Mortality in international professional football (soccer): a descriptive study.

The objective of this study was to describe the characteristics of mortalities from 2007 to 2013 in active (during career) and recently retired (post career) professional footballers. An observational prospective study was conducted. From 2007, the World Footballers' Union (FIFPro) and its related national footballers' unions (more than 70 countries distributed across all continents) collected descriptive data (football-related, cause, etc.) on mortality of active (during career) and recently retired (postcareer before reaching 45 years of age) professional footballers by means of several official sources. A total of 214 deaths were recorded among active and recently retired professional footballers, leading to an overall mortality rate of 0.47 per 1000 footballers per year. Of the 214 deaths, 183 were recorded among active players and 31 among recently retired players. Among the active players, 17% of the fatalities were related to football participation. Disease was the leading cause of death among professional footballers (55%), of which up to 33% accounted for suspected cardiac pathology. Accidents accounted for 25% of the overall deaths, and suicide for 11%. From 2007 to 2013, 214 deaths were recorded among active (during career) and recently retired (post career) professional footballers. Leading cause of death was disease (55%), one third of which were accounted for by suspected cardiac pathology, while accidents accounted for 25% of all deaths, and suicide for 11%. Attention to the predictive validity and application of heart-related precompetition medical assessment should be given, and mental health support should be developed and implemented both during and after a professional football career to prevent potential suicidal behaviors.

Risk and consequences of osteoarthritis after a professional football career: a systematic review of the recent literature.

BACKGROUND: The aim of the present study was to assess whether previous injury is a risk determinant for knee and ankle osteoarthritis (OA) in former professional football players and to explore OA-related activity and work limitations. METHODS: To retrieve the relevant recent literature, the Medline, Embase and Sportdiscus databases were systematically searched for studies published from January 2000 to May 2012. Included studies must be primary studies that are written in English, Dutch, French or German and involve former professional football players; injury had to be studied as an independent variable; and knee/ankle OA, work participation or limited activities had to be described as an outcome. The data from included studies were extracted using a standardised extraction form, and the methodological quality was assessed. RESULTS: No studies were retrieved about injury as a risk determinant for knee/ankle OA in former professional football players. Four studies about OA-related activity and work limitations were included (three of high and one of moderate methodological quality). Up to 17% of former professional football players with knee/ankle OA reported suffering from joint pain and discomfort during activities such as squatting, walking and climbing stairs. Former professional football players with knee/ankle OA reported that their conditions were very painful, chronically painful and affected their daily lives, while 28% reported work-related limitations. CONCLUSION: Knee and ankle OA in former professional football players causes joint pain and discomfort that has negative consequences for daily life and work activities. An OA health examination programs should be developed to empower the sustainable health and functioning of professional football players.

Injuries in male soccer players: team risk analysis.

Selection may be responsible for different characteristics of subgroups (teams) of soccer players resulting in different risks of injury and different injury patterns. In the present study injury rates of teams were analysed with respect to the factors age and level of play. In two Dutch non-professional soccer clubs 477 male players, active in teams of different age groups and at different levels of play, were prospectively followed during the second half of the 1986/1987 competitive season. Teams in the 17/18 years age group showed the highest incidence of injury per 1000 players hours in games. At a high level of play teams have a significantly (p < 0.01) higher risk of injury than teams at a low level of play. This difference is noticed within every age group with exception of the 15/16 years age group. At a high level of play teams of senior players have significantly (p < 0.005) more prevalent injuries than teams of junior players. Senior players, active at a high level of play, have significantly (p < 0.05) more overuse injuries than senior players of a low level of play. At a high level of play significantly (p < 0.05) more upper leg injuries are reported. In the total population of soccer players relatively more sprains are located in the ankle joint and relatively more strains are located on the upper leg. It is concluded that prevention of soccer injuries primarily should be aimed at teams and their environment and not at the individual soccer player.

Soccer injuries. II: Aetiology and prevention.

Current knowledge about the aetiology of the soccer injuries is limited. The presumed complex interaction of various risk factors requires in-depth statistical analysis of techniques to identify dependent and independent variables, and to describe the extent, direction and strength of the relationship between the independent predictor variables and soccer injuries. However, in the majority of the studies, the application of statistical analysis was restricted to descriptive and univariate analysing techniques. Moreover, the results of studies on the aetiology of soccer injuries are biased by selection according to age, gender and level of competition. Identified intrinsic risk factors are joint flexibility including pathological ligamentous laxity and muscle tightness, functional instability, previous injuries and inadequate rehabilitation. Extrinsic risk factors include the exercise load in soccer (competition and practice), inadequate equipment (shinguards, taping, shoes), playing field conditions and foul play. Also, the number of well controlled experimental studies on the prevention of soccer injuries is very limited. In different selected homogenous subgroups of the soccer population in Sweden and Denmark, different types of prevention proved to be successful in reducing the incidence and severity of soccer injuries. Selection bias should be considered in the interpretation of these results. Generally, the epidemiological information of the sport medical aspects of soccer injuries appears to be inconsistent and far from complete. The aetiology of soccer injuries may differ between different subgroups of the soccer population. As a consequence, different subgroups of soccer players may need different prophylactic programmes to achieve a major reduction in incidence and severity of soccer injuries. More research is needed to identify high risk groups and independent predictor variables of injury within those subgroups. The outcome of these studies must lead to the development of effective prophylactic programmes. Preferably, such studies should include uniform definitions of injury and should be based on sound epidemiological methodological principles.

Soccer injuries. I: Incidence and severity.

Studies on the incidence of soccer injuries have produced a variety of sometimes conflicting results. This may be explained by differences in the definition of soccer injury and the methods of data collection being used, and by selection mechanisms in the study populations. The incidence of injuries, therefore, depends on the population being studied. High risk groups exist with respect to age, gender and level of competition. Competition produces a higher risk of injury than practice, even when corrections for exposure time are made. The range of results of studies concerning different aspects of the severity of injuries may also be well explained by differences in the definition of injury, research methodology and selection with respect to age, gender, level of play and sociocultural background. In countries where soccer is very popular, the healthcare and social security systems are taxed considerably. On the other hand, soccer injuries appear to be no more serious than injuries resulting from other sports activities. A general conclusion is that the epidemiological information of the sport medical aspects of soccer injuries is inconsistent and far from complete. More research is needed to identify high risk groups and independent predictor variables of injury within those subgroups. Preferably, such studies should include uniform definitions of injury and should be based on sound epidemiological methodological principles.