Imaging of soccer injuries in adolescent female athletes.

Soccer participation is increasing among female adolescents with a concomitant rise of injuries in this group. Age- and sex-related factors, such as the transition from skeletal immaturity to skeletal maturity as well as anatomic, physiologic, neuromuscular, and behavioral differences between females and males, all play a role in injury patterns for these athletes. Anterior cruciate ligament (ACL) tears in this group have received a great deal of attention in the medical literature and the media in recent years with increasing knowledge about causative factors, surgical management, and injury prevention. There have been fewer studies specifically focused on female adolescent soccer players in relation to other types of injuries, such as patellar dislocation/instability; other knee and ankle ligament tears; hip labral tears; muscle strains and tears; and overuse injuries such as apophysitis, patellofemoral pain syndrome, and bone stress injuries. Because imaging plays a critical role in diagnosis of soccer-related injuries in female adolescents, knowledge of the mechanisms of injury, imaging findings, and clinical considerations are essential for radiologists involved in the care of these patients.

Female athlete triad cross-sectional study of soccer players by level of competition.

[Purpose] To determine the actual status of the Female Athlete Triad (low energy availability, menstrual dysfunction, and bone mineral density loss) in soccer players. [Participants and Methods] The survey was conducted between February 1 and March 1, 2022. It included 115 females between the ages of 12 and 28 registered with the Japan Football Association, from teams at different levels. [Results] Players in the top league did not differ in height and weight but were older and had a better understanding of caloric intake. There were no differences in amenorrhea or history of bone fractures based on league. [Conclusion] Of the female soccer players in the four different levels of competition, only the players in the top league had a better understanding of available energy and took preventive measures against the Female Athlete Triad.

Executive summary: Elite women's football-Performance, recovery, diet, and health.

The present special issue of Scandinavian Journal of Medicine & Science in Sports focuses on performance, recovery, diet, and health in elite women's football. Beside this summary, an editorial, topic reviews, and original articles written by several of the most published authors in football research are presented. It is, for example, highlighted that there is a great gender inequality in football research in favor of men, especially within elite football populations. Therefore, the broad-spectrum content of the special issue with focus on several performance areas in women's football, recovery strategies, nutrition, and psychological factors is highly warranted. Several of the topics examined and data presented are examined for the first on elite women's football, and therefore, we hope that this special issue will contribute to gender balance the research and emphasis on football in both genders.

The influence of angle-specific torque of the knee flexors and extensors on the angle-specific dynamic control ratio in professional female soccer players.

The purpose of this study was to assess whether dynamic torque ratios (DCR) from isokinetic strength assessments of eccentric knee flexors (eccKF) and concentric knee extensors (conKE) display differences when stratified into specific angle-specific DCR (DCRAST) groups. Fifty-two professional female soccer players (age 21.30 ± 4.44 years; height 166.56 ± 5.17 cm; mass 61.55 ± 5.73 kg) from the English Women's Super League completed strength assessments of both lower limbs on an isokinetic dynamometer at 60°âˆ™s-1. Angle-specific torque (AST) were used to calculate DCRAST to create sub-groups using clustering algorithms. The results identified for the dominant side that the Medium DCRAST group elicited significantly higher conKE AST when compared to Low and High DCRAST groups at increased knee extension (P ≤ 0.05). For the non-dominant side, the High DCRAST group had significantly higher and lower eccKF and conKE AST compared to the Low DCRAST group at increased knee extension (P ≤ 0.05). This study highlights that the inclusion of AST data may subsequently help practitioners to prescribe exercise that promotes strength increases at targeted joint angles. In turn, these approaches can be used to help reduce injury risk, identify rehabilitation responses and help inform return to play.

Premenstrual Syndrome, Inflammatory Status, and Mood States in Soccer Players.

OBJECTIVE: To evaluate the relationship between the inflammatory profile and mood states in the different phases of the menstrual cycle in soccer players with and without premenstrual syndrome (PMS). METHODS: Data on the menstrual cycle and mood states were collected using the Daily Symptom Report and the Brunel Mood Scale. Cytokine and stress hormone concentrations were measured in urine by flow cytometry before and after a game in the luteal phase and in the follicular phase of one menstrual cycle. RESULTS: In all, 59.6% of the athletes had PMS. The PMS group showed higher concentrations of interleukin (IL)-1ß, IL-6, and IL-8 than the athletes without PMS. After the game, IL-6 decreased in the follicular phase and the luteal phase. The tumor necrosis factor-α levels were higher in the group without PMS during the post-game follicular phase than before the game. In the PMS group, tension was higher in the follicular phase before the game and depression was higher in the pre-game luteal phase than in the group without PMS. The PMS group also presented a negative correlation between depression and IL-10 levels in the pre-game follicular phase. Finally, in the pre-game luteal phase were found positive correlations between growth hormone and IL-10. CONCLUSION: PMS influences the inflammatory condition related to mood states and stress hormones in female soccer players.

A concept mapping approach to identifying the barriers to implementing an evidence-based sports injury prevention programme.

BACKGROUND AND AIM: Understanding the barriers to programme use is important to facilitate implementation of injury prevention programmes in real-word settings. This study investigated the barriers to coaches of adolescent female soccer teams, in Victoria, Australia, implementing the evidence-based FIFA 11+ injury prevention programme. METHODS: Concept mapping with data collected from 19 soccer coaches and administrators. RESULTS: Brainstorming generated 65 statements as barriers to 11+ implementation. After the statements were synthesised and edited, participants sorted 59 statements into groups (mean, 6.2 groups; range, 3-10 groups). Multidimensional scaling and hierarchical cluster analysis identified a six-cluster solution: Lack of 11+ knowledge among coaches (15 statements), Lack of player enjoyment and engagement (14), Lack of link to football-related goals (11), Lack of facilities and resources (8), Lack of leadership (6) and Lack of time at training (5). Statements in the 'Lack of 11+ knowledge among coaches' cluster received the highest mean importance (3.67 out of 5) and feasibility for the Football Federation to address (3.20) rating. Statements in the 'Lack of facilities and resources' cluster received the lowest mean importance rating (2.23), while statements in the 'Lack of time at training' cluster received the lowest mean feasibility rating (2.19). CONCLUSIONS: A multistrategy, ecological approach to implementing the 11+-with specific attention paid to improving coach knowledge about the 11+ and how to implement it, linking the 11+ to the primary goal of soccer training, and organisational leadership-is required to improve the uptake of the 11+ among the targeted coaches.

The application of the Yo-Yo intermittent endurance level 2 test to elite female soccer populations.

The aim of this study was to evaluate the application of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2) to elite female soccer populations. Elite senior (n = 92), youth (n = 42), domestic (n = 46) and sub-elite female soccer players (n = 19) carried out the Yo-Yo IE2 test on numerous occasions across the season. Test-retest coefficient of variation (CV) in Yo-Yo IE2 test performance in domestic female players was 4.5%. Elite senior female players' Yo-Yo IE2 test performances were better (P < 0.01) than elite youth, domestic and sub-elite players (mean ± standard deviation; 1774 ± 532 vs 1490 ± 447, 1261 ± 449, and 994 ± 373 m). For elite senior female players, wide midfielders (2057 ± 550 m) had a higher Yo-Yo IE2 test performance (P < 0.05) than central defenders (1588 ± 534 m) and attackers (1516 ± 401 m), but not central midfielders (1764 ± 473 m) or full-backs (1964 ± 522 m). Large correlations were observed between Yo-Yo IE2 test performance and the total and high-intensity distance covered (r = 0.55; P < 0.05) during elite senior soccer matches (r = 0.70; P < 0.01). A large correlation was also obtained between Yo-Yo IE2 test performance and (r = 0.68; P < 0.01). Performances in the Yo-Yo IE2 test were greater (P < 0.05) in the middle and the end of the season compared with the preparation period for elite youth female players (1767 ± 539 and 1742 ± 503 vs 1564 ± 504 m) and in elite senior female players, Yo-Yo IE2 test performance increased by 14% (P < 0.01) after completing 4 weeks of intense training prior to the FIFA Women's World Cup Finals (2049 ± 283 vs 1803 ± 342 m). The data demonstrate that the Yo-Yo IE2 test is reproducible and is an indicator of the match-specific physical capacity of female soccer players. Furthermore, the Yo-Yo IE2 test illustrates sensitivity by differentiating intermittent exercise performance of female players in various competitive levels, stages of the season and playing positions.

The role of offensive processes and age development for female soccer players' anticipation.

Anticipation has been confirmed as a more valid measure for recognizing talented athletes than pattern recall alone. Anticipation of offensive processes in soccer, such as counter attacks and positional attacks, is essential for the sport. Additionally, the anticipation of elements such as the soccer ball, offensive and defensive players may also be affected by varied offensive processes. In this study, we combined anticipation with the pattern recall paradigm to measure the perceptual-cognitive skills of female soccer players across different age groups and offensive processes. Adult (U23) and adolescent (U15) female soccer players were recruited to complete the pattern anticipation task using coach-rated video segments. Our results show that adult female soccer players demonstrated greater accuracy in anticipating locations during positional attacks compared to adolescents, but no significant difference was observed during counter attacks. Furthermore, location anticipation accuracy is higher in all groups towards elements of the soccer ball and offensive players, but not defensive players, during counter attacks compared to positional attacks. These findings suggest that positional attack is the main advantage in perceptual-cognitive skills for adult female soccer players. Additionally, offensive processes and elements should be carefully considered when measuring perceptual-cognitive skills.

The Evolution of Physical Performance throughout an Entire Season in Female Football Players.

Research on the evolution of performance throughout a season in team sports is scarce and mainly focused on men's teams. Our aim in this study was to examine the seasonal variations in relevant indices of physical performance in female football players. Twenty-seven female football players were assessed at week 2 of the season (preseason, PS), week 7 (end of preseason, EP), week 24 (half-season, HS), and week 38 (end of season, ES). Similar to the most common used conditioning tests in football, testing sessions consisted of (1) vertical countermovement jump (CMJ); (2) 20 m running sprint (T20); (3) 25 m side-step cutting maneuver test (V-CUT); and (4) progressive loading test in the full-squat exercise (V1-LOAD). Participants followed their normal football training procedure, which consisted of three weekly training sessions and an official match, without any type of intervention. No significant time effects were observed for CMJ height (p = 0.29) and T20 (p = 0.11) throughout the season. However, significant time effects were found for V-CUT (p = 0.004) and V1-LOAD (p = 0.001). V-CUT performance significantly improved from HS to ES (p = 0.001). Significant increases were observed for V1-LOAD throughout the season: PS-HS (p = 0.009); PS-ES (p < 0.001); EP-ES (p < 0.001); and HS-ES (p = 0.009). These findings suggest that, over the course of the season, female football players experience an enhancement in muscle strength and change of direction ability. However, no discernible improvements were noted in sprinting and jumping capabilities during the same period.

Locomotor and technical characteristics of female soccer players training: exploration of differences between competition standards.

OBJECTIVES: To (i) quantify the differences in locomotor and technical characteristics between different drill categories in female soccer and (ii) explore the training drill distributions between different standards of competition. METHODS: Technical (ball touches, ball releases, high-speed ball releases) and locomotor data (total distance, high-speed running distance [>5.29 m∙s-1]) were collected using foot-mounted inertial measurement units from 458 female soccer players from three Women's Super League (WSL; n = 76 players), eight Women's Championship (WC; n = 217) and eight WSL Academy (WSLA; n = 165) teams over a 28-week period. Data were analysed using general linear mixed effects. RESULTS: Across all standards, the largest proportion of time was spent in technical (TEC) (WSL = 38%, WC = 28%, WSLA = 29%) and small-sided extensive games (SSGe) (WSL = 20%, WC = 31%, WSLA = 30%) drills. WSL completed more TEC and tactical (TAC) training whilst WC and WSLA players completed more SSGe and possession (POS) drills. Technical drills elicited the highest number of touches, releases and the highest total distance and high-speed activity. Position-specific drills elicited the lowest number of touches and releases and the lowest total distance. When the technical and locomotor demand of each drill were made relative to time, there were limited differences between drills, suggesting drill duration was the main moderating factor. CONCLUSION: Findings provide novel understanding of the technical and locomotor demands of different drill categories in female soccer. These results can be used by coaches and practitioners to inform training session design.

Daytime sleepiness in Chinese professional, semi professional and students soccer players in the Shanghai lockdown.

PURPOSE: April-May 2021 Shanghai city was under strict lockdown. Soccer players suffered from the restrictions, being unable to train and have a social life. The aim of this study was to compare differences in daytime sleepiness between genders and qualification levels in a cohort university Chinese soccer player under 0 Covid policy restrictions in the urban area of Shanghai. METHODS: 491 questionnaires of Epworth Sleepiness Scales (ESS) were compiled online by male and female Soccer Students (SS), Semi-Professional players (SP) and Professional Players (PP) during the ongoing restriction measures post Shanghai lockdown. ANOVA was performed for players levels and gender. RESULTS: Significant differences were found between the 3 levels and between males and females. PP showed a very low score in the ESS (5,97) well below the threshold of 8 for daytime sleepiness, while SS and SP showed an ESS score above the threshold. Female showed higher scores in comparison to males. Differences between males and females reflect the confinement conditions in the ESS items, showing more difference in the item of ESS which are related with indoor situations. CONCLUSIONS: This study shows the first data on sleepiness in Chinese soccer players of different level of qualification immediately post lockdown condition. Professional male's players sleepiness was lower, than females, SS and SP after the exceptional lockdown measures. The reasons can reside in the more ordered lifestyle of PP in comparison to SS and SP, which mitigated the effects of the lockdown. Our results suggest that measures to improve sleep in females' soccer player should be adopted if these exceptional conditions will happen again.

Rapid force generation during unilateral isometric hamstring assessment: reliability and relationship to maximal force.

Limited research has reported the reliability of rapid force generation characteristics during isometric assessments of the hamstrings. Therefore, the purpose of the present study was to determine the between-session reliability of rapid force generating characteristics of the hamstrings and relationship to maximal force production. Twenty-three female soccer players (age: 20.7 ± 4.7 years; height: 168.7 ± 5.9 cm; body mass: 64.4 ± 6.7 kg) performed three unilateral trials of the 90-90 isometric hamstring assessment, on two separate occasions, separated by 7 days. Peak force, force at 100- and 200 ms and average rate of force development (aRFD) over 100- and 200 ms epochs were calculated. Absolute and fair-good reliability was observed for peak force and all rapid force generating measures (<8.33CV%, ICC >0.610). Significant and meaningful relationships (p < 0.001, r > 0.802) were observed for all rapid force generating measures and peak force. The 90-90 isometric assessment can be used to assess peak and rapid force generating reliably to enable practitioners to confidently track changes in performance over time as part of fatigue monitoring and management.

Assessment of Peak Physical Demands in Elite Women Soccer Players: Can Contextual Variables Play a Role?

Aim: To describe and compare the peak physical demands through the worst-case scenario method (WCS), according to different rolling average (RA) time epochs (i.e. 1 min, 3 min, and 5 min) and contextual variables in women soccer players. Methods: Using an observational-comparative study design, an elite women soccer team from the Spanish 1st league division was monitored during 27 matches. Nine WCS-dependent variables were assessed, including total distance (TD), high-speed running distance (HSR), sprint distance (SP), acceleration, and deceleration distance at different intensities by players position (i.e., central defenders [CD], wide defenders [WD], central midfielders [CM], wide midfielders [WM], forwards [F]), match half, location, and match outcome. Results: The 1-min RA showed the lowest variability (CV = 9.8-65.8%) for all nine dependent variables. The WD presented the highest TD (168 ± 15.71 m/min). Differences between positions were observed for: CM

The profiles of single leg countermovement jump kinetics and sprinting in female soccer athletes.

The purposes were to evaluate kinetics in lower limbs using single leg countermovement jump (SLCMJ) and to identify the differences in SLCMJ kinetics between sprinting fast players and sprinting slow players in elite university female soccer players. Seventeen participants at the national tournament level completed the survey. SLCMJ and 30 m sprinting tests were performed. A force-plate was used to collect the data of the SLCMJ test. Significant differences of concentric maximum rate of force development (RFD), concentric RFD, concentric RFD/body weight (BW), peak net takeoff force/BW, peak power, and peak power/BW existed between both legs during the SLCMJ among all the participants. For further analysis, the participants were divided into fast group and slow group based on sprinting performance. Significant differences existed between the two groups in concentric peak velocity (nondominant, p = 0.028) and vertical velocity at takeoff (nondominant, p = 0.021). Concentric maximum RFD (p = 0.036) was significantly different between both legs in the slow group. Among elite university female soccer players, the players who presented more increased asymmetry of kinetic characteristics of jumping, also showed weak sprinting performance. Moreover, the players presented the best performance in velocity of the jumping variables and also had the best sprinting performance. Coaches and players should focus on keeping inter-limb balance and developing jumping velocity to improve sports performance. In future, the cause-and-effect relationship between jumping and sprinting should be identified.

Assessment of stress response and its interrelationship with external load in female soccer players.

INTRODUCTION AND OBJECTIVE: The study aimed to evaluate the physiological stress response, i.e. internal load to intermittent and continuous exercise performed during the treadmill running in professional female soccer players, and additionally to determine the most appropriate method for assessing load in the athletes. MATERIAL AND METHODS: Six professional female athletes (age 25.3±1.8 years, height 168.4±2.7 cm, weight 64.8±5.8 kg, maximal oxygen consumption (V˙ O2max) 64±4.1 mlÛ°kg-1Û°min-1, and heart rate (HRmax) 195±1.8 b.p.m.) performed a series of preseason treadmill tests. HR and V˙ O2max were measured in the athletes during intermittent load (increase and decrease of running time and treadmill speed) and an incremental load (gradual increases running time, treadmill speed and a treadmill incline angle). Banister's, Edwards', Stagno's and Lucia's training impulse (TRIMP) quantification methods were used to assess internal load. The relationships between V˙ O2max and above-mentioned TRIMPs load indicators were calculated using Pearson's correlation coefficient. RESULTS: Large, very large and near perfect correlations between TRIMP and V˙ O2max were observed during intermittent and incremental load (range r = 0.712 - 0.852 and r =563 - 930; p < 0.05, respectively). Correlations between other TRIMPs and V˙ O2max demonstrated moderate, small and negative small relationships. CONCLUSIONS: Changes in HR and oxygen consumption registered during intermittent or gradually increasing load conditions could be evaluated using the TRIMP method for both types of activities, and this method could potentially be useful for the testing of high-intensity intermittent physical fitness of players before the soccer season.

Two-dimensional and three-dimensional multiple object tracking learning performance in adolescent female soccer players: The role of flow experience reflected by heart rate variability.

Three-dimensional multiple object tracking (3D-MOT) has been used in various fields to mimic real-life tracking, especially in perceptual-cognitive skills training for soccer. Yet, the learning efficiency in 3D-MOT tasks has not been compared with 2D-MOT. Further, whether the advantage can be reflected by heart rate variability (HRV) based on the neurovisceral integration model should also be examined. Therefore, we used both 2D- and 3D-MOT in a brief adaptive task procedure for adolescent female soccer players with HRV measurement. A faster tracking speed threshold of participants was found in the 3D- compared to 2D-MOT, as well as average tracking speed in the last training period of 3D-MOT. Moreover, lower low frequency (LF) components of HRV in the 3D-MOT indicated a flow experience, demonstrating the provision of more attentional resources. Therefore, we observed that adolescent female soccer players demonstrated higher learning efficiency in 3D-MOT tasks in virtual reality (VR) through a higher flow experience. This study examined the learning efficiency between the two MOT tasks in the soccer domain using evidence from HRV and highlighted the utility and applicability of 3D-MOT application.

Normalising the conversation: a qualitative analysis of player and stakeholder perceptions of menstrual health support within elite female soccer.

PURPOSE: This qualitative study explores player and stakeholder perceptions of menstrual health support in elite female soccer. METHODS: Semi-structured interviews were conducted with 47 participants including players (n = 12), parents (n = 9), coaches (n = 9), sport scientists (n = 7), nutritionists (n = 5) and medical staff (n = 5). RESULTS: Via thematic analysis, data demonstrate that elite female soccer players experience a range of physical and psychological symptoms primarily at the onset of and during menses (as also perceived by stakeholders), with most participants perceiving these symptoms to impact performance. Nonetheless, menstrual health support is perceived as minimal and although players have their menstrual status tracked, they report little understanding as to why or how this information is used. This confusion was also present among stakeholders, often as a result of uncertainty about the evidence supporting the need for menstrual health support. The perceived lack of support may also be reflective of a culture where conversations about the menstrual cycle are not normalised. Overall, this may result in failure to identify and treat menstrual irregularities despite non-coaching staff members perceiving them to be common amongst players. CONCLUSION: These data support the need for individualised support based on the lived experiences of individual players and support staff. Furthermore, our research identifies the need for organisational, stakeholder, and player centred education programmes (led by experts in female athlete health) that create an environment where players receive personalised menstrual health support.

Evaluation of Neuromuscular Fatigue in a Repeat Sprint Ability, Countermovement Jump and Hamstring Test in Elite Female Soccer Players.

The straight-line run is the most frequent action in soccer goal scoring situations, and it deserves considerable attention. The objective of this study was to evaluate the neuromuscular fatigue produced by an independent repeat sprint ability (RSA) test, a countermovement jump (CMJ) and a hamstring test (HT) in elite female soccer players. Twenty-four elite female soccer players participated in the study. The evaluation protocol included hamstring and CMJ tests before an RSA test (6 × 40 m 30 s rest), and hamstring and CMJ post-tests. Significant differences were found between pre-post HT measurements in the maximum angulation of the right leg (p = 0.012 Effect Size (ES) = 0.27), and the maximum velocity was higher in the left leg after RSA (p = 0.023 ES = 0.34). CMJ height after RSA was significantly lower than before the RSA test (p < 0.001 ES = 0.40). The sprint total time (SprintTT) and percentage difference (%Dif) increased throughout the RSA (p < 0.001, and ES = 0.648 and ES = 0.515, respectively). In elite female soccer players, it seems that the fatigue induced by an RSA test can be assessed through the loss of CMJ height and the different performance variables extracted from the RSA itself (e.g., SprintTT, Ideal Sprint). These findings could contribute to better performance management and injury prevention for elite female soccer players.

Knee Isokinetic Profiles and Reference Values of Professional Female Soccer Players.

Few studies have previously evaluated isokinetic parameters in female soccer players in comparison to those in males. The aim of this study was to describe normative quadriceps (Q) and hamstring (H) muscle strength values in professional female soccer players and to examine differences between dominant leg (DL) and nondominant leg (NDL). A standardized test protocol of concentric knee extension and flexion test protocol was conducted using the dynamometer isokinetic system (IsoMEd 2000). All the participants were healthy female professional soccer players from Spanish first and second division teams. Players were assessed for peak torque (PT) and maximum work (MW) values at 60°/s, 180°/s, and 240°/s. The mean difference was 7.17 (p-value = 0.0036), 4.4 (p-value = 0.0386), and 4.25 Nm (p-value = 0.0241) at speed 60°, 180°, and 240°/s, respectively. No statistically significant differences were detected for H-Q values between DL and NDL. This difference was 6.44 (p-value = 0.0449), and 5.87 J (p-value = 0.0266) at speed 60°, and 180°/s. The present study can be a tool that health professionals working with female professional soccer players in their care can use to assess and monitor a particular player.

Match activity profile of professional female soccer players during a season.

It is necessary to understand movement characteristics of elite female soccer players during a match to develop effective training program. The purpose of this study is to analyze the physical demands of Korean female professional soccer players during a competitive season. Twenty-four female professional players (age: 27.8±3.9 years; height: 165.7± 5.1 cm) from a team, belonging to the women's professional soccer league in South Korea participated in the study. The players participated in 11 home matches and 10 away matches from April 26 to November 9 of the 2011 season. Body weight and body mass index decreased during the first half-season compared to the preseason (P<0.05), and the decreased values were maintained until the second half-season. Total distance covered by the players was more than 9.5 km per match. No difference was found in the total distance, movement distance by exercise intensities, number of sprints and accelerations, and maximum speed between the first half- and second half-seasons. Midfielders covered the most distance during a match compared to other positions (P<0.05). Wing forward covered the most distance of high-intensity exercise. Maximum speed during the match was higher among wing forward and forward than in other positions (P<0.05). There were no significant differences between home and away matches in all variables (P>0.05). In conclusion, in order to improve the performance of female soccer players and prevent injuries, a training program should be constructed that considers the characteristics of each player and playing position rather than uniform training in a team.