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Timing and Dose Matter: Late High-Speed Exposure and Higher High-Intensity Acceleration Volumes Reduce Hamstring Reinjury Risk in Elite Male Football (Soccer).

OBJECTIVES: The aims of this study were to (a) investigate whether the timing and magnitude of exposure to high-speed running (HSR), sprinting, and high-intensity accelerations during on-field rehabilitation after hamstring strain injury were associated with reinjury risk and (b) examine changes in match running performance upon return to play (RTP). DESIGN: Retrospective cohort study. METHODS: Data from 95 elite male football (soccer) players from five professional clubs competing in major European and Middle Eastern leagues were analyzed. Players with complete rehabilitation load profiles were included in the 2-month and 6-month reinjury analysis. Modified Poisson regression assessed associations between rehabilitation load characteristics and reinjury risk. Match running performance (HSR distance, sprint distance, and high-intensity accelerations per minute) during the five matches before injury and the first five matches after RTP was compared using paired t-tests for the entire cohort. RESULTS: Late introduction of HSR, sprinting, and high-intensity accelerations during rehabilitation (ie, &#x2265; 60% of rehabilitation progression) was associated with a significantly lower reinjury risk at 2 months (relative risk [RR] range = 0.948-0.969; P < .01) and 6 months (RR range = 0.964-0.979; P < .05). Higher daily exposure to high-intensity accelerations once introduced was protective (RR = 0.861 (0.778-0.951)). There were no meaningful associations between total volume of HSR or sprinting and reinjury. Match running performance metrics did not differ between pre-injury and post-RTP matches (all P > .05). Changes in performance were not correlated with rehabilitation load characteristics. CONCLUSION: The timing of high-intensity running exposure during on-field rehabilitation appeared associated with a lower hamstring reinjury risk. Delaying the introduction of HSR, sprinting, and accelerations, followed by a structured and progressive build-up, was associated with lower risk of reinjury without compromising the subsequent match performance of elite male football players. J Orthop Sports Phys Ther 2026;56(9):611-621. Epub 7 Jul 2026. doi:10.2519/jospt.2026.14077.

Humans

Orthopaedic injuries in athletes (ages 6 to 17). Comparison of injuries occurring in six sports.

A prospective study of orthopaedic injuries to children (ages 6 to 17) was conducted for a calendar year in the controlled environment of a military post. Data were collected on the number of participants, the hours of participation, and the number of injuries for six supervised sports (football, soccer, basketball, baseball, swimming, and gymnastics). An injury index factor was derived by a formula: (number of injuries x 10(4)) divided by [(number of participants) x (average number of hours of participation) x (number of weeks in the season of the sport)]. When the injury index factors were compared, the risk a participant has for sustaining an injury in football was twice as high (1.72) as its nearest competitors, basketball (0.88) and gymnastics (0.85). Soccer had an index factor of 0.29; baseball, 0.14; and swimming had a factor of zero. Eighty percent of all sports-related orthopaedic injuries involved the upper extremities. Lower extremity orthopaedic injuries occurred only in football and gymnastics. The evidence suggests that those persons concerned with reducing the number of injuries to the growing athlete in supervised sports should focus their attention on reducing the risk of injury to the upper extremities.

Adolescent

Comparative Effectiveness of Exercise Interventions for Hamstring Injury Prevention in Football Players: A Systematic Review and Network Meta-analysis.

BACKGROUND: Hamstring strain injury is a leading time-loss injury in football, yet trials have evaluated diverse exercise-based prevention programs with limited direct head-to-head evidence. This systematic review and network meta-analysis aimed to compare the effectiveness of exercise-based interventions for preventing hamstring injuries in football players using exposure-adjusted incidence rate ratios. METHODS: We conducted a PRISMA-aligned systematic review and random-effects network meta-analysis of randomized controlled trials in football players comparing exercise-based interventions to prevent hamstring injuries. Searches covered PubMed, Cochrane Library, Embase and Web of Science from inception to January 5, 2026. Interventions were modeled as separate nodes (Nordic hamstring exercise [NHE], FIFA 11, FIFA 11&#x2009;+&#x2009;, FIFA 11&#x2009;+&#x2009;Kids, bounding exercise program [BEP], usual training). The primary effect measure was incidence rate ratio (IRR) versus usual training, with ranking by P-scores; exploratory subgroup analyses were conducted by sex-restricted male-only evidence and age group. RESULTS: Eleven randomized controlled trials involving 9,282 participants were included. The network was connected but largely star-shaped, with most evidence comparing active interventions against usual training and no direct active-active comparisons. FIFA 11&#x2009;+&#x2009;showed the most consistent exposure-adjusted association with reduced hamstring injury incidence versus usual training (IRR&#x2009;=&#x2009;0.55, 95% CI 0.31-0.98; P-score&#x2009;=&#x2009;0.84). FIFA 11&#x2009;+&#x2009;Kids showed a favorable but imprecise estimate, whereas NHE showed a modest non-significant reduction and FIFA 11 and BEP showed no clear benefit. Male-only findings were broadly consistent with the primary analysis. Age-stratified analyses suggested that the apparent hierarchy was not fully identical across age strata, but subgroup networks were sparse and exploratory. RoB 2 judged three studies as high risk and eight as having some concerns; no trial was judged as overall low risk. Between-study heterogeneity was substantial, and treatment rankings were, therefore, interpreted cautiously. CONCLUSIONS: In this IRR-based network meta-analysis, FIFA 11&#x2009;+&#x2009;showed the most consistent exposure-adjusted association with reduced hamstring injury incidence compared with usual training. However, certainty across the primary comparisons ranged from low to very low because of clinical and methodological heterogeneity, sparse direct evidence for several nodes, reliance on indirect active-active comparisons, substantial between-study heterogeneity, and moderate-to-high risk of bias across the included studies. The treatment hierarchy should, therefore, be interpreted as a low-to-very-low-certainty, population-level summary rather than as a basis for firm recommendations. Further well-reported, age- and population-specific head-to-head trials with consistent exposure, injury-definition, adherence, and intervention-dose reporting are needed. Registration Systematic review registration PROSPERO (CRD420251243576).

FIFA 11&#x2009;+&#x2009;

A physiological evaluation of professional soccer players.

The purpose of this study was to evaluate the physiological functions of a professional soccer team in the North American Soccer League (NASL). Eighteen players were evaluated on cardiorespiratory function, endurance performance, body composition, blood chemistry, and motor fitness measures near the end of their competitive season. The following means were observed: age, 26 yrs; height, 176 cm; weight 75.5 kg; resting heart rate, 50 beats/min; maximum heart rate (MHR), 188 beats/min; maximum oxygen intake (VO2 max), 58.4 ml/kg-min-1; maximum ventilation (VEmax BTPS), 154 L/min; body fat, 9.59%; 12-min run, 1.86 miles; and Illinois agility run, 15.6 secs. Results on resting blood pressure, serum lipids, vital capacity, flexibility, upper body strength, and vertical jump tests were comparable to values found for the sedentary population. Comparing the results with previously collected data on professional American Football backs indicated that the soccer players were shorter; lighter in body weight; higher in VO2 max (4 ml/kg-min-1) and body fat (1.8%); and similar in MHR, VE max, and VC. The 12-min run scores were similar to the initial values observed for the 1970 Brazilian World Cup Team. The agility run results were superior to data collected from other groups. Their endurance capabilities, agility, and low percent of body fat clearly differentiate them from the sedentary population and show them to be similar to that of professional American football backs.

Body Composition

Turf-toe: a shoe-surface related football injury.

Plantar capsule-ligament sprain of the great toe metatarsophalangeal joint, herein referred to as "turf-toe," is discussed with emphasis on two apparantly predisposing factors, playing surface hardness and shoe stiffness. Surface hardness studies have previously been performed by the authors on natural grass and AstroTurf. A study of football shoe flexibility is presented and the results correlated with the occurrence of turftoe. We have not encountered this entity in players wearing relatively stiff conventional seven posted football shoes or the more flexible soccer style shoe on natural grass fields. We have found it to be a not uncommon injury among players wearning the soccer style shoe on AstroTurf.

Athletic Injuries

Jejunal perforation occurring in contact sports.

Two cases of jejunal rupture following blunt trauma, occurring in participants of contact sports, have been reported. Additionally, a possible mechanism of injury is described.

Adult

Injuries in soccer.

The injury profile of a professional soccer team from the 1976 to 1977 season is compiled in this report. Injuries are spread across all of the playing positions, with midfielders and forwards being most prone to injury. During the entire season of this report, 60 injuries were encountered, 35 during game situations and 25 in practice. The most common injuries noted were foot and ankle sprains, but muscle strains were also frequent. Most injuries were of a minor variety. Seventeen injuries resulted in missed games while 46 injuries resulted in no games being missed. Only one player had an injury which did not allow him to return to play during the season. Although little is written in the American literature concerning soccer injuries, it does appear that the injury potential is much less when compared with that of football. The rapid increase in interest in this sport will require physicians and trainers to become familiar with its specific needs in order to render adequate care and participate in injury prevention programs.

Ankle Injuries

Intervention components, training dose, and adherence in exercise-based prevention of hamstring strain injury in football: a systematic review and meta-analysis.

OBJECTIVE: To quantify associations between exercise-based prevention programmes and hamstring strain injury (HSI) risk in football participants, and whether training dose and adherence modify effects. METHODS: Six databases were searched to 1 October 2025. Randomised and cluster-randomised trials comparing HSI prevention programmes with usual practice or warm-up in football participants were included. Random-effects meta-analysis pooled risk ratios (RRs); subgroup analyses and meta-regression assessed effect modification. RESULTS: Fifteen trials (n = 7,465) were analysed. Programmes reduced HSI risk (RR = 0.51, 95% CI 0.36-0.71), with I&#xb2;=57% and a prediction interval crossing the null (0.18-1.40). Based on a control event rate of 7.8%, absolute risk reduction was 3.8% (38 fewer HSIs per 1000 participants; 95% CI 23-50 fewer). Effects were stronger for shorter interventions (1-6 months; RR = 0.43) than longer interventions (7-10 months; RR = 0.77; P for interaction=0.04), and for elite/semi-professional players (RR = 0.38) than amateur players (RR = 0.77; P for interaction = 0.02). Training frequency and weekly volume did not modify effects, whereas adherence did. High adherence (&#x2265;75%) was associated with lower HSI risk (RR = 0.36, 95% CI 0.28-0.48), whereas low adherence (<75%) showed no clear benefit (RR = 0.92, 95% CI 0.68-1.23; P for interaction <0.00001). Each 10% increase in adherence corresponded to an RR multiplier of 0.83 (approximately 17% lower RR). Certainty of evidence was low. CONCLUSION: Exercise-based programmes reduce HSI risk in football when implementation supports sustained adherence. Effects may be stronger in shorter interventions and elite populations, but evidence remains insufficient to differentiate programme types or components.

Humans

External load metrics and monitoring in women's football match play: A systematic review.

This systematic review aimed to identify the most commonly used variables for monitoring external load during elite women's football matches and to compare reporting practices internationally and in Brazil. Searches were conducted in Web of Science, PubMed, and SciELO using the PICOS framework between February and March 2026, resulting in the inclusion of 35 studies. The main outcomes analysed were total distance covered (TD), distance covered across speed zones (HSR, VHSR, sprint), number of accelerations and decelerations, and maximum speed. TD and distance covered across speed zones were the most frequently reported indicators (94.3%), followed by HSR (82.8%) and sprint distance (68.5%). Considerable variability was observed in the classification of speed zones and thresholds used to define accelerations and decelerations, limiting comparisons between studies. External load values varied according to playing position and competition level, with international matches generally imposing greater demands than national competitions. Brazilian research remains limited and demonstrates notable methodological variability. This review proposes standardised speed and acceleration/deceleration thresholds based on the most recurrent ranges reported in the literature, supporting improved consistency in monitoring practices across elite women's football contexts.

Humans

[Effect of different types of sports on skeletal growth in child, adolescent and young sportsmen].

The work represents a theoretical review on the influence of various kinds of sport on the locomotorium. There exists a great discrepancy on how sport influences growth and synostosis in bones. The work from the Department of Normal Anatomy of the First Medical Institute, Leningrad is dedicated to the effects of various kinds of sport on the skeleton of young sportsmen and summarizes the results of the investigations performed. It is demonstrated that different kinds of sport affect differently the process of synostosis in tubular bones. The influence depends on the character of bones involving in the given kind of sport and on the character of physical loading. Thus, the process of synostosis depends not only on genetic factors, but also on social ones which include physical culture. Despite a great number of works dedicated to the study how different kinds of sport influence growth and synostosis of bones, regularities of the process remain to be clarified. Further investigations are needed.

Adaptation, Physiological