscle thickness with activation of the transversus abdominis (P<0.01, mean difference 4.1, 95% CI: 9.97-28.07, Cohen's d=0.52), internal oblique (P<0.01, mean difference 5.2, 95% CI: 9.72-21.55, Cohen's d=0.65), and external oblique (P<0.01, mean difference 5.5, 95% CI: 20.44-39.09, Cohen's d=0.71) muscles were significantly higher during the intervention. The Y-balance distance was also significantly greater in the posterior medial reach (P<0.01, mean difference 3.3, 95% CI: 1.56-6.26, Cohen's d=0.46) during the intervention. CONCLUSIONS: Exercise-based warm-up programs may decrease ACL injuries. It can improve physical functions, such as the rate of change in trunk muscle thickness and the posterior medial distance during Y balance.