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PubMed1995

A review of injuries to professional footballers in a premier football team (1990-93).

A prospective study of injuries sustained by first team professional foot-ballers either in training or in competition was undertaken over a 3 year period. These were injuries which resulted in loss of availability for playing. In a total of 27 players, 94 significant injuries occurred resulting in 364 weeks "out of action". 79% of these injuries were sustained in matches. Midfield players suffered the most injuries (39%). A prospective study in Heart of Midlothian Football Club's first team players over a 3 year period 1990-3 revealed that significant injuries resulting in loss of availability for playing occurred in 27 players. The majority of injuries occurred in match play (79%) with the average time "out of action" per player being 13 weeks (overall total = 364 weeks). Midfield players suffered the most injuries (39%) and the most common anatomical site of injury was the thigh followed by the knee. Muscle and ligament injuries were the commonest soft tissue problem. 6% of injuries were skeletal. Players older than 26 years of age appeared to be more prone to injury. No good correlation could be found between the number of games played and increased likelihood of injuries.

Adult↗
PubMed1980

[Modifications of some cardiorespiratory parameters under a controlled work-load in a group of football players, winners of Italian championship football].

The modifications of some cardiorespiratory and metabolic parameters in 18 football players under controlled work-load has been investigated. The results obtained show that by increasing work-load VO2, HR, VE, RR, TV and VA also linearly increase; FiO2-FeO2 steeply increases at he reduced work-load (50 Watt) while at the higher loads (from 100 to 200 Watt) grows with less steep slope. The oxygen consumption evaluated at 200 Watt shows a figure of 50 ml O2/min/Kg, whereas the maxim calculated VO2 goes up to 75,56 ml/min/Kg body weight.

Adult↗
PubMed1991

Prevention of craniofacial injuries in football.

The evolution of rules and regulations governing the development and use of protective football equipment for the prevention of craniofacial and intraoral traumatic injuries to football players have reduced substantially the occurrence of these injuries. Protective football equipment such as helmets, facemasks, and intraoral mouthguards have undergone numerous developmental changes to improve their effectiveness in preventing traumatic injuries to the head, face, and mouth of participants in football during practice sessions as well as in game situations. Unfortunately, however, some of these types of injuries do continue to occur. Various regulatory agencies and football governing bodies have established quality performance standards for equipment and have enacted rulings for their proper use. Penalties have been assessed for rule infractions to aid in curtailing the misuse of such equipment, as occurs for example, when the helmet is used to spear tackle an opponent or when the facemask is grasped, pulled, or twisted by an opposing player. Dentists can contribute significantly to the overall well-being of their patients who participate in football by providing information and advice regarding the proper use of protective football equipment to prevent craniofacial and intraoral traumatic football-related injuries, by fabricating properly fitted mouthguards as one aspect of their total practice of dentistry, and by providing high-quality and expeditious emergency and long-term treatment subsequent to football-related intraoral traumatic injuries. In addition, dentists can contribute on a larger scale to the overall well-being of football athletes by participating in community service activities such as mouthguard days, as consultants to football teams, as team dentists, or as advisors to those interested in research and development to improve protective football equipment, and to those responsible for sponsoring more stringent regulations for player safety in football.

Football↗
PubMed2002

Concussions among university football and soccer players.

OBJECTIVE: A study to examine the incidence and characteristics of concussions among Canadian university athletes during 1 full year of football and soccer participation. DESIGN: Retrospective survey. PARTICIPANTS: Three hundred eighty Canadian university football and 240 Canadian university soccer players reporting to 1999 fall training camp. Of these, 328 football and 201 soccer players returned a completed questionnaire. MAIN OUTCOME MEASURES: Based on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous full year of football or soccer participation, the duration of symptoms, the time for return to play, and any associated risk factors for concussions. RESULTS: Of all the athletes who returned completed questionnaires, 70.4% of the football players and 62.7% of the soccer players had experienced symptoms of a concussion during the previous year. Only 23.4% of the concussed football players and 19.8% of the concussed soccer players realized they had suffered a concussion. More than one concussion was experienced by 84.6% of the concussed football players and 81.7% of the concussed soccer players. Examining symptom duration, 27.6% of all concussed football players and 18.8% of all concussed soccer players experienced symptoms for at least 1 day or longer. Tight end and defensive lineman were the positions most commonly affected in football, while goalies were the players most commonly affected in soccer. Variables that increased the odds of suffering a concussion during the previous year for football players included a history of a traumatic loss of consciousness or a recognized concussion in the past. Variables that increased the odds of suffering a concussion during the previous year for soccer players included a past history of a recognized concussion while playing soccer and being female. CONCLUSIONS: University football and soccer players seem to be experiencing a significant amount of concussions while participating in their respective sports. Variables that seem to increase the odds of suffering a concussion during the previous year for football and soccer players include a history of a recognized concussion. Despite being relatively common, symptoms of concussion may not be recognized by many players.

Adult↗
PubMed1993

A national survey about parent awareness of the risk of severe brain injury from playing football.

A survey was conducted to determine the level of awareness among parents of high school football players about the risk of severe brain injury. A national sample of 1007 randomly selected households was interviewed by telephone during February, 1992. All interviewees were parents of high school football players who either were currently playing football or had played within the previous 5 years. Survey questions measured the extent to which parents were aware both of the risks associated with playing high school football and the existing helmet warnings about those risks. Overall, the survey results demonstrated that parents of high school football players were uninformed about both the risk of severe brain injury from playing high school football and the football helmet warnings about that risk. Specifically, unprompted, most parents mentioned broken bones, knee injuries, sprains, or shoulder injuries as hazards associated with playing football. Few parents mentioned severe brain damage, even when prompted. Further, the overwhelming majority of parents incorrectly believed that wearing a football helmet generally eliminated the risk of severe brain injury. Very few parents had received information from any source about the risks of head injury or had heard that no football helmet can provide complete protection against this hazard. Few parents were aware of the warning label on the helmet or knew what the label said, even when prompted. In short, parents were unaware of the risk of severe brain damage, misinformed about a football helmet's ability to protect against this risk, and uninformed about the football helmet warning label about this risk.

Journal Article↗
PubMed2001

Concussions among university football and soccer players: a pilot study.

OBJECTIVE: A pilot study to examine the incidence and characteristics of concussions for one season of university football and soccer. DESIGN: Retrospective survey. PARTICIPANTS: 60 football and 70 soccer players reporting to 1998 fall training camp. Of these, 44 football and 52 soccer players returned a completed questionnaire. MAIN OUTCOME MEASURES: Based on self-reported symptoms, calculations were made to determine the number of concussions experienced during the previous season, the duration of symptoms, the time for return to play and any associated risk factors for concussions. RESULTS: Of all the athletes who returned completed questionnaires, 34.1% of the football players and 46.2% of the soccer players had experienced symptoms of a concussion during the previous season. Only 16.7% of the concussed football players and 29.2% of the concussed soccer players realized they had suffered a concussion. All of the concussed football players and 75.0% of the concussed soccer players experienced more than one concussion during the season. The symptoms from the concussion lasted for at least 1 day in 28.6% of the football players and 18.1% of the soccer players. Variables that increased the odds of suffering a concussion during the previous season for football and soccer players included a past history of a recognized concussion. CONCLUSION: More university soccer players than football players may be experiencing sport related concussions. Variables that seem to increase the odds of suffering a concussion during the previous season for football and soccer players include a history of a recognized concussion. Despite being relatively common, many players may not recognize the symptoms of a concussion.

Adult↗
PubMed2003

Brain injury-related fatalities in American football, 1945-1999.

OBJECTIVE: Brain injuries have been the most common direct cause of death among American football players since the annual recording of football-related deaths began in 1931. This study examines the 55-year experience with brain injury-related fatalities in American football from 1945 to 1999, including not only the incidence but also the cause of death in discrete 5-year spans to focus on the variables that have either increased or decreased fatalities. In addition, we describe the types of injuries that have occurred, the activities in which the players were engaged at the time of injury, the level of play involved, and whether the injuries occurred during games or in practice sessions. METHODS: Data were collected nationwide regarding football fatalities in all organized football programs in public schools and in college, professional, and youth programs by conducting personal interviews and eliciting responses to questionnaires. The information collected included demographic data about the injured player, equipment data, injury type and body part involved, and pertinent information regarding the exact circumstances of the accident. RESULTS: We found that a total of 497 brain injury-related fatalities occurred among American football players during the period from 1945 through 1999. The causes of death were brain injuries in 69% of the cases, cervical spine injuries in 16%, and other injuries in 15%. Subdural hematoma was the type of injury associated with the majority (429, 86%) of brain injury-related fatalities. A majority (61%) of the brain injury-related fatalities occurred during participation in football games, and 75% of these were high school players. It should be noted that the number of high school football players is far greater (more than 1 million) than the number of either college (approximately 75,000) or professional (approximately 2000) players. The most frequent on-field activity involved when players sustained their fatal injuries was either tackling or being tackled (35%). CONCLUSION: Brain injury-related fatalities accounted for 69% of all football fatalities from 1945 through 1999. The greatest number and percentage of brain injury-related fatalities occurred during the 5-year span from 1965 through 1969, and the smallest number and percentage occurred during the 2 decades from 1975 through 1994. Most brain injury-related fatalities involved a subdural hematoma sustained by high school football players while either tackling or being tackled in a game. In the 2 decades from 1975 through 1994, there was a dramatic reduction in these fatalities, and the preventive measures that have received most of the credit are 1) the 1976 rule change that prohibits initial contact with the head and face when blocking and tackling and 2) the National Operating Committee on Standards for Athletic Equipment helmet standard, which went into effect in colleges in 1978 and in high schools in 1980.

Adolescent↗
PubMed2001

High femoral bone mineral content and density in male football (soccer) players.

PURPOSE: This investigation examined the effect that long-term football (soccer) participation may have on areal bone mineral density (BMD) and bone mineral content (BMC) in male football players. METHODS: Dual energy x-ray absorptiometry (DXA) scans were obtained in 33 recreational male football players active in football for the last 12 yr and 19 nonactive subjects from the same population. Both groups had comparable age (23 +/- 4 yr vs 24 +/- 3 yr), body mass (73 +/- 7 kg vs 72 +/- 11 kg), height (176 +/- 5 cm vs 176 +/- 8 cm), and calcium intake (23 +/- 10 mg.kg(-1).d(-1) vs 20 +/- 11 mg.kg(-1).d(-1) (mean +/- SD). RESULTS: The football players showed 8% greater total lean mass (P < 0.001), 13% greater whole-body BMC (P < 0.001), and 5 units lower percentage body fat (P < 0.001) than control subjects. Lumbar spine (L2-L4) BMC and BMD were 13% and 10% higher, respectively, in the football players than in the control subjects (P < 0.05). Furthermore, football players displayed higher femoral neck BMC (24%, 18%, 23%, and 24% for the femoral neck, intertrochanteric, greater trochanter, and Ward's triangle subregions, respectively, P < 0.05) and BMD (21%, 19%, 21%, and 27%, respectively, P < 0.05) than controls. BMC in the whole leg was 16-17% greater in the football players, mainly because of enhanced BMD (9-10%) but also because of bone hypertrophy, since the area occupied by the osseous pixels was 7% higher (867 +/- 63 cm2 vs 814 +/- 26 cm2, P < 0.05). Leg muscle mass was 11% higher in the football players than in the control subjects (20,635 +/- 2,073 g vs 18,331 +/- 2,301 g, P < 0.001). No differences were found between the legs in either groups for BMC, BMD, and muscle mass. Left leg muscle mass was correlated with femoral neck BMC and BMD (P < 0.001), as well as with lumbar spine (L2-L4) BMC and BMD (P < 0.001). CONCLUSION: Long-term football participation, starting at prepubertal age, is associated with markedly increased BMC and BMD at the femoral neck and lumbar spine regions.

Adult↗
PubMed2005

Sweat rate and fluid turnover in American football players compared with runners in a hot and humid environment.

OBJECTIVES: To determine sweat rate (SwR) and fluid requirements for American footballers practicing in a hot, humid environment compared with cross country runners in the same conditions. METHODS: Fifteen subjects, 10 footballers and five runners, participated. On the 4th and 8th day of preseason two a day practices, SwR during exercise was determined in both morning and afternoon practices/runs from the change in body mass adjusted for fluids consumed and urine produced. Unpaired t tests were used to determine differences between groups. RESULTS: Overall SwR measured in litres/h was higher in the footballers than the cross country runners (2.14 (0.53) v 1.77 (0.4); p<0.01). Total sweat loss in both morning (4.83 (1.2) v 1.56 (0.39) litres) and afternoon (4.8 (1.2) v 1.97 (0.28) litres) practices/runs, and daily sweat losses (9.4 (2.2) v 3.53 (0.54) litres) were higher in the footballers (p<0.0001). The footballers consumed larger volumes of fluid during both morning and afternoon practices/runs (23.9 (8.9) v 5.5 (3.1) ml/min and 23.5 (7.3) v 13.6 (5.6) ml/min; p<0.01). For complete hydration, the necessary daily fluid consumption calculated as 130% of daily sweat loss in the footballers was 12.2 (2.9) litres compared with 4.6 (0.7) litres in the runners (p<0.0001). Calculated 24 hour fluid requirements in the footballers ranged from 8.8 to 19 litres. CONCLUSIONS: The American footballers had a high SwR with large total daily sweat losses. Consuming large volumes of hypotonic fluid may promote sodium dilution. Recommendations for fluid and electrolyte replacement must be carefully considered and monitored in footballers to promote safe hydration and avoid hyponatraemia.

Adult↗
PubMed2005

Equipment and running surface alter sprint performance of college football players.

The purpose of this study was to determine the effect of football equipment and running surface on sprint performance in NCAA Division II football players (n = 68). Players were timed in the 40-yd sprint on an indoor rubberized track (Day 1) and on an outdoor, natural-grass football field (Day 2) wearing either regulation football equipment or shorts and a T-shirt. Each player was assigned randomly to perform 2 trials under each condition on each surface, and the average of the 2 trials was used for analysis. Offensive backs, defensive backs, and linebackers were significantly faster than were offensive and defensive linemen in all trials, and subjects were collapsed into 2 groups, backs and linemen. Football equipment significantly impaired performance on the track (-2.8% +/- 1.7%) and the field (-2.9% +/- 1.8%). The increase in body mass due to the football equipment was significantly greater for backs (7.2% +/- 0.7%) than for linemen (6.5% +/- 1.0%), but produced a significantly greater impairment in sprint performance in linemen (-3.3% +/- 1.1%) as compared with backs (-2.5% +/- 1.5%). Sprint performance was significantly and equivalently impaired when running on grass (backs: -2.5 +/- 1.1%; linemen: -2.8 +/- 1.4%) as compared with the track. Thus, running a 40-yd sprint in football equipment on a natural grass field impairs performance by an average of 5.5% (+/- 2.3%) compared with running indoors with minimal apparel. Football equipment and running surface significantly impair sprint performance in college football players, the effect being greater in linemen than in backs, and is likely related to differences in muscle strength/power and body fat.

Adult↗
PubMed1996

Football injuries in a rural area.

This study was conducted to analyze the frequency and characteristics of football injuries in a rural hospital setting and compare it to the national data. More than 6,000 patients with a sport-related injury presenting to the emergency medicine department at the Marshfield Clinic between June 1, 1988 and June 1, 1994 were collected prospectively. Eight hundred forty-three (14% of total) patients sustained football-related injuries. A chart abstraction form was then used to retrospectively review football injuries documenting types, sites, and mechanism of injury, along with demographic aspects. The peak age sustaining football injuries was 17 years old (17.5%). Most of the football injuries occurred during school activities (73.7%). The most common site injured was the finger (16.5%), followed by the knee (15.7%). Sprains/strains were the most common diagnosis representing 40.2% of injuries overall. The most common mechanism resulting in a football-related injury was as a result of being blocked or tackled (52.7%). Surgery was required on 4.9% of individuals injured while playing football. Most patients (69.7%) were expected to recover from their injury within 14 days. There were more injured football players from our area in the age group 15 to 24 years as compared to the national data available. Diagnosis, site injured, and mechanism of injury from our study were comparable to other national publications. Prospective studies are needed to address the problem of football-related injuries. Such studies would require a multidiscipline team of experts.

Adolescent↗
PubMed2003

The neuropsychology of heading and head trauma in Association Football (soccer): a review.

Association Football (soccer) is the most popular and widespread sport in the world. A significant proportion of the injuries suffered in football are head injuries involving trauma to the brain. In normal play, head trauma frequently arises from collisions, but some researchers have claimed that it also may arise as a consequence of heading the ball. Although assessments based on biomechanical analyses are equivocal on the potential for brain injury due to football heading, a growing literature seems to support the claim that neuropsychological impairment results from general football play and football heading in particular. However, this review suggests a distinction is required between the neuropsychological effects of concussive and subconcussive head trauma and that all of the neuropsychological studies conducted so far suffer from methodological problems. At best, a few of these studies may be regarded as exploratory. The review concludes that presently, although there is exploratory evidence of subclinical neuropsychological impairment as a consequence of football-related concussions, there is no reliable and certainly no definitive evidence that such impairment occurs as a result of general football play or normal football heading. The neuropsychological consequences of football-related subconcussive effects await confirmatory investigation.

Alcoholism↗
PubMed2005

Prevalence of headache in Australian footballers.

OBJECTIVE: To survey the prevalence and risk factors for headache in a population of elite professional Australian footballers. METHODS: A prospective questionnaire based survey was performed on elite Australian footballers participating in a national competition. The survey was designed to assess the prevalence and risk factors for headache using standardised International Headache Society (HIS) criteria. Headache prevalence was compared with that of an age and sex matched community control population. RESULTS: A total of 160 questionnaires were analysed. Headaches were reported by 80% of subjects, with 49% of respondents reporting headaches during competitive match play and 60% during training. There was no significant difference between the footballers and the community sample in the number of headaches ever; however, they did report more headaches in the three months before the survey--that is, during the competitive playing season. In the footballers, 22% of headaches conformed to the strict IHS definition of migraine headaches. When the relaxed definition of "footballer's migraine" was used, 34% of headaches met these criteria. Footballers were at significantly increased risk of footballer's migraine than community controls. CONCLUSIONS: Headaches are common in Australian footballers, and the prevalence of migraine is increased in relation to community prevalence studies. Furthermore, the strict IHS criteria may not adequately identify the specific subtype of football related headache. This finding has important implications in the management of headache in this setting.

Australia↗
PubMed2006

Selected physical capacity norms for Australian football players at the non-elite level.

Australian football is a popular male team sport that consists mainly of participants competing at the non-elite level. The main purpose of this study was to compare in non-elite Australian football players competing in sub-elite and community leagues, selected physical capacities recognised as predictors of lower extremity injury in Australian football and/or other sports. Participants were 143 adult (mean age of 22.2 years) male Western Australian footballers from the Western Australian Football League (WAFL) (sub-elite) and the Western Australian Amateur Football League (WAAFL) (community). During the 2005 regular playing season participants completed a questionnaire and a physical measurement testing session. The physical testing session involved the following lower extremity measures: generalised joint laxity, leg length discrepancy, presence of Morton's toe, foot arch, hamstring flexibility and static balance. Football players from the sub-elite and community leagues did not differ significantly in any of the physical testing session measures or in the questionnaire items relating to injury number in the past 12 months and lower limb preventative device use. However, they did differ in some measures with players from the sub-elite league significantly more likely to stretch after a match and training, and to have a designated stretching leader at their club. While players from the community league were significantly more likely to smoke and to participate in sports additional to Australian football. Although the selected physical capacities did not differ between the sub-elite and community players in this study, future research should be aimed at identifying differences for a greater number of physical capacities, including skill and endurance, while utilising a larger sample.

Adult↗
PubMed2000

Prevalence of headaches in football players.

BACKGROUND: Football coaches and team physicians rely heavily on players' reports of symptoms in deciding whether a player may return to the game after sustaining head trauma. The decision is made difficult by the wide variety of associated symptoms, some of which (e.g., headache is among the most common) may or may not be associated with serious head injury. More information is needed about the clinical significance of football-related headache. METHODS: To assess the frequency of headache associated with playing football, we analyzed responses to our questionnaire asking about incidence, frequency, and outcome of football-related headache from 443 football players (320 from college, 123 from high school). RESULTS: Eighty-five percent of respondents reported previous headache related to hitting in football. Asked specifically about their most recent game, 21% of respondents reported having had headache during that game. Of players who had headache, only 19% informed the team physician, trainer, or coach, and only 6% were removed from the game. Twenty-seven percent of respondents reported previous diagnosis of cerebral concussion by medical personnel. Defensive backs (25%), defensive linemen (19%), and offensive linemen (18%) were most likely to have headache, related to hitting. CONCLUSIONS: Our data confirm that posttraumatic headache is commonly associated with football participation and often goes unreported. Given that the most serious complications of head injuries (e.g., second-impact syndrome) occur infrequently, headache as an isolated symptom lacks specificity in predicting such complications in football players. Therefore, unless it persists or is accompanied by additional symptoms, headache alone may not reliably suggest the need to remove players from the game.

Adolescent↗