The relative age effect (RAE) has been well studied in adolescent and adult soccer players; however, less information has been available about children engaged in regular soccer training and the role of performance. Thus, the aim of the present study was to examine the prevalence of RAE in children and adolescent soccer players, as well as the role of age and performance. Russian soccer players (n = 10,446) of various ages, playing positions and performance levels were examined for their date of birth. It was observed that RAE was widespread in Russian soccer teams of all age groups. RAE was most pronounced in children teams of the top tier Russian soccer academies and junior Russia national teams, where the proportions of soccer players born in the first quarter were 43.9% and 39.8%, respectively, whereas those born in the fourth quarter of the year were 7.7% and 6.3%, respectively. In top tier soccer academies, RAE did not vary by age group. In the middle tier soccer academies, RAE was less pronounced. It was still prevalent in the junior teams of the top tier clubs of the Russian Premier League, where 14.3% of the soccer players were born in the fourth quarter of the year compared to 42.9% born in the first quarter of the year. RAE can be observed in the top tier Russian adult teams as well, although it is less pronounced there. In summary, RAE is highly prevalent in Russian children and junior soccer and is associated with the level of competitiveness. At the same time, the proportion of players born in the fourth quarter of the year is higher in adult teams than in junior and youth teams, which is most likely due to the wider selection of players, not limited by their age and place of residence. In junior teams, RAE results in a bias towards selection of players who are more physically mature, whereas children who may be more talented but are less developed due to their younger chronological age tend to be overlooked.

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Background: Currently, there are few data on the association between participation in soccer and the condition of the knee joints in adult professional players. Hypothesis: A high percentage of professional soccer players will have asymptomatic intra-articular changes of the knee. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The condition of the intra-articular structures (osteophytes, cartilage, and menisci) in 94 knee joints of 47 adult professional soccer players (mean ± SD age, 25.7 ± 4.6 years; body mass index, 22.8 ± 1.4 kg/m2) was analyzed. A 1.5-T magnetic resonance imaging scanner was used to perform the imaging, and the anonymized data were analyzed by 2 experienced radiologists. Results: Cartilage of both knee joints was affected in 97.9% of soccer players. Meniscal lesions were detected in 97.8% of joints, affecting both joints in 93.6% of athletes. Grade 2 cartilage lesions were the most prevalent (36%-60% depending on the lesion site), and grade 4 lesions were detected in 12.7% of joints. The medial femoral condyle and medial tibial plateau were most frequently affected by cartilage lesions (85.1%). Among meniscal lesions, grade 2 lesions were the most prevalent, being detected in 71% of the cases. Grade 3 lesions were detected in 13.8% of the joints. The posterior horn of the lateral meniscus was the most common site of meniscal lesions (affected in 95.7% of the joints). Osteophytes were detected in 4.2% of joints. Conclusion: The prevalence of asymptomatic cartilage and meniscal lesions in the knees of adult professional soccer players is extremely high and is not associated with the reduction of sports involvement. This research should promote the correct interpretation of magnetic resonance imaging data obtained from soccer players with acute trauma and the reduction of the number of unwarranted surgical procedures.

Background: Professional soccer players are often evaluated with asymptomatic lesions of the ankle and foot, and such abnormalities may eventually become clinically relevant. Purpose: To ascertain the prevalence of foot and ankle abnormalities in elite professional adult soccer players. Study Design: Case series; Level of evidence, 4. Methods: Professional adult male elite soccer players (n = 37) underwent magnetic resonance imaging (MRI) scans of both their feet and ankles. All competed for their respective national junior or adult soccer teams. MRI scans were performed with 1.5-T scanners and analyzed independently by 2 experienced radiologists. Results: The MRI scans of 86.5% of the players showed degenerative joint disease (DJD) in at least 1 of the joints of the foot and ankle. Articular cartilage lesions in the joints of the foot and ankle were evident in 42% of the scans. Of all lesions, 17% were grade 3 or 4 (Noyes and Stabler classification) cartilage lesions and accompanied by subchondral bone marrow edema. The greater the age, weight, and height of the players, the greater was the odds ratio of DJD of the ankle joint. Synovitis in at least 1 of the joints of the foot was detected in 64% of the MRI scans. Leg dominance significantly correlated with bone marrow edema of the talus. Conclusion: Elite professional soccer players are often evaluated with a high prevalence of asymptomatic osteochondral lesions with subchondral bone marrow edema in the foot and ankle. These osteochondral lesions may remain asymptomatic or, with the continuing high-intensity stresses that modern professional soccer demands of its athletes, may evolve and cause foot and ankle pain. It is unclear whether and which interventions can be implemented to prevent the occurrence of these abnormalities in the first place.

Vitamin D (25(OH)D) insufficiency and deficiency are highly prevalent in adult soccer players and can exceed 80% even in regions with high insolation; however, the treatment of this condition is often complicated. The aim of the present study was to examine the prevalence of vitamin D insufficiency and deficiency in youth Russian soccer players and the efficacy of its treatment. Participants were 131 young male football players (age 15.6 ± 2.4 years). Low vitamin D levels (below 30 ng/mL) were observed in 42.8% of the analyzed participants. These athletes were split in two groups composed of persons with vitamin D deficiency (serum vitamin D below 21 ng/mL) and insufficiency (serum vitamin D in range of 21–29 ng/mL). A dietary supplement of 5000 IU cholecalciferol per day was administered for two months. After the treatment, an average 92% increase in vitamin D concentration was observed (before treatment—19.7 ± 5.4 ng/mL, after treatment—34.7 ± 8.6 ng/mL, p<0.001) and 74% of the post-treatment values were within the reference range (30–60 ng/mL). Serum concentration of vitamin D increased by 200% ± 98% (p<0.001) during the first month of treatment with vitamin D deficiency and insufficiency being successfully treated in 83% of the football players. In summary, the prevalence of vitamin D insufficiency and deficiency was high in young Russian soccer players. Furthermore, it was indicated that the daily usage of cholecalciferol in a dose 5000 IU was an effective and well-tolerated treatment for vitamin D insufficiency. No linear dependency between the duration of treatment and increase in vitamin 25(OH)D concentration was observed.

Background: Vitamin D insufficiency is prevalent among athletes, and it can negatively affect physical performance. At the same time, most of the available data were obtained from untrained individuals of various ages, and published studies performed in athletes led to contradictory conclusions. Methods: This cohort prospective study examined the serum concentration of 25-hydroxycalciferol (25(OH)D) and its association with running speed and muscle power in 131 young football players (mean age 15.6 ± 2.4 years). Results: 25(OH)D levels were below reference in 42.8% (serum 25(OH)D <30 ng/mL) and above reference in 30.5% of the participants (serum 25(OH)D 61–130 ng/mL). A comparison of the results of 5, 15, and 30 m sprint tests and the standing long jump test found no statistically significant differences between the two groups. Athletes from the 25(OH)D-insufficient group were treated with 5000 IU cholecalciferol supplement daily for 60 days. After the treatment, the 25(OH)D concentration increased by 79.2% and was within reference in 84% of the treated athletes (serum 25(OH)D 30–60 ng/mL). Testing was repeated after the end of treatment, and a statistically significant increase in the results of the 5, 15, and 30 m sprint tests was observed (Cohen’s d was 0.46, 0.33, and 0.34, respectively), while the results of the standing long jump test remained unchanged. Body height, body weight, and lean body mass of the football players also increased. Conclusions: These findings indicate that there is likely no correlation between serum levels of 25(OH)D, muscle power, and running speed in young professional football players, and the changes observed post-treatment might have been caused by changes in the anthropometric parameters. During the study, all the anthropometric parameters changed, but the amount of lean body mass only correlated with the results of the 5 m sprint.

Background: The present study investigated the impact of competitive soccer on the short-term changes in isometric strength of the adductor muscle group during the competitive season. Methods:In this cohort study we evaluated the association between a serum marker of muscle damage [creatine phosphokinase (CPK)] and isometric strength of the adductor muscles of the hip in 30 professional football players (age: 26.7±2.9 years) during two seasons of the national top-level championship. Serum CPK level was determined the day before the match, 12-20, 36-48, 60-72 h after the match. The maximum voluntary isometric contraction force of the adductor muscles complex was determined immediately after having taken blood samples.Results: There was evidence of a statistically significant positive association between age, body mass index (BMI), percentage of body fat, and muscle strength, and between weight and muscle strength. There was evidence of a statistically significant negative association between the level of CPK and the maximum isometric strength of the adductors of soccer players. Changes in CPK levels were associated with the muscle strength recovery trend (P<0.001). The strength/CPK ratio at different time points had a U-shaped curve.Conclusions: Exercise induced muscle damage significantly affects the strength of the adductor muscle group of professional soccer players during the competitive period. The lower the CPK level, the greater the athletes' strength at a given time point. Also, the greater the decrease in CPK level, the greater the rate of strength restoration.

Religious fasting in the Holy Month of Ramadan is an important element of the Muslim culture during which no eating or drinking is permitted from dawn till dusk. A considerable number of Muslim soccer players abide by these restrictions, which may cause a negative impact on key running performance parameters during competitive matches. Alterations to diet and water intake during the Holy Month of Ramadan may affect various running performance parameters in elite Muslim professional adult soccer players. This study was conducted with two groups of soccer players from the Russian Premier League (RPL): The Exposure Group (EG) consisted of 13 Muslims age 24.0 ± 2.8 years abiding by religious fasting and the Control Group (CG) included 13 non-Muslim age 26.0 ± 4.4 years. Using the Instat system, the running performance of each player was controlled in both groups during matches from the RPL before and in the third week of Ramadan (a total of two matches for every player). None of the measured parameters demonstrated significant changes in any match. In conclusion, restrictions in diet and liquid intake during the Holy Month of Ramadan had no negative influence on the running performance of elite Muslim professional adult soccer players during daytime matches.