Football, or soccer, is the most widely played sport among both males and females, with approximately 265 million registered players around the world. This number is increasing, particularly among females, with a variety of positive effects on personal health. These obvious physical benefits have driven efforts to link the game with health education, to promote wellness and health, and so prevent ill-health and disease. However, there is a direct correlation between this growth in athletic exposure and injuries, and both the risks and epidemiology of football-related injury have been well documented. In the last decade, attempts have been made to gain a fuller understanding about these injuries and how to prevent them. This article describes recent developments in injury prevention programmes and sheds light on the ongoing international research to refine them and improve their effectiveness among the football community.
BY HOLLY J. SILVERS DIRECTOR OF RESEARCH AND PHYSICAL THERAPIST
INTRODUCTION Football is played by hundreds of millions of males and females around the world and this number is increasing all the time. Females have accounted for most of this rise (1), with a 210% increase in female players in the USA, 250% in Switzerland and 160% in Germany in the last 10 years alone (2). There have been many positive effects on personal health, with lower rates of systemic illnesses, morbid obesity, type II diabetes and heart disease. International efforts have focused on combining participation in football with health education and promotion and prevention of illness and disease. An example is FIFA’s campaign called Football for Health, which is aimed at children in South Africa to raise awareness of preventable, non-communicable diseases (3). On the down side, this increased participation directly correlates with a rise in athletic exposure and injury. Numerous studies have been published about the risks associated with playing football and the epidemiology of injury in competitive play (4–8), and this has been behind attempts over the last decade to improve understanding of football-related injuries and the prevention of such injuries (9–14) on an international scale. This article will first examine
INJURY PREVENTION IN THE SOCCER ATHLETE
these preventive efforts and then look at the active areas of research around the world that seek to increase the effectiveness of these programmes within the football communities at large. The article starts by looking at the epidemiology of football-related injuries.
EPIDEMIOLOGY The factors that contribute to injury risk in football are diverse and include the following: n Human factors n Environmental factors n Biomechanical and neuromuscular factors. Each of these will now be considered in turn.
TABLE 1: VARIETY OF FACTORS INFLUENCING INJURY RATE IN FOOTBALL Environmental factors n Knee braces n Footwear n Playing surface n Field conditions n Weather conditions.
Human factors n Gender n Age n Level of competition n Position on the field n Setting n Location of injury n Time of injury
Biomechanical and neuromuscular factors n Excessive load-bearing n Extreme torsional forces n Inadequate warm-up and muscle training
n Sudden or inappropriate manoeuvres (e.g. landing, cutting and deceleration)
sportEX medicine 2011;47(Jan):14-21