FOOTBALL

Figure 2: Distribution of injuries sustained at specific periods during the year in 1997-98 and 2003-04 seasons. Values shown are percentage of total injuries sustained in each season.

Figure 3: Nature of all injuries sustained in 1997- 98 and 2003-04 seasons. Values shown are percent- age of total injuries sustained in each season.

training may have been tailored over recent years to be less demanding following the end of season break, thus gradually re- introducing players to the physical demands of training. Also, with the advances in UEFA coaching qualifications and the employment of professionally qualified conditioning coaches, more appropriate conditioning methods are likely to be adopted.

Surprisingly, the number of injuries sustained during March and April 2004 were significantly higher than the corresponding months in 1998 (p<0.05). This may suggest that players are fatiguing, both physically and mentally, towards the end of the season, and possibly suggests that a mid-season break may be beneficial to players, although if such a period is mismanaged there could be an increase in injury incidence. It is also possible that during the latter stages of the season the emphasis on con- ditioning is reduced somewhat, and as suggested by Mohr et al. (11) specific conditioning is required in between games to main- tain and improve physical performance.

Overall incidence The total number of injuries recorded was not different between seasons, however the mean number of days missed due to injury was significantly greater in 2003-04 24.6 +/- 0.8 versus 30.7 +/- 1.0; p<0.001), largely due to a significant increase in the number of major injuries in 2003-04 (Table 1). The nature of major injuries did not differ between seasons suggesting that injuries eg. strains and sprains were more severe rather than a change in the nature of major injuries. However, as injury sever- ity was based on the number of days absent from training/ competition, it may be that injury duration was longer in 2003- 04 rather than a difference in the actual severity of the injury. An increased awareness of injury prevention and management techniques within the clubs may mean players were allowed a longer rehabilitation time to fully recover from the injury in 2003-04 compared with 1997-98, thus increasing the number of days missed, although the actual severity of the injury may not have differed between seasons.

Severity Slight Minor

Moderate Major

1997-98 9.7

22.6 45.4 22.3

2003-04 9.4

21.8 41.8

26.9*

*Significant difference between 1997-98 and 2003-04 seasons; p<0.001

Table 1: Severity of injuries sustained during 1997-98 and 2003-04 seasons expressed as percentage of total injuries per season.

www.sportex.net

Type of injury Strains (36.3% vs. 33.0% of all injuries) and sprains (18.5% vs. 15.6%) were the most frequently observed injury in both 1997-98 and 2003-04, with no significant difference between seasons. The 2003-04 season saw a significant decrease in the number of inflam- matory synovitis, muscular contusions, tendonitis, and overuse injuries (p<0.01) (Fig.3). This decrease in chronic injuries may indicate an enhanced knowledge and implementation of injury prevention and conditioning methods. Conversely, acute injuries frequently require a long recovery time (12); consequently, an investigation into the causes of such injuries may be warranted in an attempt to reduce future occurrences.

The 2003-04 season saw a significant decrease in the number of adductor longus (p<0.05), rectus femoris (p<0.05), gastrocnemius (p<0.05), and anterior talofibular ligament (ATFL) injuries (p<0.001) compared with 1997-98 season (Fig.4). Concurrently, the number of hamstring injuries did not differ between seasons. A number of pre-disposing factors have been highlighted to contribute to hamstring injury, including inappropriate condition- ing methods for example insufficient warm up, poor flexibility, muscle weakness or imbalances (13,14); the high-speed eccentric demands of the game (15) and previous injury (16). Possible preventative measures to reduce the incidence of hamstring injuries are discussed by these research groups (14,15). Improving the endurance (15) and eccentric strength of the hamstring muscle group (17) via appropriate conditioning methods, and ensuring adequate treatment and time for rehabilitation (14,18) are consid- ered key factors in limiting the incidence of hamstring injuries. Future studies may consider investigating the mechanism of hamstring injuries to decrease the future incidence of such injuries. The number of shoulder joint injuries was significantly greater in 2003-04 compared with 1997-98 (p<0.01). Chomiak et al. (19) stated that most of the shoulder injuries reported in their study were caused by foul play. Although the referee’s decision regarding incidents leading to injuries was not recorded in the present study, this may be a focus for future studies. Discrepancies or inadequa-

Figure 4: Medical

classification of injuries sustained in 1997-98 and 2003-04 seasons. Values shown are percent- age of total injuries

sustained in each season.

7