The objective of this study was to investigate the injury incidence and patterns in elite youth football at a category 1 Premier League Academy before and after the introduction of a new development strategy, the Elite Player Performance Plan (EPPP). A prospective study was performed over six consecutive seasons encompassing three years before and after the introduction of the EPPP. The findings revealed a most likely moderate increase in total exposure per player per season when the post-EPPP football exposure (640.86 ± 83.25 hours per player per year) was compared with the pre-EPPP football exposure (539.08 ± 71.59). The total injury incidence pre-EPPP was 3.0/1000 hours compared to 2.1/1000 hours post-EPPP (rate ratio 1.43). 6% of all injuries were re-injuries (20.24 ± 33.43 days) but did not result in a substantially longer absence (16.56 ± 15.77 days). The injury burden decreased for the U12-U15 from pre- to post-EPPP, whereas the injury burden increased for the U16-U18 (respectively 125 and 47% higher). These findings suggest that following the introduction of the EPPP there has been a reduction in injuries in the younger age groups U12-U15 but in the older age groups U16-U18 there has been an increase in the severity of the injuries sustained at this club.

The Nordic Hamstring exercise program (NHP) is an evidence-based injury prevention protocol. The aims of this study were to (a) report professional English football clubs' practices of hamstring injury prevention strategies, (b) identify the NHP implementation in English football, and (c) understand reasons for the NHP's inclusion or exclusion. An electronic survey was completed by 53 of 91 (58%) English professional football clubs. Forty-three clubs had a formal hamstring injury prevention program with the NH exercise (95%), eccentric strength exercises (93%), and functional training (81%) the most common methods utilized. Twenty clubs (38%) implemented the NHP, but only 9 (17%) completed the full program and were classed as compliant. Respondents partially agreed (Mean 3.92 ± SD 0.87) the NHP could substantially reduce injuries in football and would be effective at their own club (3.77 ± 0.72). Participants partially agreed the exercise caused muscle soreness (3.90 ± 0.85). Barriers to wider implementation included players not positively perceiving the program (79%) and resulting muscle soreness (60%). 57% believed a cultural shift was required to increase compliance. Medical professionals within English football value the injury prevention role of the NHP. A cultural shift would be required mainly from players to allow successful implementation.

Background As a result of the COVID-19 pandemic a rapid transformation from face-to-face curriculum delivery to an online teaching and learning environment, was adopted in a number of higher education institutions globally. Allied Health Profession courses such as physiotherapy, traditionally utilising an in person teaching model to prepare students for practice, needed to swiftly adopt new methods of delivery, involving both synchronous and asynchronous approaches. Understanding physiotherapy student perceptions of this transition is important to allow faculty to develop their delivery of online teaching and provide an evidence base for future course curricula. Methods Cross-sectional survey of UK higher education students studying either an undergraduate or post-graduate pre-registration degree in physiotherapy was conducted between October 2020 and February 2021. The survey investigated the student’s perception of the transition to either an online or hybrid model of learning during the COVID-19 pandemic. A mixed method approach was adopted allowing respondents to share their experiences and facilitate the exploration of questions which required in-depth thought. Results Two hundred thirty-six respondents completed the questionnaire. Online learning was perceived to be a flexible (49%, n=116,CI 95% 43 to 55) and convenient (49, 116, 43 to 55) method of learning. Despite this, 79% of the students surveyed felt that the online learning experience had a negative impact on their understanding of the subject and were disadvantaged compared to traditional face-to-face teaching provision (mean 4.14 ± SD 1.06). Online physiotherapy delivery produced low student satisfaction, leaving respondents feeling disadvantaged. Decreased levels of engagement and the lack of ability to practice ‘hands-on’ skills were detrimental aspects of the online approach, with 55% (n=106) reporting they did not perceive the academic staff had the necessary skills to deliver effective online content. Conclusions The majority of UK physiotherapy students surveyed were dissatisfied and lacked engagement with an online learning approach within the curricula, compared with the traditional face-to-face delivery. Although several positives of both a synchronous and asynchronous delivery were highlighted, faculty must consider how they best deliver online learning content, making use of pedagogical strategies that will create as many learning and engagement opportunities as possible.

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Context: It is well demonstrated that Nordic hamstring (NH) program has poor compliance across European soccer clubs, but little is known about its implementation in Major League Soccer (MLS). The authors aimed to investigate MLS hamstring prevention practices and compliance with the NH program and understand the reasons for its inclusion or exclusion. Design: A cross-sectional electronic survey was completed by 24 of the 26 (92%) MLS top-division soccer clubs. Methods: The survey, based on the Reach, Efficacy, Adoption, Implementation, and Maintenance framework, was sent to team medical staff. Medical staff were also asked for opinions on barriers to implementation. Results: Eighteen clubs (75%) reported a formal hamstring injury prevention program, with eccentric exercises (94%; 95% CI [confidence interval], 74%–99%), high-speed running (94%; 95% CI, 74%–99%), and NH exercises (89%; 95% CI, 67%–97%) the most common strategies adopted. Fifteen clubs partially implemented the NH program, but only 5 (21%; 95% CI, 9%–40%) completed the full program and were classed as compliant. A total of 20 respondents reported that player perception and muscle soreness (83%; 95% CI, 64%–93%) were barriers to the implementation of the NH program. On a 5-point Likert scale, respondents “partially agreed” (4.13 [0.80]) that the NH exercise could substantially reduce injuries and would be “effective” at their own club (3.88 [0.61]). Conclusions: The NH exercise was valued, but negative player perception and muscular soreness were identified as barriers to implementing the full program. Manipulation of volume and frequency should inform future “effectiveness” research to prospectively assess such modifications in the context of MLS.

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