ABSTRACT
BACKGROUND: There are little published data on factors relating to low back pain in the younger athletic population. HYPOTHESIS: Independent predictors of recovery and return to participation in sports could be determined by event analysis, which investigates the impacts of covariates, including age, position, and injury type, on the risk of delayed recovery after injury. STUDY DESIGN: Descriptive epidemiology study. METHODS: This study examined 41 English Premiership soccer academy squads consisting of 12,306 player seasons for the incidence of lower back injury, injury severity, and investigated time to recovery in relation to potential risk factors. Injury risk was assessed for different times in a match and season, mechanism of injury, player position, player age, and competitive compared with noncompetitive play. RESULTS: A total of 310 (3.0% of all injuries sustained in the population) lumbar spine injuries were recorded. Overall, 10,265 training days (median, 14 days; interquartile range, 8-30 days) were lost. The risk of injury increased as the first half progressed and was maintained throughout the second half with a contact mechanism and with increasing age. Neither competitive play compared with noncompetitive play nor player position had an effect on injury incidence. Prognostic factors for poor recovery were bony injuries and increasing age. CONCLUSION: These findings indicate that prolonged absence from training after a back injury is seen, especially in bony injuries and in older adolescents. It is suggested that there should be a low threshold for investigation of adolescent patients with back pain in the hope of early appropriate management of more severe diagnoses.
ABSTRACT
BACKGROUND: Participation in soccer at younger ages with attendant risk of muscle injury is increasing. PURPOSE: To delineate patterns of thigh muscle injury and predictors of recovery in male youth soccer academy players. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 2. METHODS: Forty-one English Premiership soccer academy squads (all male, aged 8-16 years) over a 5-year period comprising 12 306 player seasons were studied prospectively for pattern, mechanism, and outcome after thigh muscle injury. Event analysis was used to identify independent predictors of slow recovery. RESULTS: A total of 1288 injuries were recorded representing an incidence (mean [SD]) of 0.42 (0.24) per thousand hours of training with a mean annual incidence of 0.52. Midfield players received the most injuries, followed by defense and attack positions. The quadriceps muscle group was most likely to be injured. There were 345 reinjuries (27%). Median time off for a primary injury was 13 days (interquartile range, 7-22 days) and 12 days (7-21 days) following a reinjury. Risk of such injury increased as the game progressed toward the end of the first half period (P = .028), and this risk persisted throughout the entire second half. There were 2 peaks of incidence (January and September). The percentage of the total for hamstring, adductor, and quadriceps injuries did not significantly change with player age. However, the proportion of injuries that were severe increased with age of player (t = 3.72, P = .010). Poor prognostic factors for recovery were hamstring injuries (z = 2.182, P = .029), contact injury (z = -3.137, P = .002), and older age (z = -2.2298, P = .022). CONCLUSION: The risk for prolonged recovery from thigh muscle injury was found to increase with age of the player and contact mechanism. The risk of injury increased toward the end of the first half, and this risk persisted throughout the second half. Delayed recovery was significantly associated with a hamstring muscle injury, first injury, and contact mechanism. This study, for the first time, allows identification of youth male soccer players at high-risk for prolonged symptoms after thigh muscle injury.
