BackgroundTo evaluate the efficacy of a single platelet-rich plasma (PRP) injection in reducing the return to sport duration in male athletes, following an acute hamstring injury.MethodsA randomised, three-arm (double-blind for the injection arms), parallel-group trial, in which 90 professional athletes with MRI positive hamstring injuries were randomised to injection with PRP-intervention, platelet-poor plasma (PPP-control) or no injection. All received an intensive standardised rehabilitation programme. The primary outcome measure was time to return to play, with secondary measures including reinjury rate after 2 and 6 months.ResultsThe adjusted HR for the PRP group compared with the PPP group was 2.29 (95% CI 1.30 to 4.04) p=0.004; for the PRP group compared with the no injection group 1.48 (95% CI 0.869 to 2.520) p=0.15, and for the PPP group compared with the no injection group 1.57 (95% CI 0.88 to −2.80) p=0.13. The adjusted difference for time to return to sports between the PRP and PPP groups was −5.7 days (95% CI −10.1 to −1.4) p=0.01; between the PRP and no injection groups −2.9 days (95% CI −7.2 to 1.4) p=0.189 and between the PPP and no injection groups 2.8 days (95% CI −1.6 to 7.2) p=0.210. There was no significant difference for the secondary outcome measures. No adverse effects were reported.ConclusionsOur findings indicate that there is no benefit of a single PRP injection over intensive rehabilitation in athletes who have sustained acute, MRI positive hamstring injuries. Intensive physiotherapy led rehabilitation remains the primary means of ensuring an optimal return to sport following muscle injury.Trial registration numberClinicalTrials.gov Identifier:NCT01812564.

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BackgroundAlthough the incidence of football injuries should relate to team success there is little empirical evidence.ObjectiveWe investigated the relationship between injury incidence and team success in Qatar first-division football clubs.MethodsUsing a prospective cohort study design, we captured exposure and injuries in Qatar male elite football for a season. Club performance was measured by total league points, ranking, goal scored, goals conceded and number of matches won, drawn or lost.ResultsLower injury incidence was strongly correlated with team ranking position (r=0.929, p=0.003), more games won (r=0.883, p=0.008), more goals scored (r=0.893, p=0.007), greater goal difference (r=0.821, p=0.003) and total points (r=0.929, p=0.003).ConclusionsLower incidence rate was strongly correlated with team success. Prevention of injuries may contribute to team success.

The risk of injury in handball is high among Olympic sports. Preventive measures should focus on contusions, ankle sprains, and thigh muscle strains, as well as measures aimed to reduce upper respiratory tract infections.

Objective Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020). Results Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification. Conclusions COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).

BackgroundThere is an ongoing debate regarding the optimal criteria for return to sport after an acute hamstring injury. Less than 10% isokinetic strength deficit is generally recommended but this has never been documented in professional football players after rehabilitation. Our aim was to evaluate isokinetic measurements in MRI-positive hamstring injuries.MethodsIsokinetic measurements of professional football players were obtained after completing a standardised rehabilitation programme. An isokinetic strength deficit of more than 10% compared with the contralateral site was considered abnormal. Reinjuries within 2 months were recorded.Results52 players had a complete set of isokinetic testing before clinical discharge. There were 27 (52%) grade 1 and 25 (48%) grade 2 injuries. 35 of 52 players (67%) had at least one of the three hamstring-related isokinetic parameters that display a deficit of more than 10%. The percentage of players with 10% deficit for hamstring concentric 60°/s, 300°/s and hamstring eccentric was respectively 39%, 29% and 28%. There was no significant difference of mean isokinetic peak torques and 10% isokinetic deficits in players without reinjury (N=46) compared with players with reinjury (N=6).ConclusionsWhen compared with the uninjured leg, 67% of the clinically recovered hamstring injuries showed at least one hamstring isokinetic testing deficit of more than 10%. Normalisation of isokinetic strength seems not to be a necessary result of the successful completion of a football-specific rehabilitation programme. The possible association between isokinetic strength deficit and increased reinjury risk remains unknown.

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Groin pain caused time loss for one in five players each season. Adductor-related groin pain comprised 2/3 of all groin injuries. Improving treatment outcomes and preventing adductor-related groin pain has the potential to improve player availability in professional football.