Injury, illness, and medication use surveillance during the 2020 COSAFA Women's championship: a prospective cohort study of football players from Southern Africa.

BACKGROUND: Systematic analyses of injuries, illnesses or medication use and their risk factors among female African athletes are scarce, which has implications for management of these athletes. AIM: This prospective cohort study analysed the incidence and characteristics of injuries, illnesses and medication use during the 2020 COSAFA Women's Championship. METHODS: The medical personnel of all participating teams reported all new injuries, illnesses and medication used by players daily. RESULTS: Sixty-three injuries were reported: 45 match and 18 training injuries; 45.5 (95% CI: 32.2 to 58.8) injuries/1000 match-hours and 21.7 (95% CI: 11.7 to 31.7) injuries/1000 training-hours, respectively. Most (n = 55, 87%) were caused by contact with another player and involved the lower extremity (n = 43; 68%). Fifty-eight illnesses were reported: 44.4 (95% CI: 33.0 to 58.8) illnesses/1000 player-days, mostly diarrhoea (n = 25; 43.1%) and dysmenorrhoea (n = 18; 31%). No cases of COVID-19 were reported. In total, 175 medications were prescribed: 168.8 (95% CI: 143.8 to 193.8) medications/1000 player-days. Non-steroidal anti-inflammatory drugs (NSAIDs) (n = 60; 34.3%) and analgesics (n = 33; 18.9%) were the most commonly prescribed drugs. CONCLUSION: Incidences of injury and illnesses were high but time loss was low, likely due to high NSAIDs use. Further studies should be conducted in order to inform appropriate prevention or management protocols in this population.

Application of an in silico approach identifies a genetic locus within ITGB2, and its interactions with HSPG2 and FGF9, to be associated with anterior cruciate ligament rupture risk.

We developed a Biomedical Knowledge Graph model that is phenotype and biological function-aware through integrating knowledge from multiple domains in a Neo4j, graph database. All known human genes were assessed through the model to identify potential new risk genes for anterior cruciate ligament (ACL) ruptures and Achilles tendinopathy (AT). Genes were prioritised and explored in a case-control study comparing participants with ACL ruptures (ACL-R), including a sub-group with non-contact mechanism injuries (ACL-NON), to uninjured control individuals (CON). After gene filtering, 3376 genes, including 411 genes identified through previous whole exome sequencing, were found to be potentially linked to AT and ACL ruptures. Four variants were prioritised: HSPG2:rs2291826A/G, HSPG2:rs2291827G/A, ITGB2:rs2230528C/T and FGF9:rs2274296C/T. The rs2230528 CC genotype was over-represented in the CON group compared to ACL-R (p < 0.001) and ACL-NON (p < 0.001) and the TT genotype and T allele were over-represented in the ACL-R group and ACL-NON compared to CON (p < 0.001) group. Several significant differences in distributions were noted for the gene-gene interactions: (HSPG2:rs2291826, rs2291827 and ITGB2:rs2230528) and (ITGB2:rs2230528 and FGF9:rs2297429). This study substantiates the efficiency of using a prior knowledge-driven in silico approach to identify candidate genes linked to tendon and ACL injuries. Our biomedical knowledge graph identified and, with further testing, highlighted novel associations of the ITGB2 gene which has not been explored in a genetic case control association study, with ACL rupture risk. We thus recommend a multistep approach including bioinformatics in conjunction with next generation sequencing technology to improve the discovery potential of genomics technologies in musculoskeletal soft tissue injuries.HighlightsA biomedical knowledge graph was modelled for musculoskeletal soft tissue injuries to efficiently identify candidate genes for genetic susceptibility analyses.The biomedical knowledge graph and sequencing data identified potential biologically relevant variants to explore susceptibility to common tendon and ligament injuries. Specifically genetic variants within the ITGB2 and FGF9 genes were associated with ACL risk.Novel allele combinations (HSPG2-ITGB2 and ITGB2-FGF9) showcase the potential effect of ITGB2 in influencing risk of ACL rupture.

The menstrual cycle and football: The experiences of African women football players.

BACKGROUND: The menstrual cycle is a normal biological process in women and girls. However, it is often the reason why they tend to be excluded from football medicine research. Consequently, our understanding of the menstrual cycle and football performance is still limited, especially in African women football players. AIM: The study aimed to explore African women football players' current and historical menstrual cycle status, menstrual symptoms, lived experiences, and perceptions of the menstrual cycle. METHODS: Women football players at the COSAFA Women's Championship 2020 completed demographic questionnaires and the Moos Menstrual Distress Questionnaire. RESULTS: The main findings were that 90% of the players did not use contraceptives, . Most of the players had access to their preferred choice of sanitary product; however, 36% used alternatives such as old rags during their periods, . The most commonly reported symptoms during menses were abdominal cramps (53%), headache (41%), mood swings (41%) and irritability (47%). Further, players reported irritability (48%), mood swings (52%), and breast tenderness (48%) in the week before their period. CONCLUSION: The low use of contraceptives is likely due to community level socio-cultural factors. While the use of old rags as impromptu sanitary products is likely because they cannot always afford their preferred choice. Menstrual symptoms can affect training and competition; therefore, team support personnel should be aware of the menstrual cycle's implications for African women football players and their effect on athletic performance and well-being. Additionally, team support personnel ought to be mindful of African women football players' socio-economic and religio-cultural contexts and their interaction with biological processes such as the menstrual cycle and contraceptive use.