Apophyseal injuries in soccer players.

Soccer is the most popular sport worldwide, and it is associated with high injury rates, with most of these injuries occurring in the lower extremities. Particularly, in youth soccer players with immature skeleton, the physeal plate is two to five times weaker than the surrounding fibrous structures, and therefore more vulnerable to injury. The physeal plate consists of epiphyses and apophyses, with the former serving as tendon attachment sites and being subject to traction forces. There are two types of apophyseal injury: (i) apophyseal avulsion, which consists of an acute separation across the physeal plate; and (ii) apophysitis, an injury caused by chronic and repetitive contraction of musculotendon unit, leading to inflammation of the growth plate cartilage. Apophyses of the hip and pelvis are the most commonly injured in youth soccer players, due to vigorous contractions during sports activities and the fact that they tend to fuse later compared to other epiphyseal centers, making them more susceptible to injury. In this review, we will discuss the anatomy of lower limb apophyses and clinical and imaging findings of apophyseal injuries in youth soccer players, as well as briefly review treatment options and complications.

Ultrasound imaging in professional soccer: when is it adequate?

Ultrasound imaging plays an important role in the diagnosis, monitoring and treatment of injuries in professional soccer players. With the rapid increase in the availability of hand-held portable ultrasound devices and the pressure to make timely and accurate diagnosis in professional soccer where return to play time is crucial, ultrasound imaging is an essential diagnostic tool. In this article, we discuss examples of injuries that can be adequately assessed by ultrasound imaging alone and injuries where ultrasound imaging provides a useful first step to guide further investigation and management.

Application of a Custom Device to Measure Isometric Knee Strength: Possible Injury Correlation in Professional Soccer (Football) Players.

Injury in sports is an occurrence that prevents athletes from participating in training and competitions and has an incidence of 8.1 injuries/1000 h of practice. This translates into a cost and also into danger, especially if the event is repeated, for the health of the athlete; the injury certainly has a multifactorial causality. On the other hand, having instruments that can represent an alarm could be helpful for those involved in sports science. We used a specifically designed instrument, presented in a previous work, which shows excellent reliability and repeatability in measuring the strength of the knee flexors and extensors to test 107 players belonging to three different teams playing in the Italian Serie A. We took three measurements, beginning of the season, mid-season, and close to the end of the season. This retrospective study on 107 professional soccer players demonstrates that isometric force-related parameters of the knee extensors and flexors are associated with the risk of injury to lower limbs. Logistic regression evidenced a significant correlation between the parameter indicating the imbalance of the force between the flexors of the two limbs (p≤0.05, OR = 1.089) and the occurrence of injuries. Survival analyses (p≤0.001) evidenced a correlation between the population survival time and the injury incidence. We demonstrated that the analysis of the strength imbalance is correlated with injury occurrence, but it is well known that sports injuries are a multifactorial event; so, they cannot be predicted by only one parameter. However, the method proposed in this paper could represent a useful tool for sport scientists.

Republication of "High-Speed Video Analysis of Syndesmosis Injuries in Soccer-Can It Predict Injury Mechanism and Return to Play? A Pilot Study".

Background: Ankle syndesmosis injuries in professional soccer may lead to an unpredictable and prolonged recovery. This injury has been investigated in anatomical and radiologic studies but the precise mechanism leading to syndesmosis injury is not well understood and remains debated. The 2 goals of this study were to (1) evaluate the relationship between the mechanism of syndesmosis injury as determined by high-speed video analysis and the injured structures identified by clinical and radiologic examination and to (2) investigate the relationship between mechanism of injury and time of return to play. Methods: This pilot study prospectively reviewed high-speed video analysis of 12 professional soccer players who sustained syndesmosis injuries. The mechanism of injury was compared with the clinical and MRI evaluation and the time taken to return to play. Results: Higher-grade syndesmosis injuries occurred during ankle external rotation with dorsiflexion. Supination-inversion injuries with a standard lateral ankle sprain (rupture of the anterior talofibular ligament) may extend proximally, causing a lower-grade syndesmosis injury. These may present with signs of a high ankle sprain but have a quicker return to sport than those following a dorsiflexion-external rotation injury (mean 26 days vs 91 days). Conclusions: Video analysis confirmed that at least 2 mechanisms may result in injury to the ankle syndesmosis. Those "simple" ankle sprains with signs of syndesmosis injury had a quicker return to play. This new finding may be used by club medical teams during their initial assessment and help predict the expected time away from soccer in players with suspected high ankle sprains. Level of Evidence: Level IV, retrospective cohort study.

An intervention plan for preventing and handling amateur soccer players' injuries.

Background: The majority of amateur soccer players are vulnerable to soccer-related injuries and many such injuries are avoidable with an adequate education. Aim: The present study aimed to measure the impact of an intervention educational plan on improving amateur soccer players' knowledge and skills in preventing and handling soccer-related injuries. Subjects and Methods: The study design is a group-clustered randomized intervention-control trial, and it was carried out in Taif city, Saudi Arabia. The "Neighborhood League of Football" players were randomly allocated to a soccer injury prevention education group (intervention group) and a control group. A predesigned and validated questionnaire was used to study the changes in knowledge and skills about soccer injuries before the intervention (response a) and after (response b). Results: The study included 246 participants in the intervention group and 256 in the control group (n = 502). The median age was 22 years. The comparison of both groups' participants' performance showed significant differences in response b analyses and participants in the intervention group achieved significantly higher scores than the control group in total score levels (P < .0001), injury mechanisms (P < .0001), injury treatment and prevention (P < .0001), and health status (P < .034). The intervention group's scores on response b (after the educational sessions) were significantly higher than response a (before the educational sessions, P < 0.001). Conclusions: In multiple scales and overall score levels, intervention group participants achieved significantly higher scores than their control group counterparts. Educational assistance appears to have had a good impact on their knowledge and skills.

Hip apophyseal injuries in soccer players: can MRI findings be useful to define when to return to play?

OBJECTIVE: To describe magnetic resonance imaging (MRI) findings in professional soccer players with acute apophyseal injury of the hip and to assess their relationship with return to sports. MATERIAL AND METHODS: Adolescent soccer players with diagnosis of apophyseal injury in the anterosuperior and anteroinferior iliac spine were retrospectively evaluated between 2008 and 2016. All athletes underwent hip MRI examination within 4 days after onset of clinical complaint. Images were independently analyzed by two radiologists. Medical records were reviewed to obtain clinical data. RESULTS: Mean displacement of the apophysis was 4.8 ± 4.6 mm. Bone edema was present in 82% of athletes and muscular edema in 41%. The mean time to return to sports was 37.3 ± 14.7 days. The difference between the measurements of the two radiologists was close to zero with agreement limits below 1.0 mm (p < 0.001). There was a significant correlation between displacement of the apophysis and return to sports, as well as between both and the presence of muscular edema. A displacement of the apophysis of 3.0 mm might serve as a parameter to predict return to sports/activity before 40 days, with a sensitivity of 92% and specificity of 96%, considering conservative physiotherapy treatment. CONCLUSION: Displacement of the apophysis and presence of muscular edema evaluated by MRI showed a significant correlation with return to sports in athletes with acute apophyseal injuries of the anterosuperior and anteroinferior iliac spines.

Systematic review of screening tools for common soccer injuries and their risk factors.

BACKGROUND: Several screening tools are available for use in a clinical setting to predict injury. However, there is a lack of evidence regarding the accuracy of these tools to predict soccer-specific injuries. OBJECTIVES: The purpose of this systematic literature review was to determine the psychometric properties or accuracy of screening tools for common soccer injuries. METHODS: A systematic review of diagnostic test accuracy was undertaken based on the Joanna Briggs Institute (JBI) procedure for conducting systematic reviews. Databases such as SPORT Discus, Cinahl, Medline, Science Direct, PubMed and grey literature were searched in order to access suitable studies. RESULTS: A total of 10 studies were included for the analysis - three were analysed quantitatively whilst the remaining seven were analysed qualitatively. The screening tools were of high reliability, sensitivity and specificity (calculated as intraclass correlation coefficient [ICC] (0.68 95% confidence interval [CI]: 0.52-0.84 and 0.64 95% CI: 0.61-0.66, respectively). CONCLUSION: The screening tools assessed for the prediction of common soccer injuries that emerged from this systematic review include the Functional Movement Screening (FMS™), the Landing Error Scoring System (LESS), the Tuck Jump Assessment, the Soccer Injury Movement Screening (SIMS) and the conventional hamstrings to quadriceps ratio; all with good evidence of predicting common soccer injuries. These tools were of high sensitivity and specificity thus reliable for soccer screening. CLINICAL IMPLICATIONS: The validity of these tools is acceptable and therefore the authors recommend that these tools be included in an injury prevention programme for soccer players.

Injuries in Portuguese Amateur Youth Football Players: A Six Month Prospective Descriptive Study.

INTRODUCTION: This study analyzed the incidence and characteristics of injuries sustained by amateur youth football players in Portugal during season 2015 - 2016. MATERIAL AND METHODS: This is an observational descriptive study. We analyzed Portuguese youth football players' injuries over six months of a season. A total of 529 players were divided according to their age in two groups (Under-17 and Under-19). Data on injuries were collected. RESULTS: Throughout all 62 062.0 hours of exposure recorded, 248 injuries were reported in 173 different players. The average incidence of injury was 3.87 (95% CI = 2.81; 4.94) per 1000 hours of football exposure. There was a significantly higher average incidence of injury during matches - 14.22 (95% CI = 10.35; 18.09) per 1000 hours of exposure - when compared to the average incidence of injury during training - 2.06 (95% CI = 1.22; 2.90) per 1000 hours of exposure. This significance was also observed when the comparison was made within each age group. A traumatic mechanism was involved in 76.6% of all the injuries, while overuse was reported in 12.9%. The most common type was the injury that affected muscles and tendons (52.8%). The body location most commonly affected by injuries was the thigh (24.6%). DISCUSSION: Even though is essential a better characterization of Portuguese athletes of younger age groups such as those discussed in this study, the results of the studied population are in agreement with the existing literature. However, this study provides more information that may be important to better target the Portuguese athletes' training for injury prevention. CONCLUSION: This study provides descriptive data on injuries developed in a subpopulation of Portuguese amateur youth football players that could represent a focus for future prevention.

Introdução: Este estudo foi projetado com o intuito de analisar a incidência e as características das lesões desenvolvidas pelos jovens jogadores portugueses de futebol amador durante a época de 2015 - 2016. Material e Métodos: Trata-se de um estudo observacional descritivo. Foram analisadas as lesões de jovens atletas durante seis meses de uma época. Um total de 529 jogadores foi dividido em dois grupos, atendendo à sua idade (Sub-17 e Sub-19). Os dados foram colectados semanalmente pelo responsável por cada equipa. Resultados: Ao longo de 62 062,0 horas de exposição registadas, foram reportadas 248 lesões em 173 jogadores. A incidência de lesão média foi de 3,87 (95% CI = 2,81; 4,94) por 1000 horas de exposição a futebol. A incidência de lesão média durante os jogos ­ 14,22 (95% CI = 10,35; 18,09) por 1000 horas de exposição ­ foi significativamente superior à incidência de lesão média durante os treinos ­ 2,06 (95% CI = 1,22; 2,90) por 1000 horas de exposição. Esta significância foi também observada quando feita a comparação dentro de cada grupo etário (Sub-17 e Sub-19). O mecanismo traumático esteve envolvido em 76,6% das lesões, enquanto que o mecanismo de sobre-utilização foi causa de 12,9% das lesões. As lesões mais frequentemente observadas foram as que envolveram músculos e tendões (52,8%). A coxa foi a localização mais comum das lesões (24,6%). Discussão: Apesar de ser essencial uma melhor caracterização dos atletas Portugueses de grupos etários mais novos como os abordados neste estudo, os resultados da população estudada vão de encontro ao que existe na literatura mundial. No entanto, este estudo é mais uma fonte de informação que poderá ser importante para melhor direcionar o treino dos atletas portugueses para a prevenção de lesões. Conclusão: Este estudo fornece informação descritiva das lesões ocorridas numa sub-população de jovens jogadores portugueses de futebol amador, podendo representar um foco para futura prevenção.

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma / Lesões do ligamento cruzado anterior e do menisco no esporte: incidência, tempo de prática até a lesão e limitações causadas pelo trauma

ABSTRACT OBJECTIVE: To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities. METHODS: This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation. The patients were divided into three groups: (1) isolated rupture of the ACL; (2) ACL injury associated with meniscal injury; (3) isolated menisci injury. RESULTS: The majority of the patients belonged to group 1 (44.58%), followed by group 2 (30.2%) and 3 (25%). Most patients were soccer players. The mean time from sport practice to injury in group 1 was 17.81 years. In group 2, it was 17.3 years, and in group 3, 26.91 years. Soccer athletes presented ACL injury in 0.523/1000 h of practice and meniscal injury in 0.448/1000 h of practice. Before the injury, the mean Tegner score obtained for groups 1, 2, and 3 were 7.18, 7.34, and 6.53, respectively. After knee injury, those values were 3.07, 3.18, and 2.87, respectively. CONCLUSION: Soccer was the sport that caused the majority of lesions, regardless the group. Furthermore, patients from groups 1 and 2 had less time of practice prior to the injury (17.81 and 17.3 years) than the patients of group 3 (26.91 years). Women presented a higher risk to develop ACL and meniscal injuries in 1000 h of game/practice. Running, volleyball, and weightlifting are in ascending order of risk for ACL and/or meniscal injury. Regarding the return to sport practice, the efficiency of all athletes was impaired because of the injury.

RESUMO OBJETIVO: Avaliar a incidência da lesão do LCA e dos meniscos numa população de atletas amadores e profissionais no Brasil e a relação destas lesões com o esporte praticado. MÉTODOS: Estudo prospectivo observacional de 240 pacientes com lesão meniscoligamentar do joelho desencadeada por diversas atividades esportivas. Dados dos pacientes, do esporte praticado e do questionário de Tegner foram registrados na primeira avaliação clínica. Os pacientes foram divididos em grupos: 1) lesão isolada do LCA; 2) lesão do LCA associada a lesão meniscal; 3) lesão meniscal isolada. RESULTADOS: A maioria dos pacientes pertencia ao grupo 1 (44,58%), seguido pelos grupos 2 (30,2%) e 3 (25%). O tempo médio de prática esportiva para gerar lesão foi de 17,81 anos no grupo 1, 17,3 no grupo 2 e 26,91 no grupo 3. Atletas de futebol apresentaram lesão de LCA em 0,523/1000 horas de jogo e de lesões meniscais em 0,448/1000 horas de jogo. Antes da lesão, a média de pontos obtidos no questionário de Tegner para os pacientes do grupo 1, 2 e 3 foram de 7,18, 7,34, e 6,53. Após a lesão, este valor caiu para 3,07, 3,18, e 2,87 respectivamente. CONCLUSÕES: A modalidade esportiva mais praticada foi o futebol e causou o maior número de lesões, independente do grupo. Além disso, pacientes do grupo 1 e 2 levaram menos tempo de prática do que os do grupo 3 para sofrerem lesões. As mulheres apresentaram maior risco de lesões de LCA e meniscos por 1000 horas de treino/jogo. Corrida, voleibol e academia estão em ordem crescente de riscos de lesões meniscoligamentares. Quando avaliado o retorno ao esporte, o rendimento de todos os atletas foi prejudicado pela lesão.

Epidemiology of injuries in female high school soccer players.

BACKGROUND: Sport is a compulsory activity in schools in South Africa. Female learners participating in soccer are more vulnerable to injuries than males. OBJECTIVE: This study determined the epidemiology of injuries in female high school soccer players. METHODS: A cross sectional survey captured the epidemiology of injuries in the players. The population included 200 players from 27 high schools in one district between the ages of 14 to 19 years. A self-administered questionnaire was used to collect data. RESULTS: Only 85 scholars from 8 schools participated. From the 85 respondents, 31 (36.5%) sustained injuries. Only 61 injuries were reported by the injured players. The injury prevalence for the season was 36.5%. The rate of injury was 90 per 1000 athlete exposure hours during the season. The defenders and midfielders sustained the most injuries. Most injuries reported were contact in nature. More injuries occurred during training than during matches. The lower extremity (77.8%) was injured more than the upper extremity (22.2%). The knee (22.2%) and ankle (15.9%) were the most frequently injured body parts. Muscle injury was the most commonly reported followed by bruising. CONCLUSION: Prevalence of injuries was high with the lower limb, specifically the knee and ankle being commonly injured.

Foot and Ankle Injuries in Professional Soccer Players: Diagnosis, Treatment, and Expectations.

Soccer is one of the most popular sports in the world. It has undergone many changes in recent years, mainly because of increased physical demands, and this has led to an increased injury risk. Direct contact accounts for half of all injuries in both indoor and outdoor soccer and ankle sprains are the most common foot and ankle injury. There is a spectrum of foot and ankle injuries and their treatment should be individualized in these high-demand patients. An injury prevention program is also important and should the players, the trainer, responsible physician, and physical therapists.

Lesiones en futbolistas de un equipo sudamericano durante 1 año de seguimiento / Lésions chez les footballeurs d'une équipe sud-américaine pendant un an de suivi / Injuries in Soccer Players of a South American Team for a Year Follow-Up

Introducción: las lesiones son eventos adversos frecuentes y significativos en la vida deportiva del futbolista. Objetivo: determinar las características de las lesiones derivadas de la práctica del fútbol en jugadores de un equipo profesional durante 1 año de competencia en la primera división del fútbol profesional colombiano. Método: se siguió prospectivamente durante 1 año a 24 jugadores de la primera categoría de un equipo de fútbol colombiano. Se realizó una valoración inicial a los jugadores que incluía la edad, peso, talla e índice de masa corporal. Diariamente el médico llenaba el formato de reporte de lesiones para cada jugador, en entrenamiento y competencia, donde consignaba fecha de la lesión, sitio anatómico lesionado, tipo de lesión, diagnóstico inicial, diagnóstico definitivo, lesión recurrente, mecanismo de lesión, causa de la lesión y días de incapacidad. Resultados: la edad promedio fue de 26,5±5 años El índice de masa corporal fue 24,57±1,06. El 50 por ciento de los jugadores se lesionaron. El 58,3 porciento de las lesiones ocurrieron durante la competencia. No se presentaron lesiones recurrentes. El sitio anatómico más afectado fue la rodilla. La mayoría de las lesiones fueron ligamentosas y musculares. El diagnóstico más frecuente fue el esguince. La mayoría de las lesiones fueron de no contacto (66,66 por ciento). El 33,33 por ciento de todas las lesiones fueron por sobreuso y el 66,66 porciento por trauma. El 50 por ciento de las lesiones fueron severas. Conclusiones: se presentaron más lesiones durante la competencia, la mitad severas, principalmente esguinces ligamentosos en miembros inferiores, de no contacto, por sobreuso y trauma(AU)

Introduction: Injuries are frequent and significant adverse events in the sporting life of soccer players. Objective: Determine the characteristics of the injuries resulting from the practice of soccer players of a professional team during 1 year of competition in the Colombian first division of professional soccer. Method: We prospectively followed for 1 year, 24 players from the first category of a Colombian soccer team. An initial assessment of players was performed including age, weight, height and BMI. Daily, the format injury report for each player was filled in by the physician, during training and competition, for consigning date of injury, injured anatomic site, type of injury, initial diagnosis, definitive diagnosis, recurrent injury, mechanism of injury, cause of injury, and disability days. Results: The mean age was 26.5 ± 5 years. The BMI was 24.57 ± 1.06. 50 percent of players were injured. 58.3 percent of injuries occurred during competition. No recurring injuries occurred. The most affected anatomical site was the knee. Most of the injuries were ligamentous and muscular. The most common diagnosis was sprained. Most of the injuries were non-contact (66.66 percent). 33.33 percent of all injuries were overuse and trauma 66.66 percent. 50 percent of the injuries were severe. Conclusions: more injuries occurred during competition, half severe, mainly in the lower limbs ligamentous sprains, non-contact, overuse and trauma(AU)

Introduction: Les lésions sont des événements fréquents et significatifs dans la vie sportive d'un footballeur. Objectifs: Le but de ce travail est de déterminer les caractéristiques des lésions souffertes par les joueurs d'une équipe de la première division de football professionnel colombien pendant un an de compétitions. Méthodes: Un suivi prospectif de 24 joueurs d'une équipe colombienne de football de première catégorie a été effectué pendant un an. Une évaluation initiale des joueurs a été réalisée tenant compte de l'âge, du poids, de la taille, et de l'indice de masse corporelle. Chaque jour le médecin remplissait le formulaire de rapport de lésions de chaque joueur, aussi en entrainement qu'en compétition, où il consignait la date de la lésion, sa localisation anatomique, le type de lésion, un diagnostic initial, un diagnostic définitif, les lésions récurrentes, le mécanisme de la lésion, ses causes, et les jours d'invalidité. Résultats: Le moyen d'âge a été 26,5 ± 5 ans. L'indice de masse corporelle a été 24,57 ± 1,06. La moitié des joueurs a été atteinte de lésions (50 pourcent). Un pourcentage significatif de ces lésions (58,3 pourcent) s'est produit en compétition. Il n'y a pas eu de lésions récurrentes. Le genou a été la partie anatomique la plus fréquemment touchée. Un grand nombre de lésions a été localisée au niveau des ligaments et des muscles. Le diagnostic le plus fréquent a été l'entorse. La majorité des lésions ont été sans contact (66,66 pourcent). Une partie de lésions a été due à l'abus (33,33 pourcent) tandis que l'autre a été due aux traumatismes (66,66 pourcent). Les lésions ont été sévères dans 50 pourcent. Conclusions: La plupart des lésions ont survenu au cours de compétitions, notamment les entorses ligamenteuses des membres inférieurs, sans contact, et dues à l'abus et aux traumatismes(AU)

Injury profile among elite male youth soccer players in a Swedish first league.

This study investigated the injury profile among elite male youth soccer players in a Swedish first league during two seasons. The present cohort study is based on data collected during the 2013-2014 seasons. In total, 43 young elite male soccer players, aged 15 to 19 yr, were prospectively followed regarding injuries, time of exposure, injury location, type of injury, and injury severity. The overall incidence of injury in the present study was estimated to 6.8 injuries per 1,000 exposure hours and 15.5 and 5.6 injuries per 1,000 hr for matches and training, respectively. The single most common injury subtype was muscle strain (53%). The hip and groin were the most common locations for injuries. Thirty-one percent of the injuries were classified as severe injury and caused >28 days absence from training and match play. Both the injury incidence and the number of serious injury seems to be relatively high in youth elite players according to this study. Although the injury incidence seems to be slightly lower than in adult elite players the injuries seem to be more traumatic in youth elite players.

Anterior cruciate ligament and meniscal injuries in sports: incidence, time of practice until injury, and limitations caused after trauma.

OBJECTIVE: To analyze the incidence of ACL and meniscal injuries in a population of recreational and elite athletes from Brazil and the relation of these injuries with their sports activities. METHODS: This was a prospective observational study of 240 patients with ACL and/or meniscal injuries submitted to surgical treatment. Data of patients and sport modality, as well as Tegner score were registered in the first clinical evaluation. The patients were divided into three groups: (1) isolated rupture of the ACL; (2) ACL injury associated with meniscal injury; (3) isolated menisci injury. RESULTS: The majority of the patients belonged to group 1 (44.58%), followed by group 2 (30.2%) and 3 (25%). Most patients were soccer players. The mean time from sport practice to injury in group 1 was 17.81 years. In group 2, it was 17.3 years, and in group 3, 26.91 years. Soccer athletes presented ACL injury in 0.523/1000 h of practice and meniscal injury in 0.448/1000 h of practice. Before the injury, the mean Tegner score obtained for groups 1, 2, and 3 were 7.18, 7.34, and 6.53, respectively. After knee injury, those values were 3.07, 3.18, and 2.87, respectively. CONCLUSION: Soccer was the sport that caused the majority of lesions, regardless the group. Furthermore, patients from groups 1 and 2 had less time of practice prior to the injury (17.81 and 17.3 years) than the patients of group 3 (26.91 years). Women presented a higher risk to develop ACL and meniscal injuries in 1000 h of game/practice. Running, volleyball, and weightlifting are in ascending order of risk for ACL and/or meniscal injury. Regarding the return to sport practice, the efficiency of all athletes was impaired because of the injury.

OBJETIVO: Avaliar a incidência da lesão do LCA e dos meniscos numa população de atletas amadores e profissionais no Brasil e a relação destas lesões com o esporte praticado. MÉTODOS: Estudo prospectivo observacional de 240 pacientes com lesão meniscoligamentar do joelho desencadeada por diversas atividades esportivas. Dados dos pacientes, do esporte praticado e do questionário de Tegner foram registrados na primeira avaliação clínica. Os pacientes foram divididos em grupos: 1) lesão isolada do LCA; 2) lesão do LCA associada a lesão meniscal; 3) lesão meniscal isolada. RESULTADOS: A maioria dos pacientes pertencia ao grupo 1 (44,58%), seguido pelos grupos 2 (30,2%) e 3 (25%). O tempo médio de prática esportiva para gerar lesão foi de 17,81 anos no grupo 1, 17,3 no grupo 2 e 26,91 no grupo 3. Atletas de futebol apresentaram lesão de LCA em 0,523/1000 horas de jogo e de lesões meniscais em 0,448/1000 horas de jogo. Antes da lesão, a média de pontos obtidos no questionário de Tegner para os pacientes do grupo 1, 2 e 3 foram de 7,18, 7,34, e 6,53. Após a lesão, este valor caiu para 3,07, 3,18, e 2,87 respectivamente. CONCLUSÕES: A modalidade esportiva mais praticada foi o futebol e causou o maior número de lesões, independente do grupo. Além disso, pacientes do grupo 1 e 2 levaram menos tempo de prática do que os do grupo 3 para sofrerem lesões. As mulheres apresentaram maior risco de lesões de LCA e meniscos por 1000 horas de treino/jogo. Corrida, voleibol e academia estão em ordem crescente de riscos de lesões meniscoligamentares. Quando avaliado o retorno ao esporte, o rendimento de todos os atletas foi prejudicado pela lesão.

Sports injuries profile of a first division Brazilian soccer team: a descriptive cohort study

ABSTRACTObjective:To establish the injury profile of soccer players from a first division Brazilian soccer team. In addition, we investigated the association between the characteristics of the injuries and the player's age and position.Method: Forty-eight players from a Brazilian first division soccer team were followed during one season. Descriptive statistics were used to characterize the injury profile. Spearman's tests were used to verify the association between the number and severity of injuries and the player's age. Chi-square test was used to verify the association between type of injury and player's position. Fisher's exact test was used to verify the association between the severity of injuries and player's position.Results: The incidence of injuries was 42.84/1000 hours in matches and 2.40/1000 hours in training. The injury severity was 19.5±34.4 days off competition or training. Lower limb was the most common location of injury and most injuries were muscular/tendinous, overuse, non-recurrent, and non-contact injuries. Player's age correlated with the amount and severity of muscle and tendon injuries. Defenders had more minimal injuries (1-3 days lost), while forwards had more moderate (8-28 days lost) and severe injuries (>28 days lost). Furthermore, wingbacks had more muscle and tendon injuries, while midfielders had more joint and ligament injuries.Conclusion: The injury profile of the Brazilian players investigated in this study reflected regional differences in soccer practices. Results confirm the influence of the player's age and position on the soccer injuries profile.

Incidence and risk factors of lower leg fractures in Belgian soccer players.

INTRODUCTION: Soccer is the world's most popular sport and one that is physically demanding and highly competitive. Consequently, the rate of injuries resulting from this sport is only increasing. It is estimated that 2-20% of all such injuries are fractures, one-third of which are located in the lower extremities. The aim of this epidemiological study was to investigate the incidence of lower-leg fractures (LLFs) in Belgian soccer players and determine the possible risk factors that lead to them. METHODS: All injuries of players associated with the Royal Belgium Football Association (RBFA) were reported and collected in a nationwide registry. We retrospectively compared the incidence rate of and risk factors for LLFs in Belgian soccer players during two seasons, 1999-2000 and 2009-2010. RESULTS: In total, 1600 fractures (3%) were located in the lower leg. After a decade, the number of LLFs remained unchanged. Ankle fractures were the most common (37%), followed by foot and tibia fractures (33% and 22%, respectively). The least common were fibula fractures, which accounted for just 9%. A higher incidence of every type of LLF was observed in older and amateur-level soccer players, when compared with their younger and professional counterparts. Male players experienced more tibia and foot fractures, whereas the incidences of ankle and fibula fractures were comparable with those in female soccer players. The vast majority of fractures occurred during soccer games. CONCLUSION: Ankle fractures and foot fractures represented two-thirds of all fractures noted in this analysis. Male gender, recreational level and adult age were important risk factors for LLFs. After 10 years, the incidence of LLFs did not decrease. Given the socioeconomic impact of these injuries, improved prevention techniques are required to reduce their incidence, particularly with regard to the frequently occurring ankle and foot fractures in this population.

Distribución de las lesiones en un equipo profesional de fútbol colombiano / Distribution of lesions in a colombian professional soccer team

El fútbol es uno de los deportes con mayor riesgo y frecuencia de lesiones. Para determinar la distribución de las lesiones de un equipo profesional de fútbol durante una temporada; se realizó un estudio de cohorte prospectivo incluyó a los 29 jugadores de la categoria A del Deportivo Independiente Medellín que participaron en la primera temporada de 2009 de la copa Mustang. Cada uno de los jugadores diligenció una encuesta inicial que incluía la edad, posición de juego, lesiones previas incapacitantes en los últimos dos años y dominancia del miembro inferior. Diariamente se llenaba el formato de lesión para cada jugador, en entrenamiento y competencia, que incluía sitio anatómico lesionado, tipo de lesión, diagnóstico inicial, diagnóstico definitivo, lesión recurrente, mecanismo de lesión, causa de la lesión e incapacidad. La edad promedio fue de 23,55 ± 4,65. El 44,8% de los jugadores reportaron antecendentes de les¡ón en los últimos 2 años. El 64,3% de las lesiones ocurrieron durante la competencia. El sitio anatómico más afectado fue el muslo. El primer diagnóstico fue el desgarro muscular y siempre ocurrio en competencia. La mayoría de las lesiones fueron musculares (35,7%) y de no contacto (85,7%). Las lesiones por sobreuso y trauma presentaron la misma frecuencia en todo el grupo. El 50% de las lesiones fueron leves. No se presentaron lesiones recurrentes. Se presentaron más lesiones durante la competencia, principalmente desgarros musculares del muslo, de no contacto, por sobreuso y trauma, leves en severidad y primordialmenteen jugadores con lesiones previas.

To determine the distribution of injuries to professional football team during a season, a prospective cohort study included the 29 players from Class A Deportivo Independiente Medellín who participated in the first season of 2009 Mustang Cup was done. Each player fills out an initial survery that included age, playing position, previous disabling injuries in the past two years and lower limb dominance. Every day was filled format for each player injury in training and competition, which included anatomical site injured, type of injury, initial diagnosis, final diagnosis, recurrent injury, mechanism of injury, cause of injury and disability. The average age was 23,55 ± 4,65. The 44,8% of players reported a history of injury in the last 2 years. 64,3% of injuries occurred during competition. The most affected anatomical site was the thigh. The first diagnosis was a muscle tear and always occurred in competition. Most of the injuries were muscle (35,7%) and no contact (85,7%). Overuse injuries and trauma showed the same frequency in the group. 50% of the injuries were minor. There were no recurrent lesions. There were more injuries during competition, particularly the thigh nuscle tears, no contact, overuse and trauma, mild in severity and primarily players with previous injuries.

Lesões nos jogadores de futebol profissional do Marília Atlético Clube: estudo de coorte histórico do campeonato brasileiro de 2003 a 2005 / Injuries in the professional soccer players of Marília Atlético Clube: a cohort study of the Brazilian Championship, 2003 to 2005

INTRODUÇÃO E OBJETIVOS: Vários autores têm investigado a incidência de lesões no futebol, poucos têm-se preocupado com o tempo de afastamento dos atletas ou com os prejuízos financeiros oriundos de tal situação. O objetivo deste estudo foi confrontar, através de um estudo de coorte histórico, o tempo total de afastamento de atletas lesionados com as variáveis: idade, posição dos jogadores e tipo de lesão. MÉTODOS: Foram analisados os jogadores de futebol profissional do Marília Atlético Clube que atuaram no Campeonato Brasileiro de Futebol - Série B, de 2003 a 2005. As informações foram coletadas através do acesso direto aos prontuários médicos e protocolo de coleta de dados, com um período de seguimento de 24 meses, sendo, posteriormente, realizada a análise estatística. RESULTADOS: A idade dos jogadores variou de 18 a 35 anos (24,5 ± 4,4); os jogadores mais freqüentemente lesionados foram: atacantes (36,8 por cento), zagueiros (26,6 por cento), meias (20 por cento), laterais (10 por cento) e goleiros (6,6 por cento); as lesões mais comuns foram: musculares (46,8 por cento), ligamentares (26,6 por cento), ósseas (16,6 por cento) e meniscais (10 por cento); o tempo de afastamento nos atacantes variou de 10 a 240 dias (28 ± 78,3), nos zagueiros de 20 a 120 dias (26,5 ± 33,9), nos meias de 10 a 180 dias (18,5 ± 66,3), nos laterais de 13 a 240 dias (17 ± 129,9) e nos goleiros de 35 a 60 dias (47,5 ± 17,6). CONCLUSÃO: A análise estatística mostrou não haver correlação entre a idade dos jogadores e o tempo total de afastamento dos mesmos (p = 0,31), não houve diferença significativa entre o tempo de afastamento nas diferentes posições dos jogadores dentro de campo (p = 0,49), houve diferença significativa entre o tempo total de afastamento e os diferentes tipos de lesão (p < 0,001) entre as variáveis: lesões meniscais e ósseas, lesões meniscais e musculares, lesões ligamentares e ósseas e, finalmente, lesões ligamentares e/ musculares.

INTRODUCTION AND OBJECTIVES: several authors have investigated the incidence of injuries occurred in outdoor soccer games. However, just a few are concerned about the athletes' healing period or the financial damage due to this no-activity period. The purpose of this study was to assess, through a cohort study, the injured athletes' recovery period, facing it to the variables: age, position in game and injure pattern. METHODS: The medical reports of all professional soccer players of Marília Atlético Clube who were injured during the Brazilian Soccer Championship - 2nd Division, from January/2003 to December/2005 were assessed, with a 24 months follow-up. RESULTS: Athletes' mean age (SD) was 24.5 years (4.4 years); the most frequently injured athletes were: strikers (36.8), center-backs (26.6 percent), center-midfielders (20 percent), side-midfielders (10 percent) and goalkeepers (6.6 percent). The most frequent injuries were: muscular (46.8 percent), ligament (26.6 percent), bone (16.6 percent) and meniscal (10 percent); the strikers have shown a mean recovery period of 28 days (78.3 days), the center-backs 26.5 days (33.9), the center-midfielders 18.5 days (66.3), the side-midfielders 17 days (129.9) and the goalkeepers 47.5 days (17.6). CONCLUSION: Statistical analysis showed that there was no correlation between athletes' age and their healing period (p/ =/ 0.31); there was no statistical difference between the healing period among the five different athletes' positions (p/ =/ 0.49); there was statistical difference between the healing period and the injury pattern (p/